Engaging and sustaining adolescents in Community-Based Participatory Research: Structuring a youth-friendly CBPR environment

Abstract

Community-Based Participatory Research (CBPR) partnerships typically do not include adolescents as full community partners. However, partnering with adolescents can enhance the success and sustainability of adolescent health interventions. We partnered with adolescents to address health disparities in a low income urban community. In partnering with youth, it is important to consider their developmental stage and needs in order to better engage and sustain their involvement. We also learned the value of a Youth Development (YD) framework and intentionally structuring a youth-friendly CBPR environment. Finally, we will raise some ethical responsibilities to consider when working with youth partners.

Community-Based Participatory Research (CBPR) is an approach that has been used successfully to design intervention programs.^1-4 CBPR is a “collaborative approach to research, that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community with the aim of combining knowledge and action for social change to improve community health and eliminate health disparities”⁵(p.4). Most CBPR partnerships include adults; it is rare that adolescents are included as partners. However, partnering with youth could enhance the success and sustainability of adolescent health interventions, and contextualize interventions in social, community, and cultural factors that are often overlooked. The same Principles that guide partnerships with adults in CBPR^5,6 can be applied when partnering with adolescents. Several studies have used participatory asset-based approaches in research with youth^7-10 and although an evidence-based curriculum for developing and sustaining CBPR partnerships does exist,¹¹ we did not identify any literature to date that describes how to engage youth in the CBPR process and maintain their involvement in an equitable partnership. This paper focuses on CBPR partnerships with adolescents, and strategies for maximizing the efficiency and effectiveness of these partnerships.

Partnering with youth in CBPR involves several key components. First, partnerships must acknowledge the developmental needs and capacities of youth and match the work of CBPR – which is often sedentary, slower-paced, and process-oriented research – with adolescents’ abilities and interests. Second, compared to adults, most youth have limited autonomy and independence. “Participation” on a project has some latent assumptions about what the work involves, including being able to keep commitments, attend meetings regularly, and notify the team if you are late or cannot attend. However, teens may not always have control over their own time or means of communication. Third, teens have limited experience in decision making. CBPR is based on researchers sharing power and decisions with the affected community. The limited experience most teens have in adult decision-making processes can play out in CBPR. Fourth, CBPR makes a long-term commitment to the affected community but teenagers “age out” of adolescence as they transition to young adulthood.

We will describe our partnership with adolescents, strategies we used for engaging youth in the day-to-day work of CBPR, and how the demands of that work – including its routine, frequency, difficulty, and latent assumptions of the work environment – required approaches and techniques geared to adolescents. Such approaches and techniques include: using a Youth Development (YD) framework,^12-14 a strength-based approach to engage youth in CBPR; focusing on the importance of structure; use of paid trained staff; planning meeting times and altering physical space to accommodate youth; and planning an agenda that includes age-appropriate and youth-friendly activities. We will also discuss emergent ethical issues and responsibilities that the CBPR adult staff identified and confronted related to working with adolescents, responsibility that extended beyond the more specific and straightforward tasks of the research project.

THE BRONX YOUTH PARTNERSHIP

Bronx Youth as Partners in Community-Based Participatory Research (BYAP) was an eight-year two-level partnership hosted through Albert Einstein College of Medicine in the Bronx, New York and funded by the National Institute on Minority Health and Health Disparities. The mission of BYAP was to prevent and reduce mental health and other health disparities among Latino and black non-Latino adolescents in the Bronx.

The first level of the partnership was the steering arm of the project, “Albert's Leaders of Tomorrow” (ALOT), made up of 14-20 adolescents from the Bronx (“ALOT teens”), and 3-6 adults (“ALOT adults”) who were researchers, clinicians, and professionals with a background and experience in adolescent health or mental health. Adolescent partners were recruited through various Bronx-based schools and agencies; partners were required to be between the ages of 13 and 19, identify as Black/African American or Latino, and live in the Bronx. Adolescents were not excluded from selection; rather they selected in or out based on expression of interest and balance of partnership composition. The partnership was balanced by age, gender, neighborhood (determined by zip code), school, and racial and ethnic background. If there were not open spots for additional adolescents who expressed interest, they were placed on a waiting list. Adolescents were provided a meal and a small stipend at each meeting.

ALOT meetings were held weekly over 8 years, where adolescent partners met weekly and adult partners joined them bi-weekly. As the decision-making committee leading the BYAP partnership, ALOT had three goals: 1) identify and research health disparities affecting Bronx black and Latino teens; 2) choose one disparity on which to focus their efforts; and 3) develop and pilot an intervention to help reduce this disparity in the community.

The second level of the partnership was the BYAP Coalition, which consisted of approximately 60 agencies located throughout the Bronx and New York City who serve Bronx youth. Coalition organizations included Bronx high schools, colleges and universities, libraries, hospitals and clinics, health insurance companies, community-based organizations, schools, faith-based community leaders, and government officials and policymakers. The Coalition supported ALOT by providing guidance, data, services, feedback, expertise, and referrals. Meetings were held 2-3 times per year, where the entire ALOT team met with the Coalition. In addition to the academic and community partners, a third essential component of the BYAP partnership was the ALOT staff, a team of youth experts who worked directly with ALOT on a weekly and sometimes daily basis to facilitate their work and help maintain and nurture the partnership. We will discuss the partnership and the role of staff in more detail later.

CONSIDERATIONS FOR ENGAGING ADOLESCENTS IN CBPR

Developmental needs and capacities

Adolescence is a time of rapid growth biologically, physically, psychologically, and cognitively.^15,16 For CBPR, several aspects of development are particularly important. Adolescents are developing their identity, as well as exploring sexuality and intimacy. The brain of an adolescent is not fully developed yet, thus, there may be limitations in voluntary control.¹⁷ Youth do not always “filter” or censor their thoughts. However, the upside to this quality in youth is that while it can be a challenge in certain circumstances, in the larger context of CBPR it is also a very valuable asset—it brings a very authentic, unfiltered voice to the experience.

During adolescence, youth are also developing verbal, written, cognitive, and social skills. A youth partnership will encounter teens with varying strengths, skills and competencies based in part on aptitude, in part on experience. For many youth, the CBPR partnership may be the first time they are given the opportunity to use or express a certain level of skills and build capacity in those areas. This included personal, professional, social, and general life skills. Examples included but are not limited to preparing slides and giving formal presentations, engaging in intellectual and thought provoking discussions with a diverse group of people, writing professional letters, taking notes during a meeting, researching statistics and information on adolescent health, and making calls to Coalition members.

Limited autonomy and independence

Youth often experience time constraints and limited control over their own schedule and availability. Parental expectations and rules are outside of the control of adolescents. Teens were absent or late due to an array of circumstances: a parent or guardian needed them to babysit at the last minute; teachers kept them after school to make up a lab assignment; they had to study for a test; or they had a conflicting event they needed to attend. While the rules of our partnership, as established by its members, required members to contact ALOT staff if they could not attend a meeting, youth faced obstacles in following the very rules they established. For example, teens could not call about last-minute changes in their availability because their schools do not allow them to have cell phones and schools may not let them use the school phone. In one instance, a teen was absent from one of the weekly meetings because he was “grounded” and was not allowed to attend as it was considered by his parent as an extracurricular activity, not a required activity. In this circumstance, the teen also was not allowed to call to let the partnership know he could not make it. Even though it was decided by ALOT that everyone was expected to call or email if they could not make a meeting, there were times when teens did not follow through with this expectation; on occasion it was lack of responsibility, but usually it was out of their control.

Limited decision-making experience

Consistent with the principles of CBPR, the community has full equity and shares decision making in the project. Adolescents had much of the decision-making power in the BYAP planning, but some adult ALOT members were particularly concerned that because of their higher education, life experience, professional training, and communication skills, that they would inadvertently influence their youth partners and the decisions they made. However, their concerns were misplaced. Adolescents feel they are at the center of the world¹⁸ and once trust was established, teens did not hesitate to disagree, or reject adult member advice. Sometimes, ALOT teens had difficulty identifying the boundaries of their authority. They believed that they were in charge of decisions that were governed by human resources (pay rates), our funding agency (how much money we should receive; allocation of funds), the IRB (need for consent), or the host institution (Einstein, e.g. policies, sexual harassment guidelines). Most of the adolescent partners had no previous experience distinguishing the subtleties of such institutional rules and regulations so they had difficulty understanding the difference between being the lead decision-makers for the CBPR project and making decisions about rules outside the project. As ALOT set the ground rules for the partnership and for ALOT, we also identified clearly what rules ALOT had authority over and what rules were non-negotiable organizational policies that were not under their authority; we needed to establish these boundaries for partnering with youth.

Community “ages out”

Maintaining a long-term commitment proves to be more challenging when the community naturally “ages out” and the partnership periodically changes its members. Youth partners eventually turn 18 and become young adults, graduate from high school, and are no longer a part of the defined “community.” We decided that youth could remain part of the project as long as they wanted, however, most moved on to other opportunities such as college or employment. While it was their decision, it seemed to produce some anxiety and ambivalence for them. Older teens often remained on as members but their attendance began to drop off along with their level of investment. We believe they were struggling with the dissonance between the need to move on to other ventures and not wanting to leave their fellow partners and the staff or before seeing the final product. We also struggled with “aging out” as well because some ALOT teens left the project after developing considerable expertise in health disparities, group process, and the substance of the work. When these indispensable members of the partnership “retired”, they took valuable experience with them and left empty slots that needed to be filled. The loss of experienced youth combined with the addition of new teens and the need to orient the newcomers sometimes set the project back as it impeded on the planned timeline and caused constant re-evaluation of its objectives and approaches. However, we also found that reviewing progress with new teens was helpful to existing ALOT members, who often lost track of their many accomplishments. New teen perspectives also often proved valuable for kick-starting each next phase.

PARTNERING WITH ADOLESCENTS IN CBPR

We began this work expecting that we would need to develop special procedures to work with youth as partners. However, with time, we re-defined the essential nature of the problem: it was not the youth who posed a challenge to partnering in CBPR; rather, it was that CBPR posed challenges that made partnering with youth difficult. Partnering on a CBPR project is a completely new experience for most youth. They did not have prior experience that was helpful in figuring out the role expectations and needed more support from staff to engage successfully in this process. Our solution was to restructure how we conducted CBPR to fit our community partners, and to employ specific strategies that enhanced the partnership with youth (see Table 1).

Table 1.

Partnering with Adolescents in CBPR

Considerations for Engaging Adolescents in CBPR

Developmental needs and capacities

Limited autonomy and independence

Limited decision-making experience

Community “ages out”

Model for Partnering with Adolescents in CBPR

Structure the CBPR environment to be youth friendly

Meetings and tasks focus on short-term goals

Designated staff who work specifically with youth

Ground rules and voting process

Agenda activities and physical space

Use a Youth Development (YD) framework

Train staff in YD

Engagement: Skill and competency building

Recruitment and sustainability

Structuring the CBPR environment to be youth-friendly

Scheduling meetings and tasks focused on short-term goals

ALOT decided on the frequency of meetings and the time of day they would be held -- after school, during youth-friendly hours. While the entire ALOT team decided to meet formally every two weeks, the ALOT teens requested more frequent, weekly meetings just for them in order to meet with the ALOT staff. Adult ALOT members were welcome to participate in these meetings and occasionally the adults attended to work more closely with the youth on specific tasks, but their attendance was not required. Youth enjoyed these “teen only” meetings with the staff as it provided time to work with their peers and prepare information to share with their adult partners at full ALOT meetings. In addition to weekly meetings, teens could sign up to meet with the ALOT Coordinator for additional pre-scheduled office hours to complete some of the work. Based on what we noticed over time and the feedback that we gained through our ongoing discussions with the youth, teen members noticed more progress in the partnership work overall when they worked on a weekly basis, and when tasks were clearly defined and short-term rather than long-term.

Employing designated trained staff who work specifically with youth

An important component of CBPR partnerships with youth is a designated paid team of youth centric staff. ALOT staff members were not CBPR partners in that they had no decision-making role, but they worked directly with youth weekly and sometimes daily. The ALOT staff was responsible for critical logistics, such as coordinating and facilitating both the ALOT and Coalition meetings and other activities (e.g., preparing the meeting agenda and materials, recording minutes, ordering food, paying teens, etc.,), corresponding with teens and other partners, and providing support to youth between formal meetings as they worked on project-related tasks.

Planning for meetings each week required a lot of time, organization and preparation. For this reason, an ALOT Coordinator was employed full-time. The ALOT staff met together weekly outside of the ALOT meetings to: develop the weekly agenda; develop youth friendly exercises and activities; invite outside speakers to present information and interact with youth; and implement what ALOT had identified were the next steps. These weekly staff meetings were critical to facilitating the planning and progress of ALOT's work in several ways: (1) it assured structure for each meeting; (2) it placed individual meetings in the larger timeline and assured meeting milestones; (3) it was an efficient way to bring the expertise of all team members to bear on the agenda that ALOT had generated; (4) it provided a venue for the ALOT coordinator to keep the entire staff abreast of ALOT's progress and activities. Even though we planned to have a full-time staff member as coordinator because we anticipated the need for this support to ALOT, we underestimated the importance of the dedicated staff for successfully engaging and sustaining youth as partners.

Developing the ground rules and voting process

Early in the partnership, a substantial time investment was made in developing ground rules and norms. ALOT developed its own guidelines that included policies about attendance and lateness, and consequences and exceptions to these rules. Youth developed these guidelines and policies with their adult partners, which facilitated capacity-building, and modeled the equality of youth with adults in the decision-making process. In establishing group guidelines, ALOT discussed the role of respect, personal responsibility, responsibility to the team, and how to assure accountability. The group also decided on a voting process and agreed on a two-thirds majority for all votes. The voting process was typically used when key decisions needed to be made (e.g., which health disparity to choose; choosing an intervention model). ALOT youth and adult partners were encouraged to enforce the policies and rules and hold their fellow partners accountable. However, this proved difficult. Adult ALOT members were reluctant to be the “disciplinarians,” because this might upset the delicate equality between them and the ALOT teens. Youth were not accustomed to having the power and authority to hold their adult partners accountable. ALOT staff filled the vacuum – when the teen and adult ALOT members did not act to enforce established group expectations, staff stepped in, to the relief of both.

Adapting agenda activities and physical space

A key component in partnering with youth that we did not fully anticipate was providing structure, both in the meeting agenda and the physical environment. Meeting space and agenda activities needed to be youth-friendly and purposeful, as working with youth requires more interaction and engagement than sitting around a conference table and discussing topics. Each week, ALOT staff planned focused icebreakers and activities that engaged ALOT teens in the planned agenda topics. Activities sometimes involved small group work; posing questions to the group that each individual could respond to; or collecting the different ideas presented, organizing them, and then presenting them back to the group in the next meeting for them to discuss. This was an ongoing process for both youth and adults, which challenged youth to participate in ways that were unnatural or not inherent to them. It also added a level of responsibility and commitment for staff to assure efficient workflow and continuity from week to week. When the agenda involved discussions and voting, we held the meeting around a large formal conference room table. Most youth had never participated in a professional meeting or served on a board of any kind, so this experience made them feel valued and important. However, there were times when the typical “board room” setup was not conducive to the planned activities. In these instances, it required us to alter the space or change the location of the meeting. This sometimes included standing up or moving around the room; moving chairs away from the table to create small groups; or using another room entirely, where the physical space allowed the freedom to move around the room or have a more intimate conversation without the obstruction of a table. Staff needed to be flexible; if they detected a lull in the conversation, a change of scenery was used almost as an intervention, to enhance group dynamics, facilitate the flow of conversation, or increase interaction between partners.

ALOT teens had their own office space at the research center. This space included several cubicle desks with computers, internet access, a printer, a corkboard, and mailboxes for each member. Youth could store their personal belongings here whenever they came to the center. If this space was too crowded, additional office space and computers were provided. Many of the youth did not have a private space at home to complete their school work, and some of the youth did not own computers, so having this work space was important to them.

Youth Development (YD) as a framework for engaging youth

As our work with youth extended over months and through different work tasks and challenges, we evolved the techniques we mentioned above, e.g., intentional structuring of meetings, tasks, activities; full time staff to support youth. As helpful as these practices were, we identified a larger need – to find a framework that would guide youth CBPR, a philosophy or approach that would underpin all project work. We benefited from discussions with coalition partners, many of whom were using strength-based strategies to engage and intervene with high risk youth. These approaches were complementary to and consistent with CBPR and they shared similarities in ethics and principles (see Table 2). After studying the options, we selected Youth Development (YD)¹² to guide and further reinforce our work.

Table 2.

Mapping BYAP's Approach to CBPR onto the Core Concepts of Youth Development

4 Core Concepts of YD12	BYAP Approach to CBPR
YD is a shared responsibility among family, school, community-based organizations, religious groups, civic groups, and youth themselves.	Teens partner with researchers, community organizations, practitioners, schools, faith-based organizations, government officials, policymakers, and other agencies to solve health disparities.
Each young person meets his/her needs through his/her own unique context; each person is at the center of his/her own growth.	Teens are at the center of the partnership and are equal partners, in decision making, throughout the process. The partnership is able to address the needs of, for, and with the help of the community itself. Each youth partner is able to engage in a way that works for them and fulfills his/her own needs through various skill-building, collaborative, and service-learning opportunities.
YD is active, not passive, and places value on making intentional connections with youth.	Individual connections are made between teens and adults, including staff, adult members, and Coalition members. This includes building relationships, and providing opportunities for conversation and discussion.
YD is strength-based.	CBPR takes a strength-based approach by emphasizing the community's assets, and building on these through individual and partnership activities. Youth build skills in a range of competencies (e.g., health/mental health; social and cultural competency, employability, and civic competency).

YD aims to meet the developmental needs of youth and to build a set of core assets and competencies needed to develop into healthy and successful adults. Best practices for YD include: establishing an organizational structure that is supportive of youth development and takes a holistic approach to young people (e.g., training staff, addressing youth needs and interests, awareness and follow up with youth, and multicultural understanding, representation, and cultural competency); creating an environment that allows youth to feel physically and emotionally safe; providing the experience of membership, belonging and ownership; developing quality relationships with peers and caring and trusting adults; providing structure and guidelines, holding youth accountable and to high expectations, strengthening skills, and enabling youth to discover the self and develop self-worth; encouraging youth to form their own values and discuss conflicting values; providing opportunities for contribution and full participation; offering engaging activities and fostering creativity; fostering the feeling of pride and accountability that comes with mastery; expanding their capacity to enjoy life and know that success is possible by promoting consistency and continuity while also creating closure and helping youth bridge to adulthood.^12,19 When we formally adopted a YD approach to CBPR with youth, we trained ALOT staff in youth development, shifted our strategies for recruiting and sustaining youth as community partners, and emphasized the importance of engaging youth in the process through youth friendly, skill building activities.

Importance of training staff in Youth Development

From the beginning, our project was strategically structured to rely on paid youth-friendly staff to coordinate and work directly with youth partners outside of formal meetings. The staff was trained in youth development (YD) to help them better engage the youth throughout this project. Core concepts of youth development (as outlined and modeled by one of our community Coalition partners;¹² see Table 2) became the underpinnings of this engagement and helped guide staff in reframing their approach.

Staff utilized exercises and activities to help build skills, assets, and competencies in order to enhance teens’ ability to participate in the project. We placed an emphasis on holding the teens accountable; it was imperative that we provided clear structure and guidelines, holding high expectations of youth and re-enforcing these expectations, continually pushing youth toward their potential and providing feedback. Many of these needs we did not anticipate in the beginning of the project, yet, they were issues we could not ignore. Staff provided a safe place and a space for youth to explore their peer relationships, individuality and ideas, without judgment. One important aspect to consider when using a YD approach is that it means going above and beyond the requirements or expectations of a typical CBPR project; however, we believe that this is an essential component to successfully engaging youth in CBPR. Staff put in additional time and effort before and after meetings, sometimes to meet with youth individually or to check in with them from time to time. This approach may be more time-consuming or require a different level of effort, but ultimately kept the youth interested, engaged and returning week after week, and year after year.

Importance of engagement: Building skills and competencies in youth through youth-friendly activities

In order to do the actual work, we engaged youth in a way that would also meet their needs and maintain their involvement over time. We varied the way in which we conducted meetings to be more dynamic and interactive and to appeal to various learning styles (e.g., auditory, visual, kinesthetic); this included engaging in purposeful activities and exercises, assigning specific goal-oriented tasks, and inviting community speakers. We balanced large group discussions with small group work, and provided alternative ways of brainstorming and discussing ideas through debates, surveys, interviews, panels, presentations, and other youth-friendly activities that help generate discussion. We prepared field and take-home assignments and began to use weekly journaling at the end of each meeting to create continuity from week to week and to further their idea development. Instead of doing the research for the youth, we engaged youth in the co-learning process and as they taught us more about Bronx youth, we taught them basic research skills (e.g., how to search for literature, find health statistics, and present information back to the team) and assisted them in building competency in these areas. If youth were struggling to generate ideas, we would first try problem-solving as a group to see how the group would resolve it; if the group was still “stuck”, only then would we help consolidate their ideas and present the options back to them, checking in with them to make sure we were properly representing what they discussed. We understood the importance of helping youth build skills in a variety of competency areas. We intentionally provided opportunities for youth to take on tasks that could build on their strengths, explore their interests, or expand their skill set. Examples of this include having them help set up meetings, work with our partnership evaluator to develop a survey to evaluate the partnership, take notes during meetings and report back to the group, interview community members, assist with project website development, and prepare and present power point presentations. Youth volunteered for tasks that they considered a strength, or those that presented a challenge and required acquiring new skills. One important tenet of YD is that staff hold a high expectation of youth.¹² Staff encouraged youth to push themselves outside of their comfort zone and develop new competencies, and held them accountable to their commitments. This approach is complementary to a key principle of CBPR – YD helped facilitate co-learning and capacity-building among all partners.

Strategies for recruiting and sustaining youth as community partners

YD helped us restructure recruitment so that youth who joined the project would be more likely to commit and less likely to drop out. Engaging adolescents in projects is challenging in general, but risk of drop out increases when the community is not fully engaged and does not buy into the purpose of a project or its relevance to them. After consulting the Coalition members, we asked that each site share information about ALOT with their youth and distribute or post our flyers and brochures. Site representatives were asked to have the teens contact us directly for more information. We placed this responsibility on the teens to take the initiative and follow up with us.: Youth who were interested in joining our team were expected to contact the ALOT Coordinator directly to express their interest and ability to commit. Even when adults or parents followed up with the coordinator instead (and we understood why they did), we described the project but explained the importance of the adolescent contacting the coordinator directly. We found that putting the responsibility on the youth to take initiative and follow up on their commitment not only built competency in many areas, but increased the likelihood that they would honor this commitment. Ultimately, youth tended to be more engaged and invested having gone through this process. Youth were not excluded from the partnership; rather they self-selected whether to participate by following through with this process. The majority of our adolescent partners remained on as active members for two to three years, very few left before one year.

On the other end, adolescence is a time-limited developmental period, and youth eventually began to “age out”. The dilemma is that CBPR engages the community – we needed to maintain ALOT as representative of Bronx adolescents – however, older ALOT members had formed allegiance and attachment to the project and wanted to see it through, and they had acquired valuable experience, history and skills that were a loss to the project if they left.

We developed an “alumni status” for those youth who graduated high school, were leaving to go to college, moved out of the area, moved on to other opportunities, or for some reason or another were no longer able to continue to commit as active members of the partnership and attend weekly meetings. The alumni status provided a pathway for continuing albeit restricted involvement for those youth who were struggling with leaving, and sustained a long-term relationship with them beyond their active role on the project. Youth still felt that they belonged, and maintained their connection to ALOT, but acknowledged their need to transition to the next phase in their lives. It also honored their contribution, giving them the privilege, opportunity and invitation to come back and visit, and attend meetings and events as alumni of ALOT. Through alumni status, we have kept in contact with many former and original ALOT members.

ETHICAL RESPONSIBILITIES TO YOUTH PARTNERS

Our intensive involvement with adolescents, and our equal partnership model, resulted in ethical questions for adult ALOT members and staff that were not inherent in the CBPR process itself. As much as we wanted to deal with teens as equals, because of their age they have limited life experiences with the kind of work that research imposes, or the kinds of social interactions that they were having with community leaders. Staff, adult ALOT partners, and Coalition members viewed youth as a shared responsibility and provided resources to youth in areas where they needed or elicited it; this often included helping youth build skills and competencies, and sharing adult life experience or professional expertise that helped support the youth in their mission.

CONCLUSION

Partnering with adolescents in adolescent health intervention research can be invaluable. However, even with our extensive knowledge of adolescent development, years of previous experience working with adolescents in different capacities, and strategic planning and preparation for collaborating with a community of youth, there were challenges. We struggled to find specific solutions to engaging youth but attribute our success in part to the identification of YD as a theoretical guide to the work. CBPR with youth requires relentless attention to the developmental needs and capacities of youth; structural arrangements that acknowledge their limited autonomy and independence; the fine balance between preserving decision making authority while providing needed structure and limit-setting; and a pathway to retain partners who become adults. We found that structuring the CBPR environment to be youth-friendly and relying on the principles of YD as well as CBPR helped us to successfully engage and sustain youth as full partners in the CBPR process. Providing opportunities for positive youth outcomes by building competencies among the youth; meeting universal youth needs; and building youth development competencies among staff and adults involved in the partnership helps the CBPR process. Ultimately, when we approached CBPR from a YD framework, we were able to better engage the youth in the CBPR process and do the work more efficiently and effectively.

We acknowledge that there is no one way to conduct CBPR; CBPR is an orientation to research wherein researchers and community members partner together. Our model may be useful for those interested in engaging youth as partners in CBPR, and in fact, may be helpful in any CBPR project that seeks to partner with vulnerable or underserved communities.