Native Nations Research Articles

Abstract B036: Native American cancer prevention outreach strategies: Approaches developed for outreach teams working with Native Nations and Native American urban communities

Abstract Community-directed outreach activities developed to provide cancer education and/or to promote cancer screening are quite varied and difficult to evaluate. The published literature offers few recent descriptions of cancer education efforts or interventions designed to enhance awareness of cancer risks or screening recommendations for specific underserved populations, e.g., Native Americans. Furthermore, the National Institute of Health’s guidance for Community Outreach Cores provided in Funding Opportunities for Center awards, is brief and offers few parameters and examples. This brevity is most evident in comparison with the lengthy descriptions provided for Research and Education Cores. This elusive language may be purposeful, recognizing the diversity of communities and technical assistance needed by research teams. The challenge, Outreach Cores use quite different approaches and generally do not share effective strategies that could be tested with other communities. The Outreach Core of the National Cancer Institute funded Native American Cancer Prevention Partnership (NACP), has employed several innovative strategies in the 2019-2024 funding period. To encourage increased national dialogue about culturally appropriate cancer-related outreach with underserved communities and outreach support for research teams, two strategies of the NACP Outreach Core are described. The intention is to contribute to the limited outreach literature and to inspire emerging or existing cores developing plans for engaging underserved communities and/or supporting research teams involved in community-based work. One NACP approach involves the development of a podcast series to provide cancer-related education and personal stories specifically by public health practitioners, health care providers and Native American patients, for Native American audiences. The second approach was designed to enhance research teams’ skills in reporting their activities and outcomes with communities. The Community Dissemination and Application Training (C-DAT) was developed to improve institutional and investigator capacity to conduct respectful research and share relevant research findings with Native American communities. C-DAT was supplemented with a Directory for Reaching Relatives Using Media (DRRUM), that contributes to investigators’ knowledge of dissemination venues used in Native American communities The DRRUM provides contacts and additional information on regional Native Nations or Native serving social media platforms/groups and tribal radio stations. NACP’s outreach activities are shared in an effort to initiate a Best Practices Inventory upon which outreach cores and interventions could draw. Unfortunately, evaluation continues to be a challenge, and is generally limited to reach and does not address impact. Citation Format: Nicolette Teufel-Shone, Carol Goldtooth-Begay. Native American cancer prevention outreach strategies: Approaches developed for outreach teams working with Native Nations and Native American urban communities [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B036.

Shared Ideals, But Persistent Barriers: Improving Tribal‐University Research Engagement to Strengthen Native Nation Building and Rural Development☆

Shared Ideals, But Persistent Barriers: Improving Tribal‐University Research Engagement to Strengthen Native Nation Building and Rural Development^☆

Autonomy Through Allotment: Political Strategies of the Ottawa Tribe in Indian Territory, 1870–1892

Abstract The late nineteenth-century policy of allotting tribal lands into individually owned tracts is appropriately interpreted as a destructive federal effort to expropriate Native land and eliminate tribal identities. The Ottawa Tribe in Indian Territory, however, had divergent objectives in supporting allotment. This article argues the Ottawa advocated for allotment and U.S. citizenship to escape intrusive federal control over their lands and resources. Although they embraced policies aimed at eliminating tribal existence, the Ottawa rejected the intentions behind those policies, and instead, they drew on long-established community attributes of mobility and interconnection with outsiders to resituate their nation within American society. By centering Ottawa perspectives, this article disrupts progressive narratives that denote the pursuit of U.S. citizenship as an effort to secure equal inclusion. It underscores U.S. citizenship and allotment as tools of settler colonial domination and demonstrates how the Ottawa subversively deployed U.S. citizenship and private property rights to combat colonial administration and maintain tribal sovereignty. Examining a policy often glossed over as invariably imposed on Native nations, this article underscores the necessity of analyzing Native community dynamics and political strategies to understand the implementation and impact of allotment.

Pausing and contributing towards Indigenous futures: A pedagogical reflection on college history classrooms

In this article, I explore a pedagogical approach grounded in Native feminist theories and their commitments to place, to relations, to lands, and to more sustainable, just futures. In approaching college history instruction from a place informed by Native feminist teachings, I offer that the college-level classroom can be a space for students to imagine and work towards anticolonial futures as they process hard histories from where they stand. To do so, I draw on self-reflection and an examination of student reflections on their relationships with tribal sovereignty, their perceptions of ethical commitments to Indigenous people, and their understandings of academic collaborations toward Indigenous priorities. This analysis reveals how a pedagogy that embraces “pausing” and contributions to Native nation building can create a classroom space for students to process histories of genocide, build habits of relationality and civic engagement, and work toward more just futures.

Integrating point-of-care diabetes detection with lifestyle counselling in community settings: outcomes from Western Sydney, Australia

IntroductionEarly detection and prevention of type 2 diabetes and its complications are global health priorities. Optimal outcomes depend on individual awareness and proactive self-management of health risks. This study evaluates the effectiveness of a community-based diabetes detection and intervention program in a high-risk area in western Sydney, Australia.Research design and methodsWe collaborated with the Workers Lifestyle Group, Tamil Association Arts and Culture Association, and the National Aboriginal and Islanders Day Observance Committee to implement our program. Participants underwent HbA1C testing via point-of-care blood spot testing. They received personalized feedback, education on diabetes management, and were offered opportunities to enrol in lifestyle modification programs. Participants identified with pre-diabetes (HbA1C 5.7–6.4%) or diabetes (HbA1C > 6.4%) were advised to consult their General Practitioners (GPs). A follow-up questionnaire was distributed 3–8 months post-intervention to evaluate the programs usefulness and relevance and lifestyle changes implemented by the participants.ResultsOver eight months, 510 individuals participated. Of these, 19% had an HbA1C > 6.4%, and 38% had levels between 5.7 and 6.4%. Among those with diabetes, HbA1C levels ranged as follows: 56% <7%; 20% 7-7.9%; 18% 8-8.9%; and 5% >9%. Post intervention survey indicated that the program was well-received, with 62.5% of responses reporting lifestyle changes and 36.3% seeking further advice from their local healthcare providers.ConclusionThe study demonstrates a significant prevalence of pre-diabetes and diabetes in the community, similar to findings from larger-scale hospital and general practice studies. Point-of-care testing combined with personalized education effectively motivated participants toward healthier lifestyle choices and medical consultations. The paper discusses the scalability of this approach for broader population.

THE EFFECT OF USING HEYDAR ALIYEV'S HERITAGE IN THE TRAINING PROCESS ON THE COMPREHENSIVE DEVELOPMENT OF STUDENTS

A wide network of pre-school, general, vocational, secondary and higher education institutions operating in our state today, and a powerful scientific and pedagogical staff potential have their core from the purposeful policy on education carried out under the leadership of Heydar Aliyev in the 70s of the last century, and the comprehensive educational creativity that will be carried out in the future has created a strong foundation of progress. At that time, full-time educational institutions in Azerbaijan rose to the level of modern development compared to previous years, and the consistent national policy implemented in this direction played a special role in raising the educational, general cultural and intellectual level. The life and political active activity of Heydar Aliyev is the founder of the modern history of the Azerbaijani nation, the creator of the free Azerbaijan state and statehood in every citizen of Azerbaijan. It evokes a sense of pride. The life of the national leader, full of struggles, is a living chronicle of a special period, an epoch, which he dedicated to his native nation. For the first time in the history of the Azerbaijani nation, Heydar Aliyev put forward the idea of creating the concept of national ideology, gave recommendations on the work to be done in this field, the areas of application of these works, means and opportunities. The leader attaches special importance to the promotion of the subjects of the Azerbaijani language and Azerbaijani history, religious viewpoints, traditions, and our statehood meetings, and highly valued the work and role of teachers, whom he especially respected, in creating, organizing, and implementing this ideology.

The Geographies of the Armenian Nation

A 4,500 years-old nation, Armenians settled in various environments, especially after the calamitous 1915-1921 Genocide. Many found refuge in countless countries that welcomed them as refugees, though new arrivals quickly adapted to their new societies, learned local languages, integrated, and succeeded in their respective fields of interest. This paper highlights diaspora populations’ loyalties to their native nation as well as to their adopted countries. It identifies five major communities—India, China, Russia, France and the United States—and briefly discusses how diaspora Armenians in these selected countries protected and preserved their nations. It argues that it was hard work throughout their new geographic spreads that added value, sustained and encouraged creativity, and, above all else, ensured that this minority nation would survive.

The Evolution of Maps Produced by Adam Gilg Between 1688–93: A Case-Study on the Production and Circulation of Jesuit Geographical Knowledge of Sonora

The article investigates the progress in the geographical knowledge of Sonora based on explorations by Adam Gilg, a Moravian Jesuit in Spanish service. Gilg spent eighteen years (1688–1710) at the northern frontier of New Spain, where he worked as a missionary among the Seri (Comcáac) and Pima (O’odham) peoples. In the period between 1688 and 1693, Gilg drafted three maps of Sonora that represent three stages in proselytization efforts and European geographical knowledge of Sonora. The comparative analysis of these maps makes an interesting case study of how a map, once compiled, was updated and corrected in accordance with new data subsequently collected. It also illustrates the interaction and knowledge exchange between Jesuits serving in the region (Eusebio Kino, Marcus Kappus) and the local Native Nations, the Seris and the Pimas.

Ecological partnership: Restoring Pinyon woodlands on the Navajo Nation, USA

Pinyon woodlands in the semi-arid southwestern United States developed in response to environmental factors and historical human interactions, providing sustenance and traditional ecological benefits to Native Nations, such as the Navajo (Diné). Historically, Diné communities practiced land stewardship through seasonal movements and resource management, ensuring ecosystem resilience. However, the constraints imposed by European colonization led to transformative changes in their livelihoods and environments. Encompassing 71,000 km2, pinyon-juniper woodlands comprise 89 % of forested area on the Navajo Nation reservation, providing crucial ecosystem services and cultural resources. Since reservation establishment in 1868, increased tree density has diminished understory plant communities and elevated woodland susceptibility to wildfires, compromising overall forest health. Recognizing the imperative for ecological restoration, a collaborative effort between Diné College and Northern Arizona University (NAU) was established in 2018 to develop a pinyon woodland research site on the Diné College campus in Tsaile, Arizona, on the Navajo Nation reservation. We assessed the effectiveness of restoration thinning treatments in reinstating historical woodland structure, modifying fuels for fire mitigation, and engaging students in ecological practices. Thinning resulted in a 62 % reduction in tree density and a 25 % reduction in basal area, altering the woodland structure to reflect historical conditions more accurately. This alteration mitigated the risk of high-intensity wildfires while preserving the age structure of older trees (oldest dating back to 1435 C.E.). Forest floor fuels were low throughout the study, as thinned wood was removed, and activity fuels were immediately treated with chipping. The active participation of Diné College and NAU students, interns, and faculty throughout the study contributed to a cohesive approach in advancing our goals. The comprehensive training empowered students to contribute meaningfully to fieldwork and data collection, aligning with Diné College's mission to enhance post-secondary student learning and development for the benefit of the Diné. By integrating contemporary and culturally sensitive perspectives, our study sheds light on the effectiveness of restoration thinning treatments, emphasizing the delicate balance between ecological resilience and cultural preservation for the Navajo Nation.

Federal field nurses and Indigenous births

Beginning in 1924, the US Office of Indian Affairs sent public health or ‘field’ nurses to Native nations to provide preventative healthcare and education. The field nurse programme began under...

Counting the Ways That Aboriginal and Torres Strait Islander Older People Participate in Their Communities and Culture.

This study aimed to determine the proportion of older Aboriginal and Torres Strait Islander peoples participating in cultural events and activities and determine the demographic and sociocultural characteristics associated with participation. The Australian Bureau of Statistics National Aboriginal and Torres Strait Islander Social Survey (2014-2015) was used to measure the prevalence of participation in cultural events and activities. Multivariate logistic regression models were used to measure associations. Sociocultural factors were selected by matching survey items to the 12 sociocultural factors described in the Good Spirit Good Life Framework, a culturally validated quality-of-life tool for older people. The majority (62.0%) of survey respondents 45 years and older participated in cultural events (e.g., ceremonies, funerals/sorry business, NAIDOC week activities, sports carnivals, festivals/carnivals) or were involved in organizations. Many (58.5%) also participated in activities (e.g., fishing, hunting, gathering wild plants/berries, arts/crafts, music/dance/theater, writing/telling of stories). In regression models including demographic and cultural variables, participation in cultural events was highest among people living remotely (odds ratio [OR] = 2.71), reporting recognition of homelands (OR = 2.39), identifying with a cultural group (OR = 3.56), and those reporting having a say in their communities (OR = 1.57), with similar odds seen for participation in activities. Participation was inversely proportional to increasing age, with a greater proportion of females participating in events and males in activities. The social lives of older Aboriginal and Torres Strait Islander people were characterized by widespread participation in cultural events and activities. These findings provide important insights into services as they support older people to live a good life.

Data Back

Grounded within the field and practice of philanthropy, the authors discuss the relationship between Indigenous material culture and philanthropy. This tangled relationship between philanthropy, colonial institutions, and Indigenous material culture continues to cause harm for Indigenous Peoples. We illustrate the problematizing nature of museums viewing material culture detached from current Indigenous Peoples with the case of the Nez Perce Wetxuuwíitin Collection. The Nez Perce Wetxuuwíitin Collection case shows how elite philanthropy and museum practices can negatively harm Native nations. Native collections are living Indigenous data and connected to Indigenous Peoples today. Material culture is not relegated to the past; it is Indigenous data and should be governed by Native nations. Without a change in practice, Indigenous Peoples will continue to be negatively impacted. To educate elite philanthropic partners and improve museum practices, we introduce principles from Indigenous Data Sovereignty that can help guide the partnerships and collaborations with Native nations. Indigenous Data Sovereignty can not only reduce harm and maximize benefits for Indigenous Peoples but also bring Indigenous data back home.

Exploring the Historical Complexities of Native Identity Formation, Blood Quantum, and Modern Tribal Enrolment Criteria

In the United States, blood quantum (BQ) based enrolment criteria find their roots in settler-colonial policies to erase, assimilate, and subjugate Indigenous Peoples and individuals. As a result, Native Nations throughout the United States continue to debate such practices. Current research on Native individuals’ identities does not fully account for the impact of BQ laws. Native people’s self-identity includes their identity as an enrolled or unenrolled member of their tribe. While research has examined the formation of Indigenous identity at the community and population level, current scales and tools do not properly examine the effects of BQ based enrolment on identity at the individual level. This commentary reveals how BQ based enrolment criteria negatively impact Native Nations which implement it and calls on Native Nations and Native researchers to explore the relationship between colonial enrolment policies and the impact on identity formation and lived experiences.

Co-occurring psychological distress and alcohol or other drug use among Indigenous Australians: Data from the National Aboriginal and Torres Strait Islander Health Survey.

To determine the prevalence and demographic, social and health characteristics associated with co-occurring psychological distress symptoms, risky alcohol and/or substance use among a national sample of Aboriginal and Torres Strait Islander people aged 15 years or older. This study uses secondary cross-sectional data from the 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS). Data were collected via face-to-face interviews with those living in private dwellings across Australia. Participants were Aboriginal and Torres Strait Islander people (n = 10,579) aged 15 years or older. Data pertaining to psychological distress, alcohol and substance use were obtained and weighted to represent the total population of Aboriginal and Torres Strait Islander people in Australia. A total of 20.3% participants were found to have co-occurring psychological distress, risky alcohol use and/or substance use, and 4.0% reported co-occurrence of all three conditions. Female participants in a registered marriage and fully engaged in study or employment had lower rates of co-occurring conditions. Poorer self-rated health, one or more chronic conditions and increased experiences of unfair treatment and physical harm in the past 12 months were associated with increased rates of co-occurring conditions. A range of potential risk and protective factors were identified for co-occurring psychological distress, risky alcohol and/or substance use among Aboriginal and Torres Strait Islander people. This information is critical for planning effective holistic strategies to decrease the burden of suffering imposed upon the individual, family and community members impacted by co-occurring conditions.

Estimated intake of vitamin D is low in Aboriginal and Torres Strait Islander people

Despite high UVB radiation from the sun in Australia (the primary source of vitamin D), vitamin D deficiency (serum 25-hydroxyvitamin D concentrations [25(OH)D] &lt;50 nmol/L) is prevalent among Aboriginal and Torres Strait Islander peoples (27% of adults nationally; 39% of adults living in remote areas)(1). Vitamin D deficiency affects musculoskeletal health and may be associated with non-communicable diseases, such as type 2 diabetes and cardiovascular diseases, prevalent in Aboriginal and Torres Strait Islander peoples.(2, 3) Alternative to UVB radiation, vitamin D can also be obtained from foods (e.g., fish, eggs, and meat) and supplements. However, vitamin D intake in Aboriginal and Torres Strait Islander peoples is currently unknown. Hence, we aimed to provide the first estimate of absolute vitamin D intake in Aboriginal and Torres Strait Islander peoples. We used food consumption data from the 2012-2013 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey and vitamin D food composition data for vitamin D3, 25(OH)D3, vitamin D2, and 25(OH)D2. Absolute vitamin D intake was estimated by sex and remote and non-remote areas using bioactivity factors (BF) of 1 and 5 for 25(OH)D, which may be up to five times more bioactive than vitamin D. The estimated average requirement for vitamin D intake recommended by the Institute of Medicine is 10 μg/day(4). The estimated absolute vitamin D intake from food and beverages was low for Aboriginal and Torres Strait Islander peoples. The mean estimated absolute vitamin D intake of Aboriginal and Torres Strait Islander peoples was 2.9 μg/day and 5.3 μg/day for BF 1 and 5, respectively. Males had a higher mean intake (3.2 μg/day, BF 1 and 5.9 μg/day, BF 5) than females (2.6 μg/day, BF 1 and 4.7 μg/day, BF 5). Vitamin D intake was 2.9 μg/day (BF 1) and 5.2 μg/day (BF 5) in non-remote and 2.8 μg/day (BF 1) and 5.4 μg/day (BF 5) in remote areas. The high prevalence of vitamin D deficiency and low vitamin D intake highlights a need to promote vitamin D sufficiency through public health policies. The results from this study can be used to model food fortification strategies to provide evidence for the development of nutrition policies to improve the vitamin D status of the Aboriginal and Torres Strait Islander population.

Capacity building to address antimicrobial resistance in remote Australia: The inaugural HOT NORTH Antimicrobial Academy

BackgroundRates of antimicrobial resistance (AMR) for some pathogens in Australia are considerably higher in rural and remote compared to urban regions. The inaugural Hot North Antimicrobial Academy was a 9-month educational programme aimed to build workforce knowledge and capacity in antimicrobial use, audit, stewardship, surveillance and drug resistance in remote primary health care. MethodsThe Academy was advertised to Aboriginal and Torres Strait Islander, regional and remote healthcare workers. Participants were Aboriginal health practitioners, nurses, pharmacists and doctors from Queensland, Northern Territory, South Australia and Western Australia working in remote primary health care with a focus on Indigenous health. Due to COVID-19 restrictions, the Academy ran virtually from February–November 2021 using Microsoft Teams. The Academy was evaluated using surveys and yarning circles to assess impact and knowledge gain. ResultsParticipants and faculty from across Australia attended 19 lectures and mentorship sessions. Eleven participants commenced and eight (73%) completed the Academy. The Academy raised participants awareness of AMR guidelines, governance and generating change; built confidence in advocacy; grew knowledge about drug resistant infections; and created a community of AMR champions in Indigenous health. ConclusionThe evaluation confirmed the Academy met the needs of participants, provided opportunities to move stewardship from tertiary hospitals into Indigenous and remote clinics and developed skills in research, audit, stewardship and advocacy for all involved. All sessions were recorded for future use, with facilitation by the National Aboriginal Community Controlled Health Organisation (NACCHO) in future years.

Tribal Administration Handbook: A Guide for Native Nations in the United States ed. by Rebecca M. Webster and Joseph Bauerkemper (review)

Tribal Administration Handbook: A Guide for Native Nations in the United States ed. by Rebecca M. Webster and Joseph Bauerkemper (review)

Who smokes in Australia? Cross-sectional analysis of Australian Bureau of Statistics survey data, 2017-19.

To assess the socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked in Australia. Cross-sectional analysis of Australian Bureau of Statistics (ABS) survey data. Adult participants (16 370 people aged 18 years or older) in the ABS 2017-18 National Health Survey (NHS); adult participants in the ABS 2018-19 National Aboriginal and Torres Strait Islander Health Survey (NATSIHS) (6423 people aged 18 years or older). Socio-demographic and health-related characteristics of people who smoke daily, people who formerly smoked, and people who have never smoked, expressed as population-weighted proportions, overall and by Indigeneity. Among adult NHS respondents, an estimated 58.8% of people who smoked daily (95% confidence interval [CI], 56.2-61.4%) were men, 61.3% (95% CI, 58.7-63.9%) were 25-54 years old, 72.5% (95% CI, 70.0-74.8%) were born in Australia, and 65.4% (95% CI, 62.8-67.8%) lived in major cities and 54.3% (95% CI, 51.6-57.0%) in areas in the two socio-economically most disadvantaged quintiles; 75.9% (95% CI, 73.5-78.1%) reported good to excellent health, 73.0% (95% CI, 70.5-75.4%) reported low to moderate psychological distress, 69.0% of those aged 25-64 years (ie, of working age) had completed year 12 (high school), and 68.5% were currently employed. An estimated 2.57 million people smoke daily in Australia: 2.37 million non-Indigenous people (92%) and 195 700 Aboriginal or Torres Strait Islander people (8%). While smoking is more frequent among people living in socio-economically disadvantaged areas and in certain population sub-groups, this first quantitative national profile indicates that most people who smoke daily are in paid employment, are non-Indigenous, are in good physical and mental health, and have completed year 12. Improved comprehensive structural supply- and demand-based tobacco control, informed by the needs of priority groups and the overall profile of people who smoke, is needed to reduce daily smoking prevalence among adults to the 2030 targets of 5% or less for all Australians and 27% or less for Aboriginal and Torres Strait Islander people.

The social determinants of Aboriginal and Torres Strait Islander adults who do not smoke in regional Australia.

Commercial tobacco use was systematically embedded as a valuable commodity through colonisation that continues to be exploited for profit by the Tobacco Industry. There have been significant declines in current smoking prevalence among Aboriginal and Torres Strait Islander peoples 18 years and over, from 55% in 1994 to 43% in 2018-2019. This paper seeks to better understand smoke-free behaviours, and to systematically quantify associations between a range of SDOH and non-smoking/never-smoking among Aboriginal and Torres Strait Islander adults (≥18) living in regional Australia. To explore the social determinants of health (SDOH) related to non- and never-smoking among Aboriginal and Torres Strait Islander peoples in regional Australia. Cross-sectional analysis of the NATSIHS, weighted to the Aboriginal and Torres Strait Islander adult population living in regional Australia, was conducted. Participants were characterised as people who were current smokers, never-smokers and non-smokers (ex- and never-smokers). The social determinants of health exposures related to socioeconomic position, well-being and access to healthcare. Regional Australia is distinct from urban and remote areas, based on the ASGS Remoteness Structure (ABS) 2018-2019. Aboriginal and Torres Strait Islander adults (≥18 years) who were selected, consented and asked questions about smoking in the National Aboriginal and Torres Strait Islander Health Survey (NATSIHS 2018/19). High income was associated with non-smoking (Prevalence Ratio [PR] = 2.07; 95% CI: 1.66-2.57) and never-smoking (PR = 2.02; 1.46-2.79), as was completing year 10 (non-smoking PR = 1.34; 1.12-1.61 and never-smoking PR = 1.56; 1.20-2.03). Better food security was associated with a higher prevalence of never-smoking (PR = 2.42; 1.48-3.98). Lower psychological distress scores were associated with non-smoking (PR = 1.30; 1.10-1.53) and never-smoking (PR = 1.56; 1.21-2.01). Never-smoking was more frequent in participants reporting no experiences of unfair treatment (PR = 1.59; 1.22-2.06). Having a usual healthcare provider was associated with non-smoking (PR = 1.38; 1.02-1.86). Positive exposure to the SDOH were associated with non- and never-smoking among Aboriginal and Torres Strait Islander adults in regional Australia. Structural and systemic changes to address the SDOH, including discrimination and racism, are expected to accelerate non-smoking behaviours and improve health outcomes for Aboriginal and Torres Strait Islander peoples.

Strong Born-A First of Its Kind National FASD Prevention Campaign in Australia Led by the National Aboriginal Community Controlled Health Organisation (NACCHO) in Collaboration with the Aboriginal Community Controlled Health Organisations (ACCHOs).

The Strong Born Campaign (2022-2025) was launched by the National Aboriginal Community Controlled Health Organisation (NACCHO) in 2023. Strong Born is the first of its kind national Aboriginal and Torres Strait Islander health promotion campaign to address Fetal Alcohol Spectrum Disorder (FASD) within Australia. Strong Born was developed to address a longstanding, significant gap in health promotion and sector knowledge on FASD, a lifelong disability that can result from alcohol use during pregnancy. Utilizing a strengths-based and culturally sound approach, NACCHO worked closely with the Aboriginal Community Controlled Health Organisations (ACCHOs) to develop the campaign through co-design, as described in this paper. Since its inception, the ACCHOs have continually invested in driving change towards improvements in Aboriginal health determinants and health promotion. The Strong Born Campaign developed culturally safe health promotion tool kits designed for the community and health sector staff and also offered communities the opportunity to apply for FASD Communications and Engagement Grants to engage in local campaign promotion. The tool kits have been disseminated to 92 ACCHOs across Australia. This paper describes the development of the Strong Born Campaign and activities following its launch in February 2023 from an Indigenous context within Australia, as described by NACCHO.