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All systems are interrelated: Multilevel interventions with indigenous communities.

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Area of Science:

  • Indigenous Health Research
  • Health Disparities
  • Clinical Trial Interventions

Background:

  • Colonial historical trauma and structural racism perpetuate health disparities among Indigenous peoples.
  • Indigenous communities are actively involved in multilevel clinical trial interventions with positive outcomes.
  • Existing socioecological frameworks have limitations in addressing Indigenous health needs.

Purpose of the Study:

  • To describe the utility and necessity of multilevel interventions in Indigenous health.
  • To propose a novel heuristic framework for Indigenous health research.
  • To de-center the individual and focus on collective-environmental interrelationships.

Main Methods:

  • Review of National Institutes of Health funded research in Indigenous health.
  • Critique of existing socioecological, multilevel frameworks.
  • Proposal of a dynamic, interrelated heuristic framework.

Main Results:

  • Multilevel interventions demonstrate success in improving Indigenous health.
  • Existing frameworks require adaptation to better suit Indigenous contexts.
  • The proposed framework emphasizes collective and environmental factors.

Conclusions:

  • Multilevel clinical trial research is crucial for Indigenous health.
  • A new framework is needed that centers the collective within its environment.
  • Specific calls to action are identified for future research and interventions.