“Citizen participation means a horizontal, equal relationship. It means relating with the other at the same level. One understands one’s usefulness as part of the solidarity produced within the relationship. Accepting the otherness involves admitting different modes of knowing and making possible the dialogue and the relation with the other in a plane of equality based on the acceptance of our own differences.” (Montero 2004, p. 251).

Venezuelan community psychologist Maritza Montero’s thoughtful reflection focuses on power, relationships, and differences in community research and intervention. These three concepts are intricately intertwined in the history and practice of community-based research described in this special issue. Here, we address conceptual and pragmatic issues raised in these papers and advocate for field-based researchers to establish community relationships built on trust and respect for culturally grounded lifeways and thoughtways. Montero’s clarion call to researchers comes none too soon, as community voices are challenging the way research has been conducted and the way that community participants have been treated during the research process. It also captures the shift in approach to research and intervention hailed by multicultural and indigenousFootnote 1 psychologies (Trimble 1977; Smith 1999; Trickett et al. 2011; Trimble et al. 2012).

The papers in this special issue portray in vivid detail a particular community-based preventive intervention designed to address the significant issues of alcohol abuse and suicide among Alaska Native (AN) youth. Most importantly, they document the evolution of a relationship among AN organizations, community members, and university researchers. This relationship was built on a shared belief, outlined in Montero’s quote above, in the importance of a horizontal, equal relationship among all those involved in the intervention, the negotiation of the inevitable conflicts arising when collaboration is truly authentic, and the subsequent evolution of trust, leading to local commitment and responsibility for the development of intervention processes and content. Much of the intervention story revolves around the unfolding of this relationship across the multiple facets of the intervention process.

Throughout, the story is framed within the cultural history of two Yup’ik AN communities, both coping with the consequences of externally imposed forced acculturation (Ayunerak et al. this issue) but with differing acculturative histories and differing patterns of suicide that affected how the intervention unfolded. The recurrent community emphasis on cultural restoration as a pervasive protective factor understandably flows from this history. And the inescapable influence of this history on the development of the intervention process represents an important lesson for social scientists aspiring to be helpful.

Paradigms and the Science of Community Intervention

Over 20 years ago, one of us (ET) wrote a paper entitled “Paradigms and the research report: Making what actually happens a heuristic for theory” (Trickett 1991). The notion was that filling in the picture of what actually happens in community intervention research could enrich theory by providing context, meaning, and heuristic explanatory concepts for reporting the intervention. From this vantage point, an intervention is conceptualized not as the implementation of a technology or program of specified and manualized activities, but as the creation of a setting. Long ago, Sarason (1972) defined a setting as “any instance in which two or more people come together in new relationships over a sustained period of time in order to achieve certain goals” (p. 1). The focus on “intervention as the implementation of a technology” deflects attention away from the creation of settings in which more specific intervention activities are embedded.

The papers in this volume take us closer to a “what actually happens” perspective on interventions and therefore allow us to highlight some of the pieces missing from normative intervention accounts. We find it implausible to understand the multiple effects of this intervention in the absence of elements of the story told in this issue, beginning with the cultural surround in which it occurred. Together, the missing pieces add an appreciation not only of this particular intervention, but also of some of the more general complexities involved in creating collaborative community intervention settings and the culturally responsive conduct of the research (Trimble and Fisher 2005; Noe et al. 2007; Mohatt and Thomas 2006). We now discuss several themes revealed in these papers that are often missing from more truncated reports that view interventions as the implementation of a technology. Together, these “missing pieces” contribute to an emerging paradigm of community intervention described elsewhere (Trickett et al. 2011).

A Tale of Two Cultures

A central part of the story of this community intervention focuses on a broader tension between the culture of the communities involved in the intervention and the culture of social and biomedical health science (see Gone 2012). This culture clash manifested itself though ongoing researcher efforts to make a clinical trials model of community intervention research ‘fit’ the community of concern. These resulting tensions include the struggles of local community people to understand the “why” behind biomedical research demands that usurped their indigenous ways of thinking. This cultural divide provided specific flashpoints for conflict. From the researcher perspective, these demands included funder expectations, including timelines, and deadlines that presume a significant degree of investigator control, rather than the shared control presumed in CBPR. In addition, these demands introduced prerogatives for a limited range of acceptable research designs, presumptions of linearity in how interventions unfold, and requirements for large sample sizes to facilitate sophisticated multivariate statistical analyses. From a community perspective, themes included the issue of trust, the unacceptability and cultural incongruence of random assignment, and local perceptions of a lack of direct benefits and the potential for harm arising from participating in intervention research. These strains recapitulate the recurring, historical tensions involving outside intervention efforts in American Indian and Alaska Native communities recounted in Allen et al. (this issue). Together, they represented formidable challenges to the development of trust, on the one hand, and the construction of persuasive evidence to the broader scientific community, on the other.

The specific negotiation of these two cultures is found in the different papers. Gonzales and Trickett (this issue) illustrate some of the implications for measurement development, ranging from more specific cross-cultural measurement issues such as conceptual equivalence, to broader issues of whether to assess specific concepts at all. Here, the importance of trust and the commitment of all parties to developing a mutually acceptable solution allowed the project to proceed.

Allen et al. (this issue) portrayed numerous cultural considerations in measurement and empirical theory building that require attention within current scientific paradigms. Specifically, the decision to move from qualitative to quantitative methods represented a cultural compromise between the perceived scientific credibility of measurement and model testing and the more nuanced, culturally rich, meaning filled, and locally comprehensible qualitative methodology. The Mohatt et al. (this issue) paper highlights the extent to which intervention research with rural and culturally distinct groups is impacted by limitations in current statistical methodologies. They describe several partial solutions to the challenges of conducting complex interventions using small samples. Together, these two quantitative papers map an incremental and constrained shaping of the culture of science to the community, defensible within existing mainstream intervention research paradigms. Nonetheless, these tensions highlight need for new paradigms and methods more consistent with local ecological realities, knowledge, and cultural values (e.g., Hawe et al. 2004; Trickett and Schensul 2009).

Perhaps the most vivid illustration of this clash of cultures in the current project appears in the Rasmus et al. (this issue) description of intervention program module development. In contrast to externally developed, manualized, adaptive approaches, intervention modules are rooted in an indigenous theory of protection, linked to valued cultural practices, and crafted locally. Rasmus’s (this issue) description of the process of module development takes us into the cultural world of indigenous discussions, and where Western knowledge can complement indigenous understandings. Here we see concerns about how to address taboo topics, revive and recreate ceremonial practices, teach youth traditional skills, and provide a setting for family communication.

What Constitutes “the Intervention” in Collaborative Work?

The elaborate commitment to indigenous knowledge, resources, and collaborative planning reported in this special issue also raises a larger question—what constitutes “the intervention” in such collaborative intensive work (Trimble and Fisher 2005)? Beyond implementation of specific program activities, “the intervention” includes the development of the collaboration, the ensuing trust that influenced module development and implementation, the role of local “ownership” of the work, and intervention ripple effects across multiple levels within the community. Such a view of “the intervention” is better represented as an effort to develop “best processes” rather than “best practices” (Green 2001) and as an “event in the system” (Hawe et al. 2009) rather than the implementation of a technology.

As example, the process of module creation was not intended to result in specific activities to be replicated with fidelity across other AN communities and beyond. Rather, module creation reflected ways of thinking about, respecting, and creating frameworks to enact local practices that honor cultural values and promote protective factors at multiple levels. In this spirit, the Qungasvik (Toolkit) emerged as heuristic guide for other Yup’ik communities to create their own modules. Hawe et al. (2009) frame such an approach as attending to underlying functions rather than forms of intervention components. In the Qungasvik,, the protective factors facilitated by each specific module serve as a guide for local choice on how to adapt the form of the module in light of local context, traditions, and resources (Rasmus et al. this issue). In this way, intervention implementation reinforces local control over both whether and how to integrate modules into local community contexts, while also providing guidelines for developing additional modules. Further, the process and content of module development were inextricably intertwined, reflecting but one piece of a larger collaborative portrait.

Ripple Effects in Community Interventions

One of the largest missing parts of the story in accounts of community interventions includes their ripple effects. These effects are often unanticipated changes across ecological levels, and, at times, across elements of settings affected by though not directly participating in intervention activities (Bronfenbrenner 1977). In the current papers, Elders saw rejuvenation of cultural ways and experienced renewed sense of purpose and contribution to community life. Community participants described community level changes in the social climate of everyday interactions not directly linked to specific intervention goal. Quantitative youth data provided a different picture of impact than the process data exploring community ownership of the intervention over time. Measurement development involved an ecological/cultural journey into the lifeways and indigenous meaning of concepts that far transcended the notion of translation and back translation of instruments and included relationship deepening processes as well. Indeed, the many meetings around measurement development (Gonzales and Trickett this issue) not only provided a means of identifying culturally relevant constructs, measures, and items, but, by affirming the commitment to work through local differences, provided glue for the collaborative commitment underlying the overall enterprise.

Documenting these ripple effects affirms the conceptual benefit of viewing interventions as “events in systems” (Hawe et al. 2009). In the present account, these ripple effects discussed above, plus additional findings reported elsewhere (Allen et al. 2009), suggest that these effects of the intervention may have been as important for the community as were the growth in protective factors documented among the participating youth. It certainly suggests the advisability of identifying and assessing outcomes of local relevance alongside those of interest to the scientific community. Rapkin’s (Rapkin and Trickett 2005) suggestion that every RCT be viewed as an hypothesis-generating case study includes attention to such ripples. Further, the extent of the ripple effects uncovered here suggests an ethical mandate for community intervention researchers to include procedures for exploring possible unintended and even iatrogenic consequences.

A Tale of Two Communities

The emphasis on randomization and individual level outcomes typical in current community intervention research represents an effort to rule out rather than model difference at the community level (Trimble and Fisher 2005). The differing stories of the two participating communities in the present intervention, however, illuminate how intervention processes and cultural history interact and vary across generations and communities possessing a shared linguistic and cultural heritage. Differing community histories of youth suicide necessitated modification of the goals, processes, and measures across these two culturally similar communities. Ignoring or minimizing such differences in an effort to “standardize” the intervention would have undermined local credibility and authenticity of the collaborative process, demonstrated cultural insensitivity, and reproduced prior negative histories with outside researchers.

The Promise and Peril of a Collaborative Commitment

The mediator between two cultures was the collaborative process underlying the intervention. This process was designed to interrupt the image of colonization, with its imposition of foreign values, ways of thinking, and goals, on Indigenous people. The papers in this volume document in detail the promises and perils of this collaborative commitment. Though the term community-based participatory research (CBPR) is invoked throughout, the origins of the collaborative relationship between Mohatt and his colleagues and varied AN governing organizations and communities predated the emergence of CBPR as a named perspective. However, the spirit of CBPR, as we now know it, permeated all of the work, beginning with the development of an indigenous theory of the protective factors relevant to sobriety. It is manifestly clear across the papers that the “what” and the “how” of the work made sense to the local community, was seen as in the community interest, and reflected and indeed honored local traditions and hopes. Most importantly, culture was not viewed as a gloss or add-on to the assumption of basic processes generalizable across people and over time; rather, culture was the organizing principle and underlying commitment that guided theory, power relationships, constructs, measures, processes of collaboration, and goals.

The spirit of this commitment was described 40 years ago by Argyris (1970), who suggested that the goal of intervention should be to increase local choice. Thus, a primary intervention goal should be to increase local autonomy of the system or community per se. To achieve this, Argyris posited three necessary conditions: (1) the intervention is based on valid information; (2) the community has free and informed choice in participating; and (3) there is local commitment to engage in the intervention. Papers in this special issue document how Argyris’ three conditions of valid information, free choice, and internal commitment were enabled through the collaborative commitment.

However, the papers also document the challenges accompanying the collaborative commitment. As a partial list, just some of the most prominent challenges included the time and need for extensive relationship building; the value of multiple meetings and informal discussions to mediate differences related to the cultures involved; unanticipated local resistance to various aspects of developing measures; improvising to respond to community differences in the acceptability of asking about suicide; lack of researcher control over whether certain kinds of data would be allowed to be gathered (Gonzales and Trickett this issue); and working through conflict in the face of looming externally imposed deadlines. Together these signify the depth of the relationship that occurs when CBPR is taken seriously, and the conceptual and pragmatic values of including such accounts in reporting.

University and Community Co-Researcher Roles in CBPR Intervention Research

The collaborative commitment highlights the complex and often marginal role of both university and community co-researchers in CBPR. Both roles include culture broker, translating and attempting to integrate the demands of both the culture of science and the culture of the community. One aspect of this role that has rarely surfaced in most research reports involves what, from a researcher and funder point of view, is negotiable and what is not in the design, implementation, and evaluation of externally funded CBPR. There has been a tendency in the rhetoric of CBPR to overstate what investigators can currently give away, to declare that the “community is in charge,” as if the investigator is truly able to authorize this. Even in the case of shared research questions and budgets with elements of local control, the reality is much more complex, as researchers remain accountable to the dictates of funders and their peer review community.

An additional aspect of the role involves its time commitment, including the need to improvise and adapt to ever-changing circumstances of community life. The importance of a sustained commitment to work in the community appears throughout this special issue, reflecting almost two decades of involvement by the university research team forging close collaborative relationships with AN communities. This commitment and relationship are complicated for community members who participate in the research, community based research staff, and university based researchers.

Community participants in Yup’ik communities respond to the ebb and flow of community and natural events. For example, collective responses to family tragedies or to the subsistence possibilities associated with the sighting of a pod of Beluga whales take precedent over and interrupt intervention activities. Time honored community needs and priorities can be incompatible with research timelines.

For community members working for the research project, there are risks involved in their complex roles as culture broker, research representative, and cultural go between. While the university researcher typically goes home to the University, community research staff live with the outcomes, good or bad, of a community intervention project. They are required to place their own local reputation on the line regarding any of the risks associated with the project, including potential ethical lapses, betrayal of trust, and cultural misunderstandings. If things do go wrong, the community-based researcher will be accountable to neighbors and family members and will live with whatever positive or negative ripples the project creates.

For the university researcher, the challenges of “going to the community” should not be underestimated. In favorable weather a trip to a remote community in the western Artic from Fairbanks, AK requires a day of travel in small planes (675 miles one way). In Alaska, it is not uncommon for “bush” flights to be cancelled due to icing, wind, fog, or heavy snow; researchers can be grounded for several days and in some instances, weeks, placing pressure on local resources and commitments outside the project. During harsh weather conditions, temperatures can drop far below zero (Fahrenheit). While communities were been very generous in sharing what they have, accommodations were often quite austere, and privacy, fresh food sources, access to toilet facilities, and uninterrupted communication with the outside world all became less predictable. The community commitment in such CBPR projects is considerable.

Finally, being in the field away for weeks at a time while also under parallel expectations to fulfill teaching responsibilities, supervise dissertations, serve on university committees, and advise students, impacts teaching, tenure, publication rate, and professional recognition. Universities often state they want engaged scholarship but do not always fully understand its demands. Typically, current benchmarks used to assess scholarly productivity do not account for the time or the extensive relationship development components of this work. Documentation of how these complex roles are negotiated is needed to enrich this missing piece of the story.

Exoticizing the Everyday or “Will it Play in Peoria?”

A classic dictum in anthropology is the greater the cultural difference of a setting from one’s own culture, the greater one’s own cultural preconceptions become apparent. The rich and distinctive Yup’ik culture, with its degree of linguistic intactness, set in an extreme climate and remote, isolated location, can foster a false premise that issues raised here are only salient because of this distinctive context. While we may agree with respect to form, we do not agree with respect to function. We believe elements of the issues presented here in detailed account, including the fundamental nature of culture, the primacy of local ecological context and local control, and perhaps foremost, the collision of the culture of community with the culture of science, exist to one degree or another in all community intervention stories. Typically these issues go unreported, and as such, remain unacknowledged and unreflected upon. “Will it play in Peoria?” the producer asks the vaudeville pitchman, questioning the show’s potential for mainstream acceptance. Will the ideas spawned here prove discernable and relevant elsewhere in community intervention research? From our perspective, yes, it has already played in Peoria. We just have to acknowledge the performance.

Conclusion

The story of the community intervention described in this special issue, then, involves much more than the implementation of a program. It represents the enactment of a set of social and scientific values manifested in relationships with local communities and an ongoing vigilance about community events and processes. Collaboration is an oft-invoked yet potentially deceptive word in the community intervention literature. The devil is truly in the details of how individuals treat each other, how issues are negotiated, how conflicting perspectives are received, how conflicts are dealt with, and whether commitments made are commitments kept. Yet if the devil is in the details, the details need to be presented for us to assess how devilish the account is. We have advocated here for a more detailed intervention story.

Telling the story in more detail has allowed many discrete though related themes to emerge that enlarge our understanding of the complexities of collaborative community intervention. A more general theme throughout the papers is found in the many stories describing how collaborations among community members and researchers transformed representational knowledge into relational, reflective knowledge, a key goal of effective CBPR. While missing in most reports on collaboration, descriptions are needed of those relational processes, encounters, and dialogues that create such a shared, third space, through which new understandings and choices emerge regarding a course of action to improve the local situation (see Freire 1970). These processes simultaneously affirm the fundamental value of honoring the ways local people perceive their world and their right to local control over what happens there.

Many more discrete themes also emerged in the papers. Some challenge select research and institutional orthodoxies. Responsive community intervention research reflective of local community concerns and lifeways will likely challenge funding institutions and the peer review community to promote innovative research designs and analytic frameworks. The importance of supporting the community research commitment over a longer time frame than in the present study is also necessary to learn about and assess long-term community as well as individual level change. University and professional incentive structures need to be engaged to avoid making CBPR a professional risk factor, particularly for untenured faculty. Of equal importance is work on defining and understanding the complex situations facing community research staff, whose function is critical in carrying out this work. These, and many other specific ways to enlarge our paradigms for understanding of community interventions, are found throughout this volume.

But here the larger goal has been to embed all the diverse stories into a broader portrait of a community intervention. The community story told here underscores our belief that community interventions are not generally neat, linear, and unsullied by detours caused by local events, unanticipated actions, and deep cultural differences. Rather, they reflect the messiness of real life, of “what actually happened.” But the “messiness” of such tales should not be equated with “noise.” There is conceptual lemonade to be made with what is too often viewed as experiential lemons.

We also acknowledge, despite its depth, the reporting here continues to be selective, and much of the story is still missing. Not everything that happened day in and day out can ever be described, and a myriad of key decisions, difficulties averted (or not averted), and successes go unacknowledged. We are also aware of potential ethical complexities in such reports. Some parts of stories are inconsequential and do not warrant reporting. Others are better left untold, in that they may inadvertently identify the personal circumstances of specific individuals or issues within communities that could cause harm by evoking short-term, personal, interpersonal, or intragroup difficulties, or stigmatization. We leave it to future case studies to promote a more refined conceptual sorting of the wheat from the chaff in what to leave in and out.

Our hope, however, has been to convey both the spirit and substance of events that can provide a more complete accounting for community intervention research. This back-story we have presented is critical in understanding the context and conditions in which all intervention research takes place. The field of community intervention theory and practice owes no small debt of gratitude to this journal for allowing so much of the frequently missing story to be told.