%0 Journal Article %A Sassy Molyneux %A Priya Sukhtankar %A Johnstone Thitiri %A Rita Njeru %A Kui Muraya %A Gladys Sanga %A Judd L Walson %A James Berkley %A Maureen Kelley %A Vicki Marsh %T Model for developing context-sensitive responses to vulnerability in research: managing ethical dilemmas faced by frontline research staff in Kenya %D 2021 %R 10.1136/bmjgh-2021-004937 %J BMJ Global Health %P e004937 %V 6 %N 7 %X Health research in low-resource settings often involves individuals and populations defined as ‘vulnerable’. There is growing attention in the literature to the ethical dilemmas that frontline research staff face while conducting such research. However, there is little documented as to how research staff might support one another in identifying and handling these dilemmas in different contexts. Over the course of conducting empirical ethics research embedded in the Childhood Acute Illness & Nutrition Network, we developed an approach to examine and respond to the ethical issues and dilemmas faced by the study teams, particularly frontline staff. In this paper we describe the specific tools and approach we developed, which centred on regular cross-team ethics reflection sessions, and share lessons learnt. We suggest that all studies involving potentially vulnerable participants should incorporate activities and processes to support frontline staff in identifying, reflecting on and responding to ethical dilemmas, throughout studies. We outline the resources needed to do this and share piloted tools for further adaptation and evaluation. Such initiatives should complement and feed into—and certainly not in any way replace or substitute for—strong institutional ethics review, safeguarding and health and safety policies and processes, as well broader staff training and career support initiatives.Data may be obtained from a third party and are not publicly available. The datasets generated and analysed during the study are not publicly available due to institutional rules and regulations but may be available from the corresponding author on reasonable request. %U https://gh.bmj.com/content/bmjgh/6/7/e004937.full.pdf