Breathing clean air is Są’áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centred approach to understanding commercial smoke-free policy among the Diné (Navajo People)

Abstract

IntroductionIndigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide.ObjectiveWe describe the process for applying the Diné (Navajo) paradigm of Są’áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy.MethodsFocus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy.ResultsDiné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments.ConclusionsIndigenous-centred approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.

Development of an American Indian Diabetes Education Cultural Supplement: A Qualitative Approach

“…The director of the program helped obtained letters of support for the study from relevant tribal leaders and organization and also co-presented at meetings such as the Navajo Nation Human Research Review Board (NNHRRB) meeting to inform key tribal stakeholders about the study aims and objectives. The lead author applied Indigenous health research practices and Diné values of k'é (i.e., personal conduct, traditional etiquette to establish kinship) to establish respect and build positive relationships with Diné leaders and community members ( 23 , 24 ). The NNHRRB and the University of Arizona Institutional Review Board approved this study in August 2018.…”

“…The importance of order is reflected in a constant mindfulness and reverence with every thought, every word, and every step made in the journey of life ( 28 ). The concepts of balance and harmony are parallel to the notion of holistic health which emphasizes that there is a connection between the mind, body and spirit of an individual ( 23 , 24 , 29 ). For the Diné, there is an additional relationship with living elements i.e., water, air, earth and the cosmos ( 28 ).…”

Tobacco Industry Marketing Exposure and Commercial Tobacco Product Use Disparities among American Indians and Alaska Natives

“…The NNN seeks to serve all 567 federally recognized Tribes and urban AI/AN communities with a national network of Tribes, Tribal organizations and health programs working to reduce commercial tobacco use among AI/AN (National Native Network). Due to the diversity of AI/AN Tribes, Tribal leaders and health officials may want to consider developing their own strategies and relevant policies that are uniquely tailored to their Tribal community such as the discouragement of commercial tobacco use while respecting the use of traditional tobacco and protecting health (Chief et al, 2016). The Centers for Disease Control and Prevention has several resources, including manuals titled 'Designing and Implementing an Effective Tobacco Counter-Marketing Campaign'(Centers for Disease Control Prevention, 2003) and 'The Health Communicator's Social Media Toolkit'(Centers for Disease Control and Prevention, 2011).…”

NCI's state and community research initiative: a model for future tobacco control research

“…In this issue, Nez Henderson et al 26 and Chief et al provide a rare in-depth look at secondhand smoke attitudes among advocates and community leaders on the Navajo Nation and the link between attitudes and the slow progress made towards adopting 'commercial tobacco' smoke-free policies. 27 Also in this supplement, DeLong et al 28 describe the mostly weak strategies used to regulate tobacco sales on tribal lands. Together these studies suggest inadequate application of secondhand smoke and pricing strategies to reduce tobacco use among American Indian populations.…”