Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities
- 192 Downloads
Given the paucity of empirically based health promotion interventions designed by and for American Indian, Alaska Native, and Native Hawaiian (i.e., Native) communities, researchers and partnering communities have had to rely on the adaptation of evidence-based interventions (EBIs) designed for non-Native populations, a decidedly sub-optimal approach. Native communities have called for development of Indigenous health promotion programs in which their cultural worldviews and protocols are prioritized in the design, development, testing, and implementation. There is limited information regarding how Native communities and scholars have successfully collaborated to design and implement culturally based prevention efforts “from the ground up.” Drawing on five diverse community-based Native health intervention studies, we describe strategies for designing and implementing culturally grounded models of health promotion developed in partnership with Native communities. Additionally, we highlight indigenist worldviews and protocols that undergird Native health interventions with an emphasis on the incorporation of (1) original instructions, (2) relational restoration, (3) narrative-[em]bodied transformation, and (4) indigenist community-based participatory research (ICBPR) processes. Finally, we demonstrate how culturally grounded interventions can improve population health when they prioritize local Indigenous knowledge and health-positive messages for individual to multi-level community interventions.
KeywordsCulturally grounded Health promotion programs American Indian, Alaska Native, Native Hawaiian, Indigenous Indigenist research Indigenous knowledge Decolonizing methodologies
This article was supported by the following grants: (1R01ES022583) Residential Wood Smoke Interventions Improving Health in Native American Populations; (R01HL126577) KaHOLO Project: Preventing Cardiovascular Disease in Native Hawaiians; (RO1DA035143) Intertribal Talking Circle for the Prevention of Substance Abuse in Native Youth; (R01DA037176) Yappalli Choctaw Road to Health; (R01AA023754) Qungasvik (Toolbox): Prevention of Alcohol/Suicide Risk in Alaska Native Youth; and the NIMHD Comprehensive Center of Excellence Award (P60MD006909).
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
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. This article does not contain any studies with animals performed by any of the authors.
Informed consent was obtained from all individual participants included in each study described.
- Alarcón, F. X. (2008). El poder de la palabra/The power of the word: Toward a Nahuatl/Mestizo consciousness. In M. K. Nelson (Ed.), Original instructions: Indigenous teachings for a sustainable future (pp. 265–287). Rochester: Collective Heritage Institute, Bear and Company.Google Scholar
- Cajete, G. (2014). Re-building sustainable Indigenous communities: Applying Native science. In Johnson, J. T., Pualani Louis, R., & Kliskey, A. (Eds.): Weaving Indigenous and sustainability sciences: Diversifying our methods. (WIS2DOM) Workshop. National Science Foundation: Arctic Social Sciences Program. (pp. 36–43).Google Scholar
- Castellano, M. B. (2004). Ethics of Aboriginal research. Journal of Aboriginal Health, 98–114.Google Scholar
- Grossman, Z. (2014). Decolonizing landscapes: Unlikely alliances grow resilience at the grassroots. Pp. 52–55. In Johnson, J. T., Pualani Louis, R., & Kliskey, A. (Eds.): Weaving Indigenous and sustainability sciences: Diversifying our methods. (WIS2DOM) Workshop. National Science Foundation: Arctic Social Sciences Program.Google Scholar
- Kaholokula, J. K. (2007). Colonialism, acculturation, and depression among Kānaka Maoli of Hawai’i. In P. Culbertson, M. N. Agee, & C. Makasiale (Eds.), Penina Uliuli: Confronting challenges in mental health for Pacific Peoples (pp. 180–195). Honolulu: University of Hawai’I Press.Google Scholar
- Kaholokula, J. K., Look, M., Mabellos, T., Zhang, G., de Silva, M., … Sinclair, K. A. (2015). Cultural dance program improves hypertension management for Native Hawaiians and Pacific Islanders: A pilot randomized trial. Journal of Racial and Ethnic Health Disparities.Google Scholar
- Moreton-Robinson, A. (2000). Talkin’ up to the white women. St Lucia: University of Queensland Press.Google Scholar
- Nelson, M. K. (2008). Original instructions: Indigenous teachings for a sustainable future. Rochester: Bear & Company.Google Scholar
- Paikuli-Stride, M., Enos, E., & Minton, N. (2008). Taro roots run deep: Hawaiian restoration of sacred foods and communities. In M. K. Nelson (Ed.), Original instructions: Indigenous teachings for a sustainable future (pp. 304–317). Rochester: Collective Heritage Institute, Bear and Company.Google Scholar
- Patchell, B., Robbins, L., Hoke, M., & Lowe, J. (2012). Circular model of cultural tailoring: An intervention adaption. Journal of Theory Construction and Testing, 16, 45–51.Google Scholar
- Smith, L. (1999). Decolonizing methodologies: Research and Indigenous peoples. Dunedin: Canterbury University Press.Google Scholar
- Vizenor, E. (Ed.). (2008). Survivance: Narratives of Native presence. Lincoln: University of Nebraska Press.Google Scholar
- Wallerstein, N., Duran, B., Oetzel, J., & Minkler, M. (Eds.). (2018). Community-based participatory research for health: Advancing social and health equity. San Francisco: Jossey-Bass.Google Scholar
- Walters, K. L., Stately, A., Evans-Campbell, T., et al. (2009). “Indigenist” collaborative research efforts in Native American communities. In A. Stiffman (Ed.), The field research survival guide (pp. 146–173). Oxford University Press.Google Scholar
- Walters, K. L., Mohammed, S. A., Evans-Campbell, T., Beltrán, R. E., Chae, D. H., & Duran, B. (2011). Bodies don’t just tell stories, they tell histories: Embodiment of historical trauma among American Indians and Alaska Natives. Dubois Review, 8, 179–189.Google Scholar
- Wilson, S. (2001). Research is ceremony. Halifax: Fernwood Publishing.Google Scholar