American Indian community engagement and the structural and social determinants of health: results from the THRIVE assessment

Survey data from the THRIVE assessment and community-engaged process (<i>N</i> = 100) documented the social and structural determinants of health. The community-adapted THRIVE assessment examined the underlying factors of people, places, and opportunities that contribute to health inequities in the community. Results from this work show that the adapted THRIVE tool has high psychometric reliability (<i>α</i> = 0.957) and that community members feel strong about factors related to people and vulnerability, as well as factors related to place and equitable opportunities. The authors discuss future work and actions they will undertake to address community-identified concerns through community-based programs like complementary alternative medicine, harm reduction via mobile outreach, employment readiness and job training, sober housing, culturally centered treatment, and voucher-based programs to meet basic needs. The process presented underscores the importance of involving American Indian community members in co-creating data collection tools that represent the community's needs and interests. This intersectional, holistic approach aims to enhance community conditions and achieve the highest possible health and well-being for American Indian communities.