BRIEF RESEARCH REPORT article
Front. Public Health
Sec. Life-Course Epidemiology and Social Inequalities in Health
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1608429
This article is part of the Research TopicEmpowering Community Stakeholders: Novel Approaches to Address Health InequitiesView all 5 articles
American Indian Community Engagement and the Structural and Social Determinants of Health: Results from the THRIVE Assessment
Provisionally accepted
Kellie Webb1Sadie Posey2
Katherine Hirchak3
Emily Beamon2Kelley Milligan2Sharon Wagon1Bethany Fatupaito2
Allyson Kelley2*- 1Doya Natsu Healing Center, Fort Washakie, Wyoming, United States
- 2Allyson Kelley & Associates PLLC, Sisters, United States
- 3Department of Community and Behavioral Health, PRISM Collaborative, Elson S. Floyd College of Medicine, Washington State University Spokane, Spokane, Washington, United States
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Introduction - This paper presents the community-driven adaptation process and results for the Tool for Health and Resilience in Vulnerable Environments (THRIVE) assessment, a social justice and equity-focused screening tool, in one reservation-based American Indian community in the US. Methods -Using principles of community-engaged research (CER) and community-based participatory research (CBPR), the authors describe the importance of co-creating data collection tools with community members to document the social and structural determinants of health. Authors describe a step-by-step approach to document inequities; this includes 1) recognizing the need to document inequities, 2) identifying existing tools to measure inequities, 3) adapting tools and piloting them with members of the community, 4) refining the tool based on community feedback, and 5) administering the tool to address needs identified. Results–Survey data from the THRIVE assessment and community-engaged process (N = 100) documented the social and structural determinants of health. Results from this work show that the adapted THRIVE tool has high psychometric reliability (α = .957) and that community members feel strong about factors related to people and vulnerability, as well as factors related to place and equitable opportunities. The authors discuss future work and actions they will undertake to address community-identified concerns through community-based programs like complementary alternative medicine, harm reduction via mobile outreach, employment readiness and job training, sober housing, culturally centered treatment, and voucher-based programs to meet basic needs. This intersectional, holistic approach aims to enhance community conditions and achieve the highest possible health and well-being for American Indian communities.
Keywords: American Indian, social and structural determinants of health, Validation, reservation community, Equity
Received: 08 Apr 2025; Accepted: 30 Jul 2025.
Copyright: © 2025 Webb, Posey, Hirchak, Beamon, Milligan, Wagon, Fatupaito and Kelley. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Allyson Kelley, Allyson Kelley & Associates PLLC, Sisters, United States
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.