Promising Practices for Promoting Health Equity Through Rigorous Intervention Science with Indigenous Communities
Open accessAbstract
Research in indigenous communities is at the forefront of innovation currently influencing several new perspectives in engaged intervention science. This is innovation born of necessity, involving efforts to create health equity complicated by a history of distrust of research. Immense diversity across indigenous cultures, accompanied by variation in associated explanatory models, health beliefs, and health behaviors, along with divergent structural inequities add further complexity to this challenge. The aim of this Supplemental Issue on Promoting Health Equity through Rigorous, Culturally Informed Intervention Science: Innovations with Indigenous Populations in the United States is to highlight the promising new approaches and perspectives implemented by a group of engaged researchers and their community partners, as they seek to move intervention research forward within indigenous communities. Case studies presented are from projects led by members of the National Institutes of Health Intervention Research to Improve Native American Health (IRINAH) consortioum, investigators who conduct health promotion and disease prevention research among American Indians, Alaska Natives, and Native Hawaiians. The promising practices profiled include new strategies in (a) community partnerships, engagement, and capacity building; (b) integration of indigenous and academic perspectives; (c) alignment of interventions with indigenous cultural values and practices; and (d) implementation and evaluation of multilevel interventions responsive to complex cultural contexts. The IRINAH projects illustrate the evolution of an intervention science responsive to the needs, realities, and promise of indigenous communities, with application to health research among other culturally distinct health inequity groups.
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Culturally-grounded prevention programs strengthen cultural identity, which serves as a protective factor against substance use by providing a sense of belonging and purpose.
“First, these programs strengthen cultural identity, which serves as a protective factor against substance use by providing a sense of belonging and purpose (Brown et al., 2019; D’Amico et al., 2023; Whitesell 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 Whitesell et al., 2020
The section “Creation of Interventions from Indigenous Cultural Values and Practices” describes culturally grounded health-promotion programs that prioritize Indigenous knowledge. “Sharing the Collective Experience of IRINAH Research Partnerships” also mentions cultural tailoring of youth substance-use interventions. Neither section says these programs strengthen cultural identity or that identity protects against substance use by providing belonging and purpose; no page numbers are available in our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredOne of the few studies examining sustainability of an Indigenous prevention program noted significant methodological challenges, such as ethical concerns with conventional designs and difficulties in dissemination and implementation.
“One of the few studies examining the sustainability of an Indigenous prevention program noted significant methodological challenges in this area of research, such as ethical concerns with conventional designs, and difficulties in dissemination and implementation (Whitesell 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 Whitesell et al., 2020
“The Fundamental Role of Community Engagement” describes ethical concerns with conventional no-intervention control designs. “Dissemination of Interventions in Indigenous Communities” describes implementation and scale-up difficulties and recommends attention to sustainability. But this paper surveys intervention-science challenges and other projects; it does not present itself as one of the few studies examining the sustainability of a particular Indigenous prevention program. Page numbers are unavailable in our copy. (LLM, conf=0.86)
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- Authors
- Whitesell, N. R., Mousseau, A., Parker, M., Rasmus, S., & Allen, J.
- Affiliations
- Colorado School of Public Health (US)
- University of Montana (US)
- University of Washington (US)
- University of Alaska Fairbanks (US)
- University of Minnesota (US)
- Corresponding author
- Whitesell, Nancy Rumbaugh
- Venue
- Prevention Science
- Published
- 2018-11-16
- Volume
- 21
- Issue
- S1
- Pages
- 5-12
- ISSN
- 1389-4986 (ISSN-L)
- 1573-6695
- PMC
- PMC6778005
- OpenAlex
- W2901221421
- Cited by
- 72
- References
- 24
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 8 · 2023: 15 · 2022: 11 · 2021: 9 · 2020: 5 · 2019: 6
- FWCI
- 21.90
- Type
- book chapter
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Prevention Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Drug Abuse (R01DA035111)
- National Institute on Alcohol Abuse and Alcoholism (R01AA022068, R01AA023754)
- Topics
- Social Sciences › Health › Indigenous Health, Education, and Rights
- Health Sciences › Health Professions › General Health Professions › Community Health and Development
- Health Sciences › Health Professions › General Health Professions › Indigenous Health and Education
- Keywords
- health equity, indigenous peoples, Native Americans, Alaska Natives, Native Hawaiians, community partnerships, community participation, capacity building, health promotion, disease prevention, multilevel interventions, research trust
- MeSH terms
- Health Equity, Health Promotion, Humans, Indians, North American, United States, Cultural Competency, Evidence-Based Practice, Community-Based Participatory Research
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