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与他们的土地、文化和文化有着深刻的内在联系， 社区，这对土著人的健康和福祉产生了积极影响。然而，土著人的健康 由于多层次的结构性因素， 环境暴露;家中需要维修/改造的持续坠落伤害危险;以及 获得文化上合格的医学专家的机会有限。一个由联邦指定的 阿尔伯克基地区西南部落流行病学中心（AASTEC），与大学合作 美国新墨西哥州和亚利桑那大学的一项研究提出了一种多方面的干预措施， 环境和土著人的健康。这一新的方案将纳入社区参与式 研究原则，以土著方法为中心，促进土著健康 在社会、社区、家庭和个人层面上。住房维修券计划 （主要干预）将通过家庭和受试者评估获得信息，并与临床 培训和转诊规程的制定，部落公共卫生工作队伍的发展和能力- 建设，以及多部门健康部落家园联盟。创建一个适应性强的框架， 以社区价值观为中心，同时解决环境暴露、跌倒伤害风险、日常 压力源和呼吸健康（强调哮喘）将提高参与者的生活质量， 家庭和社区。该项目将产生一个模板和一套最佳做法， 和非土著社区可能会适应以集中的方式解决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.