Mississippi INBRE Community Engagement and Training Core, Center for American Indian Research and Studies, Telenutrition Center, School of Psychology, The University of Southern Mississippi, Hattiesburg, MS, United States.
Mississippi INBRE Community Engagement and Training Core, Telenutrition Center, School of Health Professions, College of Nursing and Health Professions, The University of Southern Mississippi, Hattiesburg, MS, United States.
Front Public Health. 2024 Jul 19;12:1392517. doi: 10.3389/fpubh.2024.1392517. eCollection 2024.
This analytic essay intends to elevate Medicine Wheel, or generally "four directions" teachings, to encourage a more comprehensive alignment of lifestyle intervention components with traditional ecological knowledge systems of Indigenous cultures in North America. North American Medicine Wheels provided people with a way to orient themselves both within their traditional belief systems and to the seasonal changes in their areas, improving survivability. The wheel or circle is a sacred symbol, indicating the continuity and perpetuity of all of life. The four directions are iconized in many Indigenous cultures across North America with different directions representing different aspects of our world and of ourselves, different seasons of the year and of our lives, different beings of the earth and tribes of humans with a balance among those necessary for health and wellbeing. In the context of public health, teachings of the four directions warn that a lack of balance limits our ability to achieve optimal health. While there is much public health success in lifestyle interventions, existing practice is limited by a siloed and one size fits all approach. Medicine Wheel teachings lay out a path toward more holistic and Indigenous-based lifestyle intervention that is modifiable depending on tribal teachings and needs, may appeal to a variety of Indigenous communities and is in alignment with health behavior change theory. It is a public health imperative that lifestyle management interventions are fully optimized to rigorously determine what can be achieved when interventions are implemented in a holistic and Indigenous-based manner, and in alignment with an Indigenous model of health. This more complete alignment would allow for a stronger foundation to further explore and develop social determinants (i.e., housing, employment, etc.) and structural intervention enhancements to inform public health practice and promote health equity.
这篇分析文章旨在提升医学轮（或通常所说的“四方”教义），以鼓励将生活方式干预成分更全面地与北美原住民文化的传统生态知识体系相协调。北美医学轮为人们提供了一种在其传统信仰体系和所在地区季节性变化中定位的方式，提高了生存能力。轮子或圆圈是一种神圣的象征，代表着所有生命的连续性和永恒性。四个方向在北美许多原住民文化中都有图标化的表示，不同的方向代表着我们世界和自身的不同方面、一年中的不同季节和我们生活的不同阶段、地球上的不同生物和人类部落，这些都需要保持平衡，以实现健康和幸福。在公共卫生领域，四方教义警告说，缺乏平衡会限制我们实现最佳健康的能力。尽管生活方式干预措施在公共卫生方面取得了很大成功，但现有的实践受到孤立和一刀切方法的限制。医学轮教义为更全面和基于原住民的生活方式干预提供了一条途径，这种干预可以根据部落教义和需求进行修改，可能会吸引各种原住民社区，并与健康行为改变理论保持一致。生活方式管理干预措施必须经过全面优化，以严格确定当以整体和基于原住民的方式实施干预措施时可以实现什么，这是公共卫生的当务之急，并且与原住民健康模式保持一致。这种更全面的协调将为进一步探索和发展社会决定因素（即住房、就业等）以及结构干预增强提供更坚实的基础，以指导公共卫生实践并促进健康公平。
