Tribally specific cultural learning: the Remember the Removal program

Abstract

Remember the Removal is a program for Cherokee youth and young adults which aims to increase Cherokee knowledge, culture, and language by retracing the Trail of Tears. This study evaluated the Cherokee values that were gained and how the participants learned and applied traditional Cherokee values through the program. This is significant because cultural knowledge and connection are important developmental aspects for Indigenous youth and can also protect them from health risks. To assess cultural growth, a total of 23 Remember the Removal participants took part in focus groups. Participants comprised two cohorts: the first cohort of the program was in 1984 (n = 15) and the most current cohort occurred in 2015 (n = 9). Data were analyzed using program evaluation and decolonization methods. Results indicated that there were five themes related to Cherokee values: treat everyone with kindness, help each other, work together, take care of one another, treat each other as family, and be confident. These values mapped onto traditional Cherokee Community Values that had been pre-established by Cherokee Nation and the Cherokee community. This analysis confirmed that this cultural training is feasible; results in improved connection to peers, family, and tribe; is representative of Cherokee values; that the values are applied outside of the program and into the community; and can last up to 32 years.

Keywords

Indigenous culture youth traditional values resilience

First: You get to choose each day to get on “your bike.”

Second: There are boundaries but they can always be pushed.

Third: Never forget where you came from—and we came from the Smokey Mountains¹ and we are Cherokee.

Introduction

Indigenous people experience some of the worst health disparities in the USA and around the world. This is in no small part due to colonization and its lingering effects. Indigenous people are assuming more responsibility of health interventions and using grassroots methods to create programs (Whitbeck et al., 2012). Some Native authors suggest that the use and revitalization of traditional Indigenous cultural practices are therapeutic and critical in recovering from historical trauma and its health manifestations (Gone, 2013). Cultural revitalization can include cultural practices, ceremonies, or language.

Health interventions that utilize Indigenous cultural engagement can protect from physical and mental health problems. For example, participating in traditional activities and spiritual beliefs is associated with fewer risk factors such as high blood sugar (Carlson et al., 2017), alcohol and tobacco use, and obesity (Coe et al., 2004), which results in greater overall health and well-being (Carlson et al., 2017; Petrasek MacDonald et al., 2015). Furthermore, enculturation predicts indicators of improved mental health and well being such as reduced substance abuse (Stone et al., 2006; Yu & Stiffman, 2007), academic success (Les et al., 2001), and reduced suicide ideation (Garroutte et al., 2003).

Consistent with the above, tailoring health interventions to the specific communities they target improves the health outcomes and acceptability of the intervention. A meta-analysis of 76 studies of culturally adapted mental health treatments demonstrated that cultural adaptation led to a fourfold increase in effectiveness compared to non-adapted interventions (Griner & Smith, 2006). Interventions which integrate cultural values and practices into the curriculum have also been shown to more effectively promote exercise (Venkat Narayan et al., 1998), reduce tobacco and other substance use (Belone et al., 2017; Choi et al., 2016), prevent diabetes (Macaulay et al., 1997), and improve sexual health (Black et al., 2018). Not only do culturally tailored health interventions improve specific outcomes, but they also improve holistic healing and overall well-being (Gone, 2009).

It is not surprising that the health and well-being of Indigenous people are related to their right and ability to put into practice their knowledge, beliefs, and lifeways. Indigenous people are among the first people in the USA and the world to exist with thousands of years of land-based experience and knowledge, contributing to their cultural, spiritual, social beliefs, and practices. Spirituality and culture are the bedrock to the lifeways of Indigenous people and also for Cherokees:

Keetowah teachings stress that when we come into this world, we are born with an inherent gift of Spirit that is given to us by the creator. The acknowledgement of this gift and the acknowledgement of our inseparable connection with the Creator provide the foundation from which all spirituality is based. (Smith, 2018, p. 1)

Furthermore, culture and revitalization are basic human rights as declared in the United Nations (2011) Declaration of the Rights of Indigenous peoples:

Indigenous people have the right to practice and revitalize their cultural traditions and customs . . . manifest, practise, develop and teach their spiritual and religious traditions, customs and ceremonies . . . revitalize, use, develop and transmit to future generations their histories, languages, oral traditions, philosophies, writing systems and literatures . . . their traditional medicines and to maintain their health practices, including the conservation of their vital medicinal plants, animals and minerals . . . maintain, control, protect and develop their cultural heritage, traditional knowledge and traditional cultural expressions. (pp. 11–22)

Therefore, Indigenous cultural practices are necessary, legitimate, and fundamental to Indigenous communities.

Cherokee Nation

The Cherokee Nation is the second largest tribe in the USA, with ~320,000 citizens, and covers approximately 7,000 square miles (Figure 1) (Cherokee Nation Public Health, 2015). The Cherokee Nation comprises 14 counties in Northeastern Oklahoma and is home to 63% of Cherokee citizens and 200,000 Native American (NA) people of any affiliation. NA people living in the Cherokee Nation have a lower average income and high school completion rate (82.9%) compared to the state average (86.7%) (Note: Cherokee-only data are not available. However, approximately 85% of NAs in the Cherokee Nation tribal jurisdiction area are estimated to be Cherokee) (Cherokee Nation Public Health, 2015). Cherokee Nation provides services to its citizens that include, but are not limited to, health care, housing assistance, employment opportunities, vocational guidance programs, food assistance, college guidance and financial assistance, Cherokee seed bank, as well as online and in-person language classes and cultural programming.

Figure 1.

Original and current lands of Cherokees: (a) original territory assigned to Cherokees—1884 and (b) current Cherokee Nation jurisdictional area.

Cherokee health

Federal policies over many eras have banned Cherokee cultural practices. Just within the last 100 years, laws and policies prohibited traditional practices, including family customs, traditional community living, and traditional Cherokee spirituality (until the Indian Religious Freedom Act in 1978). The Cherokee language was banned in public schools and places due to allotment era policies. Therefore, Cherokee youth lack education of their history by their own community and have less access to traditional cultural activities than prior generations. The loss of the Cherokee language and culture has become a critical issue because it is accelerating. A report on the state of our language uncovered that there is no one younger than 40 with conversational skills; only 52 of 300 speakers surveyed actually use the Cherokee language in their home. As a result, most children of Cherokee language speakers cannot speak Cherokee (“Oklahoma Indian tribe education guide: Cherokee Nation,” 2014). Recent studies have demonstrated that the loss of a tribal language is related to worsened mental and physical health (Whalen et al., 2016).

In a report on the health-related quality of life, Cherokees reported limitations with bodily pain, physical function, and perceptions of their health status but not in the areas of social support and activities (McFall, 2000). In particular, cardiovascular disease (CVD) is a critical health issue for Cherokees. Within the Cherokee Nation boundaries, the age-adjusted CVD death rate per 100,000 people in 2009 was higher for NAs (436) than for any other group including Whites (302), Blacks (377), and Asians (163) (“Oklahoma Statistics on Health Available for Everyone [OK2SHARE],” 2015). Furthermore, the percentage of Cherokees in the tribal jurisdiction area who exercise 150 min or more a week was 39%, compared to 45% for Oklahomans and 52% of the US population in 2011 (Cherokee Nation Public Health, 2015). The percentage of Cherokees within Cherokee Nation who eat five or more servings of fruits or vegetables a day was 1% compared to 15% for Oklahomans and 24% for the US population. About 30% of Cherokees smoke, and 12% of those reported smoking for traditional purposes (Cherokee Nation Public Health, 2015).

Among NAs living on a Cherokee reservation in Oklahoma, 42% of NA 12th graders and about a third of 10th graders reported that they drank alcohol within the last month (Cherokee Nation, 2013). Among ninth graders, 25% reported alcohol abuse, 17% reported heavy drinking, 15% reported cigarette use, 12% reported using chewing tobacco, and 12% reported using marijuana (Cherokee Nation, 2013; Kann et al., 2014). About half of high school students reported having sexual intercourse, with 44% reporting not using a condom during their last sexual intercourse. Furthermore, those youth within the Cherokee Nation who reported a high frequency of perceived racial discrimination had an increased risk of prescription or illicit drug misuse as well as heavy drinking (Garrett et al., 2017). This indicates that experiences of discrimination and inequity may drive health behaviors and outcomes for Cherokee youth.

Cherokee removal

Cherokees originally resided in the southeastern USA. European colonizers’ interest in the land and subsequent treaties reduced the land base significantly during the 200 years preceding the removal (Figure 1). Despite protections on the remaining lands guaranteed through treaties (e.g. Treaty of Hopewell), thousands of Americans violated federal and Cherokee law and crossed over into Cherokee lands. In addition, missionaries settled in Cherokee territory with a goal of converting Cherokees spiritually and culturally.

The federal government recognized the Eastern Band of Cherokee Indians in 1868, and that nation currently has 16,000 citizens (Lewis, 2019). Many reside within the Qualla Boundary, a small section of the original Cherokee homelands in western North Carolina. Approximately 1,400 Cherokees remained in the southeast after the removal as a result of treaty provisions in 1817 and 1819 that enabled Cherokees to accept individual land reserves within states (Finger, 1984). In addition, some Cherokee families avoided removal through a series of loopholes and court cases affecting small towns, listing a White male as head of household, or returning after the removal (Chavez, 2016).

Between the years 1838 and 1839, the US government forcibly removed Cherokees from their homelands in the east to Indian Territory (Figure 1). Cherokee William Shorey Coodey (1840) said the following when his detachment left:

In almost an exact Western direction a dark spiral cloud was rising above the horizon and sent forth a murmur I almost fancied a voice of divine indignation for the wrongs of my poor and unhappy countrymen, driven by brutal power from all they loved and cherished in the land of their fathers, to gratify cravings of avarice.

Removal began in earnest when US soldiers forcibly rounded up Cherokees without food or any belongings and holding them in concentration camps. As a result of the squalid camp conditions and the arduous journey, approximately 4,000 Cherokees died. The accounts of the removal include terrible stories of human suffering: US soldiers forcibly raping Cherokee women, hundreds of Cherokees drowning on overcrowded boats, violent deaths of notable Cherokee elders and young children, leaving loved ones’ bodies on the side of the road, and the horrific experiences of walking 1,000 miles without adequate clothing and food. It is difficult to assess total lives lost due to the removal, but scholars have estimated deaths up to 10,000 (Perdue, 2007; Thornton, 1984). More than 10,000 Cherokees arrived in Indian Territory sick, grieving, and politically and socially divided.

Post-removal, in the 1840s and 1850s, the Cherokee Nation rebuilt homes, schools, and other public institutions despite the federal government reimbursing the Cherokee Nation only a fraction of what was promised in removal negotiations. During the Civil War, the Cherokee Nation suffered, proportionally, the greatest loss of life and property of any region of the USA. Between the years 1893 and 1936, over 6.5 million acres, 90% of Cherokee land in Indian Territory, were lost through forced privatization called allotment, sanctioned by the US government and administered by the state of Oklahoma (Stremlau, 2011).

Remember the Removal

The Remember the Removal (RTR) program is sponsored by the Cherokee Nation of Oklahoma and began in 1984. It stopped for many years and began again in 2009 when Chief Chad Smith worked with his administration to bring the program back. The purpose is to bring healing and empowerment to Cherokee young adults through increased cultural and historical knowledge and to support them in becoming informed tribal citizens and Cherokee leaders. The Eastern Band of Cherokee Indians also participate in this program but were not participants of this study. Program components include 5 months of didactic training in Cherokee culture, history, and language, along with exercise and bicycle training twice a week. Next, participants bicycle the Northern route of the Cherokee removal that occurred in 1838, totaling 950 miles and 3 weeks’ time. Continued history, culture, and genealogy lessons occur on site. (For complete training protocol, see Lewis, et al., 2019). The program was created by and for Cherokees and continues to have an all-Cherokee staff.

The program began after noticing that young Cherokees were at risk of alcohol and drug use, as well as not completing high school; Cherokee citizens including Michael Morris, Mose Killer, and Gloria Sly created a program designed to arm young people with their history and culture as a means of building cultural pride, spurring them to become active citizens of the Cherokee community. Although not solely a memorial journey, a goal of the RTR is to tell the story of the removal through Cherokee people, knowledge, and stories and take back the narrative that has been silenced or removed from history. Through history lessons, participants learn about the oppression of Cherokees that is subdued in history books, but also participants learn through historical analysis about the cultural practices and values of Cherokee, including their own relatives.

Participants receive family genealogy, learn family stories, see graves of their family members, and hear how Cherokees used their culture during times of trauma and violence. Specifically, participants discover who they are related to using genealogical analysis, which usually connects each participant to three or four others in the program through familial connection. Historical learning also connects participants’ families to one another—learning who was once your neighbor before removal, grandparents who knew one another and worked together, or other family connections. Participants also learned about how tribal members worked together and what Cherokee values and protocols were used pre- and post-removal to survive and thrive.

Previous RTR studies

Two other studies have been completed that precede this analysis. First, we assessed participants’ experience of the RTR program through the lens of biopsychosocial health and well-being categories (Lewis et al., 2019). Participants noted positive change in each category, yet social, familial, and cultural connections appeared to be most meaningful: they explained that they had improved Cherokee identity, felt more knowledgeable and informed as Cherokee citizens and future leaders, and also felt that they knew more Cherokee culture, language, and history after the program. These results informed the need to further explore Cherokee cultural learning. In addition, participants noted positive improvements in health behaviors such as selecting healthier foods from grocery stores, reduced use of soda and fatty foods, and increased exercise. Participants noted an improvement in self-efficacy after the program as well as increased patience and empathy.

The second study focused on the historical knowledge and growth that participants noted and also their experience of historical trauma (Lewis et al., forthcoming). Historical learning consisted of themes around misrepresentation and erasure, feeling mixed emotions, looking backward and looking forward, and strengthening Cherokee identity. The category of historical trauma resulted in themes including historical loss and associated symptoms; empowerment, resilience, and belonging; and contemporary discrimination and trauma. Overall, participants perceived that their learning of Cherokee history led to thoughts around historical loss and also thoughts of empowerment and resilience.

While preliminary investigations on the protective function of Indigenous culture have begun, scholars have noted that this area of research is only in its “infancy” (Jackson & Hodge, 2010; Yazzie-Mintz, 2011). The mechanisms of teaching, learning, and applying cultural content remain unclear. This study aims to fill that gap by, first, evaluating program outcomes around cultural learning using focus group methodology. In addition to program evaluation, we described how culture was taught to participants to understand the function of cultural knowledge transmission.

Teaching Cherokee culture

Program leaders

Authors 4 and 5 have served as program coordinator for the RTR program for 3 and 7 years respectively. This position requires training the participants 2 days a week for 5 months and then every day for the 3-week ride across the removal route. Program coordinators ride with the participants during the practice rides and on the removal route and also participate in classroom training about Cherokee culture, history, and language. Here, they explain the goals, style, and techniques that they used when working with RTR participants. An informal, semi-structured conversation was recorded between co-authors and then transformed to the content below.

Goals of the program

Program coordinators explained that, more than anything, they want participants to realize their connections—that they are connected to everything that is Cherokee—language, history, and people—both past and present. When riders express that they have the feeling of being Cherokee and not just saying it, this is a sign of a successful program.

Teaching culture

When asked how the participants learn Cherokee cultural knowledge and values through the program, program coordinators explain that they do not sit down and list or teach cultural values or ever even say them explicitly. In fact, author 4 said, “No one sets out to make it more Cherokee: It’s just who we are, and what we do.”

When explaining group dynamics, author 5 says,

No matter who they are, everyone has some Cherokee pieces and it takes a whole group to help us find those pieces and enhance them more. If you just boil it down to teach them ᎦᏚᎩ (gadugi—everyone coming together to solve an issue together) today that wouldn’t work. If someone heard us talking they might think they could do this program but it takes a group of Cherokees today. Everyone who helps set it up is Cherokee. It takes a lot of minds coming together from the community to keep it Cherokee. And genealogy gets them started in building relationships with one another. Genealogy gives validation to everyone’s family. Everyone in the group has a right to be there.

Author 4 adds, “I know what I want them to learn when I’m with the riders. I’m not thinking, ‘well this is what I’m going to teach them today’. Each rider needs different things every day.” The program coordinators point out that this is one of the few times that many of the participants have interacted with an all-Cherokee group for a prolonged period of time, which they believe is a key part of the program: “You get enough Cherokee people together, being responsible for each other, the groups bond, and there is more understanding of the value of holding onto each other.”

Techniques of teaching culture

Program coordinators explained that their approach was mostly hands-off in regard to handling conflict and expressed encouragement when help was needed. Author 5 said,

I didn’t want to be bossy, or use negative terms, or say quit that. Instead, I would say, you guys have to be nice to each other. We would explain they were important and chosen for this project. We are all a part of this history. When I would guide them I would be mindful of how I would talk with them. I would be more positive. There are a lot of conflicts at first. I would respond by saying that they (other person) are important too and we need to get along with each other. We would try to build them up, and teach them to build other people up around them too.

Author 4 adds,

when they say they want to quit. I just always try to be there to give them a little push without being too overbearing. Constant encouragement. Get them motivated because they start to self-defeat and it’s more mental than anything. I would say, “You can do it. Our ancestors did more than that and we come from them.”

These techniques of guiding, leading, and mentoring are represented in Section 6 of Cherokee Values (Table 2).

Techniques of teaching culture: mentorship and leadership

Participants vary according to their level of enculturation and experience being around other Cherokee people. Program coordinators notice that those who have had less Cherokee experiences, and more learning from the dominant culture (e.g., White, Eurocentric beliefs), may behave in a way that focuses more on the self and lacks community connectivity. Program coordinators explain that they

try to get them to understand that they are not the center of attention. Let that go and be part of this group. They look to you for cues because you are in charge. But they are in charge of everyone’s well-being just as much as you are. It takes a while to get there.

For example,

the less cultural participants try to gain friends through a popularity contest and this style of interaction doesn’t work. To teach them a more Cherokee way to interact I tell them, “The way we talk to each other is important so everyone feels heard.” I do not want to put them down or shame them, but shift their focus.

Author 4 explains that “Some participants have been around culture and they are already good leaders without realizing it. They watch how you and others behave and pick it up quicker.” Next, they learn to emulate the behaviors of the program coordinators and those who have had more cultural experiences and then become Cherokee leaders that the others look up to as well.

Techniques of teaching culture: personal struggle, past struggle, and taking care of one another

Program coordinators identified struggling together as another important part of this program. Author 4 says, “They all struggle together—that is what makes them care for one another. They are all hurting, tired, learning together.” They explain that it would not be the same if they were in a classroom or working out at a gym. Author 5 adds that everyone is “working together on this event that happened to everybody’s family. We are connected to this struggle historically and presently.” For example, the program coordinators recall a time when a participant was struggling, wanting to quit, and not thinking they could get through the day; one group started rallying around her, encouraging, and putting their hands on her; and another group was already finished and celebrating that they were done. This group watched as their teammate struggled to finish from the finish line. The next time this group set out to ride, the group that finished first went to the back and helped the others struggling. Program coordinators explain that it takes exposing our selfishness to learn and change. Specifically, the program allows you to learn how to help others.

The program coordinators stay in the back with those who may not be in shape or strong enough starting in practice rides. Participants emulate that behavior on the ride. Program coordinators explain that it is good for people on both sides of this interaction: it feels good to be cared for and know someone is there for you and also it feels good to know that you have helped someone in need. They added that you may not be feeling good that day, but helping someone else makes you feel better and helps to get you through. Furthermore, author 5 adds,

Just saying it is a team-building program does not express how cultural it can be out there. It is a very cultural way of building each other up. We need the cultural kids, they emulate it back because they have seen it before, so you get part of the group, then the others come along when they see the majority acting that way. How they talk, act, encourage. It is not artificial—it is a genuine caring for another human being. All of their families that came before, hundreds of years ago have done this. It is a lot bigger than getting up this one hill—it is a big moment when you realize that. It does seem to help put into perspective that the only way we got through it was each other. That’s how we have always done it. We’re not going to leave anybody—it bothers them at first to have to wait for someone, but when they see that person struggling-they realize why we did it.

How program coordinators learned to be Cherokee leaders

When asked about how they as program coordinators learned to teach in this style, they reflected on how they were taught through this program itself (as past participants), through grandparents, and through experiences with elders.

Methods

To explore how the RTR program affected various aspects of its participants’ lives, as well as to learn how to improve or develop similar programs, two cohorts of the RTR (1984, n = 14; 2015, n = 9) were invited to participate in focus groups in 2015 using program evaluation methods (Broughton, 1991). Each cohort was divided into half, creating four focus groups. Each 2-hr-long focus group took place at the Cherokee Nation in Tahlequah, Oklahoma; a facilitation guide that included prompts and interview tips was created and utilized. The study was approved by Institutional Review Boards (IRBs) at both the Cherokee Nation and the University of Minnesota.

After providing informed consent, participants agreed to not disclose the content of the focus group and were asked a number of open-ended prompts intended to structure, but not constrain, discussion. Given the small size of the group, anonymity was protected by not collecting socio-demographic information. However, participants must be between the ages of 16 and 24 years to participate in the RTR program. The primary prompt focused on their experience as a participant in the RTR and how it has affected their lives. Further prompts included the negative and positive aspects of the program. At the end of the discussion, participants were given an opportunity to summarize their overall experience and provide closing remarks. Afterward, they were thanked for their participation and provided with a meal and a US$30 gift card. The discussions were recorded and transcribed by a research assistant. Participants were then afforded the opportunity to view and edit their responses; three comments were added and none retracted. (For further methodological detail see [Lewis et al., 2019].)

Indigenous methodology

Cherokee Nation Institutional Review Board

Cherokee Nation requires all potential research projects to be reviewed and approved before research may begin. Cherokee Nation asserts its sovereign right to decide who can conduct research and what projects are appropriate. In assessing the appropriateness of the project, Cherokee Nation considers not only human subjects protection but also potential risk of harm to the tribal community. In addition, the Cherokee Nation Institutional Review Board (CNIRB) encourages researchers to collaborate with tribal members, consult on the dissemination of the project, and use Cherokee-specific cultural values and protocol. Furthermore, the CNIRB requires that all dissemination including presentations and publications be first approved through them.

Decolonizing methodology

Decolonizing and Indigenous methodologies assert the importance of equity and relationships in research (Smith, 1999). The author is a citizen of Cherokee Nation and therefore is accountable both to the research project and to the community (Wilson, 2008). A tribally driven participatory research approach was used to create the program and to gather data (Straits et al., 2012). For instance, this project took place over many years of consultation with tribal leaders, program staff, and RTR alumni to ensure it was a project that was needed and would be beneficial for citizens. The research team identified a need to evaluate the program to create internal and external reports: reports were given to the tribal council to ensure future funding of the program and reports were created that are available to the general public to share program details and successes for others to replicate. At each stage of research, data were first brought to the RTR alumni group for discussion and editing before it would go to the next stage. All presentations and publications were co-authored by community members involved in the RTR project.

Data analysis

To determine the impact of the RTR program, participant responses were subjected to thematic analysis. All responses were coded, organized, and analyzed using “NVivo qualitative data analysis software” (2016). Two researchers (first and second author) independently extracted and coded segments of data with coherent meanings. After these segments were shared and confirmed, codes with similar meanings were grouped together to create themes. Forty-eight unique themes emerged, although there was considerable overlap given the intricate layers of meaning in the responses. Exemplars of each theme were chosen by the researchers and confirmed by a Cherokee Nation program staff member. No significant thematic differences emerged between the four focus groups.

Cherokee Community Values

The Cherokee Community Values is a list of traditional Cherokee values, behaviors, and beliefs based on traditional spiritual instruction compiled by elder and Cherokee traditionalist Benny Smith (third author). These values were used as a framework for program evaluation. The list covers many different matters such as community values, daily practices, and spiritual practices. “The nature of Cherokee terms is to induce thought with action” (B. Smith, personal communication, October 2017). These values are widely accepted and utilized throughout Cherokee Nation including the Cherokee Nation immersion school, the Johnson O’Malley program, Community & Cultural Outreach Department, and Northeastern State University Cherokee language degree program. B. Smith has given (first author) permission to evaluate Cherokee programs using these values as a tool to measure Cherokee values and behaviors (personal communication, January 2017). It was his expressed intention that these traditional values continue to be passed down to future generations of Cherokee communities. For the purpose of this article, we focus just on the traditional Cherokee Community Values (ᏍᎦᏚᎩ ᏗᎧᏃᏩᏛᏍᏗ [sgadugi dikanowadvsdi]), given that the Cherokee RTR program focuses on this aspect of Cherokee teachings. These values guide Cherokees on how to relate to one another and their roles as members of a Cherokee community. The first author classified a list of 21 community values created by Smith by themes into six groups. Smith edited and confirmed the classifications and also added Cherokee names to the group titles. When the top five themes from the RTR focus group analysis were compared to the list of five Cherokee community value categories, we found many similarities and linked related themes to values. What was classified in English was then retitled into the Cherokee construct (see Tables 1 and 2).

Table 1.

Themes and Cherokee Community Values that best exemplify the theme.

	RTR themes	Cherokee Community Values
	RTR themes	Cherokee	English
1.	Treat everyone with kindness
	Treat everyone well despite the circumstances.	ᎾᏂᎥ ᏴᏫ ᏕᏣᏠᏯᏍᏗᏍᎨᏍᏗ(nani’v yvwi detsatloyasdisgesdi)	Include everyone, all human kind; however many.
2.	Help each other; work together
	Look for those who need help and help them.	ᏗᏣᏓᏍᏕᎵᏍᎩ ᎢᏤᎮᏍᏗ (ditsadasdelisgi itsehesdi)	You all live, helping one another.
3.	Take care of one another
	Support each other, believe in one another, and encourage others.	ᏗᏣᏓᎫᏍᏓᏂᏙᎯ ᎢᏤᎮᏍᏗ (ditsadagusdanidohi itsehesdi)	Live and support each other in all that you do.
4.	Treat each other as family
	Treat each other as you would your ownfamily—with love, care, fondness, and closeness.	ᏕᏣᏓᏩᏛᎯᏙᎮᏍᏗ(datsadawatvhidohesdi)	Visit one another with love, locate and find one another.
5.	Be confident
	Work to be good at what you do and never give up	ᎬᏩᎵᏨ ᏗᏣᏓᏲᎯᏍᏗ ᎢᏤᎮᏍᏗ (gvwalitsv ditsadayohisdi itsehesdi	Live and never give up on what you start.

RTR: Remember the Removal.

Table 2.

Full list of Cherokee Community Values organized by focus group themes.

1.	Treat everyone with kindness
	ᎾᏂᎥ ᏴᏫ ᏕᏣᏠᏯᏍᏗᏍᎨᏍᏗ	(nani’v yvwi detsatloyasdisgesdi)	Include everyone, all human kind; however many.
	ᏕᏣᏓᎵᎨᏅᏗᏍᎨᏍᏗ	(detsadaligenvdisgesdi)	You all take responsibility for one another’s well-being.
	ᏕᏣᏓᎸᏉᏕᏍᏗ	(detsadalvquodesdi)	Like one another without conditions, admire one another.
2.	Help each other; work together
	ᏗᏣᏓᏍᏕᎵᏍᎩ ᎢᏤᎮᏍᏗ	(ditsadasdelisgi itsehesdi)	You all live, helping one another.
	ᏗᏣᎵᎪᎯ ᎢᏤᎮᏍᏗ	(ditsaligohi itsehesdi)	Live united, work as a team with one another.
	ᏂᎦᏯᎢᏐ ᎦᏚᎩ ᏂᏨᏁᏍᏗ	(nigaya’iso gadugi nitsvnesdi)	In the mind and heart always have the thought of working together.
	ᎦᏚᎩ	(gadugi)	People coming together as one and working to help one another.
	ᏰᏥᎴᏆᎶᏍᎨᏍᏗ ᏗᎦᎸᏫᏍᏓᏗ ᎦᎾᏅᎪᏉ	(yetsilequalosgesdi digalvwisdadi gananvgoquo)	You all gang up on work whenever and wherever it arises.
	ᏕᏣᏓᎦᏘᏰᏍᏗ	(detsadagtiyesdi)	Watch over and wait for one another.
3.	Take care of one another
	ᏗᏣᏓᎫᏍᏓᏂᏙᎯ ᎢᏤᎮᏍᏗ	(ditsadagusdanidohi itsehesdi)	Live and support each other in all that you do.
	ᏕᏣᏓᏙᎯᏳᏎᏍᏗ	(detsadadohiyusesdi)	You all have a strong conviction for and believe in one another.
	ᏕᏣᏓᏝᏂᎪᎯᏍᏙᏗᏕᎨᏎᏍᏗ	(detsadatlanigohisdodidegesdi)	Strengthen one another with encouraging words in all that you do.
	ᎤᎵᏍᎨᏗ ᏕᏣᏓᏰᎸᏎᏍᏗ	(ulisgedi detsadayelvsesdi)	Treat each other’s existence as being sacred or important.
4.	Treat each other as family
	ᏕᏣᏓᏩᏛᎯᏙᎮᏍᏗ	(datsadawatvhidohesdi)	Visit one another with love, locate and find one another.
	ᏕᏣᏓᎨᏳᏎᏍᏗ	(detsadageyusesdi)	Be stingy with one another’s existence, like a mother with child.
	ᏕᏣᏓᏟᏴᏎᏍᏗ	(detsadatliyvsesdi)	Struggle to hold on to one another or cling to one another.
5.	Be confident
	ᎬᏩᎵᏨ ᏗᏣᏓᏲᎯᏍᏗ ᎢᏤᎮᏍᏗ	(gvwalitsv ditsadayohisdi itsehesdi)	Live and never give up on what you start.
	ᏕᏣᏓᏏᎾᏍᏗ ᎢᏤᎮᏍᏗ	(detsadasinasdi itsehesdi)	Live and be very skilled in all areas of life, be resourceful.
6.	Encouraging and directing
	ᏄᏓᏅᏘᏳ ᏕᏣᏓᏅᏫᏗᏍᎨᏍᏗ	(nudantiyu detsadanvwidisgesdi)	Encourage and instruct one another in a gentle and thoughtful way.
	ᏚᏳᎪᏛ ᎢᏗᏢ ᏕᏣᏓᏎᎮᏍᏕᏍᏗ	(duyugtv iditlv datsadasehesdesdi)	Direct one another in the right way, without confining or pushing.

Numbered concepts = project themes; Title in Cherokee = from Cherokee Community Values.

This is an application of ᏍᎦᏚᎩ ᏗᎧᏃᏩᏛᏍᏗ (Cherokee Community Values) created by Benny Smith and compiled by Cherokee Nation Community & Culture Outreach.

Results

Several patterns appeared in the data. First, participants from 1984 and 2015 reported very similar experiences despite such a long span in time between cohorts and given changes to the program intervention over time (Table 3). Second, participants explained (A) how the program taught them the value (program intervention), (B) how they learned it (participant learning), and (C) how they brought the skill home with them (application) (see Figure 2 and Table 4). Third, values learned from the program correspond to Cherokee Community Values (see Tables 1 and 2).

Table 3.

Similar experiences from 1984 and 2015 participants.

	1984	2015
1. Treat everyone with kindness	After the talk with the elders and spending time together in camp, we all began to accept one another. There was no judgment; just understanding we were becoming, “The People,” That was the first night before we started out on the Trail.	And then, we had an elder tell us, he said, “No matter if you guys stayed or if you guys walked the trail, no matter what, we’re still one people, one fire. No matter what.”
2. Help each other; work together	I remember [name] one day, we were on the side of a mountain and he said “I can’t do this no more!” And he was hollering, he said “I’m just going to wait for the van!” And I said “no you’re not.” I [told him], “straighten up,” And he said [to me], “I’m tired.” So I said “Give me your hand,” and he said “What,” I said “Give me your hand,” and I pulled him up that mountain.	Whenever we were coming up a hill and he was struggling and he was falling back, and I caught him with my hand while we were still going up the hill, and I helped him get up the hill.
3. Take care of one another	(W)e were used to just, turning to that anger, but when I got around all them, the heart, the care really built me up. Made me look at things different, I thought wow, I can do this. I can do this, this is bearable, I can do it. And (it) got to the point where I (would) start to smile a lot. [Agreement] During the trip I just started, just smiling . . . but it was a pretty rough time in those days, ya know.	When we first started I thought I knew it all . . . I quickly learned that body size and shape has nothing to do with strength . . . I slowly started changing all the crooked faults in me and my team helped me and reshaped me. I told them (other participants) all about my rough childhood and how everything seemed to be falling apart . . . They didn’t understand because they all had never experienced it, yet they offered words of encouragement. A helping hand. They were all there for me. I than grew to be patient, understanding, sensitive to others, and even less a jerk. The constant support from everybody on the team definitely helped me be the man of the house my family needed. I can never repay the team for what they’ve done for me.
4. Treat each other as family	I didn’t know just the importance of family and I think (it) just goes back to the root of what being Cherokee is all about. And being there for each other and how our people did it.	Just the importance of family-I think it kind of just goes back to the root of ya know, what being Cherokee is all about.
5. Be confident	Every time I hit a-a wall in my life I’d think “Man, this is nothing,” This is nothing because I did that trip, this is nothing, I can do this, this is nothing.	You knew you could do anything after that.

Figure 2.

Program evaluation application process.

Table 4.

Exemplary quotes of how participants learned Cherokee values.

	Program intervention	Participant learning	Application
	How the program taught the participant the value	How the participant learned/ absorbed/used the value during the program	How they applied the value after the program was complete
1. Treat everyone with kindness	Elders: And then, we had an elder tell us, he said, “No matter if you guys stayed or if you guys walked the trail, no matter what, we’re still one people, one fire. No matter what.”	Peers: Actually I learned from these two (other participants), just watching them because there was one rider, she was just so difficult and honestly most of the people had given up on her, but these two never gave up until the day she left. They were always there to motivate her and be patient with her and help her and that was honestly really inspiring and it helped me want to be (like them).	–I want to be a doctor for my nation and help people who need financial help . . . I know what it’s like to be in the basement and now I know what it’s like being on the top floor. I’ll pull everybody up with me, because, like my elders say, “we are one people, we are one fire.”
2. Help each other; work together	Program staff: “They (program staff) just said be there for each other.”	–Whenever we were coming up a hill and he was struggling and he was falling back, and I caught him with my hand while we were still going up the hill, and I helped him get up the hill.	–Now I supervise 70 employees. I learned from (the RTR program). We had the cooking crew, the cleanup crew, and the set up crew. Being able to work with everybody to get one task done. I think we all learned how to speak to one another. Instead of saying “You go do this,” you ask for their help, you ask for their input.
3. Take care of one another	Peers: I slowly started changing all the crooked faults in me and my team helped me and reshaped me. I told them (other participants) all about my rough childhood and how everything seemed to be falling apart . . . They didn’t understand because they all had never experienced it, yet they offered words of encouragement. A helping hand. They were all there for me. I than grew to be patient, understanding, sensitive to others, and even less a jerk. The constant support from everybody on the team definitely helped me be the man of the house my family needed. I can never repay the team for what they’ve done for me.
4. Treat each other as family	Ancestors: It’s kind of unbelievable that people can do that (i.e., survive removal)—that the only way that they were able to do it was through the teamwork. The responsibility to each other and the family. And really isn’t that what Cherokee people, what we are? We’re family, because, it illustrated that, right there.	Peers: I never felt this need and want to just, want to protect him (another participant) and want to like, make sure that he was going to be ok, and take care of him. I’ve never had this feeling of like, loving somebody else outside of my family and wanting to protect them like my family.	–I feel like, I spend more time with my family now. I didn’t really spend a whole lot of time with them before, but I cherish family time now. I think it’s one thing that I learned from this ride.
5. Be confident	Elders/Ancestors: He (Elder) was talking to us about the trip and the journey that we were going to make. And his encouragement to us, here’s a man that we didn’t know from (anyone). But he’s there, he’s trying to be positive, he’s motivating us. And then I can remember we rode out around along the springs and started up that first mountain, but I can still hear his words, “Be positive, stay positive. Ya know, you can do this. Remember your Cherokee heritage. Your heritage is strong. Because your ancestors have already done this. You can do it too.”	Peers: I really enjoyed that we worked together; we’d encourage, we’d work together, make new friends. And when one was down, we’d encourage [each other]. It gave me confidence, it filled me up, ya know? It made me feel like I was somebody. Made me feel like, wow, I’m doing something that’s making a difference.	–I have those 2 little ones to raise. And I teach my kids the value, “Don’t ever underestimate yourself.” I said “just keep going,” “You know what you’re capable of doing.” I said “So do to the best of your ability.”

RTR: Remember the Removal.

We chose to focus on the functional theme, what participants learned/gained from the program, because it addresses our main question regarding the evaluation of this program. This theme had the most references of all themes and was analyzed for sub-themes. Sub-themes were both the most meaningful and most cited in the data, and included the following items: treat everyone with kindness, help each other, work together, take care of one another, treat each other as family, and be confident. Next, we will summarize the five major themes, including examples from both cohorts that illuminate the program evaluation application process described in Figure 2 and Table 4 (what they learned, how they learned it, and how they applied it later).

Treat everyone with kindness

The first sub-theme is best summarized as learning how to treat one another and specifically to be kind to everyone and during all circumstances. The participants explained that being kind includes extending kindness to everyone including those you do not necessarily like, you do not agree with, those who treat you poorly based on the color of your skin, and those whom you have been estranged from, for example. This program brings together two tribes that have been physically separated by the US government for over 175 years. Mentors, staff, peers, and elders were cited as the ones who taught this sub-theme value to the participants, and the distance between the two groups was a common point of discussion between both the 1984 and the 2015 cohorts:

2015: And then, we had an elder tell us, he said, “No matter if you guys stayed or if you guys walked the trail, no matter what, we’re still one people, one fire. No matter what.”

For Cherokees, fire is an essential part of cultural and spiritual practices and it became an important part of the removal as well. Spiritual leaders brought the sacred fire with them during removal to re-establish spiritual practices in Indian Territory. The elder is referring to the sacred fire, knowing that through removal, the Cherokee people and their spiritual practices were separated, but reminding participants that we all come from the same sacred fire, in an effort to build unity to Cherokees who have been divided.

Participants were next asked how they learned this value and subsequent behaviors:

2015: Actually I learned from these two (other participants), just watching them because there was one rider, she was just so difficult and honestly most of the people had given up on her, but these two never gave up until the day she left. They were always there to motivate her and be patient with her and help her and that was honestly really inspiring and it helped me want to be (like them).

A participant from 2015 described how they continued to apply this value after the program was complete:

I want to be a doctor for my nation and help people who need financial help. . . . I know what it’s like to be in the basement and now I know what it’s like being on the top floor. I’ll pull everybody up with me, because, like my elders say, “we are one people, we are one fire.”

Help each other; work together

This sub-theme is also somewhat simply stated but is quite broad in practice. Participants noted that they looked out for each other—they looked out for those who may need help and worked as a team to assist those who needed assistance. When asked how they learned this value through the program, participants said, “They (program staff) just said be there for each other.” While these may seem like small examples of helping one another, they appeared to still apply after the program. Most examples stem from how to treat one another when you are experiencing your own hardships, which is why a physically challenging environment may be a good place to learn how to practice Cherokee values:

2015: Whenever we were coming up a hill and he was struggling and he was falling back, and I caught him with my hand while we were still going up the hill, and I helped him get up the hill.

It is noteworthy to hear this example of helping others given that participants did not know each other before they started the program, so it is notable that they learned to look for and assist other participants who need it after such a short time of knowing one another:

1984: Now I supervise 70 employees. I learned from (the RTR program). We had the cooking crew, the cleanup crew, and the set up crew. Being able to work with everybody to get one task done. I think we all learned how to speak to one another. Instead of saying “You go do this,” you ask for their help, you ask for their input.

Participants explained that they chose jobs working for the Cherokee Nation and working with children so that they could continue to help others in need. Not only did they discuss choosing jobs in which they could help others as part of a team, they also discussed passing on the value of helping one another to their family and friends at home.

One participant explains that he looks for and sees those needing help more after the program:

2015: You go through this whole thing and you realize that different people need help, certain times, so you see somebody having a hard time and you just pick up on that a lot, a lot more now, that we’re back.

Take care of one another

Many values that appeared in the data as sub-themes (like Cherokee cultural values) overlap yet also have unique components to them. This sub-theme involves being kind and helping others, but entails a unique aspect of learning to care for others. For example,

2015: I never felt this need and want to just, want to protect him (another participant) and want to like, make sure that he was going to be ok, and take care of him and um, I’ve never had this feeling of like, loving somebody else outside of my family and wanting to protect them like my family.

Participants from both years explain the changes they experienced through the program and what it was like for others to care for them. A participant from 1984 opened up about the hardships that he experienced in his life and on this trip and how the kindness of other participants positively affected him:

1984: (W)e were used to just, turning to that anger, but when I got around all them, the heart, the care really built me up. Made me look at things different, I thought wow, I can do this. I can do this, this is bearable, I can do it. And (it) got to the point where I (would) start to smile a lot. [Agreement] During the trip I just started, just smiling . . . but it was a pretty rough time in those days, ya know.

This participant expresses gratitude to his peers for taking care of him when he was expressing his personal challenges. He also explains that he then learned to take care of those in his family better because of what he learned from—the care they extended to him, he later extended to his own family.

Treat each other as family

This sub-theme reflects a Cherokee value to treat others like one might treat a family member. First, one must start to see each other as connected—tribal members are like family members and they must be taken care of in that way:

1984: It’s kind of unbelievable that people can do that (i.e., survive removal)—that the only way that they were able to do it was through the teamwork. The responsibility to each other and the family. And really isn’t that what Cherokee people, what we are? We’re family, because, it illustrated that, right there.

This participant looked to their ancestors as models for how they should treat other Cherokees today. They extend this belief to apply to the relationships of their own family and responsibility to them as a caring family member:

1984: I didn’t know just the importance of family and I think (it) just goes back to the root of what being Cherokee is all about. And being there for each other and how our people did it.

This participant is highlighting what they believe to be core Cherokee values and how they learned and confirmed these values. They believe that taking care of one another—taking care of family—is a critical aspect of Cherokeeness and was reflected in what they learned about Cherokees during the removal. In addition to learning this value from historical stories, one participant from 2015 said,

Just caring for people that I didn’t know, for so long, and then I slowly got to know them.

Those who completed the program in 1984 have a unique perspective about peer connections given the length of time that has passed:

To this day we still have each other. No matter how long it’s been, and it’s over 30 years now. We can still contact each other or run into each other and it’s like no time has passed. We will always be close like a family. Like [name] said, “We are brothers and sister for life.” That is the most important and powerful thing to gain in this world is a family. This world is tough place to live and we are never alone thanks to that Trail. Family is a Cherokee value that was instilled in me before and since The Trail.

This participant discusses family in a Cherokee-specific way: family is not simply those in a nuclear family, but it may also include extended family, friends, and tribal members. A participant from 2015 expresses an application of this sub-theme:

I compare it to (other) situations; There will be some days where my ma or my brothers aren’t feeling good and I’ll think about my chain falling off and I’ll just ask them, “Hey, are you ok,” and “I’m here if you want to talk.”

This participant recalled a specific difficult event when others helped him when his bicycle was having maintenance issues and applied it to a time when he saw his family in need and then he took action to help them. This is notable because he learned this value within the context of a peer group and applied it to a family context. Overall, participants’ increased knowledge and beliefs around the concept of family were interwoven from several learning components of this program: learning about their family’s history, learning about their tribe’s history, and applying Cherokee values of family to peers and family members.

Be confident (self-efficacy)

Participants in both cohorts echoed that if they could complete this program, if they could ride the removal route, then they could do anything in their lives: “You knew you could do anything after that.” Participants explained that they were inspired by their ancestors and each other. They were inspired for their children, their future children, and the future generation of Cherokees. One participant explained that before they started their journey on the removal route, an elder gave them advice that continued to help them through their journey:

He (Elder) was talking to us about the trip and the journey that we were going to make. And his encouragement to us, here’s a man that we didn’t know from (anyone). But he’s there, he’s trying to be positive, he’s motivating us. And then I can remember we rode out around along the springs and started up that first mountain, but I can still hear his words, “Be positive, stay positive. Ya know, you can do this. Remember your Cherokee heritage. Your heritage is strong. Because your ancestors have already done this. You can do it too.”

Participants took this positivity and applied it to interactions with one another, and it resulted in increased personal self-efficacy:

1984: I really enjoyed that we worked together; we’d encourage, we’d work together, make new friends. And when one was down, we’d encourage [each other]. It gave me confidence, it filled me up, ya know? It made me feel like I was somebody. Made me feel like, wow, I’m doing something that’s making a difference.

Participants cited feeling increased confidence after the ride as well which they believed led them to be successful leaders in areas such as their education, occupation, military, family, and community. Participants took these lessons home with them and explained how they are passing on this value to the next generation, citing that they needed to learn about their history and culture so that they could teach the next generation. The participants linked cultural learning and self-efficacy by thinking about the strength of their ancestors. They wanted to then teach their children as well:

1984: I have those 2 little ones to raise. And I teach my kids the value, “Don’t ever underestimate yourself.” I said “just keep going,” “You know what you’re capable of doing.” I said “So do to the best of your ability.”

1984: Where we came from, our history. I’ve developed ways to teach kids that sense of belonging. I made them understand that and I taught a lot what I learned on the road as far as working together, using my leadership skills, and just, being there for these kids and telling them that they do belong in their company. And who they come from is a strong people that got here. I said you we wouldn’t be here if it wasn’t for our ancestors.

This participant’s quote exemplifies the link between the value of confidence in one’s self and the connection to identity. This connection was so important that they wanted to continue teaching this lesson to the next generation.

Discussion

The purpose of this study was to (1) examine how Cherokee culture was taught in a Cherokee young adult leadership program and (2) to learn what cultural knowledge participants gained and how they applied it to other life domains after the program. Our results demonstrated that, at the completion of the program and over 30 years later, participants learned about Cherokee culture such as history, language, and ancestry and also learned Cherokee-specific culture behaviors through values and relational ways of being. Five themes were identified: treat everyone with kindness, help each other, work together, take care of one another, treat each other as family, and be confident. These values correspond to the Cherokee Community Values that are used to direct Cherokees regarding how to treat one another. Participants learned these values through elders, ancestors, mentors, program staff, and each other. Participants also noted that they brought these skills home and to their community when the program was complete—up to 32 years later.

The changes that RTR program participants discussed are similar to other Indigenous adolescents participating in cultural programming. For instance, Henson and colleagues recognized nine themes that related to protective factors for Native youth: self-efficacy, family connection, peer/other connections, cultural connectedness, as well as future aspirations, positive self-image, positive opportunities, positive social norms, and personal wellness (Henson et al., 2017). Another study noted similar themes around positive mental health and protective factors of Alaskan Native youth. The authors discovered that themes related to land-based activities, language, and history were found throughout their analysis. Specifically, knowing and using traditional knowledge and skills was a key theme in addition to using these skills to be an asset to the community. Furthermore, resilience related to having role models, self-efficacy, and positive family and community connec-tions. These connections appeared to relate to positive social outcomes (MacDonald et al., 2013). Remember the removal participants as well as Native youth in other studies who work to teach culture cite increased connections—to each other, to family, to culture, to community, and to place (Fiedeldey-Van Dijk et al., 2017; Rowan et al., 2014). Group affiliation can help members see life difficulties as a collective struggle and feel more able to tackle the difficulties (Wexler et al., 2009). In other words, the challenges that Native people experience disproportionately (e.g., police brutality, homicides, sexual violence, education and health inequities) can be less detrimental to an individual if they have strong ties to those around them (Hobfoll et al., 2002; LaFromboise et al., 2006; Stumblingbear-Riddle & Romans, 2012).

Teaching culture through enculturation is feasible and appears to result in numerous protective factors for Indigenous people. However, few studies exist in this area, and the relationship between Indigenous enculturation and physical health outcomes is particularly lacking. This research requires close collaboration with Indigenous communities throughout the research process. Okamoto and colleagues present a model to create culturally focused health interventions and corresponding action items and resources needed for each level of cultural tailoring (Okamoto et al., 2014). However, Native nations are vast and unique, rendering transferability unlikely without significant consideration and tailoring to each nation and each community. The RTR program provides one example of how citizens can create a program out of a local and timely need, utilize tribal sponsorship to continue the program, and develop a research partnership with a Cherokee Nation citizen to ensure the research appropriately reflects the values and beliefs of the participants and their tribe.

Cultural connectedness has been cited as a vital protective factor in Native youth resilience (Mohatt et al., 2011; Wexler et al., 2009); thus, the value and inclusion of culturally relevant facets within youth programming cannot be understated. Kenyon and Hanson (2012) emphasize the importance of incorporating traditional Indigenous values into positive youth development programs to increase the acceptance and receptivity of such programs by Indigenous youth, rather than focusing entirely on decreasing negative behaviors (Kenyon and Hanson, 2012). The inclusion of culture and spirituality in prevention programs has previously been shown to be effective in research on Indigenous youth suicidality, hopelessness, depression, and other self-reported health statuses (Barney, 2001; Kenyon and Hanson, 2012; Middlebrook et al., 2001). These programs comprise activities that focus on a specific tribal culture and are developed with the support of tribal members.

This project sought to evaluate a cultural program and uncover the techniques used to teach culture and illustrate a tribally specific example of cultural training. For these participants, they were able to gain a better understanding of Cherokee teachings and beliefs congruent with elder and community teachings. These teachings were in the form of Cherokee Community Values. Participants explained how they learned, practiced, and applied these values, and these examples can be applied to other tribal programs. Further analysis is needed on how the increase in cultural knowledge and use of these values may relate to health and well-being outcomes. It is also important to learn more about the application of these values after the program is completed. In addition, further studies are needed to address feasible interventions that are not resource-heavy and can provide similar outcomes for cultural learning in tribal communities.

Footnotes

Acknowledgements

The authors thank Tosh Welch for Cherokee Values Table; Karla Washington, Moira Villard, and Cathy Smith for review; and Julie Reed and Rose Stremlau for their historical contribution.

Authors’ note

The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the Cherokee Nation.

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was made possible with support from Washington University in St. Louis CDTR (Grant Number P30DK092950 from the NIDDK). The content is solely the responsibility of the authors and does not necessarily represent the official views of the CDTR or NIDDK.

ORCID iDs

Melissa Lewis

Tyler Jimenez

Notes

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