Community-based participatory research (CBPR) and community-engaged research have been established in the past 25 years as valued research approaches within health education, public health, and other health and social sciences for their effectiveness in reducing inequities. While early literature focused on partnering principles and processes, within the past decade, individual studies, as well as systematic reviews, have increasingly documented outcomes in community support and empowerment, sustained partnerships, healthier behaviors, policy changes, and health improvements. Despite enhanced focus on research and health outcomes, the science lags behind the practice. CBPR partnering pathways that result in outcomes remain little understood, with few studies documenting best practices. Since 2006, the University of New Mexico Center for Participatory Research with the University of Washington’s Indigenous Wellness Research Institute and partners across the country has engaged in targeted investigations to fill this gap in the science. Our inquiry, spanning three stages of National Institutes of Health funding, has sought to identify which partnering practices, under which contexts and conditions, have capacity to contribute to health, research, and community outcomes. This article presents the research design of our current grant, Engage for Equity, including its history, social justice principles, theoretical bases, measures, intervention tools and resources, and preliminary findings about collective empowerment as our middle range theory of change. We end with lessons learned and recommendations for partnerships to engage in collective reflexive practice to strengthen internal power-sharing and capacity to reach health and social equity outcomes.

We developed a set of four community-based participatory research (CBPR) partnership tools aimed at supporting community–academic research partnerships in strengthening their research processes, with the ultimate goal of improving research outcomes. The aim of this article is to describe the tools we developed to accomplish this goal: (1) the River of Life Exercise; (2) a Partnership Visioning Exercise; (3) a personalized Partnership Data Report of data from academic and community research partners; and (4) a Promising Practices Guide with aggregated survey data analyses on promising CBPR practices associated with CBPR and health outcomes from two national samples of CBPR projects that completed a series of two online surveys. Relying on Paulo Freire’s philosophy of praxis, or the cycles of collective reflection and action, we developed a set of tools designed to support research teams in holding discussions aimed at strengthening research partnership capacity, aligning research partnership efforts to achieve grant aims, and recalling and operationalizing larger social justice goals. This article describes the theoretical framework and process for tool development and provides preliminary data from small teams representing 25 partnerships who attended face-to-face workshops and provided their perceptions of tool accessibility and intended future use.

Healthy Indigenous child development is grounded in Indigenous ways of knowing and being. Attachment theory has been influential in understanding the significance of parenting for infant development in Western science but has focused on child–caregiver bonds predominantly within the parent–child dyad. To bring forth Indigenous perspectives regarding understandings of parenting, the attachment bond, and the well-being of Indigenous children, we conducted semi-structured interviews with 28 members of a Northwest tribal community (21 female) in spring and summer 2020. Themes included Community caregiving, Family value systems, Bonding, Traditional teachings, and Historical trauma. The need to expand the lens of attachment theory beyond the dyad is clear. Implications for improving the child welfare system and prevention programs within Indigenous communities are discussed.

Over the past 20 years, national and global health initiatives have increasingly used resources, implemented tools, and proposed policies to change the social determinants of health contributing to health inequities. The World Health Organization and the US Centers for Disease Prevention and Control have applied their evidence-based frameworks to these efforts. Yet, for tribal nations and Indigenous communities in the United States, these frameworks’ relevance and applicability are limited. The disproportionate impact of the COVID-19 pandemic (e.g., incidence and mortality rates) highlighted Indigenous epistemologies and realities (e.g., tribal sovereignty, strained state–tribal health systems) that were either missing or did not conceptually fit in these social determinants of health frameworks. We describe findings from the 2018 to 2024 Indigenous Social Determinants of Health Project completed by Seven Directions, an Indigenous public health institute. We propose constructs for Indigenous healing, health, and wellness frameworks developed by and for tribal nations and Indigenous communities. Practitioners and policymakers may use these tailored frameworks in collaboration across sectors (e.g., public health, social services, behavioral health) to align systems for transformational change, decolonize public health, and achieve health equity. ( Am J Public Health. 2025;115(5):726–731. https://doi.org/10.2105/AJPH.2024.307958 )