Examining knowledge, interests, and preferences of Cherokee adults for improved program design and implementation

Introduction: Cultural engagement and connection are integral to Indigenous health and well-being yet there is limited protocol for eliciting community-based needs to develop and implement culture focused health interventions. This paper details findings from a tribally based participatory research study that documented the level of knowledge and interest Cherokee citizens have in key components of their culture. The study also collected participants’ program design preferences. This information will inform the creation of a Cherokee cultural intervention to prevent cardiovascular diseases. Methods: Indigenous and decolonizing research methodologies were central to the conceptualization, design, and implementation of this research. Data collection was conducted using a cross-sectional, self-report, online survey developed and tested by a Cherokee community advisory board. The study population included enrolled Cherokee citizens over the age of 18 (n=355). Chi-square (X2) analysis, t-tests for continuous variables, and analysis of variance (ANOVA) were utilized to assess sample demographic differences of primary variables of interest. Results: Most respondents self-reported limited knowledge of important periods in Cherokee history, a low level of knowledge of traditional beliefs, values, lifeways and feelings of tribal connection, and a limited ability to understand, use, and/or speak more than a few Cherokee words (0-9 words). Most participants across all ages, genders, and locations wanted to know more about their history, traditions, and language and reported that they were willing to commit time, over a prolonged period, to further their learning and cultural engagement. Conclusions: The improved understanding of cultural knowledge, interests, and preferences resulting from this study will play a central role in the development of acceptable, appropriate, and feasible interventions that are grounded in Cherokee community needs and desires for the future. The results also expand upon existing knowledge about optimizing the design and implementation of cultural interventions focused on improving the health and well-being of Indigenous communities.