Promoting culture, a social determinant of health for native americans is a must to promote health equity and social justice.

Paul Masotti, PhD1, John Dennem, MA, CADC-II, USN(Ret.), PhD Candidate2, Janet King, MSW1, Karina Bañuelos, M.A.1, Gloryanna Valerio-Leonce1, Shir Hadani, MSc, BSc.1, Chirag Patel1 and Cheyenne Seneca, BA1
(1)Native American Health Center, Oakland, CA, (2)Claremont Graduate University, Lennox, CA

APHA's 2020 VIRTUAL Annual Meeting and Expo (Oct. 24 - 28)

Background: The Culture is Prevention Project was initiated by 6 Urban Indian Health Organizations in response to concerns about the lack of culturally informed methods for evaluating SAMHSA funded programs.

Concerns included: a) lack of strength-based approaches; b) that government/western medical model responses to Indigenous/Native health have not proven to be very effective; and c) lack of understanding by the dominant culture that for Native Americans, culture is an important social determinant of health.

Methods: This CBPR project features 6 methodological phases where in Phases 3-4 the Cultural Connectedness Scale-California (CCS-CA) was developed and validated in a sample of 344 urban Native Americans with representation of 105 Tribes. The CCS-CA (29 items and 3 sub-scales: identity, traditions, spirituality) was paired with the Herth Hope Index (HHI) as a proxy for mental health/well-being. In Phase 5, we are recruiting adult Native Americans (N ≈ 400) to investigate the predictive properties of the CCS-CA and to further explore Native/Indigenous culture as a social determinant of health for: chronic disease, quality of life, depression, substance abuse and domestic violence.

Results/Implications: Confirmatory factor analysis indicated a good comparative fit index (CFI = .913) adequate factor loadings and good scale score reliabilities (Cronbach Alpha = .941). Correlations between CCS-CA (sub-scales) the HHI were significant and in the expected direction (increased cultural connectedness was associated with increased mental health). We conclude the CCS-CA is valid and reliable and that Native American/Indigenous culture is a social determinant of mental health/well-being. In this presentation we highlight results of the psychometric testing and present results from Phase 5. We will support the assertions/public health implications: a) since culture is a social determinant of health, that can be measured, the degree of cultural connectedness can then be considered an important program objective and viable outcome measure; and b) given that the loss of culture has negatively impacted the health/well-being of Native/Indigenous peoples, the degree of reclaimed culture or increased cultural connectedness may be a more important program objective or outcome measure, for Native American/Indigenous people, than the reductions in frequency of some risky behaviors.

Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Public health or related public policy Public health or related research Systems thinking models (conceptual and theoretical models), applications related to public health