| This dissertation analyzes the use of a community-centered approach in a feasibility study funded by the National Institute on Drug Abuse (NIDA) to involve four Alaskan communities in designing, implementing, and evaluating an integrated community prevention model to prevent youths' misuse of inhalants and other harmful legal products (HLPs). While the development of evidence-based interventions for prevention favors investigator-driven models, recent evidence suggests that community-centered approaches increase the adoption and proper implementation of science-based prevention. To realize a community-centered approach, the feasibility study adapted and integrated the Tribal Participatory Research (TPR) model.; To examine the study's community-centered approach, this dissertation: (1) explores a single case of the adaptation of the TPR model, explicating a narrative of how and why TPR was modified; (2) conducts a multi-case analysis of the integration of the four TPR mechanisms into each of the study's three phases (design, implementation, and evaluation), drawing on examples from the four participating communities; and (3) assesses the extent to which the adapted participatory model was realized in relation to TPR and other published guidelines for participatory health research. The analyses rely on: (a) data collected during the implementation of the feasibility study; and (b) extended participant-observation by the author, who served as the study's research manager.; The results show the feasibility study made only minor modifications to the TPR model, based on population-specific considerations. The integration of the four mechanisms of TPR was extensive, and community participation was achieved most in the implementation of the intervention, followed by the design phase. Participatory principles were least realized in the evaluation phase. The TPR model was achieved fairly completely, and the study aligned moderately with other guidelines for participatory research. Limitations of participatory research in the study included the need to maintain consistency in the evaluation across all four communities in order to assure the evaluation met with the scientific integrity.; Although traditional prevention research has marginalized anthropology as a contributing but not central discipline in prevention science, the findings of this dissertation demonstrate the centrality of anthropology in the development of meaningful and effective prevention programs that integrate community-centered models. |
