The authors declare that they have no conflict of interest with respect to their authorship or the publication of this article.C. Ethical Approval. All procedures performed in studies 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 article does not contain any studies with animals performed by any of the authors. D. Informed Consent: Informed consent was obtained from all individual participants included in each study described.

Objectives: The foundational role culture and Indigenous knowledge (IK) occupy within community intervention in American Indian and Alaska Native (AIAN) communities is explored. To do this, we define community or complex interventions, then critically examine ways culture is translated into health interventions addressing AIAN disparities in existing programs and research initiatives. We then describe an Indigenous intervention based in the cultural logic of its contexts, as developed by Alaska Native communities. Yup’ik co-authors and knowledge keepers provide their critical and theoretical perspectives and understandings to the overall narrative, constructing from their Indigenous knowledge system, an argument that culture is prevention. Conclusions: The intervention, the Qungasvik (phonetic: qoo ngaz vik; tools for life) intervention, is organized and delivered through a Yup’ik Alaska Native process the communities term ‘qasgiq’ (phonetic: kuz-gik; communal house). We describe a theory of change framework built around the ‘Qasgiq Model,’ and explore ways this Indigenous intervention mobilizes aspects of traditional Yup’ik cultural logic to deliver strengths-based interventions for Yup’ik youth. This framework encompasses both an Indigenous knowledge (IK) theory-driven intervention implementation schema and approach to knowledge production. This intervention and its framework provide a set of recommendations to guide researchers and Indigenous communities who seek to create Indigenously-informed and locally sustainable strategies for the promotion of health and well-being.

Highlights• Long-term CBPR requires preparation and resolution of crises when we lose key partners over time.• Relational cycles are a natural part of a CBPR process and impact upon the research in keys ways.• Long-term community-based participatory research allows the spirit to come into the science.Abstract This retrospective analysis of a long-term community-based participatory research (CBPR) process spans over two decades of work with Alaska Native communities. A call to action from Alaska Native leadership to create more effective strategies to prevent and treat youth suicide and alcohol misuse risk initiated a response from university researchers. This CBPR process transformed into a collaborative effort to indigenously drive and develop solutions through research. The People Awakening project started our team on this translational and transformational pathway through community intervention science in the Central Yup'ik region of Alaska. We examine more deeply the major episodes and their successes and struggles in maintaining a long-term research relationship between university researchers and members of Yup'ik Alaska Native communities. We explore ways that our CBPR relationship has involved negotiation and engagement with power and praxis, to deepen and focus attention to knowledge systems and relational elements. This paper examines these deeper, transformative elements of our CBPR relationship that spans histories, cultures, and systems. Our discussion shares vignettes from academic and community perspectives to describe process in a unique collaboration, reaching to sometimes touch upon rare ground in emotions, tensions, and triumphs over the course of a dozen grants and twice as many years. We conclude by noting how there are points where, in a long-term CBPR relationship, transition out of emergence into coalescing and transformation can occur.Keywords American Indian and Alaska Native Community-based participatory research indigenous intervention science indigenous knowledge ✉ Stacy M. Rasmus

The well-being of Indigenous communities in Alaska is inextricably linked to traditional harvest practices (THPs) such as hunting, fishing, and gathering local wild foods. Regional trends in the health of THPs have not been quantitatively evaluated in Alaska. Therefore, we surveyed Indigenous residents in the Western Coastal (n = 623) and Interior (n = 437) Regions of Alaska to estimate perceptions of the extent and cause of change in the health of THPs over the last ten years. We found that THPs improved in Western Coastal and declined in Interior Alaska. The best predictors of improvement or decline in the health of THPs were 1) change in the ability to share the harvest, 2) change in participation in hunting and fishing activities, and 3) extent of challenges caused by climate change. The odds of a decline in the health of THPs were 8 to 13 times higher for households that reported a decrease in sharing of traditional foods.