Date of Award

August 2024

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Indigenous Health

First Advisor

Melanie Nadeau

Abstract

Indigenous Peoples have always understood the interconnectedness of health. There are many Indigenous-specific health determinants that positively or negatively impact prevalent health conditions. Each of the products in this three-part portfolio highlight health determinants that directly or indirectly contribute to the health of Indigenous Peoples. Key topics within each product include Cultural Protocol, culturally safe practices, food security and access, type 2 diabetes, and localized health approaches. The products also highlight the historical and current impacts of colonization on Indigenous health. Each product interconnects to consider the variable ways Indigenous-specific health determinants impact Indigenous populations. In the first product, I conducted a scoping review of the literature on Indigenous-specific Cultural Protocol implemented to protect Tribal communities from research and health related harm. Twenty studies were identified and analyzed, resulting in six major concepts relevant to the integration of Protocol in various settings. The review highlighted resources that integrated elements of Cultural Protocol and the findings will serve as a precursor to a community-led Cultural Protocol Guide for research and healthcare providers. For the second product, I developed a policy brief to highlight the negative health implications of an existing federal nutrition policy and to propose policy recommendations to reduce food insecurity among American Indians/Alaska Natives (AI/ANs) in the United States (US). The policy brief discusses the impacts of historical events and the ongoing impacts of colonization on AI/AN food systems and health. Multi-faceted policy recommendations were developed in collaboration with an AI/AN research professional and law student, and the brief was peer reviewed by two experts in the field. In the third product, I conducted a systematic review with an international team of Indigenous and non-Indigenous researchers and professionals to examine the prevalence of type 2 diabetes among global Indigenous adult populations. In total, 204 articles met the inclusion criteria representing approximately 187 Indigenous populations from 37 countries published between 1980 and 2022. Several of the Indigenous populations (67%) reported T2D prevalence above the estimated global prevalence of 6.1%. Indigenous-led, community-based practices that recognize Indigenous-specific determinants of health are necessary to prevent and manage chronic health conditions among Indigenous populations.

Available for download on Sunday, August 23, 2026

Share

COinS