Indigenous healthy homes and healthy communities: A community-led initiative to improve health and support Indigenous Resilience in the US Southwest

摘要 主权、土著民族的居民本质上与他们的土地、文化和 这对土著人民的健康和福祉产生了积极影响。然而，土著健康是 被多层次的结构性因素削弱，这些因素在许多方面都表现出来，包括室内 暴露在环境中；需要修理/改装的家庭中持续存在的坠落伤害危险；以及 接触具有文化能力的医疗专家的机会有限。由联邦指定的团队领导的团队 阿尔伯克基西南部落流行病学中心(AASTEC)，与该大学合作 新墨西哥州大学和亚利桑那大学提出了一个由多个部分组成的干预措施来改善家庭 环境与土著健康。这一新颖的计划将纳入社区参与式 以土著方法论为中心促进土著健康的研究原则 在社会、社区、家庭和个人层面。住房维修代金券计划 (主要干预)将由家庭和参与者评估通知，并与临床合作 培训和转诊方案的制定、部落公共卫生人员的发展和能力-- 建设，以及多部门健康部落之家联盟。创建一个适应性强的框架 以社区价值为中心，同时解决环境暴露、跌伤风险、日常生活 压力源和呼吸健康(强调哮喘)将提高参与者的生活质量，他们的 家庭和社区。该项目将产生一个模板和一套最佳做法，其他土著 非土著社区可以适应以以下方式处理他们的健康优先事项 他们的价值观和身份。

ABSTRACT Residents of sovereign, Indigenous Nations intrinsically hold deep connections to their land, culture, and community, which positively affects Indigenous health and well-being. However, Indigenous health is diminished by multi-level structural factors that manifest in numerous ways including indoor environmental exposures; persistent fall injury hazards in the home needing repair/modification; and limited access to culturally competent medical specialists. A team led by the federally-designated Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC), in partnership with the University of New Mexico and University of Arizona, proposes a multi-part intervention to enhance the home environment and Indigenous health. This novel program will incorporate community-based participatory research principles with an approach that centers Indigenous methodologies to promote Indigenous health across the societal, community, household and individual levels. A housing repair voucher program (primary intervention) will be informed by home and participant assessments, and partnered with clinical training and referral protocol development, tribal public health workforce development and capacity- building, and a multi-sectoral Healthy Tribal Homes Coalition. Creating an adaptable framework that centers upon community values to address simultaneously environmental exposures, fall injury risk, daily stressors, and respiratory health (emphasizing asthma) will increase quality of life for participants, their families, and community. This project will yield a template and set of best practices that other Indigenous and non-Indigenous communities may adapt to address their health priorities in a manner centered upon their values and identity.