Resource Library

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Cover page of the document titled "Practical Ways to Implement the 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain among American Indian and Alaska Native Patients. There is an elder man with a young toddler on his shoulders. Published November 2020. The Seven Directions geometric logo is in the bottom left corner, with the publishing date May 2025.
Practical ways to implement 2022 Practice Guidelines….Clinical Practice, Opioid Overdose PreventionResource GuideThe 2022 CDC Clinical Practice Guideline for Prescribing Opioids for Pain provides recommendations for clinicians providing pain care, including opioid …clinical-practice opioid-overdose-preventionresource-guide
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Reducing opioid overdose deaths in Minnesota: Insights from one tribal nationGathering GroundsAmerican Indians and Alaska Natives in the United States continue to persist and thrive, but the opioid crisis and opioid …gathering-grounds
Cover page of the document titled "Risk Communication Toolkit, 2022." A woman holds her child facing a window. At the bottom, it states "This Risk Communication Toolkit has resources and examples of effective communications for Indigenous communities related to suicide, adverse childhood experiences, and intimate partner violence."
2022 Risk Communication ToolkitInjury Prevention, Violence PreventionToolkitSeven Directions, in partnership with the Inter-Tribal Council of Arizona (ITCA) and the Great Lakes Inter-Tribal Epidemiology Center (GLITEC), created …injury-prevention violence-preventiontoolkit
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Gathering Grounds COVID-19 Community Meeting II ResourcesGathering GroundsResource GuideThe following are resources that were shared during the Gathering Grounds: How is your Tribal or Urban Indian community responding to …gathering-groundsresource-guide
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Gathering Grounds COVID-19 Community Meeting I ResourcesGathering GroundsResource GuideThe following resources were shared during the Gathering Grounds Indigenous Community of Practice meeting on March 26, 2020 by meeting …gathering-groundsresource-guide
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Gathering Grounds COVID-19 Community Meeting III ResourcesGathering GroundsResource GuideThe following are resources that were shared during the Gathering Grounds: How is your Tribal or Urban Indian community responding to …gathering-groundsresource-guide
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
COVID-19 Emergency Response Resources for Tribes in New Mexico and the Navajo Nation by Roanhorse ConsultingGathering GroundsResource GuideRoanhorse Consulting is developing a document with COVID-19 Emergency Response Resources for Tribes in New Mexico and the Navajo Nation. …gathering-groundsresource-guide
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Gathering Grounds Community Meeting IV: A Look at Lummi Nation’s Response to COVID-19Gathering GroundsBriefOn April 16, during our Gathering Grounds Community Meeting, we heard from Cristina J. Toledo-Cornell, MD-MPH, Public Health Director of the …gathering-groundsbrief
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Questions, Considerations, and Tips for Indigenizing Communications by Native Governance CenterGathering GroundsBriefNative Governance Center has developed this list of questions to help guide your communications efforts. To watch the presentation, “Indigenized …gathering-groundsbrief
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Ruptured Knowledge Ecologies in Indian Country by Marisa DuarteGathering GroundsBook ChapterDr. Duarte recently published “Ruptured Knowledge Ecologies in Indian Country” in the book, Data Justice and COVID-19: Global Perspectives. This …gathering-groundsbook-chapter
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Quantifying opioid use disorder Cascade of Care outcomes in an American Indian tribal nation in MinnesotaArticleAmerican Indian communities in Minnesota have been disproportionately impacted by the opioid use disorder (OUD) epidemic, which tribal communities have …article
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Entrenched, Unrelenting, Unsettled: Cultural Essentialism in International Development Research on Domestic Violence in NepalViolence PreventionArticleDomestic violence (DV) is a serious issue that supports systems of oppression. Research and development work often describe DV in …violence-preventionarticle
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Exploring theoretical mechanisms of community-engaged research: a multilevel cross-sectional national study of structural and relational practices in community-academic partnershipsConceptual FrameworkArticleThis National Instittues of Health funded research examined survey data from 453 people, including scientists and community partners in 165 …conceptual-frameworkarticle
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
All systems are interrelated: Multilevel interventions with indigenous communitiesHealth SystemsArticleColonial history and ongoing racism have harmed Indigenous peoples for generations, causing health problems that continue today. Despite this, Indigenous …health-systemsarticle
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Predictors of STD Screening From the Indigenist Stress-Coping Model Among Native Adults With Binge Substance UseClinical Care, Substance MisuseArticleThis research study examined the EMPWR (Educate, Motivate, Protect, Wellness and Respect) intervention data exploring how stressors and protective factors …clinical-care substance-misusearticle
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The inclusion of tribes and American Indian and Alaska Native People in State comprehensive cancer control plansCancer Care & PreventionArticleThis study study, funded by by Cancer Prevention and Control Research Network cooperative agreements (U48 DP006413, U48 DP006389, U48 DP006400) …cancer-care-preventionarticle
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Understanding determinants of lung cancer preventive care in at-risk urban American Indians and Alaska Natives: A mixed-methods studyCancer Care & Prevention, Qualitative ResearchArticleThis research study, funded by the American Lung Association, American Thoracic Society and CHEST Foundation (MT) and by the NCI/NIH …cancer-care-prevention qualitative-researcharticle
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Beyond attachment theory: Indigenous perspectives on the child–caregiver bond from a northwest tribal communityQualitative Research, YouthArticleThe purpose of this Robert Wood Johnson Foundation funded pilot study was to explore Indigenous perspectives on parenting from a …qualitative-research youtharticle
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Conceptualizing Indigenous strengths-based health and wellness research using group concept mappingConceptual FrameworkArticleThe purpose of this research study was to define an Indigenous strengths-based approach to health and well-being research.conceptual-frameworkarticle
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Prevalence of Mental Health Disorders and Treatment Utilization among Urban Lesbian, Gay, Bisexual, and Transgender American Indians and Alaska NativesClinical PracticeArticleThis research study, funded by the NIMH (5R01-MH065871), examined prevalence of mental health treatment utilization among 447 lesbian, gay, bisexual, …clinical-practicearticle
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Substance-Specific Risk Factors among Young Adults: Potential Prevention Targets across Cannabis-Permissive EnvironmentsSubstance Misuse, YouthArticleThis research study, funded by the National Institute on Drug Abuse of the National Institutes of Health under grant numbers …substance-misuse youtharticle
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Indigenous Research Ethics Requirements: An Examination of Six Tribal Institutional Review Board Applications and Processes in the United StatesResearch EthicsArticleThis study, funded by Nicole S. Kuhn’s research with the Ronald E. McNair Fellowship was provided by the Graduate Opportunities …research-ethicsarticle
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Developing Indigenous-Centered Healing, Health, and Wellness Frameworks to Strengthen Indigenous Health Systems, Decolonize Public Health, and Achieve Health EquityHealth SystemsArticleThis project was funded by the Centers for Disease Control and Prevention (CDC) of the US Department of Health and …health-systemsarticle
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The intersection of social and Indigenous determinants of health for health system strengthening: a scoping reviewHealth SystemsArticleThis project was funded by the Centers for Disease Control and Prevention (CDC) of the US Department of Health and …health-systemsarticle
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
A pilot study of virtual Harm Reduction Talking Circles for American Indian and Alaska Native adults with alcohol use disorderClinical Practice, Qualitative Research, Substance MisuseArticleThis research study, funded by NIAAA (P60AA026112, Project-002-835), tested an 8-week, single-arm pilot were to initially document feasibility, acceptability, and …clinical-practice qualitative-research substance-misusearticle
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Developing an Indigenous systems alignment framework: A call for direct fundingHealth SystemsArticleThis research study was funded by the Georgia Health Policy Institute at Georgia State University, through by the Robert Wood …health-systemsarticle
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Making older adult fall prevention a routine part of healthcare in tribal clinical settingsClinical Practice, Injury PreventionArticleA research study funded by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human …clinical-practice injury-preventionarticle
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Risk and Protective Factors Associated with Moderate and Acute Suicidal Ideation among a National Sample of Tribal College and University Students 2015-2016Suicide Prevention, Tribal Colleges and UniversitiesArticleA research study funded by NIMHD (5P60MD006909) examining the risk and protective factors associated with suicide risk among tribal college …suicide-prevention tribal-colleges-and-universitiesarticle
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Engage for Equity: A Long-Term Study of Community-Based Participatory Research and Community-Engaged Research Practices and OutcomesCommunity Based Participatory ResearchArticleA research study funded by NINR (1 R01 NR015241-01A1) testing the impact of a community based participatory research training among …community-based-participatory-researcharticle
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Engage for Equity: Development of Community-Based Participatory Research ToolsCommunity Based Participatory ResearchArticleA research study funded by NINR (1 R01 NR015241-01A1) testing the fit and use of community based participatory research tools …community-based-participatory-researcharticle
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Perceived descriptive norms for alcohol use among tribal college students: Relation to self-reported alcohol use, consequences, and risk for alcohol use disorderSubstance Misuse, Tribal Colleges and UniversitiesArticleA research study funded by NIMHD (5P60MD006909) and NIAAA (5R01AA022068) that tested relationships between perceived descriptive alcohol use norms and …substance-misuse tribal-colleges-and-universitiesarticle
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Prevalence of Moderate and Acute Suicidal Ideation among a National Sample of Tribal College and University Students 2014–2015Suicide Prevention, Tribal Colleges and UniversitiesArticleA research study funded by NIMHD (5P60MD006909) examining the relationship between suicide risk and hazardous drinking, depression, and anxiety among …suicide-prevention tribal-colleges-and-universitiesarticle
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Strengthening Tribal Governance to Improve HealthHealth SystemsWebsiteA research study funded by Grant R01AA028236 from the National Institutes of Health to analyze tribal alcohol policy environments and …health-systemswebsite
Cover page for a document. Text: A Tribal Public Health Accreditation Readiness Guidebook and Roadmap. Cultivating A Culture of High Performance and Quality: Lessons Learned from the Three Sisters - Corn, Squash, & Beans. Published March 2018.
Public Health Accreditation Guidebook and RoadmapHealth SystemsToolkitCultivating A Culture Of High Performance And Quality: Lessons Learned from the Three Sisters – Corn, Squash & Beanshealth-systemstoolkit
Cover page for a document. Text: Tribal Health Governance Transformation: A Resource to Strengthen Sovereignty through Public Health Authority. Published February 2021.
Health SystemsHealth SystemsResource GuideThis Tribal Health Governance Transformation Resource is a practical guide to enhance tribal governance and public health law, build strategic …health-systemsresource-guide
Cover page for a document. Text: A Unified Approach to Indian Health: The Case for Tribal Public Health Institutes. Published August 2015.
Making the Case for an Indigenous PHIHealth SystemsReportThe Case for Tribal Public Health Institutes, Tribal Public Health Feasibility Institute, Redstar Innovationshealth-systemsreport
Text: Public Health Accreditation Board Standards and Measures. Version 1.5, Adopted December 2013.
Public Health Accreditation Board Standards & MeasuresPublic Health AccreditationResource GuideOfficial standards, measures, required documentation, and guidance blueprint for PHAB national public health department accreditationpublic-health-accreditationresource-guide
Cover page for a document. Text: Development a Tribal Health Department. Strategic Plan: How-To Guide.
Guide to Tribal Health Department Strategic PlanningPublic Health AccreditationResource GuideRedstar Innovations and National Association of County & City Health Officials (NACCHO)public-health-accreditationresource-guide
Cover page for a document. Text: Tribal Health Department Guide to Self-Study. An In-Depth Approach to Tribal Health Department Capacity Assessment for Accreditation Preparation. Based on the Public Health Accreditation Board's Tribal Standards and Measures, Version 1.0.
Guide to Tribal Health Department Self-Assessment for Public Health AccreditationPublic Health AccreditationResource GuideRedstar Innovations and National Association of County & City Health Officials (NACCHO)public-health-accreditationresource-guide
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Self-Assessment Workbook for Tribal Health DepartmentsPublic Health AccreditationWorkbookGray Horse Strategiespublic-health-accreditationworkbook
Text: Welcome Becoming Ka Ma Ma Webinar Series: (Re) Imagining Tribal Health Systems. January 14, 2020.
(Re)Imagining Tribal Health Systems WebinarHealth SystemsWebinarThis was the first of three webinars in the Becoming Ka Ma Ma: A Journey of Health System Transformation series. …health-systemswebinar
Text: Welcome Becoming Ka Ma Ma Webinar Series. An Integrated Public Health Performance Management Mode. February 11, 2020.
An Integrated Public Health Performance Management Model WebinarHealth SystemsWebinarThis presentation was the second of three webinars in the Becoming Ka Ma Ma: A Journey of Health System Transformation …health-systemswebinar
Cover page for a practice brief. Text: Practice Brief, September 2020. Becoming Butterfly: An Indigenous Approach to Healing and Transforming Tribal Health Systems through Performance Management. By Allena M. Kawe, MPH and Myra Parker, JD/MPH, PhD.
Becoming Butterfly: Practice BriefHealth SystemsBriefThe Becoming Butterfly framework is promising practice for sustainable tribal health system transformation through performance management practices. It draws on …health-systemsbrief
Cover page for a document. Text: Data Storytelling Through Participatory Media: A Step-by-Step Guide for Public Health Practitioners. A woven basket is featured on the cover.
NAACHO Data Storytelling GuideIndigenous Evaluation, Qualitative ResearchToolkitThis guide is intended for use by local public health departments and their partners in all functions of public health …indigenous-evaluation qualitative-researchtoolkit
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Indigenous Evaluation Recommended ReadingsIndigenous EvaluationReference ListDr. LaFrance has offered an additional reading list to supplement the Indigenous Evaluation Training.indigenous-evaluationreference-list
First page of a book chapter. Text: Chapter 3, Through A Cultural Lens, Reflections on Validity and Theory in Evaluation. By Karen E. Kirkhart, Syracuse University.
Through a Cultural Lens – Reflections on Validity and Theory in Evaluation by Karen E. KirkhartIndigenous EvaluationBook ChapterThis resource was recommended by Dr. Joan LaFrance to supplement the Indigenous Evaluation Training Series.indigenous-evaluationbook-chapter
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Introduction to the Four Foundations of Indigenous Evaluation – Discussion SummaryIndigenous EvaluationBook ChapterThis document summarizes the discussion section of the presentation, “Introduction to the Four Foundations of Indigenous Evaluation.”indigenous-evaluationbook-chapter
First page for a book chapter. Text: Chapter 3, Cultural Views of Validity, A Conversation. By Joan LaFrance, Karen E. Kirkhart, and Richard Nichols.
Cultural Views of Validity – A ConversationIndigenous EvaluationBook ChapterThis chapter was recommended by Dr. Joan LaFrance to supplement the Indigenous Evaluation Training Series.indigenous-evaluationbook-chapter
First page of a journal article with text "The Centrality of Practice to Evaluation" by Thomas A. Schwandt.
The Centrality of Practice to EvaluationIndigenous EvaluationArticleThis article was recommended by Dr. Joan LaFrance to supplement the Indigenous Evaluation Training Series.indigenous-evaluationarticle
Cover page for a document. Text: Indigenous Evaluation Toolkit: An Actionable Guide for Tribal and Urban Indian Impaired Driving Prevention Programs. Published July 2024. Seven Directions' logo, with text: Seven Directions: A Center for Indigenous Public Health, University of Washington. The bottom is an illustration from the Toolkit of the outline of a woman looking over a winding river with evergreen trees on the banks.
Indigenous Evaluation Toolkit Supplement: An Actionable Guide for Driving Under the Influence (DUI) Prevention ProgramsIndigenous Evaluation, Injury Prevention, Substance MisuseToolkitIntended to be used in tandem with the Indigenous Evaluation Toolkit, this guide provides examples from Indigenous communities addressing DUI …indigenous-evaluation injury-prevention substance-misusetoolkit
The first page of a book chapter. Text: Spirituality Matters: The Role of Religion in Development Project Evaluation in the Tibetan Communities in China, by Laura Pan Luo, Yonggong Liu, Yanli Liu.
Spirituality Matters: The Role of Religion in Development Project Evaluation in the Tibetan Communities in ChinaIndigenous EvaluationArticleThis article was recommended by Dr. Joan LaFrance to supplement the Indigenous Evaluation Training Series.indigenous-evaluationarticle
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Introduction to the Four Foundations of Indigenous Evaluation – Q&A SummaryIndigenous EvaluationQ&AThis document summarizes a Q&A held during the Indigenous Evaluation Training Seriesindigenous-evaluationqa
Cover page for a document. Text: Indigenous Evaluation Toolkit: An Actionable Guide for Tribal and Urban Indian Adverse Childhood Experiences (ACEs) Prevention Programs. July 2024. Seven Directions logo, text: Seven Directions: A Center for Indigenous Public Health. The bottom is an illustration from the Toolkit of the outline of a woman looking over a winding river with evergreen trees on the banks.
Indigenous Evaluation Toolkit Supplement: An Actionable Guide for Tribal and Urban Indian Adverse Childhood Experiences (ACEs) Prevention Programs (2024)Indigenous EvaluationToolkitIntended to be used in tandem with the Indigenous Evaluation Toolkit, this guide provides examples from Indigenous communities addressing Adverse …indigenous-evaluationtoolkit
Cover page of the document titled "Indigenous Evaluation Toolkit: An Actionable Guide for Tribal and Urban Indian Suicide Prevention Programs." Published July 2024. Seven Directions logo with text: Seven Directions, a Center for Indigenous Public Health, University of Washington. The bottom is an illustration from the Toolkit of the outline of a woman looking over a winding river with evergreen trees on the banks.
Indigenous Evaluation Toolkit Supplement: An Actionable Guide for Tribal and Urban Indian Suicide Prevention Programs (2024)Indigenous Evaluation, Suicide PreventionToolkitIntended to be used in tandem with the Indigenous Evaluation Toolkit, this guide provides examples from Indigenous communities addressing suicide …indigenous-evaluation suicide-preventiontoolkit
Seven Directions' logo. Geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Seven Directions’ Indigenous Evaluation Toolkit TrainingIndigenous EvaluationTrainingWhile Indigenous evaluation approaches have been documented for use in educational settings, for violence prevention, for youth well-being, and for …indigenous-evaluationtraining
Cover page of the document titled "Tailoring Opioid Overdose Prevention Efforts for Diverse Groups within Tribal and Urban Indian Settings: A Toolkit for Providers and Community Organizations Serving American Indian / Alaska Native Communities." Published March 2022. Seven Directions logo with text: Seven Directions, a Center for Indigenous Public Health, University of Washington.
Tribal Opioid Overdose Prevention Toolkit for Diverse GroupsOpioid Overdose PreventionResource GuideThe purpose of this toolkit is to add to the compendium of tribal and urban Indian opioid overdose prevention summaries …opioid-overdose-preventionresource-guide
Cover page of the document "2021 Update: COVID-19 & the Pivot to Telehealth. An Environmental Scan of Tribal Opioid Overdose Prevention Responses: Community-Based Strategies and Public Health Data Infrastructure." Published October 2021. Seven Directions logo with text: Seven Directions, a Center for Indigenous Public Health, University of Washington.
An Environmental Scan of Tribal Opioid Overdose Prevention Responses: Community-Based Strategies and Public Health Data Infrastructure 2021COVID-19, Health Systems, Opioid Overdose PreventionResource GuideThis brief updates the Environmental Scan (2019) and the Models of Tribal Promising Practices brief (2020) with COVID-19-induced and telehealth-specific …covid-19 health-systems opioid-overdose-preventionresource-guide
An image of the 2019 Executive Summary of the document, "An Environmental Scan of "Tribal Opioid Overdose Prevention Responses: Community-Based Strategies and Public Health Data Infrastructure."
Executive Summary: An Environmental Scan of Tribal Opioid Overdose Prevention ResponsesOpioid Overdose PreventionExecutive SummaryThis is an executive summary of the 2019 Environmental Scan.opioid-overdose-preventionexecutive-summary
Cover page of the document titled "An Environmental Scan of Tribal Opioid Overdose Prevention Responses: Community-Based Strategies and Public Health Data Infrastructure." Prepared by Seven Directions: A Center for Indigenous Public Health, September 2019.
An Environmental Scan of Tribal Opioid Overdose Prevention Responses: Community-based Strategies and Public Health Data Structure (2019)Health Systems, Opioid Overdose PreventionResource GuideThis document is written for community members, tribal and organizational leaders, and healthcare professionals at the forefront of the opioid …health-systems opioid-overdose-preventionresource-guide
Cover page of the document titled "Models of Tribal Promising Practices: Tribal Opioid Overdose Prevention Care Coordination and Data Systems." Published November 2020. Seven Directions: A Center for Indigenous Public Health.
Models of Tribal Promising Practices Tribal Opioid Overdose Prevention Care Coordination and Data SystemsHealth Systems, Opioid Overdose PreventionResource GuideThis brief features four models of tribal promising practices that address Opioid Use Disorder (OUD) and opioid overdose prevention. This …health-systems opioid-overdose-preventionresource-guide
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Characterizing risk and protective factors for Alzheimer’s disease and related dementias in American SamoaClinical PracticeArticleThis study was supported by the Native Alzheimer’s Disease Resource Center for Minority Aging Research (NAD-RCMAR) which is funded by …clinical-practicearticle
The Seven Directions logo: a geometric design with colored arrows and diamonds in green, yellow, black, gray, blue, and brown.
Between International Policy and Local Practice: Nepali Service Providers’ Constructions of Domestic Violence in ContextViolence PreventionArticleThis study used critical discourse analysis method to looke at how domestic violence (DV) is described by service providers in …violence-preventionarticle

About Our Practice

The Seven Sacred Directions

Seven Directions was born from a desire to create greater connectivity across the many tribes, communities and organizations that have the health and wellness of American Indian and Alaska Native people at the heart of what they do. We are guided by the “seven directions” of practice: Integration & Holistic Wellness, Culture & Identity, Families & Communities, Respect for Sovereignty, Service, Indigenous Knowledge, and Tribal Governance.

The Seven Sacred Directions serve as an indigenous framework for presenting the strategic directions for the public health agenda.

Glen Oaks, NY, USA - July 26, 2014: Two Native American female girl dancers at annual pow-wow at Queens County Farm Museum.