Alaska Native; family wellness; Tribal health; community-based intervention; strength’s-based; adverse childhood experiences; intergenerational trauma; domestic violence; child abuse


Community Health


Background: Increasing evidence demonstrates the life-long physical, emotional, and social effects of traumatic experiences. In recognition that many health disparities are driven by high rates of traumatic experiences, Alaska Native and American Indian people have created wellness programs that build health by first healing historical and lifetime trauma. Yet, many of these promising community-based interventions are not described in the health sciences literature. Southcentral Foundation’s Family Wellness Warriors Initiative (FWWI) was created by Alaska Native people, addresses traumatic experiences as the root cause of family violence, and builds on cultural strengths. The goal of this study was to build a conceptual model for the program, which has more than 11, 494 participants.

Methods: Focus groups were conducted with 27 training graduates and 7 program staff. Transcripts from previous focus groups with 52 total participants were also analyzed. The evaluator and 15 program staff used participatory qualitative analysis and grounded theory to build the conceptual model.

Results: Participant responses indicated that change occurred in stages, with healing from the pain and shame of trauma a necessary precursor to building self-esteem, improving family relationships, making positive life changes, and helping others. Activities reported to drive changes included sharing story in group and receiving affirming responses, connecting to others with similar experiences, and actively practicing interpersonal skills, goal setting, and observing and accepting emotions. Additionally, respondents said that participating in a strengths-based Alaska Native-led process was healing and increased self-esteem.

Conclusion: As trauma survivors often develop behaviors that disrupt family life and affect the next generation, FWWI heals this trauma to prevent its transmission. The specific techniques utilized and symptoms addressed closely match evidence-based interventions for complex trauma. FWWI differs because it is Alaska Native-led, emphasizes culture and spirituality, and uses peer leaders and modeling rather than clinical hierarchy.