Document Type

Capstone Experience

Graduation Date


Degree Name

Master of Public Health


Health Promotion

First Committee Member

Patrik Johansson

Second Committee Member

Shinobu Watanabe-Galloway

Third Committee Member

Corey Smith


Background: Great Plains American Indians/Alaska Natives (AI/ANs) experience higher mortality rates than Non-Hispanic Whites from the same region. The National Behavioral Risk Factors Surveillance System (BRFSS) survey can have limitations of the estimates the health risks behaviors and services from one Tribal community to another. Goals and Objectives: The goal of this project is to address the lack of Tribal specific data among AI/ANs in the Great Plains region (ND, SD, NE, IA) by using Great Plains Tribal BRFSS data that captured information for three tribes in the Great Plains region. Tribal specific data will allow tribes to access, address, and possibly implement evidence-based health promotion and chronic disease prevention practices and health policies. The objectives of this project were to: 1) conduct an analysis of the prevalence of different behavioral risk factor indicators in two Great Plains Tribal communities and their respective State Non-Hispanic White population; 2) identify a framework and describe the steps for disseminating results to the two Tribal communities, including tribal specific reports with the BRFSS data; and 3) conduct a literature review to identify evidence-based interventions to address alcohol-related risk factors in AI/ANs residing in the Great Plains region. Methods: We used the Great Plains BRFSS data that were collected in 2013. We conducted exploratory data analysis to note any large differences between the Tribal results and their respective State’s results. Existing dissemination strategies employed by the Great Plains Tribal Chairmen’s Health Board were reviewed and a literature review was conducted to identify evidence-based interventions to address alcohol related issues. Results: The Great Plains American Indian BRFSS Project appears to show health disparities between Tribal populations and Non-Hispanic Whites in several behavior risk factors including health care access, cancer screenings, alcohol misuse, smoking, obesity, and diabetes. A community based participatory research approach framework was identified while observing Tribal Sovereignty. The literature review shows two effective evidence-based interventions. Discussions: Data from this project will allow the two Tribes to identify health risk behavior priority areas and address gaps in health level risk behavior knowledge. In addition, this report will provide evidence-based interventions that Tribal Leadership and Tribal Health Departments can implement in their respective communities, specifically related to alcohol use.