How historical trauma informs a community-based collaboration to prevent alcohol-exposed pregnancies in an urban AI/AN community: Practice-based evidence for developing culturally-driven processes

Public health research and interventions within AI/AN communities have often been implemented and results interpreted without reference to the effect of historical trauma and cultural genocide on these communities. This lack of awareness, along with a lack of integration of culturally-specific needs, has caused a loss of effective communication and trust among many AI/AN communities. Today, many interventions, community-planning processes and research practices continue to disregard or ignore AI/AN cultural needs.

We discuss the development of a community-based collaborative between AI/AN community members, community-based organizations and a local health department to prevent substance-exposed pregnancies in AI/AN women in Mutlnomah County, Oregon. The “story” of how historical trauma informed the development of this Collaborative is an important example of practice-based evidence for creating culturally-driven processes for community-based planning.

We will describe the rich and sometimes challenging process of bridging and building cultural paradigms in a public health intervention that requires close examination and acknowledgement of the present-day relationship with historical trauma. These processes are complicated when we recognize that the systems and agencies now seeking partnership with AI/AN communities often played a role in cultural genocide of Native people. Successful strategies for overcoming these difficult challenges will also be discussed.