A Sequential Mixed Methods Approach to Identifying and Understanding Indigenous Ways of Evaluating Physical Activity Programs

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Physical activity has been identified as a strategy for addressing the disproportionate prevalence of diabetes and obesity among American Indians/Alaska Natives (AI/AN). Despite the importance of evaluation to improve programs, there is a lack of evaluation among AI/AN physical activity programs. While the absence of evaluation broadly in Indian Country has been attributed to the disconnect between Western and Indigenous ways of knowing and the negative history of research among AI/ANs, barriers to and experiences with evaluation have not been explored in the context of physical activity. To address this gap, this dissertation used an exploratory sequential mixed methods design to explore AI/AN physical activity program evaluation.

In-depth interviews were conducted with staff at AI/AN organizations conducting externally funded AI/AN physical activity programs (n=17), transcripts were thematically analyzed, and the findings were used to create and pilot test a survey designed to assess the prevalence of the qualitative findings among the target population. 

Through the interviews, the following themes emerged regarding barriers to evaluation: (1) measuring desired physical activity related constructs in ways that are scientifically and culturally sound is a challenge; (2) a lack of resources and support prevents AI/AN organizations from evaluating their physical activity programs; (3) collecting evaluation data is challenging due to the unique culture and experiences of AI/ANs and the context of physical activity programs; and (4) the lack of alignment between the evaluation requirements set by the external funding source and the evaluation desired by the AI/AN organization and community being served creates a barrier to meaningful evaluation. The following themes emerged explaining the perception of and interest in Indigenous evaluation: (1) Indigenous approaches to evaluating AI/AN physical activity programs are perceived as narrative and holistic; (2) Indigenous knowledge is used in AI/AN physical activity program decision-making but sometimes is not acknowledged as evaluation; and (3) there is not a universally desired way to evaluate AI/AN physical activity programs. 

Findings from this study contribute to the knowledge base of physical activity program evaluation in the context of AI/AN programming, and informs the practice of culturally responsive evaluation with AI/AN communities.