# Development of an Instrument for Assessment of Indigenous Historical Trauma as a Social Determinant of Health Among American Indian/Alaska Native Populations

> **NIH NIH R01** · GEORGE WASHINGTON UNIVERSITY · 2023 · $663,504

## Abstract

ABSTRACT
American Indian/Alaska Native (AI/AN) populations experience some of the most extensive health disparities in
the U.S. for any demographic group. Increasing evidence shows that indigenous historical trauma (IHT) is a
likely causal factor for AI/AN health disparities. However, recent research has only begun the process of
defining and operationalizing IHT as a construct that could be measured and assessed as a health
determinant, and the instruments now available focus primarily on historical loss experience and associated
symptoms, though the experience and effects of IHT are likely to be more extensive. Progress is needed to
develop validated assessment tools that capture broader and cross-generational aspects of the phenomenon.
To address this specific gap in the literature and contribute to the reduction of health disparities among AI/ANs,
we propose community-based research that brings together complementary strengths of the Department of
Prevention and Community Health (DPCH) at the George Washington University Milken Institute School of
Public Health (GWSPH), the Eastern Band of Cherokee Indians (EBCI), and Western Carolina University
(WCU) in a partnership to: 1) Use systematic qualitative methods, cultural models theory, and a community
participatory approach to elicit/validate characteristics and manifestations of an expanded IHT construct (to
include those identified in previous research), followed by scale development procedures to develop and pre-
test an expanded IHT instrument that integrates these broader factors; and 2) administer the newly developed
IHT scale and health assessment instrument to a sample of 400 Tribal participants to test its internal
consistency, reliability, and factor structure. We will additionally evaluate the associations between IHT and
behavioral risks/outcomes and priority health conditions prioritized by EBCI, including substance abuse and
related issues, violence and abuse, diabetes, stress and depression. Results will be disseminated to EBCI and
to the field.

## Key facts

- **NIH application ID:** 10736011
- **Project number:** 1R01MD018118-01A1
- **Recipient organization:** GEORGE WASHINGTON UNIVERSITY
- **Principal Investigator:** MARK EDBERG
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $663,504
- **Award type:** 1
- **Project period:** 2023-07-10 → 2027-11-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10736011

## Citation

> US National Institutes of Health, RePORTER application 10736011, Development of an Instrument for Assessment of Indigenous Historical Trauma as a Social Determinant of Health Among American Indian/Alaska Native Populations (1R01MD018118-01A1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10736011. Licensed CC0.

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