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We see several conditions illuminated at Tubman and at other sites that likely influenced the impact and sustainability of PAR, and that may be informative for the conceptualization and implementation of PAR in other school settings.
It is also important to recognize that adults' effective implementation of PAR requires substantial experience and support.
To our knowledge, however, the field is lacking specific guidelines about how to assess the processes that reflect a high-quality implementation of PAR.
Problems with these instruments underscore the challenge of translating research findings into clinical practice and achieving more widespread implementation of PAR schemes [ 17].
It also provided an elective "space" for the implementation of PAR in low-performing schools, where implementation in regular academic classes would not have been feasible due to the great demands on instructional time.
Processes that promote a high-quality implementation of PAR but are not unique to it include: expansion of the social network of the youth, opportunities and guidance for working in groups to achieve goals, and the development of skills to communicate with other youth and adult stakeholders.
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We focus here on Year 1 of the collaborative project, a pilot phase in the overall study, in which our university-based team consulted with a CBO to support the initial implementation of the PAR project in an elective peer counseling class at Tubman and at five high school sites.
The participatory action research (PAR) approach [ 25, 40] was adopted in the design and implementation of the EMPOWER-PAR intervention to ensure that the primary care providers involved in this study are empowered to choose between actions within their constraints to improve their patients' health outcomes.
It is evident that the MVAPACK implementation of icoshift performs on par with published results from the existing implementation by Savorani et al. Similarly, MVAPACK includes a wide variety of normalization, scaling, and denoising methods routinely used by the metabolomics community for pretreatment of NMR data sets.
This silence around the creation of PAR makes it appear as though PAR is simply used, rather than developed over time with varying degrees of implementation.
The tools available today for studying these injuries are not up to par with the latest implementation of restraint systems and airbags.
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