A Framework for Culturally Relevant Online Learning: Lessons from Alaska’s Tribal Health Workers

  • Katie Cueva
  • Melany Cueva
  • Laura Revels
  • Anne P. Lanier
  • Mark Dignan
  • K. Viswanath
  • Teresa T. Fung
  • Alan C. Geller


Culturally relevant health promotion is an opportunity to reduce health inequities in diseases with modifiable risks, such as cancer. Alaska Native people bear a disproportionate cancer burden, and Alaska’s rural tribal health workers consequently requested cancer education accessible online. In response, the Alaska Native Tribal Health Consortium cancer education team sought to create a framework for culturally relevant online learning to inform the creation of distance-delivered cancer education. Guided by the principles of community-based participatory action research and grounded in empowerment theory, the project team conducted a focus group with 10 Alaska Native education experts, 12 culturally diverse key informant interviews, a key stakeholder survey of 62 Alaska Native tribal health workers and their instructors/supervisors, and a literature review on distance-delivered education with Alaska Native or American Indian people. Qualitative findings were analyzed in Atlas.ti, with common themes presented in this article as a framework for culturally relevant online education. This proposed framework includes four principles: collaborative development, interactive content delivery, contextualizing learning, and creating connection. As an Alaskan tribal health worker shared “we’re all in this together. All about conversations, relationships. Always learn from you/with you, together what we know and understand from the center of our experience, our ways of knowing, being, caring.” The proposed framework has been applied to support cancer education and promote cancer control with Alaska Native people and has motivated health behavior change to reduce cancer risk. This framework may be adaptable to other populations to guide effective and culturally relevant online interventions.


Community-based participatory action research Community health workers Alaska Native Health disparities Program planning Online learning Health promotion 



This work is part of “Distance Education to Engage Alaskan Community Health Aides in Cancer Control,” supported by the National Cancer Institute of the National Institutes of Health (NIH), award R25CA186882. Theoretical understandings and manuscript preparation and submission were supported by NIH grant 3R25CA057711. The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the views of the NIH.


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Copyright information

© American Association for Cancer Education 2018

Authors and Affiliations

  1. 1.Institute of Social and Economic ResearchUniversity of Alaska AnchorageAnchorageUSA
  2. 2.Community Health Aide ProgramAlaska Native Tribal Health ConsortiumAnchorageUSA
  3. 3.Alaska Native Tribal Health ConsortiumAnchorageUSA
  4. 4.Department of Internal MedicineUniversity of Kentucky College of MedicineLexingtonUSA
  5. 5.Department of Social and Behavioral SciencesHarvard T.H. Chan School of Public HealthBostonUSA
  6. 6.Department of NutritionSimmons CollegeBostonUSA

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