Prevention Science

, Volume 21, Supplement 1, pp 74–82 | Cite as

Prevention Research with Indigenous Communities to Expedite Dissemination and Implementation Efforts

  • Valarie Blue Bird JerniganEmail author
  • Elizabeth J. D’Amico
  • Joseph Keawe’aimoku Kaholokula


Effectively translating evidence-based interventions into clinic and community settings is an increasing priority for health researchers. The successful dissemination and implementation (D&I) of interventions found efficacious ensures that major health funders such as the National Institutes of Health can demonstrate a return on investment in biomedical and behavioral research and that all populations receive maximum benefit from scientific discoveries. However, the products of research efficacy trials, the evidence-based interventions, are rarely designed with D&I in mind, rendering these interventions fundamentally misaligned with real-world settings. Further, while some evidence-based interventions have been successfully adapted for implementation in indigenous communities, few such examples have been published. Literature regarding the adoption and implementation of evidence-based interventions in indigenous communities is scarce, and the feasibility of scaling up successful interventions is poorly understood, potentially widening health disparities. The Intervention Research to Improve Native American Health (IRINAH) partners are generating efficacy data on community-responsive and engaged interventions that are also designed to facilitate D&I efforts, reducing the time between research to practice to benefit indigenous communities, should these interventions prove effective. In this manuscript, we provide an overview and key challenges of D&I science with indigenous communities. We then use IRINAH case studies to highlight strategies that IRINAH partners are using to plan for the scale-up and implementation of the studies. We conclude with recommendations to inform the next phase of IRINAH research efforts.


Indigenous Health disparities Community-based participatory research Dissemination and implementation 



This Supplemental Issue of Prevention Science was supported through funds from the National Cancer Institute (NCI). Support for this paper included grants from NHLBI (R01HL117729, Jernigan, PI; R01HL126577, Kaholokula, PI), NIMHD (R01MD011266, Jernigan, PI), and NIAAA (R01AA022066, Dickerson and D’Amico, MPIs).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The studies referenced in this article did not include animals.

Informed Consent

Informed consent was obtained from all individual participants included in these studies.


  1. Blue Bird Jernigan, V., Peercy, M., Branam, D., Saunkeah, B., Wharton, D., Winkleby, M., et al. (2015). Beyond health equity: Achieving wellness within American Indian and Alaska Native communities. American Journal of Public Health, 105, S376–S379.CrossRefPubMedCentralGoogle Scholar
  2. Blue Bird Jernigan, V., Wetherill, M. S., Hearod, J., Jacob, T., Salvatore, A. L., Cannady, T., et al. (2017). Food insecurity and chronic diseases among American Indians in rural Oklahoma: The THRIVE study. American Journal of Public Health, 107, 441–446.CrossRefPubMedCentralGoogle Scholar
  3. Brown, R., Dickerson, D., & D’Amico, E. (2016). Cultural identity among urban American Indian/Alaska Native youth: Implications for alcohol and drug use. Prevention Science, 17, 852–861.CrossRefPubMedCentralGoogle Scholar
  4. Brownson, R., Colditz, G., & Proctor, E. (Eds.). (2012). Dissemination and implementation research in health: Translating science to practice. New York, NY: Oxford University Press.Google Scholar
  5. Cochran, P., Marshall, C., Garcia-Downing, C., Kendall, E., Cook, D., McCubbin, L., et al. (2008). Indigenous ways of knowing: Implications for participatory research and community. American Journal of Public Health, 98, 22–27.CrossRefPubMedCentralGoogle Scholar
  6. Delafield, R., Hermosura, A., Ing, C., Hughes, C., Palakiko, D., Dillard, A., et al. (2016). A community-based participatory research guided model for dissemination of evidence-based interventions. Progress in Community Health Partnerships: Research, Education, and Action, 10, 585.CrossRefGoogle Scholar
  7. Dickerson, D., Johnson, C., Castro, C., Naswood, E., & Leon, J. (2012a). Community voices: Integrating traditional healing services for urban American Indians/Alaska Natives in Los Angeles County: Learning collaborative summary report, February 2012. Los Angeles, CA: Los Angeles County Department of Mental Health.Google Scholar
  8. Dickerson, D., Robichaud, F., Teruya, C., Nagaran, K., & Hser, Y. (2012b). Utilizing drumming for American Indians/Alaska Natives with substance use disorders: A focus group study. The American Journal of Drug and Alcohol Abuse, 38, 505–510.CrossRefPubMedCentralGoogle Scholar
  9. Dickerson, D., Brown, R., Johnson, C., Schweigman, K., & D’Amico, E. (2016). Integrating motivational interviewing and traditional practices to address alcohol and drug use among urban American Indian/Alaska Native youth. Journal of Substance Abuse Treatment, 65, 26–35.CrossRefPubMedCentralGoogle Scholar
  10. Dionne, R., Davis, B., Sheeber, L., & Madrigal, L. (2009). Initial evaluation of a cultural approach to implementation of evidence-based parenting interventions in American Indian communities. Journal of Community Psychology, 37, 911–921.CrossRefGoogle Scholar
  11. Dutta, M. J. (2007). Communicating about culture and health: Theorizing culture-centered and cultural sensitivity approaches. Communication Theory, 17, 304–328.CrossRefGoogle Scholar
  12. Fixsen, D., Naoom, S., Blasé, K., Friedman, R., & Wallace, F. (2005). Implementation research: A synthesis of the literature (FMHI Publication No. 231). Tampa, FL: University of South Florida Louis de la Parte Florida Mental Health Institute.Google Scholar
  13. Gilder, D., Luna, J., Calac, D., Moore, R., Monti, P., & Ehlers, C. (2011). Acceptability of the use of motivational interviewing to reduce underage drinking in a Native American community. Substance Use & Misuse, 46, 836–842.CrossRefGoogle Scholar
  14. Glasgow, R. (2003). Translating research to practice: Lessons learned, areas for improvement, and future directions. Diabetes Care, 26, 2451–2456.CrossRefGoogle Scholar
  15. Glasgow, R., Vogt, T., & Boles, S. M. (1999). Evaluating the public health impact of health promotion interventions: The RE-AIM framework. American Journal of Public Health, 89, 1322–1327.CrossRefPubMedCentralGoogle Scholar
  16. Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: The National Academies Press.Google Scholar
  17. Jernigan, V. (2010). Community-based participatory research with Native American communities: The chronic disease self-management program. Health Promotion Practice, 11, 888–899.CrossRefGoogle Scholar
  18. Jernigan, V., & Lorig, K. (2011). The internet diabetes self-management workshop for American Indians and Alaska Natives. Health Promotion Practice, 12, 261–270.CrossRefGoogle Scholar
  19. Jernigan, V., Burkhart, M., Magdalena, C., Sibley, C., & Yepa, K. (2014). The implementation of a participatory manuscript development process with Native American tribal awardees as part of the CDC Communities Putting Prevention to Work initiative: Challenges and opportunities. Preventive Medicine, 67, S51–S57.CrossRefGoogle Scholar
  20. Jiang, L., Manson, S., Beals, J., Henderson, W., Huang, H., Acton, K., et al. (2013). Translating the diabetes prevention program into American Indian and Alaska Native communities. Diabetes Care, 36, 2027–2034.CrossRefPubMedCentralGoogle Scholar
  21. Kaholokula, J., Nacapoy, A., & Dang, K. (2009). Social justice as a public health imperative for Kanaka Maoli. AlterNative: An International Journal of Indigenous Peoples, 5, 117–137.CrossRefGoogle Scholar
  22. Kaholokula, J. K., Wilson, R. E., Townsend, C. K. M., Zhang, G., Chen, J., Yoshimura, S., et al. (2014). Translating the Diabetes Prevention Program in Native Hawaiian and Pacific Islander Communities: The PILI ‘Ohana Project. Translational Behavioral Medicine, 4, 149–159.CrossRefPubMedCentralGoogle Scholar
  23. Kaholokula, J., Look, M., Wills, T., de Silva, M., Mabellos, T., Seto, T., et al. (2017a). Kā-HOLO project: A protocol for a randomized controlled trial of a Native cultural dance program for cardiovascular disease prevention in Native Hawaiians. BMC Public Health, 17, 321.CrossRefPubMedCentralGoogle Scholar
  24. Kaholokula, J., Look, M., Mabellos, T., Zhang, G., de Silva, M., Yoshimura, S., et al. (2017b). Cultural dance program improves hypertension management for Native Hawaiians and Pacific Islanders: A pilot randomized trial. Journal of Racial and Ethnic Health Disparities, 4, 35–46.CrossRefPubMedCentralGoogle Scholar
  25. Knowler, W., Barrett-Connor, E., Fowler, S., Hamman, R., Lachin, J., Walker, E., et al. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346, 393–403.CrossRefPubMedCentralGoogle Scholar
  26. Look, M., Maskarinec, G., de Silva, M., Seto, T., Mau, M., & Kaholokula, J. (2014). Kumu Hula perspectives on health. Hawai'i Journal of Medicine & Public Health, 73, 21–25.Google Scholar
  27. Lorig, K., Sobel, D., Ritter, P., Laurent, D., & Hobbs, M. (2001). Effect of a self-management program on patients with chronic disease. Effective Clinical Practice, 4, 256–262.PubMedPubMedCentralGoogle Scholar
  28. Lorig, K., Ritter, P., Laurent, D., Plant, K., Green, M., Jernigan, V., et al. (2010). Online diabetes self-management program. Diabetes Care, 33, 1275–1281.CrossRefPubMedCentralGoogle Scholar
  29. Miller, W., & Rollnick, S. (2012). Motivational interviewing: Helping people change. New York: NY. Guilford Press.Google Scholar
  30. National Institutes of Health. (2016). Dissemination and implementation research in health. Retrieved May 16 from
  31. National Research Council and Institute of Medicine. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: National Academies of Sciences, Engineering, and Medicine.Google Scholar
  32. Norris, T., Vines, P., & Hoeffel, E. (2012). The American Indian and Alaska Native population: 2010. Washington, DC: US Department of Commerce, Economics and Statistics Administration, US Census Bureau.Google Scholar
  33. Persaud, N., & Mamdani, M. M. (2006). External validity: The neglected dimension in evidence ranking. Journal of Evaluation in Clinical Practice, 12, 450–453.CrossRefGoogle Scholar
  34. Pukui, M. K. (1983). ‘Ōlelo Noeau: Hawaiian proverbs and poetical sayings. Bishop Museum Special Publication No. 71, Honolulu, HI: Bishop Museum Press.Google Scholar
  35. Savaya, R., Spiro, S., & Elran-Barak, R. (2008). Sustainability of social programs: A comparative case study analysis. American Journal of Evaluation, 29, 478–493.CrossRefGoogle Scholar
  36. Usagawa, T., Look, M., de Silva, M., Stickley, C., Kaholokula, J., Seto, T., et al. (2014). Metabolic equivalent determination in the cultural dance of Hula. International Journal of Sports Medicine, 35, 399–402.PubMedGoogle Scholar
  37. Venner, K., Feldstein, S., & Tafoya, N. (2007). Helping clients feel welcome: Principles of adapting treatment cross-culturally. Alcoholism Treatment Quarterly, 25, 11–30.CrossRefGoogle Scholar
  38. Villanueva, M., Tonigan, J., & Miller, W. (2007). Response of Native American clients to three treatment methods for alcohol dependence. Journal of Ethnicity in Substance Abuse, 6, 41–48.CrossRefGoogle Scholar
  39. Walker, R., & Bigelow, D. (2015). Evidence-informed, culture-based interventions and best practices in American Indian and Alaska Native communities. In P. Nathan & J. Gorman (Eds.), A guide to treatments that work (pp. 23–54). New York: NY. Oxford University Press.Google Scholar
  40. Wallerstein, N., & Duran, B. (2010). Community-based participatory research contributions to intervention research: The intersection of science and practice to improve health equity. American Journal of Public Health, 100, S40–S46.CrossRefPubMedCentralGoogle Scholar
  41. Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., et al. (2008). Bridging the gap between prevention research and practice: The interactive systems framework for dissemination and implementation. American Journal of Community Psychology, 41, 171–181.CrossRefPubMedCentralGoogle Scholar

Copyright information

© Society for Prevention Research 2018

Authors and Affiliations

  1. 1.Center for Indigenous Health Research and ActionUniversity of Oklahoma Health Sciences CenterTulsaUSA
  2. 2.RAND CorporationSanta MonicaUSA
  3. 3.Department of Native Hawaiian Health, John A. Burns School of MedicineUniversity of HawaiiHonoluluUSA

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