Encompassing Cultural Contexts within Scientific Research Methodologies in the Development of Health Promotion Interventions
Daniel Dickerson, D O., M.P.H., Julie A. Baldwin, Ph.D., Annie Belcourt, Ph.D., Lorenda Belone, Ph D., M.P.H., Joel Gittelsohn, Ph.D., Joseph Keawe’aimoku Kaholokula, Ph.D., John Lowe, Ph.D., Christi A. Patten, Ph.D., Nina Wallerstein, Ph.D.
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 evidenced-based treatment. Findings revealed that qualitative methodologies and community-based participatory research (CBPR) approaches to 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.