title: Challenges in community-based participatory research implementation: experiences in cancer prevention with Pacific Northwest American Indian tribes.
abstract: BACKGROUND
  Much has been written about community-based participatory research (CBPR) history and principles, but few have addressed challenges in implementation in transcultural situations. The goal of this discussion is to address CBPR implementation issues in cancer prevention research with American Indian tribal communities in the Pacific Northwest.
  
  
  METHODS
  Information in this discussion is drawn from qualitative research conducted over a 10-year period in which CBPR was employed in cancer prevention research with Pacific Northwest Indian tribes. CBPR principles provide the framework for the discussion: establishing trusting relationships, assuring participation, sharing power, and communicating.
  
  
  RESULTS
  In this work, we found that CBPR is appropriate for use in Pacific Northwest Indian tribal communities and is compatible with cultural values. We also found that there are many challenges. Recommendations are provided on needed institutional and structural changes.
  
  
  CONCLUSIONS
  CBPR is an important research approach in addressing cancer prevention health disparities among American Indian tribal communities. Continued effort needs to be directed toward creating systems and structures to support researchers in utilizing this method. Findings are of value to researchers aiming to implement CBPR in Indian communities and to practitioners, policy makers, and administrators who make decisions about CBPR funding and support structures.
authors.affiliation: Psychosocial and Community Health, University of Washington School of Nursing, Seattle 98195, USA. jstrickl@u.washington.edu
authors.forename: C June
authors.initials: CJ
authors.lastname: Strickland
mesh_terms: D001294:Attitude to Health / Q000208:ethnology*; D003142:Communication; D018672:Community Health Planning; D003256:Community Participation; D003159:Community-Institutional Relations; D003466:Cultural Characteristics; D006302:Health Services Research / Q000458:organization & administration*; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D009369:Neoplasms / Q000517:prevention & control* / Q000523:psychology; D015205:Northwestern United States; D044382:Population Groups