From tradition to evidence: decolonization of the evidence-based practice system

Culture counts in the prevention and treatment of behavioral ailments. The Native American Health Center (NAHC) has successfully developed a model that incorporates cultural adaptations into EBPs, yet also believes community-defined and practice-based evidence are relevant in the validation of traditional practices. American Indian/Alaska Native (AI/AN) traditional practices are more than complementary forms of healing. They are stand-alone methods, developed and used by tribal people long before the concept of EBPs existed. There is a need for funders to respect these practices as autonomous mental health strategies. The reasons for promoting change are explained through an understanding of key dimensions of AI/AN behavioral health issues. These key dimensions were identified in the 2001 Surgeon General's Report and an extensive literature review of Indigenous research methodologies. Recommendations are made based upon their ability to promote AI/AN empowerment, to support movement toward self-determination using the Indigenous Research Agenda model. This model honors fluid movement of Indigenous people through states of survival, recovery, development and self-determination through four categories for action: decolonization, mobilization, transformation, and healing. The end results are options for holistic approaches to influence policy changes in the EBP system.