Developing culturally appropriate materials and building capacity with and for American Indian and Alaska Native communities

Background:

American Indian and Alaska Native (AIAN) women are twice as likely to die from pregnancy-related causes than White women, and tragically, most of these deaths are preventable. While these stark disparities make it an urgent priority to develop resources to reach these communities, it is difficult for many AIAN people to trust healthcare professionals and the government due to ongoing and historical trauma. This distrust is only reinforced when AIAN people and culture are not represented appropriately in public health resources or mass media.

Program background:

Centering on the culture and strength of AIAN people, and with support from partners, CDC developed a suite of Hear Her™ campaign resources that honor the voices of AIAN people and work toward improving maternal health outcomes. This new segment shares stories from five American Indian women who experienced pregnancy-related complications. These videos are accompanied by resources that help AIAN people who are pregnant and postpartum and their support people recognize the urgent maternal warning signs and get the care they need. CDC also released materials to support healthcare professionals who serve AIAN communities in their delivery of respectful, culturally appropriate care.

Notably, the development of these resources was a community-grounded process. The campaign team worked to include American Indian and Alaska Native voices, perspectives, expertise and creative talents through meaningful partnerships and ongoing engagement. Community voices drove the development, paired with expertise from CDC and other subject matter experts (SMEs), but not limited to the SME perspective. The Division also worked with a Native-owned and serving creative agency, graphic designer, photographer, and creative talent, ensuring that the materials reflect the communities' vision and culture. These resources meet another public health need of respectful, accurate representation of American Indian and Alaska Native people in public health resources, on a national platform.

The approach for implementing this segment differs from common health communication practice - with a focus on building capacity for Tribes, Tribal-serving organizations, and Urban Indian Organizations to implement the campaign. CDC is working with the National Indian Health Board on implementation, including funding tribes and tribal serving organizations to build capacity, implement the campaign, and improve maternal outcomes. These implementation strategies continued commitment to a community-grounded campaign.

Evaluation Methods and Results:

These new resources for AIAN communities were released in November 2022. Since launch, the resources have been well received among AIAN communities, AIAN serving organizations, other partner organizations, and federal agencies. The effects of the resources will continue to grow over time as the campaign expands their distribution and promotion through both paid and organic digital and social media, including American Indian and Alaska Native serving channels, to further the reach.

Conclusions:

Meaningful engagement with Tribes, Tribal Serving Organizations and Urban Indian Organizations is essential for health communication efforts aiming to serve American Indian and Alaska Native communities.

Implications for research and/or practice:

The full impact of the campaign goes well beyond quantitative measures, however. In addition to addressing communication needs to improve maternal health, these resources also help increase visibility and representation of American Indian and Alaska Native culture and stories.