The first step in any AIAN CBPR project should be to contact tribal leadership, as this acknowledges sovereignty and helps researchers learn who controls permission to approach tribal members and whether the tribe has its

own review board.166,167,170,174,177,178 If tribal leaders approve a CBPR partnership, researchers should consider council members, chiefs, or elders for CAB membership.163,166,167 Funding sources may include payment for AIAN staff or it may be awarded directly to the AIAN council with researchers as subcontrac-

tors.166,167,170,177 A formal, written agreement should be made involving data

use, analysis and ownership, and publication rights; this may include provisions for data or biological samples to be housed in the AIAN community, for participants to review interview transcripts, or for the community to review

findings and request reinterpretation.163,164,167,170,172,177,178 In addition to steps

regularly taken for CBPR, the CAB should discuss whether Western theories and methods fit with the local AIAN worldview and engage in a continuing discussion on cultural competence of the methods.175 Photovoice may help to center AIAN perspectives.172,174,179,181 In addition to honoring the data ownership agreement, progressive data findings may be disseminated regularly to the community at large if the CAB members or tribal leadership so desire.172,178 Manuscripts should be reviewed by the CAB members and, possibly, the AIAN

leadership before publication.166,174,177


An advantage of CBPR, when used to its strengths in this setting, is that it allows for the cultural differences between AIAN and Western research cultures to generate data and to create unique, viable solutions for distinctive, diverse AIAN cultures. Given the high level of health disparities faced by AIAN populations, the need for culturally relevant interventions to help close those gaps is evident.163,165-171,175

Used as a decolonizing method to center in-group knowledge, CBPR may have a greater ability to help than traditional Western research approaches, but CBPR projects must increasingly focus on intervention and dissemination, not merely


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