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Good Health and Wellness: Measuring Impact Through an Indigenous Lens


Data collections were primarily conducted at Tier 1, the local level. Tier 1 Evaluation questions are 1) What were the major facilitators and challenges to achieving recipient-selected outcomes? 2) To what extent did the design, implementation, and evaluation of activities integrate culturally specific values? 3) To what extent has the program been able to partner with staff from existing projects funded by federal, state, local, or tribal governments or foundations to maximize impact toward the intermediate outcome? and 4) To what extent have elements that will sustain supportive environments and systems increased in the efforts toward recipient-selected outcomes? Data to answer these questions come from recipient evaluation reports. Partnerships connect Tier 1 and Tier 2, regional level data. The Tier 2 Evaluation question is to what extent does GHWIC contribute to improvements in collaborations; capacity; policy, systems, and environmental outcomes; health outcomes; access to clinical preventive services; healthy behaviors; and quality of care? Data to answer this question are collected at the IHS regional level by Tribal Epidemiology Centers. Tier 2 and Tier 3, the national level, are connected by the community of practice. Tier 3 Evaluation questions are 1) What is the national impact of GHWIC efforts? 2) What are promising practices for tribal chronic disease prevention? and 3) What documentation is there on effective approaches to health and wellness in tribal communities? Data to answer these questions are collected from recipient performance measures and project narratives. Tier 3 and Tier 1 are connected by indigenous values.

Conceptual diagram of the 3-tiered evaluation of Good Health and Wellness in Indian Country (GHWIC) impact on tribal health and wellness, with questions that are answered within each tier. Abbreviation: IHS, Indian Health Service. Figure was created by the Urban Indian Health Institute.

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The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors’ affiliated institutions.

Page last reviewed: August 15, 2019