Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities


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.

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    Indigenist research seeks to develop culturally centered, liberatory research methods and practices that are rooted in Indigenous epistemologies, ontologies, and axiologies as well as community aspirations in surviving and thriving beyond settler colonialism.


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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).

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Correspondence to Karina L. Walters.

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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.

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Informed consent was obtained from all individual participants included in each study described.

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Walters, K.L., Johnson-Jennings, M., Stroud, S. et al. Growing from Our Roots: Strategies for Developing Culturally Grounded Health Promotion Interventions in American Indian, Alaska Native, and Native Hawaiian Communities. Prev Sci 21, 54–64 (2020).

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  • Culturally grounded
  • Health promotion programs
  • American Indian, Alaska Native, Native Hawaiian, Indigenous
  • Indigenist research
  • Indigenous knowledge
  • Decolonizing methodologies