title: Disseminating research in rural Yup'ik communities: challenges and ethical considerations in moving from discovery to intervention development.
abstract: BACKGROUND
  The native people of Alaska have experienced historical trauma and rapid changes in culture and lifestyle patterns. As a consequence, these populations shoulder a disproportionately high burden of psychological stress. The Yup'ik Experiences of Stress and Coping project originated from rural Yup'ik communities' concerns about stress and its effects on health. It aimed to understand the stressful experiences that affect Yup'ik communities, to identify coping strategies used to deal with these stressors and to inform culturally responsive interventions.
  
  
  OBJECTIVE
  Here, we examine the process of moving from research (gaining understanding) to disseminating project findings to translation into intervention priorities. We highlight the importance of community participation and discuss challenges encountered, strategies to address these challenges and ethical considerations for responsible intervention research with indigenous communities that reflect their unique historical and current socio-cultural realities.
  
  
  METHODS
  Community-wide presentations and discussions of research findings on stress and coping were followed by smaller Community Planning Group meetings. During these meetings, community members contextualized project findings and discussed implications for interventions. This process placed priority on community expertise in interpreting findings and translating results and community priorities into grant applications focused on intervention development and evaluation.
  
  
  RESULTS
  Challenges included translation between English and Yup'ik, funding limitations and uncertainties, and the long timelines involved in moving from formative research to intervention in the face of urgent and evolving community needs. The lack of congruence between institutional and community worldviews in the intervention research enterprise highlights the need for "principled cultural sensitivity".
  
  
  CONCLUSIONS
  Cultural sensitivity requires sharing results that have practical value, communicating openly, planning for sustainability and incorporating indigenous knowledge and expertise through a community-guided process. Our research findings will inform continued work within our partnership as we co-develop culturally based strategies for multilevel community interventions to address stress.
authors.affiliation: Department of Psychology, Center for Alaska Native Health Research, University of Alaska Fairbanks, Fairbanks, AK 99775, USA. idrivkin@alaska.edu
authors.forename: Inna
authors.initials: I
authors.lastname: Rivkin
authors.forename: Joseph
authors.initials: J
authors.lastname: Trimble
authors.forename: Ellen D S
authors.initials: ED
authors.lastname: Lopez
authors.forename: Samuel
authors.initials: S
authors.lastname: Johnson
authors.forename: Eliza
authors.initials: E
authors.lastname: Orr
authors.forename: James
authors.initials: J
authors.lastname: Allen
mesh_terms: D000223:Adaptation, Psychological; D000413:Alaska; D055812:Community-Based Participatory Research / Q000941:ethics; D003469:Culture; D032984:Ethics, Research; D006801:Humans; D007198:Indians, North American / Q000523:psychology*; D033181:Information Dissemination / Q000941:ethics* / Q000379:methods; D012424:Rural Population; D013315:Stress, Psychological / Q000208:ethnology* / Q000628:therapy; D014175:Translating
keywords: Alaska Native; community-based participatory research (CBPR); coping; reporting research results; research ethics; stress