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Background American Indians (AI) in North Dakota present with higher rates of advanced-stage disease for screening detectable colorectal cancers and have lower overall baseline colorectal cancer screening rates than non-AIs. We sought to identify the perceived barriers and facilitators for the engagement with colorectal cancer prevention within North Dakota tribal communities. Methods Twelve semi-structured interviews were carried out across four tribal reservation communities in the state of North Dakota with American Indian adults between the ages of 30 and 75 years. We utilized purposive sampling to ensure maximum variation in age, sex, and tribal community until data saturation was achieved. The interviews were transcribed, and thematic analysis was carried out to identify consistent themes rooted within the data. Ethical approval was gained for this project from all relevant institutional review boards. Results Four main themes were identified as barriers for the engagement with colorectal cancer prevention, including: colorectal cancer screening barriers, focused on other health problems, lack of colorectal cancer tailored health promotion, and socio-cultural factors affecting colorectal cancer prevention. Three main themes were identified as facilitators for the engagement with colorectal cancer prevention, including: reasons for getting colorectal cancer screening, role of culture, and getting out into the community. Conclusion There is need for more community-rooted, strengths-based approaches to colorectal cancer prevention activities in AI communities in North Dakota. Socio-cultural factors, such as the use of storytelling, and the use of traditional knowledge have been demonstrated to be an important element of consideration for colorectal cancer tribal community engagement and prevention planning in the state.

Background Rural, Indigenous, and isolated communities faced unique challenges and opportunities during the SARS-CoV-2 pandemic. Identifying lessons from these communities, which are rarely studied, is crucial for improving future crisis responses similar populations. This study aims to inform similar communities by centralizing lessons learned and improving preparedness for future health crises. Methods We examined three geographically and culturally distinct self-governing communities: a Tibetan Buddhist monastic community in southern India, Alaska Native communities in Interior Alaska, and the Cheyenne River Sioux Tribe in South Dakota. Through semi-structured interviews conducted from 2021 to 2022 with community members working in healthcare, education, law enforcement, and governance, we analyzed the policies implemented, the decision-making processes behind them, and the psychological experiences of community members during the pandemic. Results The themes identified from the interviews included the creative mobilization of internal resources amid limited external support, such as community members assuming new roles like quarantine enforcement and using shared culture as a resource to change health behaviors. All three communities implemented travel restrictions. Reported stress on a personal and community level was high, particularly due to deaths caused by the pandemic. Conclusions Rural, Indigenous, and isolated communities responded to the COVID-19 pandemic with a range of strategies, including strict shutdowns, travel restrictions, community-driven support, and traditional healing practices. Despite demonstrating resilience and adaptability, they faced challenges such as resource limitations, enforcement difficulties, and community stress, highlighting the need for ongoing support and tailored approaches.

This qualitative study is intended to elucidate Lakota elders’ views on traditional tobacco and commercial/addictive tobacco use, capturing the oral history that depict the cultural protocol regarding traditional tobacco, called Cansasa. Commercial tobacco use has significantly impacted the Northern Plains Indians. National surveillance systems report that tobacco use is more prevalent among American Indian/Alaska Natives than any other population, and is notably higher than the national average. Lung cancer among Native Americans is highest in the Northern Plains and Alaska, where smoking prevalence is also the highest, and smoking is responsible for nearly 90% of all lung cancer cases. Yet, the use of traditional tobacco is largely ignored by surveillance and seems to have a distinct, positive role. Using a community-based participatory research approach, semi-structured interviews, and qualitative analysis tools, the research team, including 2 Lakota tribe elders, Lakota speaking tribal college students, and university faculty, sought to discern tribal elders’ distinctions between traditional and the addictive commercial tobacco. The team interviewed thirty Lakota elders, transcribed the interviews and field notes, and analyzed them using immersion/crystallization organizing framework. The research design engaged the Lakota tribal community in all stages, from planning to publication. Analysis revealed a clear distinction between traditional and commercial tobacco: tribal elders conveyed strong positive messages connected to traditional tobacco use (i.e., spirituality, respect, health and wellness, humility, and thoughtfulness) versus strong negative messages linked to addictive tobacco (i.e., crime, loss of control and selfesteem, lack of respect to self and others, sickness and death). These messages, along with stories in the Lakota language that were told and recorded during the interviews, can guide new ways to address addictive tobacco prevention in this community, to enhance cultural pride, and to serve as a cross-generation bridge regarding tobacco use.

Objective. We assessed health status and behavioral risks in American Indians (Als) from rural, northern plains reservation communities. Methods. Al interviewers from the communities administered the core and optional modules of the Behavioral Risk Factor Surveillance System (BRFSS) to 404 Al adults randomly selected from housing lists from four Al tribal communities located on the northern plains of the U.S. The BRFSS interview assessed several health functioning areas including medical conditions, preventive screenings, and behavioral risks. We measured health disparities by comparing the Al sample data with a northern plains statewide (North Dakota) sample and a U.S. national sample. We compared outcomes with BRFSS statewide (North Dakota) and U.S. national data from telephone-based interviews. Results. Al participants showed a significantly greater prevalence of diabetes, coronary heart disease, myocardial infarction, smoking, obesity, and heavy alcohol use than either the regional or national samples. They also reported being less likely to engage in leisure-time physical activity and to have had age-appropriate preventive screenings for several diseases including colorectal cancer, prostate cancer, breast cancer, and cardiovascular disease. Conclusions. Face-to-face interviews conducted by Al community members are an effective means of gathering health information about Als living in rural, reservation communities. Als living in these communities on the northern plains have a much higher prevalence of many health-risk behaviors and some medical conditions than are found in the general population. Improved health-care access, better preventive screenings, and culturally appropriate communitybased health promotion programs and policies should be examined as possible ways to reduce health disparities.

This community-based participatory research case study demonstrates how Dakota Wicoḣaƞ utilized Indigenous and feminist epistemologies to create, implement, and evaluate a cultural intervention, the Mni Sota Makoce: Dakota Homelands Curriculum, to increase Native 6th- and 10th-grade social studies students’ peoplehood sense of belonging (Tachine et al., 2017). Findings demonstrate Native students liked the curriculum and reported an increase in support and a decrease in invalidation of their sense of belonging. While the curriculum provided a source of racial-ethnic socialization, some European American students criticized the curriculum, which likely negatively impacted 6th-grade students psychological sense of school membership (Goodenow, 1993). Results indicate Indigenous culture, epistemologies, and pedagogies should be infused throughout all curricula, teachers need to be prepared to effectively deal with racist and discriminatory behavior, and Indian education is important to Native students’ belonging. Implications and recommendations for funders, schools, researchers, teacher education programs, and Native communities are discussed.

The We RISE Study aimed to support young American Indian mothers on a tribal reservation by addressing social determinants of health at an individual and community-wide level. To address community-based barriers, the study developed the Tribal Resource Guide, a comprehensive list of available resources that was created through partnerships with community programs and staff. In addition to the guide, the study also developed the Poverty and Culture Training in order to train program staff at numerous community programs to better understand and serve lower socioeconomic and/or Native clients. The two projects facilitated collaboration between community programs and provided tools for programs to address barriers and ultimately better serve their target audience. Despite challenges, the transdisciplinary approach used with the local community maximized potential for success. This process and model could be duplicated in communities with similar demographics, resources, and barriers.

To assess the impact of patient navigation (PN) on satisfaction with health care and medical mistrust among American Indians (AI) undergoing cancer treatment. This was a pre-post cohort survey study of 52 AI cancer patients who participated in a culturally-tailored PN program during their cancer treatment. Surveys were administered prior to and after cancer treatment assessing medical mistrust and satisfaction with health care using two Likert-type scales. Participation refusal rate was 7%. Mean scale scores for satisfaction with health care were significantly improved after PN compared with pre-navigation (p<.0001; Wilcoxon signed-rank test). There was no significant difference in the mean scale scores for medical mistrust after PN compared with those observed prior to treatment (p=.13). American Indian cancer patients who received PN services during their cancer treatment showed improvement in levels of satisfaction with health. However, no improvements were observed in levels of medical mistrust.

The story and teachings of Nicholas Black Elk (1863–1950), first recorded by John G. Neihardt in Black Elk Speaks , have played a critical role in shaping the way in which Native Americans and others view the past, present, and future of Native America. These conversations with the descendents of Black Elk offer an intimate look at life on the Pine Ridge Reservation and fresh perspectives on the religious, economic, and political opportunities and challenges facing the Lakota people today. In addition to revealing more about Black Elk the healer, the family also provides glimpses of Black Elk as a family man, teacher, and influential ancestor.

This article discusses Indian gaming issues from the perspectives of “traditional” Lakota and Dakota people through the lens of cultural sovereignty. The author reviews the sociopolitical background of gambling on Indian reservations, compares mainstream and Indian gaming, observes historical locations of tribal sovereignty, identifies traditional views through direct interviews, and illustrates economic development and social change issues, all considered through the lens of modernity. Findings include positive effects in each of these social realms, comparatively few and quite small negative results, and internal conflicts arising from fast-acting shifts in social location for many Indian nations and tribes.