to involve the community in every aspect of a prevention trial (LaFromboise and Lewis, 2008; LaFromboise, 1996; Madison, McKay, et al., 2000; McCormick, McKay, et al., 2000; Baptiste, Blachman, et al., 2007; Bell, Bhana, et al., 2007; McKay, Hibbert, et al., 2007; Pinto, McKay, et al., 2007). However, developing and maintaining community involvement throughout all stages of program implementation present considerable challenges, as discussed below.
Community-driven implementation builds heavily on the decision making of community leaders, often in partnership with researchers, with a focus on improving the community relevance and sustainability of a program. Implementation is guided by a community-driven agenda and staged implementation of a prevention program, in some cases including development, implementation, and testing of a locally developed intervention. Evidence-based programs or principles are often introduced by research partners relatively late in the process. Built on the community-based participatory research approach, an agenda for community action is developed through a cooperative process with community members and multiple community constituencies. The involvement of researchers in identifying priorities may be quite limited or very involved (Minkler, 2004), but it always focuses on community leadership and establishment of an organizational structure for building and sustaining one or more interventions (Baptiste, Blachman, et al., 2007). In many minority communities, there is a history of mistrust of outsiders, government agencies, or researchers in particular (Thomas and Quinn, 1991), which influences the degree to which researchers are involved in decision making (McKay, Hibbert, et al., 2007).
The traditions of research, including reliance on planned research designs, multiple assessments, and legal consent documents, are often viewed negatively by communities. Thus, researchers may begin as outside advisers who listen to the goals and needs of communities, with a partnership in the decision-making processes evolving over time. The wealth of practical experience and wisdom in community-based organizations may offer opportunities for communities to establish an empirical basis for interventions with strong community support through community–research partnerships. Collaborations with key community constituents can (1) enhance the relevance of research questions, (2) help develop research procedures that are acceptable to potential community participants from diverse cultures, (3) address challenges to conducting community-based research, (4) maximize the usefulness of research findings, and (5) foster the development of community-based resources to sustain prevention funding beyond grant funding (Israel, Schulz, et al., 1998; Institute of