Community-engaged dissemination and implementation of an evidence-based health promotion intervention for Native American families: “Delivery of Turtle Island Tales to promote family wellness” protocol

Abstract

Background. Native American communities possess a wide range of assets that can contribute to reducing persistent inequities in food insecurity, obesity, cancer, chronic disease, and other related outcomes. Community engaged dissemination and implementation (CEDI) strategies that emphasize available, relevant, and generalizable evidence as well as community strengths and assets are well aligned to improve health outcomes with these communities. Methods. “Delivery of Turtle Island Tales to Promote Family Wellness” applies a culturally grounded, evidence-based intervention for obesity prevention through partnership with local organizations (e.g., Cooperative Extension/Supplemental Nutrition Assistance Program Education [SNAP-Ed]) to understand and enhance community capacity for sustained health promotion. A descriptive case study design applies bundled CEDI strategies (e.g., participatory Project Steering Committee; site-specific Community Implementation Teams) guided by the Consolidated Framework for Implementation Research and the Reach, Effectiveness, Adoption, Implementation, and Maintenance Framework to examine implementation across multiple communities. CEDI strategies will be tracked longitudinally, by community, to document iterative identification of locally specific and project general CEDI strategies as they relate to program reach, adoption, adaptation, implementation, and maintenance using mixed methods approaches (e.g., validated surveys, focus groups, interviews). An economic assessment of Turtle Island Tales also will be conducted. Discussion. This study applies innovative CEDI science to the equitable implementation of Turtle Island Tales, one of the only family-centered, home-based, evidence-based obesity prevention intervention developed for and with Native American communities. Key innovations include a mailed intervention model and culturally specific strategies that honor local community assets to support the program’s relevance, scalability, and long-term sustainability.