Abstract
Centuries of historical oppression have targeted and undermined Indigenous foodways, which fundamentally disrupts the culture and wellness, yet decolonized, resilient, and transcendent Indigenist practices persist. The purpose of this research was to use the framework of historical oppression, resilience, and transcendence (FHORT) to understand foodway practices among Indigenous Peoples. Given a limited understanding of how foodways may promote health and wellness the focal research questions for this critical ethnographic inquiry were: (a) How do participants describe Indigenist foodways? (b) How do Indigenist foodways reflect decolonized values and practices? and (c) How may Indigenist foodways be promotive for health and wellness? Data were drawn from 31 participants across a rural, reservation-based Southeast (SE) region and an urban Northwest (NW) region. Reconstructive data analysis revealed the following emergent themes: (a) Indigenous Values of Generosity Expressed Through Foodways: “It’s Always About Sharing, and Caring, and Loving, and Giving”; (b) Gardening, Subsistence, and Food Sharing: “You Bring Enough for Everybody to Share”; (c) Decolonized Feasts and Foodways: “Everybody Pitch in and Help as Much as They Can.” Despite centuries of historical oppression, participants reported decolonized values, worldviews, and foodways that reflected unity, cooperation, sharing, and social cohesion and caring, which were promotive factors for family resilience, health, and cultural identification. This research provides promising pathways about how Indigenist foodways remain salient in daily and cultural life, reflect decolonized values and practices, and may be promotive for health and wellness within the natural world.
Keywords: Indigenist, Native American or American Indian or Indigenous, Foodways, Resilience, Historical Oppression
The purpose of this research was to use the framework of settler colonial historical oppression, resilience, and transcendence (FHORT) to understand how and whether decolonized foodway practices persist among Indigenous Peoples. Centuries of historical oppression have targeted and undermined Indigenous foodways, which fundamentally disrupted the culture, health, wellness, food security and sovereignty of Indigenous Peoples (Burnette & Figley, 2017; Mihesuah & Hoover, 2019). According to Cidro et al. (2015), “Food and health are indelibly linked. Food is a source of preventative health” (p. 32). Food is interlinked with health, cultural memory, relationships, and lifeways (Reddy, 2015). Foodways encompass the activities, meaning, and values surrounding the production, harvesting, processing, preparing, serving, and consuming food (Peres, 2017; Ruelle & Kassam, 2013).
Historical Oppression and Foodways
The impact of chronic, intergenerational exposure to historically traumatic events (e.g., forced removals, land dispossession; Evans-Campbell, 1999; Walters et al., 2011) combined with contemporary, continued, intergenerational, and chronic forms of structural oppression in the forms of disrupted foodways and culture, socioeconomic disparities, and psychosocial health inequities (Burnette & Figley, 2017) have created an overarching legacy of historical oppression (Burnette & Figley, 2017). The destruction of Indigenous foodways is a primary and persistent structure of settler colonial historical oppression, where settlers arrive to extract and exploit resources and land they intend take for their own (Fredericks & Anderson, 2013); they target Indigenous peoples’ removal, assimilation, and erasure (Wolfe, 1999). Foodways and Indigenous food sovereignty are undermined through warfare, the destruction of crops, habitats, and game and the imposition of a lack of healthful or culturally appropriate rations and commodity foods (Fredericks & Anderson, 2013). The settler colonialis disrupts foodways through environmental, land, and ecological losses from human and natural disasters, impaired access to safe and healthy environments, thwarted nutrition, and exposure to environmental contaminants (Evans-Campbell, 2008; McKinley, Spencer, et al., 2020; Walters et al., 2011).
Historical oppression is perpetuated by contemporary food deserts (Jernigan et al., 2012; Jernigan et al., 2017). Due to historical oppression imposing intergenerational and chronic experiences of inequalities (Burnette & Figley, 2017), Indigenous Peoples are the most food insecure of any ethnic group, which drives much of the concomitant mortality, morbidity, and lower quality of life (Jernigan et al., 2017; Mihesuah & Hoover, 2019). Obesity-related conditions (e.g., cardiovascular disease, diabetes, chronic liver disease, and suicide) pose greater risks for Indigenous Peoples than any other group (Holm et al., 2010). The life expectancy for Indigenous Peoples is almost 6 years lower (Indian Health Service, 2019), and death rates are 50% higher than for non-Hispanic Whites (Centers for Disease Control and Prevention, 2014).
Food security is the availability of and access to safe and nutritious foods aligned with food preferences to meet the dietary needs of the active lifestyles that are consistent with peoples’ social and cultural customs and values (Gurney et al., 2015; Jernigan et al., 2012; Jernigan et al., 2017; Mihesuah & Hoover, 2019; Pinstrup-Andersen, 2009; Sowerwine et al., 2019), whereas food insecurity is not having culturally appropriate, nutritional, and safe foods (Morrison, 2011). Indigenous scholars recommend Indigenous food sovereignty initiatives to resolve and promote Indigenous health and resilience. Food sovereignty is the right of people to self-determine strategies and policies to sustainably produce, distribute, and consume foods in culturally and contextually relevant ways (Ruelle & Kassam, 2013). A precursor to producing, distributing, and consuming foods in culturally relevant ways—a key aspect of food sovereignty—is to understand the cultural meaning, values, and activities around food or foodways (Ruelle & Kassam, 2013). Indigenous food sovereignty affirms peoples’ rights to define food and agricultural systems and to healthy, culturally appropriate foods produced through sustainable and ecologically sound means (Forum for Food Sovereignty, 2007; Mihesuah & Hoover, 2019; Ruelle & Kassam, 2013; Sowerwine et al., 2019).
Still, losses in Indigenous foodways and culture are prominent but invisible and overlooked, drivers of health and behavioral health inequities, whereas the promotion of culture, connection to nature, and subsistence can promote health, wellness, and resilience in Indigenous youth and adults (Brown et al., 2022). Because foodways, food security, and food sovereignty have been and continue to be direct targets of the settler colonial conquest of Indigenous Peoples and contribute to the mortality, morbidity, and mental health inequities Indigenous Peoples experience (Centers for Disease Control and Prevention, 2014; Holm et al., 2010; Indian Health Service, 2019), social scientists must center foodways as a path toward greater health, equity, and wellness across physical, mental, socioeconomic, and spiritual domains.
This research investigates foodways as ground zero to understand Indigenous health, family, and culture. We frame foodways within an Indigenist (Walters & Simoni, 2002) framework of historical oppression, resilience, and transcendence (FHORT; Burnette & Figley, 2017), to examine potential decolonizing protective factors related to resilience and transcendence. Indigenist frames aim for liberation, sovereignty, and empowerment, while acknowledging settler colonialism and associated systems continue unrelentingly through policies and practices to erase or disrupt Indigenous Peoples’ relationships to their territories, land, and lifeways (Walters & Simoni, 2002). Walters et al. (2011) explained that historical trauma, which is perpetrated through historically traumatic events targeting the collective, serve to uphold settler colonial structures. Communal and embodied stress reactions associated with historically traumatic events, particularly over generations interact with systemic and ecological inequities to drive Indigenous health inequities (Walters et al., 2011).
We use the FHORT, which frames health equity in a culturally grounded, relational, and holistic way, to understand transcendent foodways among Indigenous Peoples. After introducing core components of FHORT, we investigate Indigenous foodways as a protective factor related to health equity. Figure 1 displays a constellation of risk and protective factors related to Indigenous health equity. For this article, we focus on culturally relevant promotive factors, namely subsistence, a connection with place, and foodways as a decolonial act of resilience, resistance, and transcendence to promote health. We document re-envisioned and decolonized protective practices related to Indigenous foodways, namely how transcendent views are expressed through foodways, how substance and foodways are forms of resistance and resilience, and how unity and cooperation are expressed through feasts and foodways.
Figure 1. Promotive and Risk Factors Related to Indigenous Health Equity.

Note. Factors associated with the + are promotive, whereas those associated with − are risk factors. A confluence of risk and protective factors interact and coalesce to promote greater or lesser resilience, wellness, and Indigenous health equity. The focus of this article is on the protective factors of foodways and subsistence. Adapted with permission from Author(s) (In Press). Health equity among U.S. Indigenous peoples: Understanding the intersections of historical oppression, resilience, and transcendence. In P. Liamputtong (Ed.) Handbook of Social Sciences and Global Public Health.
FHORT and Foodways
The interruption of foodways is one way U.S. settler colonialism has undermined the health and well-being of Indigenous Peoples, but Indigenist foodways persist despite settler colonial efforts at their eradication. Encompassing both past and contemporary forms of historical oppression, FHORT is a critical framework that examines the interactions of patriarchal settler colonization as a persistent dominant structure perpetuating rampant inequity; and, it situates health inequities within their sociostructural and historic causes (Burnette & Figley, 2017; Wolfe, 1999). FHORT was developed in partnership with Indigenous Peoples (Burnette & Figley, 2017), and is an intersectional and ecological (examining race, politics, gender, and colonization) framework that recognizes structural violence as it has been imposed through settler colonialism (Brassard et al., 2015; Burnette & Figley, 2017). It frames corresponding health inequities with regard to cumulative risk factors that perpetuate inequalities, such as food insecurity (Burnette & Figley, 2017). FHORT centers the interconnections among ecosystemic risk and protective factors across multiple levels (Tutty et al., 2020). Risks exacerbate challenges, whereas protective factors prevent the harmful effects of adversity; promotive factors offer strengths under any circumstances (Masten & Monn, 2015).
Surviving, resisting, and thriving under the blanket of historical oppression requires survivance, resilience, transcendence (Cross, 1998; Robbins et al., 2013). Building skills through experiences of adversity is the hallmark of resilience and is evident in the political, familial, and cultural strengths and survivance (Burnette & Figley, 2017; Vizenor, 2008). Indigenist relational resilience (Cross, 1998) is a flexible, fluid, multidetermined process that occurs in reciprocity with the environment (Masten & Monn, 2015; Waller, 2001). Resilience and transcendence contribute to a balance across time and circumstances, or wellness, a holistic sense harmony across body, mind, spirit, and socio-environmental context (Burnette & Figley, 2017).
The ecosystemic resilience perspective of the FHORT centers interrelationships across culturally grounded protective, promotive, and risk factors at structural, cultural, community, familial, relational, and individual levels (Burnette & Figley, 2017). Survivance includes a connection to place, humor, persistence, spirit, and ingenuity (Vizenor, 2008). Thrivance integrates harmony across survivance, resilience, and transcendence – reaching new personal, spiritual, growth, and meaning. Thrivance is nurtured through being aware of settler colonial historical oppression and through living in alignment with agility (AWA), or living AWAke. The FHORTs frame of transcendence extends beyond recovery and resilience in response to, rising above, and operating at a higher level than the challenges that present themselves (Author(s), 2017). The process of liberation entails identifying and addressing historical oppression to break through toward liberation, freedom, and praxis, where clear critical decolonizing thought sparks a catalyst for dialogue and collective decolonizing action that ultimately redresses structural violence through collective emancipation (Burnette & Figley, 2017; Freire, 2000). Decolonization is banishing external and internalized settler colonial structures while re-aligning one’s life according to chosen values, purpose, and goals ([Living AWAke] McKinley, 2022).
Nutritional Colonialism
The role of settler colonialism in undermining healthy foodways has been endemic (Fredericks & Anderson, 2013). Nutritional colonialism is a form of historical oppression that sought to destroy foodway knowledge as well as the plant and animal life used to cook in historic and traditional ways (Fredericks & Anderson, 2013). Lindholm (2019) defines this concept as:
the negation of subsistence lifestyles, cultural suppression or marginalization, removal or control over resources, lack of food sovereignty, fostered dependence, environmental degradation, increase in chronic diseases, and negation of any dominant sense of responsibility. Products of nutritional colonialism contribute to sedentary lifestyles, require cash, contain suboptimal nourishment, and are culturally insignificant. (p. 162)
Because of nutritional colonialism, “Today, few if any of the descendants of the early Native American tribes eat diets that closely resemble those of their ancestors.” (Park, 2016, p. 171)
Settler colonial forms historical oppression disrupted Indigenous foodways, impairing subsistence activities by limiting or destroying crops and preventing access to ancestral hunting, fishing, and gathering homelands through removal, reservation, and relocation policies (Burnette et al., 2018; Fredericks & Anderson, 2013). The Indian Removal Act (1831) removed Southeastern tribes from their sacred homelands 500 miles West on the Trail of Tears (Howard University School of Law, 2018). The Indian Appropriations Act (1851), restricted Indigenous peoples to reservations (National Library of Medicine, 2022), limiting access and continuity of foodways (Fredericks & Anderson, 2013). Indigenous Peoples experienced starvation or had to live off rations (often expired or spoiled meat products) with processed foods higher in fats, carbohydrates, and sugars, while lowering the availability and access to fruits, vegetables, and subsistence diets (Bodirsky & Johnson, 2008). Reservation environments impaired their ability to participate in traditional harvests and have access to traditional foods (Gurney et al., 2015).
At the same time of the relocation of Indigenous peoples to urban areas in the 1950s, with little help or support (Hoover & Mihesuah, 2019), widespread hunger and malnutrition were prominent (Gurney et al, 2015). Commodities became the new version of rations on reservations and were distributed through the U.S. Governments Food Distribution Program on Indian Reservations, which provides foods free of charge to low-income families (Mihesua, 2019; Vantrease, 2013). Some foods today that are considered “traditional,” such as fry bread, represent relics of the introduction of white flour and other processed foods through governmental rations and commodities; these commodities both enabled survival, but also, impaired health and foodways (Mihesuah, 2019; Vantrease, 2013). In summary, the dispossession of Indigenous lands and the removal of Indigenous Peoples to reservations and urban areas while simultaneously introducing, often coercively, European foods and forced dependency on rations caused disconnections from the land, foods, cultural knowledge, and concomitant health inequities for Indigenous Peoples (Gurney et al., 2015).
Indigenous Resilience through Foodways: Past, and Present
Unlike in Eurocentric contexts, food and the natural world are seen as interconnected and mutually supporting systems within Indigenous worldviews (Salmón, 2000). Indigenous creation stories describe how earth, water, wind, plants, and animals were created first, and human beings were formed last. In many Indigenous stories, Creator instructs the plants and animals to take pity on their younger siblings, the humans, and to teach them how to live successfully and ethically with the rest of Creation (Salmón, 2000). For this reason, Indigenous North Americans understand that everything in nature—land, water, plant, or animal—has spirit and consciousness and should be treated with respect (Salmón, 2000). From this perspective, plants and animals are considered older relatives and teachers who possess valuable teachings concerning how to live harmoniously in specific environment; humans are extensions of nature and part of a broader ecological family of relatives who all share common origins (Salmón, 2000).
For millennia, Indigenous Peoples have nourished their peoples through growing, hunting, and gathering foods (Lunsford et al., 2021). Approximately 60% of the foods eaten by the world today are thought to originate from North America (Park et al., 2016). Traditional diets include culturally and geographically appropriate foods; such foodways were place-based and included wild meats, approximately 8,000 varieties of corn, and other fruits and vegetables (Gurney et al., 2015). When European invaders settled, they removed Indigenous peoples from their homeland and separated communities from the continuity and connection to land and health through eating corns, beans, squash, fishing, foraging, and hunting (Lunsford et al., 2021).
During settler colonization, Indigenous Peoples had an ample supply of nutritious, balanced diet of healthy foods, including corn, a staple of many Indigenous groups, along with beans, squash (Park et al., 2016). Corn, beans, and squash— known as the three sisters—tended to be planted next to each other (Bodirsky & Johnson, 2008; Park et al., 2016). Other foods included a variety of berries, including chokeberries, blueberries, black raspberries, serviceberries, blackberries, cranberries, and buffalo berries (Park et al., 2016). Hunted foods included small game, turkeys, grouse, turtles, deer, and bear, along with fish (Park et al., 2016).
Indigenous foodways are inseparable from land and traditional lifestyles, interwoven with subsistence, family, spirituality, gender, livelihood, health, and cultures (Lemke & Delormier, 2017). Meals are integral to reinforcing cultural continuity and cross-generational stability, especially in cases of rapid social change (Reddy, 2015). Food in ceremonial contexts strengthens connectedness (Reddy, 2015). Food is an important expression of cultural identity and predominates feasts, mourning, and other gatherings (Reddy, 2015).
Examinations of foodways in the Southeast have focused on feasting, gendered foodways, socioeconomic and political diversity, and food security (Peres, 2017). Feasting is sharing food for special, not every day, events between people (Peres, 2017). Historically, feasting in the Southeast occurred for important events or mark transitions such as birth, death, war, naming, calendrical cycles, as well as for other communal ceremonies such as the Busk or Green Corn Ceremony, which was a time of fasting, forgiving, and feasting (Peres, 2017). Feasting required relational spiritual understanding as well as technical skills in procuring, preparing, presenting, and consuming food (Peres, 2017).
Food Sharing as an Act of Resilience and Decolonization
Food sharing with families and communities has been found to be integral promotive factor fostering community connections and to enable informal supports to care for loved ones in times of shortfall and socioeconomic hardship (Peres, 2017). People froze foods for future times (Mihesuah, 2019). Food is at the center of social and symbolic activities in society. Implicit in the examination of foodways is the social, cultural, familial, and personal meaning that is experienced and transmitted through the production, distribution, and consumption of food (Peres, 2017). Subsistence is the strategy for acquiring food, which can include fishing, hunting, growing, and gathering (Peres, 2017). It has been found to promote resilience, not only because it promotes and healthy diet and nutrition, but also because it promotes family and cultural bonding, as well as a sense of psychological wellness (Burnette et al., 2018; McKinley et al., 2020). Food sharing among families and kin strengthened social bonds and ensured food security and cultural continuity (Gurney et al., 2015). Gurney (2014, p. 685) connected how dismantling foodways, due to forced relocation and removal to reservations, impairs resilience and culture:
Traditional foods—including the means of obtaining, preparing, and sharing them—are woven throughout Native history as an integral part of cultural heritage …. Food has historically represented a central component of Native American life and people’s direct connection to the land …. Cultural customs and procedures … were passed down across generations … ensuring the health and prosperity of Native people. The gathering and sharing of food brought people together for a common purpose and solidified social bonds …. In just a few generations, with the decline of hunter-gatherer ways of life, Native Americans lost their ability to gather and consume the traditional foods that stood as pillars of their culture …. The consequences of this shift are far-reaching. As the availability of these foods declined, so too did the stories, language, and customs.
This research used the FHORT to understand foodway practices among Indigenous Peoples. Given a limited understanding of how foodways may promote health and wellness the focal research questions for this inquiry were: (a) How do participants describe Indigenist foodways? (b) How do Indigenist foodways reflect decolonized values and practices? and (c) How may Indigenist foodways be promotive for health and wellness?
Methods
Research Design
This work is part of broader research spanning more than 10 years to develop and evaluate a culturally grounded Indigenist research intervention to promote wellness and resilience while preventing substance abuse and violence (Author(s), 2022). The focus of this work was to identify culturally specific protective factors related to wellness across social, physical, spiritual, and psychological dimensions. Interviews were an extension of a broader critical ethnography to promote Indigenous health and wellness to inform the foodways and nutritional aspects of a family-based and culturally grounded intervention (Author(s), 2019; 2021). Critical ethnographies place primacy on structural oppression and how its imposition disrupts daily living (Carspecken, 1996; Quantz, 1992). Carspecken’s (1996) methodology, noted for rigor (Carspecken, 1996; Hardcastle et al., 2006), was integrated with ethical, culturally relevant, and community-grounded research strategies developed with Indigenous Peoples (Author(s), 2014; Author(s), 2019). Data were drawn from 31 participants across a rural, reservation-based Southeast (SE) region and an urban Northwest (NW) region.
Identifying information of the tribal communication is kept confidential to reflect tribal agreements, to follow suggestions for culturally relevant research, and to avoid inadvertently causing harm (Author(s), 2014; Author(s), 2019). The SE context included members from a federally recognized tribe with autonomous school systems, healthcare facilities, and social and mental healthcare systems, as well as environmental, law enforcement, and criminal justice systems. The NW urban context was comprised of an Indigenous urban health center.
Data Collection
Before collecting data, the university Institutional Review Board and tribal agency and approvals for study activities were attained. Numerous cultural insiders assisted with purposive sampling of participants with knowledge of Indigenous foodways of respective tribes and regions. Recruitment efforts included word-of-mouth and posting fliers in agencies, newsletters, and online (Author(s), 2014; Author(s), 2019). Participants had the option to be interviewed by tribal or nontribal interviewers for cultural sensitivity. The first author conducted all interviews with assistance from cultural insiders if interviewees preferred. Interviews took place in a local agency, private conference room, or other preferred location of participants. Although participants had the option of having solely an Indigenous interviewer, none selected this option. Interviews were completed throughout December of 2018 and January of 2019 with 31 participants. In total, 23 participants identified as women and eight identified as men, with 16 SE participants and 15 NW participants. Inclusion criteria were (a) Indigenous tribal member(s) with local foodway knowledge as identified by cultural insiders, or a professional with specialized Indigenous foodway knowledge, and (b) being an adult. See Table 1 for participant demographics. Participants received $50 on a Clincard, which could be used as credit or for cash.
Table 1.
Participant Demographics
| Participant Demographics | Qualitative (N = 31), % |
|---|---|
| Southeast Rural Area | 16 (51.6%) |
| Northwest Urban Area | 15 (48.4%) |
| Age (30–78 years) | M = 58.6 |
| Number tribal | 30 (96.8%) |
| Female | 23 (74.2%) |
| Male | 8 (25.8%) |
| Marital Status | |
| Single | 4 (12.9%) |
| Divorced | 8 (25.8%) |
| Married/Domestic Partner | 13(41.9%) |
| Widowed | 6 (19.4%) |
| Number of children (range = 0–10) | M = 3.39 |
| Number of siblings (range = 0–13) | M = 5.27 |
| Education | |
| Less than high school | 2 (6.5%) |
| High school or equivalent | 6 (19.4%) |
| Some college/vocational degree | 10 (32.2%) |
| Associate’s | 1 (3.2%) |
| Bachelor’s degree | 8 (25.8%) |
| Master’s degree or higher | 4 (12.9%) |
| Number who engaged in Member-Checks | 25 (80.6%) |
Note. M indicates mean. Adapted table reprinted with permission “We were always doing something outside. … I had a wonderful, wonderful life”: U.S. Indigenous Peoples’ subsistence, physical activity, and the natural world.” By (Author(s)), 2022, Social Science & Medicine: Qualitative Research in Health. 100170, 2667-3215. Copyright 2022 by (Author(s)).
A relational, life history approach guided these critical ethnographic interviews, which have been recommended to align with storytelling practices that tend to be culturally congruent with Indigenous Peoples and to follow the methodology of the past decade of preliminary research (Author(s), 2014; Author(s), 2019; Carspecken, 1996). Cultural insiders assisted with the development of the semi-structured interview guides, which were based on research questions about how the dimensions of health, foodways, and wellness had changed from the past to present generations. Interview guides were developed for a fifth-grade comprehension level with relevant interview questions including: “What do you know about how tribal community members ate in the old days/ways? What memories or stories have you been told of eating practices (Where, with whom, how/who prepared)? How does it compare with how people eat today?” (See Supplemental Materials for complete interview guide).
Data Analysis
Team-based qualitative data analysis was used with research assistants who had been engaged in prior work with the focal tribes (Author(s), 2019; Guest & MacQueen, 2008). Interviews were professionally transcribed and analyzed in NVivo1 using reconstructive analysis, a data analysis specific to this critical ethnographic method (Carspecken, 1996). Immersion in the data was gained by listening to and reading interview transcripts multiple times and checking for accuracy. The first author created sample coding hierarchies with overarching themes and subthemes organized according to interview questions by conducting line-by-line coding; codes and subcodes were agreed upon with research assistants through collaborative consensus and discussion and checked across research assistants for interrater agreement. Implicit meaning and explicit interpretations of the data were explored through an inductive and iterative process finalized by the first author and checked for agreement with cultural readers from each tribe and through participant member checks. Following this methodology (Author(s), 2014; 2019), the aim was to identify universal themes while noting the region and sex of each participant to elucidate and qualify across contexts and regions. Themes related to foodways were chosen due to their frequency and saliency across participants. The following themes emerged across all 31 sources, with the first author distributing interview transcripts and a summary of results to more than 80% of participants, or all participants who could be reached. No disagreements were expressed with summative themes during member checking with participants, and each respondent affirmed themes and findings. All results were reported to tribal councils prior to publication and have been disseminated, presented, and reported numerous times with focal tribes. Moreover, findings have informed the nutrition and wellness component of an Indigenist and culturally grounded intervention to promote wellness and health (Author(s), 2021).
Results
Despite centuries of historical oppression, the following emergent themes demonstrated decolonized values, worldviews, and foodways, which were promotive factors for family resilience, health, and cultural identification: (a) Indigenous Values of Generosity Expressed Through Foodways: “It’s Always About Sharing, and Caring, and Loving, and Giving”; (b) Gardening, Subsistence, and Food Sharing: “You Bring Enough for Everybody to Share”; (c) Decolonized Feasts and Foodways: “Everybody Pitch in and Help as Much as They Can.”
Indigenous Values of Generosity Expressed Through Foodways: “It’s Always About Sharing, and Caring, and Loving, and Giving”
A SE male spoke about the transcendent and traditional values of love and generosity even in relationship to colonization and relationship to foreigners (settlers):
We’re [Indigenous Peoples] here on this land given to us. But if it’s given to you, you have a big responsibility to share it. So, whatever you’re given, God only gives you something so that you can spread the wealth. So, we didn’t say, oh, this is our land, or I want to build a wall …. It was all about the love and that’s the way we work. We’re all about the love. “Hey,” somebody may have said, “Why do we want to let these foreigners in?” … That’s our brother, he needs somewhere to stay. Let him stay where he wants …. First 3 years, 5 years, they [settlers] didn’t really know how to survive. So, they relied on us, and we shared our food …. It’s always about sharing and caring and loving and giving …. That’s really it. It’s amazing isn’t it, because if you think about land loss, all the decimation of the people, Native people have been crucified. We got crucified.
A SE male elaborated on how the spiritual value of generosity relates to balance and harmony:
Mom used to say that for every good deed that you do, the Creator adds another day to your life, and I believe it. Or if you give away the thing that is most important to you, you’ll get more positive things in return …. People don’t try it out to realize …. And the first time that you do it and give away stuff, you know, you might say to yourself, you know, “I needed that. I shouldn’t have done it. I may need it later on. But if you do it often enough, it’s going to be part of you …. I didn’t realize it was spirituality until later on …. You use the word harmony; balance was the word they taught us. They didn’t say, “This is balance” …. Other Native American tribes has [sic]the same teachings.
As indicated by this person, despite it being a challenge to give away something he valued, he felt he received something better in return because he was willing to be generous. Thus, sharing was not only expressed through foodways but expressed through a broader value of generosity.
Gardening, Subsistence, and Food Sharing: “You Bring Enough for Everybody to Share”
The value of generosity extended to food sharing. Sharing food, generosity, and hospitality were prominent themes that dated back to precolonial times. A male SE archeologist shared the importance of Indigenous foods that are still used today and how, historically, they were saved to be resilient through times when foods may be in short supply:
The production of corn focused … not just on producing food for immediate consumption … During the winter or during the early spring when many other foods might have been in short supply, some amount of corn … and beans and squash … was probably saved for planting in future crop cycles and … for the possibility of shortfalls.
The archeologist went on to talk about how different foodways and subsistence were seasonal,
Meat provided a food with symbolic, ceremonial and political significance … the mainstay of Native American diets was probably based on plant foods, especially corn, beans and squash …. The acquisition of food … were very important in structuring social relations within households and within larger communities …. Sharing of food took place first and foremost at the level of the household.
A SE female related the importance of generosity and food sharing within families in that it reinforced communal values of taking care of the whole family:
My mom was a cook … she’d say, “When you’re going to these feeds … you don’t bring this little thing, you bring enough for everybody to share because that’s what feeds your family. And don’t just bring one, bring your whole meal.”
This participant emphasized how important, prosocial values were transmitted through elders. Another SE female mentioned being able to eat fresh foods throughout the year by freezing produce from the garden, and how this surplus was used to care for family members:
She [grandmother] had some corn, she had some peas, she had some collard greens, and tomatoes. And what we used to like was the watermelon …. The cantaloupe …. And there was plenty for all of us. We freeze them she would help; we would help her.
Another NW female remembered preserving the surplus fresh produce for the future:
We had a garden that I swear was 10 city-blocks big …. we had rows, and rows, and rows of garden, you know, potatoes … berries, and you know, the kids, we’d all go with the mothers and grandmothers out to the hillside and pick berries and cut fruits. Oh, we had a full garden, vegetables, everything was garden …. Everything was dried, canned.
Eating traditionally—including sharing, gardening, and preserving food from the land—could offset the economic burden of purchasing healthy foods. One SE female related:
At times, yeah, I’ve struggled [financially] …. Going over there and helping out cooking with his grandma. It’s, it’s helped a lot …. She had a garden and what they used to say back then, is if a little kid helps you … plant your garden, then it will grow … good [sic; children helping plant was believed to be blessing to help gardens grow] …. My dad does [grows] corn or cabbage or turnips and tomatoes and peppers … and my mom picks them tomatoes …. She bags them after that she boils it and … freezes it.
Indeed, gardening, subsistence, and food activities were activities that brought families together, offering an important opportunity to pass family stories, as this NW female stated,
We have this thing we do every spring where we go out and we gather the wild green onions that grow. And we would go out and … get the medicinal plants at a certain time of the year … in the early spring when they first started coming up and they’re young and tender and we would gather them all together. All the families would put their things together … the whole family, like the whole community, would join in …. We’d be sitting around the house, and my grandmother would tell us stories about like what our family went through and how hard it was to be a [tribal name] Native back then …. So, we got to keep our traditions and we got to pass them down to our children.
Thus, subsistence brought together family and community and promoted culture and connectedness. A NW female remembered food that was hunting and preserving it:
My mom was such a great cook …. We had rice and deer meat, dry meat …. My dad … he would hunt pretty much everything, like pheasants, grouse [birds].
Another NW female spoke about how subsistence was used by her family growing up to trade, like in pre-colonial times: “My Mom and dad did have a garden. They had corn, squash. And among tribes, we would trade stuff and take it to the trading posts.” A NW female echoed:
My grandpa used to grow a lot of corn and squash and potatoes … radishes …. They would dry them, and then they had an old root cellar …. all the aunties and uncles, everybody would put stuff in there, so then they’d go down there when they’d need them … people would … trade … my two uncles … had ranches … they’d butcher.
This is another example of families banding together to share foodways, resources, and skills for the greater good. When asked whether this communal food storage was still common, the participant replied, “No, I don’t think so. I think a lot of people don’t think like that anymore—Like saving … generating enough.” In some families, when the elders had become functionally impaired, the family’s younger generation stepped in to continue the tradition of sharing food:
I have a big little family already … but I usually like to invite some people over. I’m like, hey, come eat, … We’ll mostly go to his grandma’s …. She’s an elder and she can’t get around. So … whoever got off early or was already off [work], then we start preparing a meal over there. So, we, as a family we just come together, and we eat.
This participant opened up her home and shared food, while pitching in to prepare meals when an elder could no longer do so. Similarly, a NW female spoke about living in her grandmother’s household, which was where everyone could go to for sustenance. As described, “Well, our house was the house that, she [grandma] had great big pots, and she’d have her tea and her coffee or her big pot of soup with her bread and you come in, you eat and you go.” A male SE participant remembered fishing and hunting in traditional tribal ways and food sharing:
We used to go fishing all night long. We used to set up hooks and sometimes we’d come home, but sometimes we would stay …. The men would go out and fish and then later on, like morning time or next time the females would bring the pots and pans and coffee and uh, we eat … our hunt. Even if I caught two (fish), our family would get equal share, … we would divide … it wasn’t only in fishing but … hunting squirrels and rabbits.
Similarly, a SE female spoke about how generosity and making sure everyone had enough was an important tribal value, as stated, “Sometime grandma used to mix two or three different beans.” This enabled her to, “ have enough beans to go around.” Another SE female discussed family members’ sharing and supplementing collective food sources like in traditional times:
My sister had this little land … I had the cucumbers and squash …. My sister had peas, but mom had different vegetables, and … my brother … had Okra …. It was good …. We were able to share, but for the past couple … years we haven’t.
A fast-paced lifestyle and family obligations had made growing food in the garden unsustainable. Cooking outside, hunting, and subsistence were important tribal values, especially generosity:
I’d say cooking outside, …. My husband, or the other families and their friends go hunting together, then they usually come and eat with us, and we usually try to have enough for everybody …. I’m preparing the meal, I want to make sure everybody eats.
When asked whether feasting was a common practice, she said: “Yeah. People get together … everybody … in the community … they eat and do the same thing.”
Decolonized Feasts and Foodways: “Everybody Pitch in and Help as Much as They Can”
Parallel to historical tribal practices, in more recent contemporary times, cooking outside and subsistence were traditional tribal cultural practices. Feasts, or eating together for special occasions, were remarked upon by many participants. As stated by a SE female, cooking outside, having a feast with family, and cooking a pig—along with hunting wild game—seemed to be a recurrent theme of traditional tribal practices in the Southeastern tribe:
Well, growing up, um, my grandmother stayed in the [specific tribal] community, and I used to go over there a lot and like get to-we used to have these get-togethers and we’ll kill some pigs and uh, we do outside cooking and back then we used to like skin it and gut it and everything and I used to help my grandma wash the intestine … the chitterlings …. We go hunting and we’ll kill either rabbit, deer, or a squirrel. And that’s how I basically grew up just eating, you know, wild animals.
She went on to describe that cooking outside had practical implications and was meant for a: “Special occasion.” For example, hominy “has to be done outside.” It was cooked over a,
Open fire. Usually we put, like usually the cast iron pots they have these legs, then we get bricks and put it on top … and then put some woods [sic] and then fire around it …. They did it [for] like special occasions—Or any family they wanted to get together …. We’ll cook some greens outside too, like collared or turnip greens to go with it or … cabbage …. We just boil it … put it in cast iron pots and when it’s done then we all just get together and eat …. I used to be in like a lot of sweets, but … on the reservation, there’s a whole lot of people becoming diabetic … so we’ve done cut down on sweets …. It’s basically just dried beans, or any greens, and the meat will be the pig, or like deers [sic], or rabbits, or squirrels, and another thing that goes with it is hominy.
A male SE participant described the whole family participating in preparing traditional foods:
That’s another thing she [grandma] used to say that the corn is [tribal] food. So, she would make hominy outside in those cast iron, like kettle, once a week. And um, we used to cut firewood for her …. So, the corn was big, and squash, and … the hunting …. Some of the squash … [grandma] she would plant, or we would plant different types.
Family would be exposed to traditional foods and how to cook them from elders during feasts. A SE female emphasized the traditional practices of cooking outside. She remembered eating:
Turnip greens, collard greens. Yeah, I love to cook. Outside too. That’s where we come from [her tribal community cooks outside]. My mom used to cook outside; my grandmother used to. My mama did, and I do, and I teach my kids too …. I still do it, … You can cook it in the stove, but it don’t taste like the outside, I mean, it tastes better.
Other participants mentioned cooking outside on special occasions, as this SE female described, “When it’s a special occasion. Hominy. And they can cook chicken outside.”
Cooking outside was not only traditional; it also was economical for community members who had scarce resources. A SE female emphasis important skill to learn for survival:
We didn’t want to use a lot of electricity since we didn’t have enough money, and cooking was done outside and people [a relative explained], “You’re gonna have to learn … You have to know the habits … Your grandma and your mom teaching you how.
This participant described learning to cook outside and learning a lot from the community members who taught her. She explained: “And I just go and help out. So, I don’t say no to them. So, every time I go, there she is!’ And that’s it …. [They say] this is what you need to do, and I learned a lot from them too as a community.” She went on to describe how all family members were part of this food preparation, through cooking, hunting, and cleaning or preparing food:
Thanksgiving, all the family members get together to eat. They bring … flour, corn meal, a chicken …. The men folks go hunt a squirrel, rabbit or sometimes racoon –all that, they bring it in. And from there you cleaned it then and have a big cookout …. That’s Thanksgiving food for us … I never had turkey … until I got married. [laughter].
Instead, she had eaten rabbit or raccoon, which she had learned to hunt with her uncle:
Rabbit, racoon …. He had a good arm, so he just threw it and hit it, knocking. Knocked it on the ground and he ran over there, picked it up and hit him on the head. He went, “I killed a rabbit now, we’re going to have fried rabbit or stew.” So, he loved it.
Growing up, a SE female supplemented commodities, garden food, game meat, and fish:
We eat some garden food and then the, mostly in the morning we eat some scrambled eggs and like I said, some commodity food …. I know, when it starts getting cold, they killed the hog … if they have birthday … they cook hominy … outside …. My daddy usually, hunt, fishing and my two brothers they always go fishing …. In [traditional community], women can fix everything. They can fix the rabbit and squirrel and fish.
One SE female recalled “eating off the land.” She described: “We did, we sure did … we still had the garden, then we still have the hogs.” She added: “I love hominy. Now I don’t know how to do it [cook hominy outside], but my sister does … when we have family gathering … outside cooking.” One SE female spoke about eating a lot of dried beans growing up:
My mom was divorced … but we live with grandma … she had kids of her own. So, everybody pitch in and help as much as they can. We also cook outside …. We had beans to cook just about every day, rice, … cornbread, or biscuits …. hominy – the corn we grew ourselves, and peas … we would dry … with … beans, wash it and cook it.
Through feasting with family, everyone pitched in, which was a historical Indigenous value; they ate healthy freshly procured food and game, which promoted nature based physical activity.
Discussion
This article aimed to understand (a) How do participants describe Indigenist foodways? (b) How do Indigenist foodways reflect decolonized values and practices? and (c) How may Indigenist foodways be promotive for health and wellness? First, results indicated the presence of decolonized foodways, which entails recovering old ways of knowing and then restoring and re-envisioning to survive, become resilient to, and transcend continued historical oppression (Fredericks & Anderson, 2013). Foodways enabled the connection with each other, nature, and Indigenous values, identity and knowledge. As such they not only connected to their foodway roots, but their ancestral and Indigenous roots and worldviews. Restoring foodways also allowed Indigenous peoples to reclaim their relationship with the environment, and promote wellness (Mihesuah, 2019). Sharing food is a fundamental Indigenous value affirming social and familial connections and values of generosity (Fredericks & Anderson, 2013; McKinley et al., 2020). Because food is the center of family, social, and healthy living, healthy foodways promote health for Indigenous peoples and offset inequities (Fredericks & Anderson, 2013).
Despite experiencing historical oppression, transcendent and decolonized Indigenist values were evident in participants’ stories that reflected unity, cooperation, sharing, and social cohesion and caring (Burnette, 2015a, 2015b, 2015c; Fredericks & Anderson, 2013; Gurney et al., 2015; Peres, 2017). After experiencing historical oppression and land loss it would be understandable to respond to this subjugation with the same tools of oppression that were used on them (Burnette & Figley, 2017), participants described transcendent values that have persisted through the test of time, including, as one participant put it: “Sharing, and caring, and loving and giving.” These values of love and generosity were often expressed through food sharing (Fredericks & Anderson, 2013), and are established promotive factors for family resilience within the FHORT that enhance health and wellness (Burnette et al., 2020). Participants elaborated about how the Indigenist spiritual value of generosity and giving contributed to greater balance and harmony, all of which contribute to the FHORT’s wellness (Burnette & Figley, 2017). Sharing food, generosity, providing enough for all to eat, and hospitality were prominent collectivist and decolonized themes (Gurney et al., 2015; Peres, 2017).
The practice of conserving and preparing while living in harmony with the environment and the seasons has been documented since colonial and precolonial times (Lunsford et al., 2021; Salmón, 2000). Similar to the precolonial Indigenous peoples’ accounts of food storage for the family and extended family, participants reported that this practice was still salient for some (Mihesuah, 2019; Peres, 2017). Participants emphasized how important, prosocial values were transmitted through elders, and this practice, along with the associated prosocial values, may be impaired over time. Similar to traditional practices, participants explained how they were able to eat home grown foods throughout the year by freezing produce from gardens (Mihesuah, 2019; Peres, 2017). These practices promoted health and wellness, as many of the foods that participants described eating were consistent with the first foods of traditional decolonized Indigenous diets, namely eating corn, beans, squash, wild game, along with other fruit and vegetables; these foods were procured through similar means of fishing, foraging, and hunting that have been practices for centuries (Gurney et al., 2015; Lunsford et al., 2021; Mihesuah, 2019; Park et al., 2016). Participants echoed this practice of sharing food communally with family/extended family. Yet, like many other tribal practices, this tradition may be less common in current times.
Decolonized and Indigenist food practices were thoroughly described. Beyond sharing food as a practical matter, sharing food at feasts, social gatherings, and meals was highlighted throughout (Peres, 2017; Reddy, 2015). Part of these family gatherings would be to cook in traditional ways. Cooking outside, hunting, and subsistence were important tribal values, particularly related to communal living, cultural continuity, and the transmission of cross-generational foodway knowledge (Peres, 2017; Reddy, 2015). Not only did these foods tend to be healthy and economical, but subsistence simultaneously fostered wellness and health the promotion activities, including physical activity, connection with nature, family, and community, as well as psychological wellness (Burnette et al., 2018; McKinley et al., 2020; Peres, 2017; Reddy, 2015). Participants remembered fishing and hunting in traditional tribal ways and sharing food with other families, and spoke about how generosity ensured everyone had enough and fostered collective caring (McKinley et al., 2020). As such, the transmitted ancient Indigenist values of pooling resources and pitching in to take care of elders and those who were unable.
Parallel to historical tribal practices, in more recent contemporary times, cooking outside and subsistence were traditional tribal cultural practices. Cooking outside, along with hunting wild game, was a recurrent theme of traditional tribal practices in the Southeastern tribe. Cooking outside over an open fire was a traditional practice used for special occasions and more frequently among some community members. Cooking outside was not only traditional; it also tended to foster healthier preparation styles, such as boiling foods, and was economical for community members who had scarce resources, thus making it an important and practical skill to learn. Participants learned cultural traditions from community members. All family members were part of this food preparation, whether it be through cooking, hunting, or preparing.
As times changed, participants transcended limitations imposed by the processed foods of commodities by eating a mixture of commodities, garden food, hunted meats, and fish. “Eating off the land” was a core component of this practice. Healthy foods like dried beans, garden-grown vegetables, hunted meats, and fish were prepared and consumed in these practices. Eating in this traditional way—including sharing, gardening, and preserving food from the land—offset the economic burden of food costs. Living off the land, food preparation, and making things from scratch could be inconvenient, but transmitted important life lessons (Burnette et al., 2018).
Limitations and Future Research
This self-report study from two regions does not extend to the diverse tribes across the United States or internationally. Future research should focus on gender roles, which is an important dimension of food sovereignty (Ruelle & Kassam, 2013). Foodway transmission is growing in research as a way to understand how people convey foodway knowledge in families and communities (Ruelle & Kassam, 2013). Research indicates that decision-making related to Indigenous food sovereignty must be community-driven, culturally relevant, and reflect the priorities of the communities most affected (Rudolph & McLachlan, 2013). Collaborative foodway research enhances the understanding of how communities can bolster these instrumental processes for health and well-being, socially, physically, culturally, environmentally, spiritually, and mentally (Ruelle & Kassam, 2013).
Food sovereignty is an important opportunity for future research to integrate the mutual benefits of reconnecting with and decolonizing foodways while promoting health. Food sovereignty entails [re]activating and [re]energizing cultural, spiritual, and relational responsibilities with plants, water, land, ecology, star and calendrical systems, and associated Original Instructions (Walters et al., 2020) or ancient teachings therein for wild, foraged as well as farmed plant medicines and foods (Kimmerer, 2013). Food sovereignty entails harvesting, cultivating and preserving food, seeds, and medicines—all of which can promote health and wellness (Johnson-Jennings et al., 2020). Indigenous communities are actively restoring or augmenting these relational responsibilities, lifeways and traditional ecological knowledges as they are key to revitalizing not only healthful Indigenous foods and practices, but are integral in strengthening community health (Cote, 2016; Fernandez et. al., 2020; Walters et. al., 2011) and promoting cultural, community, family, and individual wellness (Gurney et al., 2015). More research to extend the foodway and food sovereignty movements is needed.
Implications and Conclusions
This research provides promising pathways about how Indigenist foodways remain salient in daily and cultural life, reflect decolonized values and practices, and may be promotive for health and wellness within the natural world. Foodways can affirm important ecological knowledge, cultural values, and family and community relationships (Ruelle & Kassam, 2013). Foodways are naturally occurring within Indigenous communities already and foster the prosocial Indigenous and values that are known components of family resilience. For example, the Indigenist, Family Resilience Inventory is an empirically based measure of culturally grounded promotive factors that make up family resilience (Burnette et al., 2020). Participants described the promotive factors that are described in this inventory, including sharing love and affection, living a life guided by strong tribal values, being close knit, passing down cultural traditions, drawing strength through challenging times by providing food to those in need, spending quality time together – including through feasts and special events – and helping each other out (Burnette et al., 2020). Family resilience has been associated with decreased risk for depression, alcohol use, and anxiety; thus, foodways may promote culturally grounded Indigenist family resilience (McKinley et al., 2021; McKinley & Miller Scarnato, 2021).
Participants described subsisting, which promotes physical activity, eating healthy foods, and promoting culture and psychological wellness (Burnette et al., 2018). In contrast to loss of subsistence lifeways foodways knowledge due to nutritional colonialism, Lindhom (2019) stated,
Decolonial acts include sharing with friends and family and engaging in subsistence practices, which brings communities and families together. Subsistence activities also provide a combination of physical activity and relationship building that contributes to well-being. Identity and sense of place are essential to mental health … intervention programs must recognize the cultural significance of subsistence activities. (p. 166)
Lindhom (2019) explained, “Because cultural health is considered a byproduct of physical, mental, and social health, a return to more subsistence-based lifestyles and diets is perceived as essential for all areas of individual and community health” (p. 170). Exploring, envisioning, and enacting sustainable ways of supporting healthy foodways is imminent. (Re)connecting to Indigenist foodways can not only promote health and social equity, but it can also redress the nutritional colonialism imposed and perpetuated for centuries.
Incorporating Foodways and Food Sovereignty into Health Promotion Programs
Foodways may be a natural and culturally relevant ways to promote health and wellness by building on existing familial and community infrastructures rather than imposing external programs that may be incongruent or unfamiliar. Satterfield et al. (2014) recommended incorporating tribal values such as generosity, sharing, and gratitude for the earth, water, children, and land and respecting the diverse histories and cultures in health research. Indeed, food was seen as a component of culture and identity that nourished the body, mind, and spirit of the community and transmitted important cultural knowledge experientially, as people work together in subsistence through gardening, fishing, or hunting—a perfect time to transmit intergenerational cultural stories and values. Food brings people together through feasts, ceremonies, stories, sharing, and relationships. Food sovereignty and living off the land enable avenues of economic growth and freedom from external dependence; it provides a way to care for each other and the communities. Providing for each other is an important value to uphold (Burnette et al., 2018; Hoover, 2019). An integral element of food sovereignty is a process of learning about and sharing knowledge about your culture cross-generationally (Hoover, 2019). According to Gurney et al., (2015),”Future research should place primacy on making use of existing traditional knowledge frameworks to address the unique concerns, opportunities, preferences, and barriers associated with Native American food insecurity” (p. 689).
Programs that integrate experiential foodways are promising approaches to promote health. Schultz et al. (2016) described one such wilderness experience program that centered Indigenous worldviews to enable Indigenous women to reconnect to place, their bodies, and health. This holistic program placed primacy on traditional and ecological knowledge and the interconnections of all things and seeing health problems as imbalances across social, physical, spiritual, psychological, and environmental domains (Schultz et al., 2016). As Indigenous women walked the Trail of Tears, the path of their ancestors’ removal, participants experienced changes and improvements in attitudes, beliefs, and health behaviors (Schultz et al., 2016).
Ruelle and Kassam (2013) stated, “The global food sovereignty movement led by Indigenous peoples is resulting in revitalization of their food cultures” (p. 316). Ecological knowledge is necessary to pass down Indigenous foodways across generations. Living off the land enables self-reliance and independence from broader social systems that historically have been oppressive (Burnette et al., 2018; Ruelle & Kassam, 2013). Subsistence activities such as gardening, raising livestock, and especially fishing provide both nutritional sustenance and important cultural activities for the tribe (Burnette et al., 2018). Indeed, foodways are not only important for diet, sustenance, and health (Ruelle & Kassam, 2013). They hold central and even sacred cultural, social, environmental, and familial meanings. Engagement with foodways nurtures relational and cultural connectedness, important for health, wellness, and resilience, thrivance, and transcendence (Burnette & Figley, 2017; Ruelle & Kassam, 2013).
Supplementary Material
Acknowledgements and Funding
The authors thank the dedicated work and participation of the tribes and collaborators who contributed to this work. We thank The National Association for Children of Addiction for the original program that the WHF program was developed from, and White Bison for introducing cultural components. This work was supported, in part, by Award K12HD043451 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (Krousel-Wood-PI; Catherine McKinley (Formerly Burnette)-Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Scholar); and by U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center. Research reported in this publication was supported by the National Institute on Alcohol Abuse and Alcoholism of the National Institutes of Health under Award Number R01AA028201). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Footnotes
A qualitative data analysis software program.
Conflicts of Interest
The author has no relevant financial or non-financial interests to disclose.
Ethics Approval
All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This research gained approval from social-behavioral sciences component of the Tulane University’s IRB board [Study: 2018-1372-OTH], along with the tribal councils and agencies associated with this study.
Consent to Participate
Informed consent was obtained from all individual participants included in the study.
Contributor Information
Catherine E. McKinley, Associate Professor, Tulane University School of Social Work, 127 Elk Place, New Orleans, LA 70112.
Karina Walters (Choctaw Nation of Oklahoma), Professor, Katherine Hall Chambers Scholar, University of Washington School of Social Work.
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