A community-based, culturally grounded public health approach to health promotion and substance abuse prevention in a Tribal community

American Indian and Alaska Natives (AIAN) have been the victims of centuries of harmful state and federal policies including removal and relocation, eradication, assimilation and termination. These policies have resulted in alarming rates of health disparities for AIAN communities, including problems associated with alcohol and drug abuse. However, self-determination policies and a cultural resurgence are allowing AIAN communities to build on their traditional strengths, resources, and resiliencies to improve health outcomes. AIAN communities are additionally becoming informed gatekeepers with regards to allowing outside researchers into their communities. Most AIAN communities now require that researchers respect Native wisdom, are culturally competent, and that they give back to the communities in which the research takes place. Community Based Participatory Research and Tribal Participatory Research (CBPR/TPR) are two respectful and scientifically sound methodologies that are suited to conducting research with AIAN communities. This study used CBPR/TPR in collaboration with a rural, reservation Tribe to: 1) identify substance abuse prevention and a sense of belonging to the community as the health disparity issue of greatest concern; 2) develop an intervention that incorporated traditional Tribal values, practices, and beliefs; 3) develop outcome measures that include outcomes of importance to the Tribal community; and 4) begin piloting of the intervention and assessments. This project also developed measures to assess the quality of the collaborative relationship between research partners. This presentation will include lessons learned from both the Tribal and University perspectives and how this can, and should, inform health care policy for AIAN communities.