Most CTSA sites have expanded programs for community engagement, which include cultural sensitivity training for researchers, community and provider education and outreach, development of software to facilitate the collaboration of community practitioners, and facilitation of two-way communication with diverse populations and community groups. Acting independently or as regional consortia, CTSA sites have developed new or improved partnerships with their communities predicated on the development of trust, ongoing involvement, and bidirectional control of the agenda for establishment of priorities, clinical investigation, and communication about research findings and best practices. The ultimate aim is to mobilize communities to (1) identify their own health needs and the role of AHCs in framing a response to those needs, (2) work with academic partners on the design of clinical trials to develop evidence-based practices, (3) act as leaders in communicating about health research and the implementation of new methods of managing health issues, and (4) work with AHCs to evaluate existing practices.6 Partnerships exist at all levels, from the immediate community surrounding a CTSA-associated institution, to a county-, regional-, or state-wide program, to a network that includes multiple states, a section of the country, and/or other areas of the world. Communities may be defined by location, demographic or ethnic composition, a shared exposure, or a particular rare or common disease. Community members are linked with academic counterparts and with each other through new media and communication systems, such as teleconferencing. To ensure a comprehensive approach to community engagement, CTSA institutions involve social and behavioral experts and economists, as well as experts in communications, informatics, education, research design, epidemiology, statistics, and ethics. In building community engagement activities, CTSA institutions have developed a deeper understanding of the complex factors involved in forming community relationships and in designing metrics for assessing health outcomes.