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Encompassing Cultural Contexts Within Scientific Research Methodologies in the Development of Health Promotion Interventions
Open accessAbstract
American Indians/Alaska Natives/Native Hawaiians (AI/AN/NHs) disproportionately experience higher rates of various health conditions. Developing culturally centered interventions targeting health conditions is a strategy to decrease the burden of health conditions among this population. This study analyzes characteristics from 21 studies currently funded under the Interventions for Health Promotion and Disease Prevention in Native American (NA) Populations program among investigators currently funded under this grant mechanism. Four broad challenges were revealed as critical to address when scientifically establishing culturally centered interventions for Native populations. These challenges were (a) their ability to harness culture-centered knowledge and perspectives from communities; (b) their utilization of Indigenous-based theories and knowledge systems with Western-based intervention paradigms and theories; (c) their use of Western-based methodologies; and (d) their cultural adaptation, if based on an evidence-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches were very commonly used to finalize the development of interventions. Various Indigenous-based theories and knowledge systems and Western-based theories were used in the methodologies employed. Cultural adaptations were made that often used formative mixed qualitative and quantitative methods. Illustrative examples of strategies used and suggestions for future research are provided. Findings underscored the importance of CBPR methods to improve the efficacy of interventions for AI/AN/NH communities by integrating Indigenous-based theories and knowledge systems with Western science approaches to improve health.
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“Fourth, culturally-informed approaches explicitly address historical and intergenerational trauma, which are key drivers of substance use in AI/AN communities (Brave Heart & DeBruyn, 1998; Dickerson et al., 2020).”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Dickerson et al., 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“To date there has been insufficient exploration of the barriers that communities face in adapting, implementing, and sustaining substance use prevention programs (Dickerson et al., 2020; Raghavan et al., 2008).”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Dickerson et al., 2020
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
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“Significant barriers to implementing evidence-based practices in AI/AN settings have been identified, including limited infrastructure, funding constraints, and workforce challenges (Dickerson et al., 2020).”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Dickerson et al., 2020
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“Dickerson et al. (2020) noted that while cultural adaptation is frequently recommended, rigorous research examining specific adaptation processes and their outcomes remains limited.”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Dickerson et al., 2020
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“However, limited research has been conducted to understand program implementation and sustainability in AI/AN organizations and communities.”
From Bridging Traditions and Prevention: Insights into Implementing and Sustaining Substance Use Programs for Urban AI/AN Communities (2026) · cites this paper as Dickerson et al., 2020
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“providing inputs to program design, formative research, creation and vetting of a prototype, implementation processes, summative (post-implementation) evaluation, and dissemination of results and successful programs [28].”
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“However, researchers should be aware that RCTs may be viewed as unacceptable within some Indigenous communities (e.g., it may be perceived as unfair that only certain community members receive a desired intervention within a context of scarce resources; Dickerson et al., 2020).”
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“It is important to acknowledge that Western models used in this and other reviews are not the only way of knowing and that Indigenous populations in the USA (Dickerson et al. 2018), Australia (Cochran et al.”
BackgroundMethodInfluentialSelf-citation
Metadata
- Authors
- Dickerson, D., Baldwin, J. A., Belcourt, A., Belone, L., Gittelsohn, J., Keawe’aimoku Kaholokula, J., Lowe, J., Patten, C. A., & Wallerstein, N.
- Affiliations
- University of California, Los Angeles (US)
- Northern Arizona University (US)
- University of Montana (US)
- University of New Mexico (US)
- Johns Hopkins University (US)
- Florida State University (US)
- Mayo Clinic (US)
- Corresponding author
- Dickerson, Daniel
- ORCID
- Venue
- Prevention Science
- Published
- 2018-06-29
- Volume
- 21
- Issue
- S1
- Pages
- 33-42
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC6311146
- OpenAlex
- W2809803165
- Cited by
- 151
- References
- 58
- Citations by year
- 2026: 16 · 2025: 18 · 2024: 20 · 2023: 26 · 2022: 25 · 2021: 16 · 2020: 12 · 2019: 13 · 2018: 4
- FWCI
- 12.05
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01 AA022066-04)
- National Institute of Environmental Health Sciences (1R01ES022583-01A)
- National Cancer Institute (R01 CA164533)
- National Heart, Lung, and Blood Institute (1R01HL126577)
- National Institute on Drug Abuse (1R01DA037174)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Community Health and Development
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Cultural Competency in Health Care
- Keywords
- health promotion, indigenous knowledge, community-based participatory research, cultural adaptation, intervention development, health disparities, research funding programs
- MeSH terms
- Health Equity, Health Promotion, Humans, Indians, North American, Research Design, United States, Native Hawaiian or Other Pacific Islander, Native Hawaiian or Pacific Islander, Cultural Competency, Health Status Disparities
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