From Weaving Healthy Families to Weaving Healthy Communities: An Indigenist Dissemination and Implementation Approach Integrating Talking Circle Feedback

从构建健康家庭到构建健康社区:一种融合对话圈反馈的本土化传播与实施方法

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Abstract

A gap exists both in culturally grounded, evidence-informed Native American and Alaska Native (NA/AN) programs and in dissemination and implementation (D&I) approaches to replicate, translate, and adapt such clinical programs. D&I approaches grounded in Indigenous knowledge are needed to translate evidence-informed programs effectively into real-world settings. The purpose of this article is to (a) outline the Weaving Healthy Communities (WHC) D&I approach, with a focus on talking/sharing circles, and (b) provide results of talking/sharing circle feedback from the culturally adapted and efficacious Chukka Auchaffi' Natana (in Choctaw) or Weaving Healthy Families program (WHF). WHF promotes resilience, wellness, and health equity, while preventing problem alcohol and other drug use, violence, and mental health conditions among NA/ANs. Using a community-based, critical ethnography with a southeastern tribe in the United States, we conducted quarterly talking circles after each cohort of WHF participants (i.e., families and facilitators) completed their active intervention. Team-based thematic qualitative data analyses were completed by the principal investigator and research team engaged in prior work with the tribe. Thematic data analysis revealed important themes of core WHF components, along with participants' desires for extended and deepening programs that could benefit NA communities. The most frequently reported theme was talking circle benefits, coded 228 times. Within this theme, prominent subthemes included: building trust; providing stress relief and offsetting personal burdens; learning from listening; fostering positive communication; sharing within the same peer groups; and help with problem and solution identification.

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