title: A constructive Indian country response to the evidence-based program mandate.
abstract: Over the last 20 years governmental mandates for preferentially funding evidence-based "model" practices and programs has become doctrine in some legislative bodies, federal agencies, and state agencies. It was assumed that what works in small sample, controlled settings would work in all community settings, substantially improving safety, effectiveness, and value-for-money. The evidence-based "model" programs mandate has imposed immutable "core components," fidelity testing, alien programming and program developers, loss of familiar programs, and resource capacity requirements upon tribes, while infringing upon their tribal sovereignty and consultation rights. Tribal response in one state (Oregon) went through three phases: shock and rejection; proposing an alternative approach using criteria of cultural appropriateness, aspiring to evaluability; and adopting logic modeling. The state heard and accepted the argument that the tribal way of knowing is different and valid. Currently, a state-authorized tribal logic model and a review panel process are used to approve tribal best practices for state funding. This constructive response to the evidence-based program mandate elevates tribal practices in the funding and regulatory world, facilitates continuing quality improvement and evaluation, while ensuring that practices and programs remain based on local community context and culture. This article provides details of a model that could well serve tribes facing evidence-based model program mandates throughout the country.
authors.affiliation: Oregon Health & Science University, Gaines Hall 155, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
authors.forename: R Dale
authors.initials: RD
authors.lastname: Walker
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Bigelow
mesh_terms: D003466:Cultural Characteristics; D055317:Evidence-Based Practice; D006293:Health Promotion / Q000458:organization & administration*; D006801:Humans; D007198:Indians, North American; D009922:Oregon; D015397:Program Evaluation