Tale of Eight Researchers: A Process Evaluation of a Blended RCT-CBPR Sexual Risk Reduction Trial

INTRODUCTION: There is very little in the published literature that evaluates the process of conducting complex interventions that merge elements of community-based participatory research (CBPR) with traditional randomized control trial (RCT) methodology to deliver a sexual risk reduction intervention to active stimulant users. Process evaluation rarely addresses questions related to the challenges of implementing a research protocol that is context dependent on the social environment such as: How do you retain protocol fidelity? What is the basis or role of community involvement: is it just recruitment or are they empowered to identify the key problems/aims of the study? The importance of gaining a better understanding of these issues is needed to ensure effective use of CBPR strategies to enhance the impact of behavioral health research and guarantee successful university-community collaborations. METHODS: Semi-structured in-depth interviews were conducted by the first author. With the exception of one field staff member who could not be contacted for a second interview, and the principal investigator who received 3 interviews, each member of the study team received two interviews for a total of 16 interviews.  RESULTS AND CONCLUSIONS: Our findings demonstrate that the merging of element of a CBPR with RCT can result in the generation a certain level of methodological tension. As expected, this tension is in part related to the epistemological balancing act that researchers must be ready to perform in order to create a space in which CBPR methodologies can thrive. The extent to which elements of CBPR were able to thrive within the context of the complex RCT seem to depend on the research teams’ commitment to a high level of scientific integrity and to providing study participants with the best possible efficacious research experience they could devise. In addition, the research team took extra steps to protect the integrity of the RCT (i.e., blinding, Respondent Driven Sampling), while at the same time providing a high measure of respect for the field staff and community.