Indian Community Research Articles

Development and validation of a questionnaire in Hindi language to assess Parental Knowledge, Attitude and Practices regarding Calcium and Vitamin D deficiency in children

Background: Despite being in temperate zone, India is endemic to nutritional rickets. However, very little has been studied on knowledge, perception and cultural practices of Indian communities, towards calcium and vitamin-D deficiency in children. Aim & Objective: The study aimed to develop and validate a questionnaire in Hindi language for the assessment of knowledge, attitude, and practices of parents towards calcium and vitamin D deficiency among children. Methodology: We searched electronic databases for item generation. The questionnaire was developed in Hindi language by five experts in the field of pediatrics, pediatric orthopaedics and community medicine using Delphi method. After language correction from Hindi language experts, a convenient sample of 30 participants filled the questionnaire and tested for internal consistency and test-retest reliability. Results: The overall Cronbach’s alpha value for the finalized 46-item scale indicated an acceptable reliability (alpha = 0.91). The internal consistency reliability for six domains created was acceptable. The results revealed ‘high’ test-retest reliability, and there was no statistically significant difference noted between any of the first test and re-test corresponding values (p>0.05). Conclusion: The present questionnaire developed in Hindi Language to assess knowledge, attitude and practices (KAP) of parents towards Calcium & Vitamin-D deficiency in children, has a good validity and reliability. This newly developed instrument could prove its use to highlight the gaps that may exist among parents. The use of this tool may help clinicians, health educators and policy makers to identify key areas of intervention with regards to Calcium & Vitamin-D deficiency in children.

Predicting Air Quality

A list for revealing air quality is known as the air quality file (AQI). It measures the short-term effects of air pollution on a person's health. The motivation behind the AQI is to instruct general society on the negative well-being impacts of neighbourhood air contamination. How much air contamination in Indian urban communities has altogether expanded? The air quality index can be calculated mathematically in several different ways. Various examinations have found a connection between air contamination openness and unfavourable well-being influences in the populace. Data mining is one of the most intriguing methods for predicting and analysing AQI. This paper aims to determine the most efficient means by which AQI prediction can aid in climate control. The best technique can be enhanced to track down the most ideal arrangement. As a result, the work that is done in this paper requires extensive research as well as the addition of novel methods to guarantee that the best solution to the issue of poor air quality will be found. Another significant objective is to exhibit and show the specific measurements engaged with our work so that it is instructive and clever and subsequently gives legitimate examinations and helps future scientists. Keywords – Air Quality Index (AQI), Air pollution, Short-term effects, Health impacts, AQI prediction, Climate control, Novel methods, Extensive research, Comparative analysis, Future research.

Genetic variant rs1205 is associated with COVID-19 outcomes: The Strong Heart Study and Strong Heart Family Study.

Although COVID-19 infection has been associated with a number of clinical and environmental risk factors, host genetic variation has also been associated with the incidence and morbidity of infection. The CRP gene codes for a critical component of the innate immune system and CRP variants have been reported associated with infectious disease and vaccination outcomes. We investigated possible associations between COVID-19 outcome and a limited number of candidate gene variants including rs1205. The Strong Heart and Strong Heart Family studies have accumulated detailed genetic, cardiovascular risk and event data in geographically dispersed American Indian communities since 1988. Genotypic data and 91 COVID-19 adjudicated deaths or hospitalizations from 2/1/20 through 3/1/23 were identified among 3,780 participants in two subsets. Among 21 candidate variants including genes in the interferon response pathway, APOE, TMPRSS2, TLR3, the HLA complex and the ABO blood group, only rs1205, a 3' untranslated region variant in the CRP gene, showed nominally significant association in T-dominant model analyses (odds ratio 1.859, 95%CI 1.001-3.453, p = 0.049) after adjustment for age, sex, center, body mass index, and a history of cardiovascular disease. Within the younger subset, association with the rs1205 T-Dom genotype was stronger, both in the same adjusted logistic model and in the SOLAR analysis also adjusting for other genetic relatedness. A T-dominant genotype of rs1205 in the CRP gene is associated with COVID-19 death or hospitalization, even after adjustment for relevant clinical factors and potential participant relatedness. Additional study of other populations and genetic variants of this gene are warranted.

ROLE OF GENDER IN THE CONSERVATION OF THE NGABERE LANGUAGE IN SITIO PRADO, INDIGENOUS AREA

Language plays a significant role in our daily lives and is an essential part of our identity as human beings and members of society. It holds unique views, patterns, and beliefs distinct from its speakers; as Amery (2019) noted, when a minority group speaks a different language, they can choose to keep using it, become bilingual, or switch to the dominant language. The first option is language maintenance, where the community collectively chooses to keep using their traditional language(s) (Fasold, 1984). The second option is bilingualism, where individuals use both languages in different contexts for cognitive and social reasons, as Grosjean (2008) and García (2009) pointed out. Bilingualism is excellent for professional development and preserving heritage languages. Some Indian communities in America face language extinction, but some indigenous areas in Panama have successfully preserved their cultural heritage for centuries. A study was done to see if women in indigenous communities are less likely to use heritage languages than men. Participants took an oral and written exam and were asked which language they preferred for daily conversations. The study had support from a bilingual facilitator. The study was conducted with a sample of 120 people of legal age, including 60 men and 60 women, from the local area of Sitio Prado. Results showed that, as hypothesized, women are more conservative in the Ngäbere language than men by a small margin of difference of 3% in the preference level in using the Ngäbere language. It was also shown that both women and men are more conservative in their mother tongue between the ages of 24 and 29. Preserving the Ngäbere language is crucial for future generations and their cultural identity. It should be introduced into the formal education system.

Association of Water Arsenic With Incident Diabetes in U.S. Adults: The Multi-Ethnic Study of Atherosclerosis and the Strong Heart Study.

We examined the association of arsenic in federally regulated community water systems (CWS) and unregulated private wells with type 2 diabetes (T2D) incidence in the Strong Heart Family Study (SHFS), a prospective study of American Indian communities, and the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective study of racially and ethnically diverse urban U.S. communities. We evaluated 1,791 participants from SHFS and 5,777 participants from MESA who had water arsenic estimates available and were free of T2D at baseline (2001-2003 and 2000-2002, respectively). Participants were followed for incident T2D until 2010 (SHFS cohort) or 2019 (MESA cohort). We used Cox proportional hazards mixed-effects models to account for clustering by family and residential zip code, with adjustment for sex, baseline age, BMI, smoking status, and education. T2D incidence was 24.4 cases per 1,000 person-years (mean follow-up, 5.6 years) in SHFS and 11.2 per 1,000 person-years (mean follow-up, 14.0 years) in MESA. In a meta-analysis across the SHFS and MESA cohorts, the hazard ratio (95% CI) per doubling in CWS arsenic was 1.10 (1.02, 1.18). The corresponding hazard ratio was 1.09 (0.95, 1.26) in the SHFS group and 1.10 (1.01, 1.20) in the MESA group. The corresponding hazard ratio (95% CI) for arsenic in private wells and incident T2D in SHFS was 1.05 (0.95, 1.16). We observed statistical interaction and larger magnitude hazard ratios for participants with BMI <25 kg/m2 and female participants. Low to moderate water arsenic levels (<10 µg/L) were associated with T2D incidence in the SHFS and MESA cohorts.

Adolescent engagement in a stepped care, transdiagnostic mental health intervention delivered in Indian schools

Given the relationship between poor engagement and worse treatment outcomes, improving engagement has been the focus of attention in recent years. Engagement is a particular challenge among minoritized and otherwise challenged youth, such as those from socioeconomically disadvantaged groups, including youth in low- and middle-income countries (LMICs), where they face lower levels of access to resources, including mental health treatment. The present study describes engagement challenges that arose in an uncontrolled pre-post evaluation of a school-based, modular, multi-problem, stepped-care intervention delivered in urban Indian communities. Specifically, the study aimed to (1) characterize barriers and facilitators of youth treatment engagement; and (2) evaluate treatment acceptability and fit of treatment from the youth perspective. Youth participants completed semi-structured interviews, which were transcribed and coded using thematic analysis. Participants described numerous facilitators to engagement (e.g., positive therapeutic relationship) and reported high overall satisfaction with the intervention, while also identifying barriers to engagement (e.g., concerns about confidentiality) and offering suggestions to increase fit and acceptability (e.g., more visually appealing treatment materials). Findings highlight ways in which engagement can be enhanced and implementation supports improved to maximize treatment effectiveness among minoritized and disadvantaged youth in LMICs.

Community-Identified Implementation Strategies for Promoting the Adoption of HIV Self-Testing in a Southern California American Indian community: A Rapid Qualitative Analysis

HIV incidence increased by 18% between 2015 and 2019 among American Indians (AIs) despite declining rates in other racial/ethnic groups. Culturally-appropriate implementation of prevention programs is needed to address the intersectional conditions contributing to HIV vulnerabilities experienced by AIs. The objectives of this study were to understand factors influencing HIV testing decisions and identify implementation strategies to promote the acceptability of HIV self-testing (HIVST) in a southern California AI community. A total of 15 semi-structured interviews were completed with adult community members of a southern California AI reservation. Analysis used a rapid analytic approach that was guided by the Exploration, Preparation, Implementation, Sustainment (EPIS) framework and expert recommendations for implementing change (ERIC) compilation. Two team members applied a standardized summary template to elucidate implementation determinants and implementation strategies for adopting HIVST. Barriers to HIV testing identified by community members included HIV-related stigma and privacy concerns within their community. Community members expressed positive perceptions of the acceptability of HIVST, with many identifying ease of use and privacy as appealing attributes. Several implementation strategies were suggested for facilitating the adoption of HIVST, including increasing access to tests by mailing kits to community members and increasing demand for kits through media campaigns (e.g., local flyers, social media posts, and booths at tribal events). Community members also recommended discreet packaging of kits and cultural adaptation of accompanying materials (e.g., educational videos featuring community members). The qualitative input from AI community members facilitated identification of implementation strategies that may promote the acceptability and culturally-appropriateness of HIVST.

Understanding American Indian tribal college student knowledge, attitudes, beliefs, and behaviors surrounding alternative tobacco products

Objectives To examine knowledge, attitudes, beliefs, and behaviors about alternative tobacco products among American Indian tribal college students. Participants One hundred and five tribal college students. Methods Focus groups, one interview, and demographic surveys. Results Tobacco use varied across the sample with 35.2% of the participants being users of ENDS products and 29.5% were cigarette smokers. Overall, participants viewed electronic nicotine delivery systems and chewing tobacco as primary examples of alternative tobacco products and described a generational divide between alternative and conventional tobacco product use. Alternative tobacco products were not considered suitable for use in traditional contexts. Conclusions Previously successful cessation programs in this population have relied on cultural tailoring related to traditional tobacco use in American Indian communities. Our findings suggest that this strategy may be less effective for addressing alternative tobacco use. Reliance on the importance of family relationships may prove more impactful in future programming.

Chronic Illnesses and Depression among Community-based Adolescents in Rural Haryana, India.

Evidence on the association of chronic illnesses with depression among adolescents in the Indian community setting is limited. A simple random sample of 583 adolescents, comprising 56.6% of boys and 43.4% of girls, were interviewed on home visits. Self-reports on chronic illnesses were elicited, followed by administration of Patient Health Questionnaire-9 (PHQ-9) questionnaire to screen for depression, and for confirmation of diagnosis by age-appropriate Mini-International Neuropsychiatric Interview for Children and Adolescents (MINI Kid), or MINI. The prevalence of chronic illnesses was 8.4% (95% confidence interval [CI]: 6.3-11.0). Of these participants, 42.8% screened positive for depression. The prevalence of depression was 10.2% (95% CI: 3.4-22.2) among adolescents with chronic illness. The prevalence of physical-mental multimorbidity was 0.8% (95% CI: 0.3-2.0). The presence of chronic illness was associated with depression identified using both PHQ-9 (adjusted odds ratio [AOR] =3.1 [95% CI: 1.7-5.8], P < 0.001) and MINI Kid/MINI (AOR = 3.2 [95% CI: 1.1-9.4], P = 0.037). Adolescents with chronic illnesses can be targeted for mental morbidity screening in a bid to improve functional outcomes.

Leveraging The Indian Diaspora in UAE: Catalyst for Education and Skill Transfer

Abstract: The Indian community in the United Arab Emirates (UAE) is a substantial and talented group. This paper delves into the potential of utilizing this community to facilitate training and knowledge transfer among India and the UAE. Exploring the present scenario of the Indian community in the UAE, focusing on their educational achievements, professional skills, and business acumen. The paper highlights important areas for the diaspora in regards to knowledge and skill transfer. The paper delves into the challenges and opportunities linked to leveraging the potential of the diaspora. Highlighting the importance of cooperation among administrations, educational organizations, and private sector stakeholders to establish supportive frameworks and mechanisms. Through tapping into the ability, specialization, and connections of the Indian diaspora in the UAE, the two countries have the potential to reap substantial benefits in terms of educational progress, skill enhancement, and economic growth.

Assess the Attitude Towards Mental Illness Among Nurses Working in Selected Tertiary Care Hospital

Mental health is an urgent concern in India as every sixth Indian needs mental health help as reported by a recent National Mental Health Survey done by Gururaj in the year 2016. Further, while 20% of Indians suffer from a mental illness, only 10-12% of them seek help from mental health professionals mainly due to ignorance, stigma and discrimination that largely prevail in Indian community. The study aimed to assess the attitude towards mental illness among nurses and to associate the attitude towards mental illness among nurses working in selected tertiary care hospitals with background selected variables. A non-experimental descriptive research design was used in this study. A purposive sampling technique was used to select the samples and 400 samples were taken for the study. The majority of the nurses have negative 310 (77%) attitudes towards mental illness and only 90(23%) of them have positive attitudes towards mental illness. The mean value of attitude is 59.59 with a standard deviation of 4.94. There is no significant association was found between attitudes toward mental illness among nurses working in selected tertiary care hospitals with background variables at p&lt;0.05. The study results recommend initiating training programs for the nurses aimed at promoting positive attitudes and making them sensitive to the needs of mentally ill patients.

Income Inequality by Gender in Malaysia

Objective - Studies related to the distribution of income are very important for national development as they are related to efforts to reduce the gender earnings disparity. Women have overcome many challenges within the labour market, but gender income differentials persist in Malaysia. Methodology/Technique —Reducing gender income differentials is one ingredient for sustained economic growth. This article examines the gender income distribution in several submarkets within the Malaysian labour market and discusses some initiatives to reduce income disparities therein. The data used here were drawn from the Department of Statistics and cover the 10-year period from 2010 to 2019. Findings - Data show evidence that there exists gender earning disparity in Malaysia along the lines of education, specifically tertiary education, and ethnicity, specifically in Indian and Chinese communities. Novelty - This paper proposed a few policy recommendations with the hope that they will aid in the effort of reducing gender income differentials, which are a critical share of the country's human capital development. Type of Paper: Empirical JEL Classification: M41. M49, Keywords: Differentials, Gender, Income, Labour, Malaysia. Reference to this paper should be referred to as follows: Cheong, J.Q; Narayanan, S. (2024). Income Inequality by Gender in Malaysia, Acc. Fin. Review, 8(4), 01 – 10. https://doi.org/10.35609/afr.2024.8.4(1)

Mythic Reverie and Memory Trails: Unveiling the Layers in K.R. Meera's Hangwoman

In Hangwoman, K.R Meera integrates the narrative of Chetna Grddha Mullick, the first female executioner in Indian history is revealed through the blending of myth and memory. The novelist explores the intricacies of identity, power, and the human mind against the backdrop of a culture rooted in patriarchal customs. Chetna struggles with her own sense of self and purpose as she makes her way through her turbulent journey, plagued by her past and obligations. Meera expertly creates a novel that transcends time and place through vivid female characters that are unrelated to each other. This allows the readers to reflect on the complexities of human experience and the lasting effects of history. "Hangwoman" interweaves strands of the past and present to shed light on myth and memory in a captivating way. The Indian communities have focused on preserving their traditions and customs and the same is reflected in the work of Meera. The paper sheds light on how the beliefs, traditions and myths of executioners is preserved and as each generation passes by, they ensure to share this gathered information to the next as a gesture to extend the hand of the elders in the growth of the present and future generations.

Food insecurity in urban American Indian and Alaska Native populations during the COVID-19 pandemic

BackgroundFood insecurity is an important social determinant of health that was exacerbated by the COVID-19 pandemic. Both food insecurity and COVID-19 infection disproportionately affect racial and ethnic minority groups, particularly American Indian and Alaska Native communities; however, there is little evidence as to whether food insecurity is associated with COVID-19 infection or COVID-19 preventive behaviors such as vaccination uptake. The purpose of this study was to evaluate associations between food insecurity, COVID-19 infection, and vaccination status among urban American Indian and Alaska Native adults seen at 5 clinics serving urban Native people.MethodsIn partnership with health organizations in Alaska, Colorado, Kansas, Minnesota, and New Mexico, the study team conducted a cross-sectional survey in 2021 to assess food security status and attitudes, barriers, and facilitators for COVID-19 testing and vaccination. Logistic regression was used to examine the association of food security status with sociodemographic factors and COVID-19 infection and vaccination status. Marginal standardization was applied to present results as prevalence differences.ResultsAmong 730 American Indian and Alaska Native adults, the prevalence of food insecurity measured during the pandemic was 38%. For participants who reported persistent food security status before and during the pandemic (n = 588), the prevalence of food insecurity was 25%. Prevalence of COVID-19 infection and vaccination did not vary by food security status after adjustment for confounders.ConclusionsHigh rates of food insecurity among American Indian and Alaska Native communities likely increased during the COVID-19 pandemic. However, despite the high prevalence of food insecurity, community-led efforts to reduce COVID-19 infection and increase vaccination uptake across Indian Health Service and Tribal healthcare facilities may have mitigated the negative impacts of the pandemic for families experiencing food insecurity. These successful approaches serve as an important reference for future public health efforts that require innovative strategies to improve overall health in American Indian and Alaska Native communities.

Abstract 1012: Colorectal cancer in the American Indian and Alaska Native community: A holistic review

Abstract Colorectal cancer (CRC) is ranked third in the United States for both cancer incidence and mortality. Despite a decline in both categories, CRC continues to be a great concern in American Indian/Alaska Native (AI/AN) communities. AI/AN populations have also experienced the largest increase in early-onset colorectal cancer, have the second highest CRC incidence rates, and the AN community has the highest rates of CRC worldwide. AI/AN populations face numerous barriers and are susceptible to risk factors that may contribute to these findings. Currently, a significant amount of research is on screening efforts. Through conducting a literature review of 63 articles, as well as an additional 11 supplemental sources, this manuscript aims to look at several aspects of CRC including demographics, diet, screening, and the impact of geography. This review presents and organizes available research on CRC in the AI/AN population and explores research beyond screening because a more comprehensive and population-specific fund of knowledge on the totality of the subject is critical to directing more effective prevention, earlier detection, and management. Evaluating different components of CRC honors the holistic approach to health practiced by AI/AN communities. Citation Format: Angela R. Monetathchi, William Carson, Alyssa Little, Felina M. Cordova-Marks, Jennifer Erdrich. Colorectal cancer in the American Indian and Alaska Native community: A holistic review [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1012.

AN EXPLORATORY STUDY ON THE CULTURAL BARRIERS IMPACTING WOMEN ENTREPRENEURSHIP IN THE HOSPITALITY INDUSTRY IN INDIA

Background: Entrepreneurship is a complex, multidimensional phenomenon that involves value creation and considered as a driving force of economic development. Entrepreneurship is one of the growing trends, and studies are focusing on it generally not only at the national but also at the global level. Objectives: To explore the cultural barriers in various Indian communities that limits the movement of women towards entrepreneurship in the hospitality business and suggest ways to overcome such barriers for women development. Methodology: The research design of the study was both qualitative and quantitative. The present study was conducted in Kolkata. The sample was collected from 43 female entrepreneur associated with various hotel oriented business using the convenience sampling technique. A well structured questionnaire was used to collect the data. Results: The study found that 32.6% of the female entrepreneurs faced financial issue as one of the biggest challenge. It was also found that 44.2% of women did not have the freedom to market the product. 25.6% of the women entrepreneurs mentioned that family commitment always affected the business performance. 44.2% of women were of the opinion that they faced psychological challenges in dealing with men in the hospitality sector. Majority of women (around 51.2%) faced problems in availing the facility of government funds whereas around (50.5%) faced challenges in loan sanctions. Conclusion: It was found that family and societal commitments and domination of men in the society in terms of business were key factors to the hindrances Support from the government and formulation of policies can be a matter of great help in this regard.

The Influence of Bollywood Movies on the representation of Indian Indentured Labourers in Mauritian Media and Culture

This study explores the influence of Bollywood movies on the representation of Indian indentured labourers in Mauritian media and culture. The research investigates the ways in which Bollywood movies have impacted the depiction of Indian Indentured labourers in Mauritian society, and how this representation has changed over time. The study utilizes a qualitative method, including questionnaires, relevant literature reviews, and content analysis of popular Bollywood films and Mauritian media. The findings indicate that Bollywood movies have had a significant impact on the representation of Indian indentured labourers in Mauritian media and culture. While earlier representations of indentured labourers in Mauritian media were largely negative and stereotypical, Bollywood movies have played a key role in challenging these stereotypes and promoting a more positive image of the Indian community in Mauritius. The study highlights the importance of media representation in shaping cultural perceptions and argues that Bollywood movies have played a vital role in promoting a more nuanced and positive image of Indian indentured labourers in Mauritian society. The study concludes by discussing the implications of these findings for future research and for promoting cultural diversity in Mauritian society.

Novel signals and polygenic score for height are associated with pubertal growth traits in Southwestern American Indians.

Most genetic variants associated with adult height have been identified through large genome-wide association studies (GWASs) in European-ancestry cohorts. However, it is unclear how these variants influence linear growth during adolescence. This study uses anthropometric and genotypic data from a longitudinal study conducted in an American Indian community in Arizona between 1965-2007. Growth parameters (i.e. height, velocity, and timing of growth spurt) were derived from the Preece-Baines growth model, a parametric growth curve fitted to longitudinal height data, in 787 participants with height measurements spanning the whole period of growth. Heritability estimates suggested that genetic factors could explain 25% to 71% of the variance of pubertal growth traits. We performed a GWAS of growth parameters, testing their associations with 5 077 595 imputed or directly genotyped variants. Six variants associated with height at peak velocity (P < 5 × 10-8, adjusted for sex, birth year and principal components). Implicated genes include NUDT3, previously associated with adult height, and PACSIN1. Two novel variants associated with duration of growth spurt (P < 5 × 10-8) in LOC105375344, an uncharacterized gene with unknown function. We finally examined the association of growth parameters with a polygenic score for height derived from 9557 single nucleotide polymorphisms (SNPs) identified in the GIANT meta-analysis for which genotypic data were available for the American Indian study population. Height polygenic score was correlated with the magnitude and velocity of height growth that occurred before and at the peak of the adolescent growth spurt, indicating overlapping genetic architecture, with no influence on the timing of adolescent growth.

Clerodendrum Glandulosum Lindl.: A Review of Ethnopharmacology, Pharmacological Potentials, and their Mechanism of Action.

Clerodendrum glandulosum Lindl. is popularly known for its traditional herbal remedies and therapeutic properties among the people of Northeast Indian communities, as well as Chinese traditional medicine. For the myriad pharmacological properties, viz., anti-hypertensive, hypolipidemic, hepatoprotective, anti-inflammatory, and neuroprotective, planting this species in kitchen gardens is a common practice to treat various ailments, especially hypertension, diabetes, and other metabolic complications. Different phytochemicals, representing the diverse classes of secondary metabolites comprising physiological and phytopharmaceutical significance, have been reported from C. glandulosum. Compounds with terpenoids, steroids, and phenolics are in demand in the pharmaceutical industry. An overview of the mechanism of action of the prominent compounds has also been collated for future research on C. glandulosum-based therapeutics. Current information focuses on this important medicinal plant's ethnomedicinal use, phytochemistry, pharmacology, associated mechanisms, and toxicology. This review will help explore this potential medicinal plant, which can pave the path for its application in the pharmaceutical industry.

Association of Achievement of the American Heart Association's Life's Essential 8 Goals With Incident Cardiovascular Diseases in the SHFS.

Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in American Indian people. In 2022, the American Heart Association developed the Life's Essential 8 goals to promote cardiovascular health (CVH) for Americans, composed of diet, physical activity, nicotine exposure, sleep, body mass index, blood lipids, blood pressure, and blood glucose. We examined whether achievement of Life's Essential 8 goals was associated with incident CVD among SHFS (Strong Heart Family Study) participants. A total of 2139 SHFS participants without CVD at baseline were included in analyses. We created a composite CVH score based on achievement of Life's Essential 8 goals, excluding sleep. Scores of 0 to 49 represented low CVH, 50 to 69 represented moderate CVH, and 70 to 100 represented high CVH. Incident CVD was defined as incident myocardial infarction, coronary heart disease, congestive heart failure, or stroke. Cox proportional hazard models were used to examine the relationship of CVH and incident CVD. The incidence rate of CVD at the 20-year follow-up was 7.43 per 1000 person-years. Compared with participants with low CVH, participants with moderate and high CVH had a lower risk of incident CVD; the hazard ratios and 95% CIs for incident CVD for moderate and high CVH were 0.52 (95% CI, 0.40-0.68) and 0.25 (95% CI, 0.14-0.44), respectively, after adjustment for age, sex, education, and study site. Better CVH was associated with lower CVD risk which highlights the need for comprehensive public health interventions targeting CVH promotion to reduce CVD risk in American Indian communities.