Preventive Medicine 67 (2014) S51–S57
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The implementation of a participatory manuscript development process with Native American tribal awardees as part of the CDC Communities Putting Prevention to Work initiative: Challenges and opportunities Valarie Blue Bird Jernigan a,⁎, Isaiah ‘Shaneequa’ Brokenleg b, Margie Burkhart c, Cornell Magdalena d, Candace Sibley e,1, Kristyn Yepa f,2 a
Department of Health Promotion Sciences, University of Oklahoma College of Public Health, 4502 E 41st St., Tulsa, OK 74135, USA Great Lakes Inter-Tribal Epidemiology Center, PO Box 9, Lac du Flambeau, WI 54538, USA c Comprehensive Cancer Program, Cherokee Nation Health Services Group, PO Box 948, Tahlequah, OK 74464, USA d Department of Public Health, Jemez Health and Human Services, 110 Sheep Springs Rd., Jemez Pueblo, NM 87024, USA e ICF International, 3 Corporate Square NE, Suite 370, Atlanta, GA 30329, USA f Department of Public Health, Jemez Health and Human Services, 110 Sheep Springs Rd., Jemez Pueblo, NM 87024, USA b
a r t i c l e
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Available online 7 February 2014 Keywords: American Indian Native American Community-based participatory research Participatory publication Participatory evaluation
a b s t r a c t Objective. In 2009, the Centers for Disease Control and Prevention funded 50 communities, including three tribal awardees, to implement environmental approaches to address obesity and smoking through the Communities Putting Prevention to Work initiative. The tribes were among the selected awardees offered training support for analyzing, writing, and publishing their findings. This article describes the process of translating the workshops, guided by a participatory framework, for implementation with the tribes. Methods. Nine participants from three tribes attended the workshops in Decatur, Georgia, in August and October of 2012: 1) a one-day pre-conference workshop focused on integrating both Indigenous and academic evaluation methods; 2) a 4 day data analysis workshop; and 3) a 5 day scientific writing workshop. Participants were provided with technical assistance following the workshops. Results. Participants viewed the workshops positively and have continued to develop their manuscripts. To date one tribal awardee has submitted their manuscript for publication. Conclusion. The participatory manuscript development process described here is the first of its kind outlining a pathway for tribal community health practitioners to translate and publish their work. Further development of this process could increase the number of community-developed manuscripts, thereby advancing the field of translational intervention science and leading to improved health equity. © 2014 Elsevier Inc. Open access under CC BY-NC-ND license.
Introduction Obesity and tobacco use are two leading causes of preventable death in the United States (Danaei et al., 2009). Approximately 35% of US adults are obese and 20% smoke (Prevention, 2012). Among Native Americans, 39% of adults are obese and the smoking rate is 40% — twice that of the US general population and the highest of any racial/ethnic group
⁎ Corresponding author. E-mail addresses:
[email protected] (V. Blue Bird Jernigan),
[email protected] (I.‘S.’ Brokenleg),
[email protected] (M. Burkhart),
[email protected] (C. Magdalena),
[email protected] (C. Sibley),
[email protected] (K. Yepa). 1 Present address: Workforce Development and Capacity Building ORISE Fellow, Office of the Director, National Center for the Viral Hepatitis, HIV/AIDS, TB and STD Prevention, 1133 Gables Way NE, Atlanta, GA 30329, USA. 2 Present address: Chief Health & Wellness Programs Officer, Notah Begay III Foundation, 290 Prairie Star Rd., Santa Ana Pueblo, NM 87004, USA. http://dx.doi.org/10.1016/j.ypmed.2014.01.027 0091-7435/© 2014 Elsevier Inc. Open access under CC BY-NC-ND license.
(Jernigan et al., 2010; Prevention, 2012). While individual-level prevention and treatment programs have achieved limited success, environmental strategies to increase physical activity and reduce smoking (e.g. zoning policies to facilitate physical activity; smoking bans in public places) have been shown to be important components for improving population health (Glanz et al., 2005; Khan et al., 2009; Koplan et al., 2005; Story et al., 2008). In 2009 Centers for Disease Control and Prevention (CDC)3 launched the Communities Putting Prevention to Work initiative (CPPW),4 aimed at reducing obesity and tobacco use by funding 50 awardees, including three Native American tribal awardees, to implement evidence-based and locally driven environmental strategies to reduce obesity and tobacco use within their communities (Bunnell et al., 2012).
3 4
Centers for Disease Control and Prevention. Communities Putting Prevention to Work.
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Disseminating CPPW work: Data analysis and writing workshops for CPPW awardees The Institutes of Medicine and CDC have increasingly promoted environmental approaches to address obesity (Glanz et al., 2005; Khan et al., 2009; Koplan et al., 2005; Story et al., 2008); however, little is known about the implementation of such strategies within Native American communities (Blue Bird Jernigan et al., 2012; Caballero et al., 2003; Davis and Reid, 1999; Teufel and Ritenbaugh, 1998). The generalizability of evidence-based environmental strategies within geographically, culturally, and politically diverse tribal sovereign nations is poorly understood. To address gaps in knowledge and to support the dissemination of findings from CPPW, CDC contracted with ICF International to host two 4–5 day intensive training workshops for selected CPPW awardees, including the tribal awardees. These workshops were designed to train awardees in how to analyze their data, which included for all tribes both qualitative (e.g. focus group and interview data) and quantitative (e.g. survey and policy scan data) and produce submission-ready manuscripts for publication in scientific peerreviewed journals. An additional one-day pre-conference workshop was offered to the tribal awardees to discuss culturally responsive and participatory evaluation with Native American communities. The workshop addressed issues unique to Native communities, including the lack of culturally relevant and validated environmental measures (e.g. measures of traditional food practices and associated physical activity to obtain these foods) (Blue Bird Jernigan et al., 2012; deGonzague et al., 1999; Story et al., 2000); tribal political and structural conditions in policy development as well as the publication process (Frohlich and Potvin, 2008; Warnecke et al., 2008); and ways that historical abuses by nonNative outside researchers have created negative perceptions of publication in some tribal communities (Atkins et al., 1988; Foulks, 1989; Mello and Wolf, 2010). Case study Tribal community awardees and workshop participants The three tribal community awardees were culturally and geographically diverse and included the Cherokee Nation, a large tribe located in Northeastern Oklahoma, spanning over 7000 miles2, with a population of more than 200,000 citizens; the Pueblo of Jemez, a Southwestern pueblo located in North-Central New Mexico and comprised of 3400 tribal members, most of whom reside in a puebloan village known as “Walatowa” (a Towa word meaning “this is the place”); and the Great Lakes Inter-Tribal Council, a non-profit organization made up of a consortium of twelve federally recognized Native American tribes living in rural Wisconsin and Upper Michigan, led by a board of tribal members, with the goal of expanding sovereignty and self-determination. A total of nine participants, all Native American health professionals from each of the three tribal awardee communities, attended all three workshops. The participants brought substantial experience in developing and implementing culturally responsive public health interventions within tribal communities and represented many fields, including nursing, social work, and public health. While all had been involved in informal program evaluation efforts, few had conducted or led formal program evaluations and only two had previously been co-authors of a published scientific article. While the needs of each tribal awardee varied, they all shared two overarching goals: 1) to honor the holistic nature of the work of the communities; and 2) to translate that work into a manuscript format that would be publishable in a peerreviewed scientific journal. Indigenous Pre-Conference Workshop A Native American academic faculty member specializing in intervention science and participatory evaluation (lead author of this
paper) facilitated the session. The workshop was open to all tribal awardees and included CDC and ICF faculty and staff. The Indigenous evaluation model (LaFrance, 2004; LaFrance and Nichols, 2008), which explores how values shared by many Native communities might influence an evaluation approach, guided the workshop. The workshop aims included: 1) understanding how Indigenous and academic ‘ways of knowing’ can be used to focus and shape evaluation; 2) assessing which components of academic evaluation methods can be used to assist each grantee in achieving their evaluation goals; and 3) developing an evaluation plan that reflects community needs. The pre-conference workshop did not include specific training on data analysis or writing for publication; instead, it was meant as an introduction to evaluation through an Indigenous lens. The workshop also set the stage for providing tailored technical assistance to the tribes given their unique status as sovereign nations. As citizens of sovereign nations Native Americans are afforded certain protections and rights, including research protections. Both historic and even contemporary abuses have occurred within tribal communities in the name of scientific research and have caused significant emotional, cultural, and financial damage to tribal nations (Atkins et al., 1988; Foulks, 1989; Mello and Wolf, 2010). While each of the more than 550 federally recognized tribal nations has its own governing structures and laws, many tribal nations have developed their own tribal IRBs that review all research proposals to be conducted within the tribal nation and carefully and thoughtfully weigh the benefits and risks of the research within the context of tribal culture and community. Many tribes require ownership of all data collected as well as maintain publication review committees that must review and approve all publications utilizing tribal data. The Indigenous Pre-Conference Workshop laid the foundation for ensuring that communication and collaboration with tribal IRBs and adherence to the appropriate policies would be a focus through the duration of the trainings and process. Consistent with the Native tradition of using storytelling to create and share knowledge (Hodge et al., 2002), the workshop began with the screening of a short video created by another tribal community and shared with permission. The story focused on the process and challenges the community faced in increasing healthy food access within their reservation. Participants then identified any similar challenges or opportunities within their own communities, including working with tribal leadership; the generalizability of evidence based environmental strategies and measures for implementation in Native American communities; and the changing nature of tribal politics. A facilitated discussion with the participants was held to determine which components of academic evaluation methods were culturally acceptable to use in evaluating their interventions and to find common ground between the implementation ‘evidence base’ in tribal community settings and the academic ‘evidence base’ as described within the scientific literature. The participants were encouraged to find their own value in the publication process. The discussion was guided by the concept of cultural humility (Tervalon and Murray-Garcia, 1998), which suggests that cultural competence is best defined not as a discreet endpoint but as a commitment and active engagement in a lifelong learning process that we enter into with communities, colleagues, and ourselves (Tervalon and Murray-Garcia, 1998). Cultural humility was recognized by all as critical to the development of an evaluation plan that would be responsive to both community needs as well as the needs of funders. The value of publishing from a tribal perspective was summarized by one participant who stated, “If we write it down, they will listen to us”. Adaptation and implementation of the data analysis and writing workshops The data analysis and writing workshops, designed by George Rutherford and colleagues from the University of California at San Francisco, are highly structured, have been implemented internationally (Macfarlane et al., 2008), and are led by expert faculty from fields
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including medicine, statistical analysis, behavioral economics, and psychology. ICF International adapted the workshops to be appropriate for CPPW awardees and to assist them in developing publishable papers (see Tables 1 and 2). The workshops were broken into morning and afternoon sessions. The morning sessions began with a welcome, the identification of specific goals for each day (e.g. complete final tables for peer review; write an outline of a results section), and didactic sessions on key topics/learning objectives (e.g. an introduction to tables and figures; how the analysis section fits into a paper). The afternoon sessions were primarily devoted to independent one-on-one work with rotating faculty to prepare the awardees for review by academic faculty occurring every afternoon. The workshop concluded each day with status updates and goal setting from each awardee, followed by a group evaluation of the day's activities. Tribal awardees attended the morning sessions with all participants, but the afternoon sessions were modified for them in several ways. The tribal awardees had their own workroom and the Native faculty member provided technical assistance almost exclusively for tribal awardees for the duration of the workshops, while other faculty members (e.g. statisticians, subject matter experts) rotated between all of the awardees. The afternoon sessions began with a debriefing — a general discussion about the lessons and the identification of specific questions. This process occurred within the large group of all of the tribal awardees so as to facilitate dialog and co-learning. The tribal participants had essentially never been exposed to the process of writing a scientific manuscript before and thus had many questions about not only the structure of a manuscript but also how the writing might be interpreted by Native American lay readers. The de-briefing process gave the tribal members the opportunity to put all of their questions and concerns on the table, which then informed much of the technical assistance provided to them in the afternoon sessions. The afternoon sessions primarily involved the translation of what the tribal participants reported as academic language (e.g. “sample size”) into public health practice or implementation language (e.g. “total
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number of community members who participated”) with a specific focus on implementation within the tribal community context. For example, after a morning training on the development of the single overarching communication objective or “SOCO” statement, tribal participants worked in small groups to find the story of their community's intervention, in a clear and concise “SOCO” way, while not overly narrowing the story in a way that would fail to recognize the significant time and effort the families who had participated in the intervention had invested. The data analysis and writing workshops were both adapted in this way, whereby the Native faculty member and the project coordinator (and a co-author of this paper) translated the scientific manuscript format from academic language to the language of public health practice using popular education techniques in the Freirean tradition (Freire and Mellado, 1970) to develop a community narrative. The “methods” section was re-framed as “Describe what you did”; the results section was reframed as “What happened as a result of what you did?”; and so forth. The tribal practitioners would answer verbally as the Native faculty member “interviewed” them and the project coordinator took written notes. Targeted questions or “prompts” were used to solicit key components required in a manuscript. For example, one tribal workshop participant, when working on the methods section, was asked to explain how the recruitment process occurred. She said, “Our outreach workers know everyone in the community, so we just had them call the right people”. This was translated in the manuscript as a “purposive sample” and further described in detail. This iterative process allowed tribal participants to document their extensive implementation knowledge in a community narrative and work with the Native faculty member to strategically insert sections of the community narrative into the scientific manuscript format. Once each of the three tribal awardees had developed a manuscript outline then additional appropriate faculty rotated to provide them with technical assistance in further developing each section of their manuscripts. For example, the biostatistician would review iterations
Table 1 Indigenous evaluation pre-workshop and data analysis workshop agenda, Decatur, GA, August 2012. Indigenous evaluation pre-workshop
Data analysis workshop
Workshop objectives:
Workshop goal: Data will be analyzed for inclusion in a paper that can be published in a peer-reviewed scientific journal Learning objectives: Workshop participants will be able to
• Identify how both Indigenous and academic knowledge can be used for evaluation • Assess which components of academic evaluation methods are appropriate for grantees • Develop an evaluation plan that reflects community needs
Morning
Afternoon
• • • •
complete final tables; outline results and methods sections; finalize analysis plan and evaluation questions; write main point for opening of discussion section, as the transition from results to discussion.
Pre-meeting
Day 1
Day 2
Day 3
Day 4
• Opening prayer ceremony • Tribal organization introductions • Description of the paper for this week • Description of the data that will be analyzed this week • Session 1: Conducting evaluation in tribal communities • Session 2: Tailoring evaluation to tribal organizations • Session 3: Identification of the importance of publication to tribal leadership • Reception
• Welcome and introductions • How to use the CPPW Logic Model to guide data analysis and to write papers for peer-reviewed journals • Course overview and objectives • Getting started — The evaluation question
• Morning greeting and updates • Set goals for the day • Tables and figures • From output to final tables: The results section • Peer review session on analysis plan • Independent and one-on-one work with faculty
• Morning greeting and updates • Set goals for the day • How the analysis fits into your paper • How to outline the methods section • Peer review of 1 to 3 sentences on results and outline of methods section • Independent and one-on-one work with faculty
• Morning greeting and updates • Final peer review • Independent and one-on-one work with faculty • Closing comments and plan sharing • Workshop close
• Statistical analysis • Independent and one-on-one work with faculty • Daily check-in
• Independent and one-on-one work with faculty • Daily check-in
• Independent and one-on-one work with faculty • Daily check-in
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Table 2 Writing workshop agenda, Decatur, GA, October 2012. Workshop goal: To provide the time, space, and support for evaluators from CPPW communities and states to produce submission-ready manuscripts for scientific journals Learning objectives: Workshop participants will be able to • write a complete scientific manuscript for publication; • choose a journal for manuscript submission, and have a second and third journal in mind as back-ups; • respond to reviewers' comments, and revise and resubmit manuscripts.
Morning
Afternoon
Day 1
Day 2
Day 3
Day 4
Day 5
• Welcome • Writing workshops and the local CPPW story • Course overview and objectives • Getting started — The evaluation question • Analysis, tables, and figures • Independent and one-on-one work with faculty • The results section • Daily check-in
• Morning greeting and updates • Choosing a journal and authorship • Peer review I: Tables and figures with facilitators • The discussion section • Independent and one-on-one work with faculty
• Morning greeting and updates • Peer review II: Results, tables, and figures with facilitators • The introduction and methods • Putting it all together: Titles, cover page, authorship, keywords, acknowledgements • Independent and one-on-one work with faculty
• Morning greeting and updates • Peer review III: Discussion, introduction, and methods with facilitators • Preparing the abstract and ethics of publication • Submitting to journals, authorship issues, peer review, and revisions • Independent and one-on-one work with faculty
• Morning greeting and updates • Final peer review • Independent and one-on-one work with faculty • Closing comments and plan sharing • Workshop close
• Independent and one-on-one work with faculty • Daily check-in
• Independent and one-on-one work with faculty • Daily check-in
• Independent and one-on-one work with faculty • Daily check-in
of their drafts and might suggest adding additional statistical information. The Native faculty member would support the tribal participants in determining whether or not they had collected that information and, if so, how they could incorporate it into the manuscript or address the absence of that information in a limitations section. The biostatistician would then review a next draft and provide further guidance, and so forth. This iterative process allowed the tribal participants to further refine their manuscripts. After each workshop, select faculty members provided technical assistance on an individual basis to all three tribal awardees. The technical assistance consisted of providing reviews of data analysis and findings, reviewing manuscript drafts, and a special session on identifying appropriate journals for publishing their manuscripts, including journals with a focus in health disparities, intervention science, and/or Native American health. To date, one of the three tribal awardees has received tribal approval and has submitted their manuscript in a peer-reviewed journal; one community is in the process of gaining tribal approval to submit their manuscript to a journal; and one community continues to finalize their manuscript.
The non-Native academic faculty and staff reported that the preconference workshop served as an important opportunity for them to learn about the perspectives of the tribal participants and identify the appropriate technical assistance to provide. They had been surprised to discover the extensive, high-quality data that the tribal awardees had collected, as some of the tribal participants chose not to discuss their data until they met the faculty in person and learned more about the publication process. This presented a barrier to pre-workshop technical assistance, all conducted long-distance by phone or email. Several recent studies have highlighted the importance of spending time developing ‘relational accountability’ before engaging in research/work (Ball and Janyst, 2008; Castleden et al., 2012; Pualani Louis, 2007; Tobias et al., 2013), and this was true for this process. The development of relationships assisted more reticent tribal participants to fully engage in determining what data were useful and could be “publishable” and what story they wanted to share.
Discussion
The high level of implementation expertise that the tribal participants brought to the workshops required a culturally-responsive process of tapping into that expertise by translating their words, via their development of a community narrative, into the scientific manuscript format. Thus emerged this translational process, grounded in the principles of cultural humility (Tervalon and Murray-Garcia, 1998) and participatory evaluation (Springett and Wallerstein, 2003), and depicted in Fig. 1. This model, adapted from the National Institutes of Health Centers for Population Health and Health Disparities (CPHHD) program (Holmes et al., 2008), highlights the community narrative as the central component, developed from the translation of the data analysis and writing workshops, and then used to describe the intervention and its findings in the format of a scientific manuscript.
All nine tribal participants reported that the experience was unique and important. Indeed, to our knowledge, this is the first report of a participatory manuscript development process implemented with tribal community health practitioners. The tribal participants had a lived knowledge of Indigenous evaluation and extensive experience incorporating this knowledge into the adaption and implementation of culturally responsive interventions. Thus, the Indigenous pre-conference was less important for identifying Indigenous evaluation methods than it was for cultivating cultural humility among both Native participants and the non-Native workshop faculty and staff in efforts to find common ground between the implementation evidence base and the academic evidence base and build trust. Part of finding this common ground was the tribal participants finding their own value in publishing. While the “publish or perish” motivation was not applicable to them, the responsibility to share what they'd learned with other tribes for the benefit of Native people was applicable and recognizing that responsibility created value in publishing for many of them.
The translation of the data analysis and writing workshops and the emergence of a “participatory manuscript development process”
Challenges and opportunities Several challenges were identified through the implementation of these trainings, including, most considerably, the high level of technical assistance support the tribal awardees needed for data analysis. One of
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Translational Process Inputs
Outputs Activities
Outputs
Culturally responsive evaluation and documentation
Tribal implementation evidence base
Cultural Humility
Data Analysis Workshop
Outcomes
Outcomes
Short
Long
Translation of Knowledge
Policy
Practice
Capacity building to find common agenda
Increased Awareness Indigenous Evaluation Workshop
Community Empowerment
Writing Workshop Scientific evidence base
Training
Community Narrative
Scientific Manuscript
Scientific Innovation
Health Outcomes
1
Model adapted from the National Institutes of Health Centers for Population Health and Health Disparities (CPHHD) program (Holmes, Lehman et al. 2008) Fig. 1. Participatory Manuscript Development Process with Tribal Communities1. 1Model adapted from the National Institutes of Health Centers for Population Health and Health Disparities (CPHHD) program. Holmes et al. (2008)
the awardees had no access to an in-house statistician or statistical analysis software. The other two awardees had access to basic data analysis support, in the form of organizational staff members who had experience conducting limited data analysis (e.g. descriptive statistics) but not extensive data analysis (e.g. regression analysis), which may have strengthened the manuscripts. CDC and ICF addressed this by providing the technical assistance support of a biostatistician who completed the analysis for the awardee without access to a statistician or software and provided ongoing guidance to the other two awardees with some capacity. All of the participants recommended the provision of ongoing and comprehensive data analysis support when replicating these workshops. Another limitation was that the tribal awardees lacked access to scientific databases and subscriptions to scientific journals to conduct literature searches required to write the introduction and discussion sections of their manuscripts. This challenge was addressed by having the project coordinator (and a co-author of this paper) conduct extensive literature reviews for each of the awardees. While this was helpful, the tribal participants reported that it was still difficult for them to fully articulate the contribution of their work within the context of the literature at a level required for a scientific manuscript. They reported that more extensive training and direct access to journals would help to build the capacity of tribal health practitioners to publish their work. Indeed, many countries are now requiring that university researchers funded through governmental entities target open-access journals. In the US groups like the Community Campus Partnerships for Health at the University of Washington and other community-based
participatory research groups are calling upon researchers to make their work available through open-access websites. Such efforts are critically important in addressing access issues. Lastly, despite support of these efforts from administrative leadership at all of the participating organizations, few of the participants had time allocated outside of the workshops to work on the manuscripts during the course of regular business hours. The partners made tremendous progress on the development of their manuscripts during the trainings, however carving out time to complete the manuscripts proved to be an ongoing challenge. Thus, delivering the trainings in weeklong intensive workshops, though time intensive and expensive, may be the best way for tribal and community participants to get the time they need to create publishable manuscripts. Despite these challenges, the tribal participant expertise in intervention science, particularly in the areas of cultural adaptation and implementation, proved to be a tremendous asset to this participatory manuscript development process. The tribal participants knew what steps to take to implement a successful community-based intervention, and thus it was only a matter of translating that knowledge into a publishable format. Additionally, the tribal participants understood how to work with the appropriate tribal IRB and research review boards, an essential component of publishing with Native American communities, and a process that is often poorly understood by outside academics. Several lessons were identified from the development of these workshops. First, there is a clear need for funders and community partners to plan evaluation and publication efforts together from the outset of the intervention work, and include the appropriate tribal leadership
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and tribal IRB approval boards in this planning. Extending the scope of the workshops to address the full range of technical assistance needed in data analysis and writing is also recommended. In addition, presenting the workshops less as one-directional trainings and more as partnerships between implementation experts and academics, each bringing skills that complement and contribute to the partnership, will likely produce the greatest results, as bi-directional learning, cultural humility, and relational accountability proved critical in translating the publication process into practice with these participants. Indeed, the tribal awardee who was able to complete their manuscript, gain appropriate tribal permissions to publish, and submit their manuscript for publication partnered with academic faculty members after the completion of the workshops and continued to utilize the participatory manuscript development process (Fig. 1). What began as a training developed into a true partnership based not on the continued provision of technical assistance but on a collaborative and co-learning process of translating a successful project of the CPPW initiative for publication in the scientific literature. It is unlikely that this work would have been developed into a publishable manuscript were it not for these workshops and the partnerships that resulted from them. The resulting paper is the first of its kind to report on specific issues around smoking bans and tribal casinos, providing a strong contribution to the scientific literature and addressing gaps in public health knowledge. Conclusions The novel participatory manuscript development process outlined here is a pathway by which tribal community health practitioners can contribute their work to the published literature. The manuscripts created by the tribal awardees capture critical implementation knowledge that can guide other practitioners in employing environmental approaches to address obesity and smoking within Native American communities. Such a ‘roadmap’ for implementing environmental approaches does not exist within the current literature and must be informed by those directly implementing such approaches. The translation of research into practice, beyond just within Native American communities, depends on trustworthy, well-written reports, particularly written from a community perspective, which is what this effort facilitated. Community participation in the publication process is particularly important in sustaining funding for programs and expanding them, which often depends on providing evidence for decision-makers and funders in the form of peer-review publications. Funding agencies aiming to increase the reach and translation of their efforts may seek to implement this type of mentoring and training as part of their funding requirements. As the fields of translational science and community-based participatory research continue to evolve, communities will increasingly be called upon to share their expertise within the published literature. The process outlined here offers one way for communities to engage in these efforts. Conflict of interest The authors declare that there are no conflicts of interests.
Acknowledgments The authors would like to acknowledge and thank the creators of the data and writing workshops: George Rutherford, M.D., Christina Lindan, M.D., Randahl Kirkendall, M.P.H., Kathleen Whitten, Ph.D., and Phyllis Ottley, Ph.D. We would like to thank Simone Peart Boyce, Ph.D., the statistician who worked closely with the participants. The Centers for Disease Control and Prevention (CDC) supported awardees in the Communities Putting Prevention to Work initiative through cooperative agreements. However, the findings and conclusions in this paper are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Users of this document should be aware that every funding
source has different requirements governing the appropriate use of those funds. Under US law, no Federal funds are permitted to be used for lobbying or to influence, directly or indirectly, specific pieces of pending or proposed legislation at the federal, state, or local levels. Organizations should consult appropriate legal counsel to ensure compliance with all rules, regulations, and restriction of any funding sources. CDC supported staff training and review by scientific writers for the development of this manuscript through a contract with ICF International (Contract No. 200-2007-22643-0003). CDC staff reviewed the paper for scientific accuracy. CDC invited authors to submit this paper for the CDC-sponsored supplement through a contract with ICF International (Contract No. 200-2007-22643-0003).
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