Table 1.

Intervention modules and associated adaptations based on qualitative feedback.

PTSDa Coach Online tools	Health is Our Tradition guides	Description	Adaptations
N/Ab	Trauma and your Health	Patient education	Content developed from Phase 1 interviews, focus groups, and recommended existing SCFc and CNHSd patient education materials on the impact of trauma on overall health including testimonial videos from AI/ANe people with a history of trauma
Be in the moment	Be in the moment	Guided relaxation and grounding activities	Minor adaptation to add an estimation of activity duration and information before the guided relaxation activity acknowledging that some people may not have a quiet place to listen to the audio activity
Change feelings by changing thoughts	Change feelings by changing thoughts	Educational activities with written exercises to work toward changing negative beliefs about oneself to more helpful positive beliefs	Major adaptation to focus on false beliefs and shame messages common among AI/AN people who have experienced trauma including educational videos narrated by members of the AI/AN community; content developed based on Phase 1 interviews and focus groups, addition of testimonial videos from AI/AN people with a history of trauma
Change how you think about sleep	Change how you think about sleep	Educational activities with interactive content that suggests new ways of thinking about negative thoughts that impair sleep	Minor adaptation to replace the word nightmare with bad dream
Change negative thinking patterns	Change negative thinking patterns	Educational activities with written exercises to work identifying and changing negative thought patterns	No adaptation outside of those listed in Overall
Deal with trauma reminders	Cope with trauma reminders	Educational and guided relaxation activities with written exercises to learn to cope with reminders or triggers related to trauma	Minor adaptation to rename guide from Deal with trauma reminders to Cope with trauma reminders and to add additional examples of triggers
N/A	Develop healthy relationships	Educational and written activities to help identify how trauma may affect interactions with others and to change negative interactions to more positive ones	Content developed from Phase 1 interviews and focus groups and adapted from FWWIf curriculum materials including testimonial videos from AI/AN people with a history of trauma
N/A	Discover your story	Educational and written activities to encourage acceptance and sharing of one’s story that includes traumatic experiences and their effects on resilience and personal growth	Content developed from Phase 1 interviews and focus groups and adapted from FWWI curriculum materials including testimonial videos from AI/AN people with a history of trauma
Form good sleep habits	Form good sleep habits	Educational and interactive activity to learn about good sleep habits	Minor adaptation to replace a drawing of generic sleeping man with one more easily recognized as having AI/AN heritage; changed the drag and drop motion in the interactive activity to a mouse click motion
Identify your values and goals	Identify your values and goals	Educational and written activity to help identify values and goals to guide decisions in life	Minor adaptation in wording of text and omitting the calendar feature
Learn to be assertive	Express your feelings and wants	Educational, written, and checklist activities to foster effective communication skills	Major adaptation to replace all references to assertiveness with expressing oneself and to replace educational and interactive activities with content adapted from FWWI
Notice your thoughts and feelings	Notice your thoughts and feelings	Educational and mindfulness exercises to help user learn to live in the present moment	Minor adaptation to add an estimation of activity duration and information before the mindfulness activities acknowledging that some people may not have a quiet place to listen to the audio activity
Plan something enjoyable	Plan something fun	Educational and interactive activities to help users identify and plan fun activities	Minor adaptation to add or omit suggested activities that are common or uncommon in AI/AN communities; omitted the calendar function
Relax through breathing	Relax through breathing	Animated relaxation activity focused on deep breathing	No adaptation outside of those listed in Overall
Relax through visualization	Relax through visualization	Animated relaxation activity focused on picturing a calm or comfortable scene	Minor adaptation to add an estimation of activity duration and information before the guided relaxation activity acknowledging that some people may not have a quiet place to listen to the audio activity
Relax your body	Relax your body	Animated relaxation activity focused on releasing body tension	No adaptation outside of those listed in Overall

^aPTSD: Posttraumatic stress disorder.

^bN/A: not applicable.

^cSCF: Southcentral Foundation.

^dCNHS: Cherokee Nation Health Services.

^eAI/AN: American Indian and Alaska Native.

^fFWWI: Family Wellness Warriors Initiative.