Academic–community partnership in Appalachia as having the highest (“a lot” rating) level of knowledge (44%, 93 of 211) of local industrial emissions, followed by environmental groups (39%, 84 of 217) and chemical industry offi­ cials (30%, 62 of 210; Figure 3C). As evident in Figure 3A, respondents identified almost all categories, except news reporters, environ­ mental groups, and Web sites, as sources from which they receive “no” information. Survey respondents have “no” trust for the informa­ tion received from officials from the chemical industry (43%, 90 of 208); local (20%, 43 of 212), state (17%, 37 of 213), and federal gov­ ernment (20%, 44 of 214); people they know who work for local industry (16%, 34 of 211); and church meetings and/or announcements (15%, 30 of 204; Figure 3B). Codevelopment of grant applications. After the pilot studies, we began planning two NIEHS grant applications: a CBPR award and Partners in Research (PIR) award. The CBPR grant would focus on scientifically addressing the community’s primary research question related to the neurobehavioral effects of Mn on children, and the PIR grant would focus on furthering the academic–community reciprocal research relationship and build on the risk communication findings from the communityw­ide survey. The community partners were very involved in the planning process. Multiple in­person meetings were held with the aca ­ demic research team and community partners in Marietta to discuss what a larges­cale study would look like and what resources the com­ munity offered that could be used for the study. Although the academic research team and UC environmental health researchers developed the hypothesis, specific aims, and research meth­ odology for the grant application, the input of the community, in terms of what would be feasible and appropriate, was extremely impor­ tant in the development of the application. For instance, two CAB members are Marietta College faculty members who provided a con­ venient study location and oversight of under­ graduate and graduate students participating in data collection. Other resources in the com­ munity included networks with media outlets to engage the community in the ongoing study through local media outlets and subject recruit­ ment ideas. The community partners were also involved in identifying research questions. For instance, the CAB and community part­ ners were very concerned about Mn exposure through ingestion of locally grown and raised food products, such as fruits and vegetables, milk and beef. To address this, potential local exposure sources have been incorporated into a nutritional questionnaire developed by an expert in nutrition science. Involvement of the community partners was also very important during the develop­ ment of the R03 proposal, which evaluates the effects of providing reciprocal environmen­ tal health education for local media, health care providers, UC journalism and technical writing students, and community members. The community partners were instrumental in identifying the target populations and in determining the education topics and formats for each group. The community’s role in plan­ ning the research was critical in implementing CBPR principles and helped to ensure that the research agenda would be community driven and that the results would be dissemi­ nated in culturally appropriate, accessible, and useful formats. Discussion Through the development and conduct of the pilot research study, we were able to identify the assets of the community for an epide­ miologic study and determine the feasibility of a large­scale research project in partner ­ ship with the community. We were also able to build the capacity of the community for research through their participation in plan­ ning and conducting the core epidemiologic study. Data were presented to the CAB for their interpretation of the findings and discus­ sion of how, when, and where to share the findings with the communitya­tl­arge. The relationship between the community and university researchers was strengthened through their collaboration on the sur­ vey research project. The CAB helped build the questionnaire, including identifying community­anticipated responses to closed­ ended questions. The initial draft of the ques­ tionnaire developed by the university team is a shadow of the final survey product. The input from the community dramatically changed the survey questions and possible responses. Through both of these jointly conducted research efforts, mutual trust and respect for each other’s expertise grew. As a result of the multiple meetings held in the community and university campus, along with attending sev­ eral community events, the academic research team researcher and her investigative team became part of the Marietta community, and the NCA director and other CAB members became an essential part of the university research effort (the outcome of a productive, bidirectional relationship). The survey also provided an outlet for community members to voice their thoughts and perceptions about local air quality and their interest and willing­ ness to participate in a research study before the development of a research proposal. This opened the dialogue between the community and the academic institution, thereby height­ ening the quality of the research. The CAB’s views and concerns about air quality were echoed in the community­wide survey. The survey respondents, CAB, and research community were in agreement that Environmental Health Perspectives • volume 119 | number 10 | October 2011 young children and the elderly are highly susceptible, at­risk populations for exposure to air pollution and are the populations on which research should focus (Hong et al. 2007; Saric and Piasek 2000; Tasker et al. 2003). Although not trained in environ­ mental health science, community members demonstrated their native understanding of the problems they faced because they were able to identify at­risk populations that warrant further research. Their perception of air­quality–related health outcomes pre­ dominantly included those related to respira­ tory function. These community perceptions match scientific findings of positive associa­ tions between airborne particulate matter and pulmonary health effects. Their uncertainty of the relationship between Mn and health effects is also accurate; scientifically, little research has been conducted on the potential harmful effects of Mn on other organ systems, including the lungs (Barceloux 1999; Roth and Garrick 2003). Further, this evidence that community members’ native understanding of environmental health problems coincide with scientific evidence supports the concept that community members should be an inte­ gral part of the initial phases of the research process, including the determination of the research study questions and design. Survey respondents reported their concern about the quality of air (91% concerned to very concerned), and they perceived the air to have a direct impact on their and their chil­ dren’s health (93% and 94%, respectively). This finding supports the claim by Elliott et al. (1999) that the “relationships between an environmental exposure (e.g., air pollution) and health (e.g., respiratory effects) are medi­ ated by perceptions of the ‘exposure’ (e.g., air quality), which are in turn influenced by a host of both individual and contextual factors.” Of the respondents, > 90% also could identify spe­ cific health effects they perceived to be strongly linked to air quality (asthma, cough, eye irrita­ tion, throat irritation, and difficulty breathing). This finding of a relationship between people’s risk perceptions and air quality, especially when people have illnesses that could be caused by pollution (e.g., respiratory problems), is not new (Bickerstaff and Walker 2001; Elliott et al. 1999; El­Zein et al. 2006). Because respon­ dents were able to identify related conse­ quences of poor air, we wanted to know how they identified poor air. One way people make risk perception judgments is through their per­ sonal or sensory encounters or, as termed by Scammell et al. (2009), their use of “tangible evidence.” More than 70% of the respondents listed the smell and sight of the air as ways they perceived poor air quality. The community’s identification of cancer as a leading community health concern (80%) is not surprising because cancer mortality in 1369