Capacity for Collaboration: A Call to Advance Equity through Honoring Indigenous Knowledge and Healing

Introduction: Indigenous youth and young adults endure some of the highest rates of physical and mental health problems in the United States compared to their non-Indigenous counterparts. Colonization, oppression, and discrimination play a substantial role in these inequitable disease rates. However, culture (e.g., identity, participation, and connection) relates to the prevention of and recovery from illness in Indigenous populations. The Remember the Removal program aims to teach Indigenous youth and young adults tribally specific culture, history, and language to put them on a trajectory to become informed and culturally connected community leaders. We examined the program’s effects on health. Method: Thirty Remember the Removal program participants, mainly young adults, completed surveys four times: before the program’s start, at the end of the training period, at the program’s end, and at a six-month follow-up. Various indicators of physical, mental, spiritual, and cultural health and well-being were measured at each time period. Paired t-tests were completed to compare baseline scores to each subsequent time interval. Results: At program completion, and as indicated with an asterisk at the six month follow-up, participants had statistically significantly improved diet and exercise measures (e.g., reduced sugary, salty, and fatty foods, reduced soda consumption, increased fruit consumption, and improved self-efficacy for exercise), improved mental health indicators (e.g., reduced stress, anxiety, depression*, anger*, post-traumatic stress disorder, and microaggressions*, and improved positive mental health) and improved social and cultural connection (e.g., social support, Cherokee identity*, Cherokee values). Discussion: This is one of the first quantitative studies to demonstrate the profound effects that cultural learning and connection have on the health and well-being of Indigenous people and practices. It also demonstrates the specificity and effectiveness of a program created by and for tribal citizens. Future programs with Indigenous populations should work to center cultural connection and ensure that programs are created and directed by tribal community members.

Section: Discussionmentioning

confidence: 99%

The Health Effects of a Cherokee Grounded Culture and Leadership Program

Lewis

Smith

Wildcat

et al. 2022

“…Lastly, research evaluating culturally safe interventions is greatly needed in the family violence literature, and thoughtful, Indigenous-driven evaluation research that respects Indigenous knowledge and cultural practices can be healing and promote health equity [ 93 ]. Only three studies integrated or reported on measures of evaluation for their cultural safety intervention [ 44 , 59 , 73 ], and one study framed their work within the purview of quality improvement [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Indigenous Cultural Safety in Recognizing and Responding to Family Violence: A Systematic Scoping Review

Allice

Acai

Ferdossifard

et al. 2022

This systematic scoping review synthesizes the recommended approaches for providing culturally safe family violence interventions to Indigenous peoples in health care and social service settings. A total of 3783 sources were identified through our electronic database searches, hand-searching of Indigenous-focused journals, and backward and forward citation chaining. After screening those sources in duplicate, 28 papers were included for synthesis in June 2020. Forward citation chaining of these 28 included articles in June 2022 identified an additional 304 possible articles for inclusion; following the screening of those 304 articles, an additional 6 were retained in the review. Thus, a total of 34 articles were included for data extraction and narrative synthesis. Initial results were presented to members of the Six Nations of the Grand River Youth Mental Wellness Committee, and their feedback was incorporated into our inductive organization of findings. Our findings represent three thematic areas that reflect key recommendations for health care and social service provision to Indigenous families for whom family violence is a concern: (1) creating the conditions for cultural safety; (2) healing at the individual and community level; and (3) system-level change. These findings demonstrate the need to center Indigenous peoples and perspectives in the development and implementation of cultural safety approaches, to acknowledge and address historically contingent causes of past and present family violence including colonization and related state policies, and to transform knowledge and power relationships at the provider, organization, and government level.

“…TTUP I data generated the above-mentioned 59% prevalence estimate of smoking among Minnesota American Indians. Additionally, TTUP I showed that nearly three-fourths (71%) of Minnesota American Indians had ever used tobacco for ceremonial prayer or in a sacred way [9]-data that have been used by tribes (e.g., "Two Tobacco Ways" Principle Guiding Work in Tribal Nations [13]) and public health organizations (e.g., Clearway Minnesota's "Keep Tobacco Sacred" campaign) to make the case that tobacco control, which includes surveillance efforts, cannot be conducted without acknowledging the sacred role of tobacco in American Indian culture.…”

Section: Introductionmentioning

confidence: 99%

Tribal Tobacco Use Project II: Planning, Implementation, and Dissemination Using Culturally Relevant Data Collection among American Indian Communities

Roland

Anderson

Carroll

et al. 2022

American Indians have substantially higher commercial tobacco-related cancer rates when compared to the general population. To effectively combat commercial tobacco-related cancer, it is important that tribal nations obtain current and accurate community-specific data on commercial tobacco use and exposure-related attitudes and behaviors. With the goal to collect, synthesize, and disseminate data on tobacco use, including the role traditional tobacco plays among American Indian people, the American Indian Cancer Foundation (AICAF) and various stakeholders developed and implemented the Tribal Tobacco Use Project II (TTUP II) during 2018–2021. Building upon its predecessor, the Tribal Tobacco Use Project I (TTUP I), TTUP II used principles of community-based participatory research and culturally appropriate methods, such as Reality-Based Research, in partnership with tribal nations. We describe the TTUP II rationale, methods for participant recruitment and data collection, emphasizing the importance of using culturally relevant survey items to disentangle commercial tobacco use from traditional tobacco use. American Indian traditional tobacco is viewed as medicine in these communities with a unique socio-cultural context that must be addressed when engaging in commercial tobacco control efforts in American Indian communities. This approach may be useful to other tribal nations who are interested in conducting culturally relevant tobacco surveillance efforts.