Developing a Tribal Health Sovereignty Model for Obesity Prevention.

BACKGROUND: Few models for effective health interventions exist for stemming the tide of American Indian (AI) childhood obesity rates; they are among the highest in the United States and are increasing. Obesity-related chronic diseases (i.e., diabetes type II and cardiovascular disease) rates far exceed other U.S. racial groups. Some studies show success with health interventions that center within an AI worldview and approach, rather than those that center on an individualistic Western worldview. The Tribal Health Sovereignty (THS) model presented here defines health through an AI perspective and applicably to food and exercise intervention. The model discussed in this paper is grounded in a study, which used a community-based participatory research (CBPR) photovoice methodology and can be used to design effective health interventions.

METHODS: Development of the THS model was guided by Earp and Ennett's representation of concept model development for health education research and intervention. Findings from a CBPR study that used photovoice methodology informed the model. Differences between AI and Western models of health are explored and illuminate how an interventions shaped by Indigenous culture and worldview can lead to better health outcomes among AI people.

RESULTS: A THS model was developed to guide future AI interventions embedded within tribal culture.

CONCLUSIONS: By using a THS model, tribal communities can engage in identifying barriers and facilitators for health to lower childhood obesity.