title: Breathing clean air is Są'áh Naagháí Bik'eh Hózhóó (SNBH): a culturally centred approach to understanding commercial smoke-free policy among the Diné (Navajo People).
abstract: Indigenous worldviews and research approaches are fundamental to make meaning of complex health issues and increase the likelihood of identifying existing cultural protective factors that have contributed to the resilience and survival of Indigenous people worldwide.
  
  
  
  We describe the process for applying the Diné (Navajo) paradigm of Są'áh Naagháí Bik'eh Hózhóó (SNBH), a belief system that guides harmonious living, and demonstrate how the application of SNBH enhances understanding of Navajo principles for well-being. Specifically, we juxtapose this analysis with a conventional qualitative analysis to illuminate and interpret Diné perspectives on the health and economic impact of commercial secondhand smoke and smoke-free policy.
  
  
  
  Focus groups were conducted throughout Navajo Nation to assess the appeal and impact of several evidence-based messages regarding the health and economic impact of smoke-free policy.
  
  
  
  Diné perspectives have shifted away from family and cultural teachings considered protective of a smoke-free life, and struggle to balance the ethical and economics of respect for individual and collective rights to live and work in smoke-free environments.
  
  
  
  Indigenous-centred approaches to public health research and policy analysis contribute to understanding the cultural knowledge, practices and beliefs that are protective of the health and well-being of Indigenous people.
authors.affiliation: Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA.
authors.forename: Carmenlita
authors.initials: C
authors.lastname: Chief
authors.affiliation: Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA.
authors.forename: Samantha
authors.initials: S
authors.lastname: Sabo
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Hershel
authors.initials: H
authors.lastname: Clark
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Nez Henderson
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Alfred
authors.initials: A
authors.lastname: Yazzie
authors.affiliation: Black Hills Center for American Indian Health, Rapid City, South Dakota, USA.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Nahee
authors.affiliation: Health Services Research, Mayo Clinic, Scottsdale, Arizona, USA.
authors.forename: Scott J
authors.initials: SJ
authors.lastname: Leischow
mesh_terms: D003466:Cultural Characteristics; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006291:Health Policy; D006801:Humans; D007198:Indians, North American; D008297:Male; D010865:Pilot Projects; D011634:Public Health; D061845:Smoke-Free Policy; D012907:Smoking / Q000208:ethnology*; D014028:Tobacco Smoke Pollution / Q000517:prevention & control*
chemical_list: D014028:Tobacco Smoke Pollution
keywords: Disparities; Public opinion; Public policy; Secondhand smoke