Date of Award


Degree Name

PhD Nursing

Dissertation Committee

Mary Jo Clark, PhD, RN, PHN, Jane Georges, PhD, RN, Ann Mayo, DNSc, RN, FAAN


American Indian, health perceptions, health promotion, vulnerable populations, women


Background: Most problems affecting the health of American Indian women are related to lifestyles and health-related behaviors (Carter, Morse, Giruad, & Driskell, 2008; Linsley, Kane, & Owen, 2011). Understanding health promotion behaviors could decrease or prevent a number of chronic diseases that afflict the American Indian population; however, little is known about how American Indian women perceive illness, how they promote their health within the context of their culture, and the barriers they face.

Purpose: This study was designed to develop knowledge about the health perceptions and health promoting behaviors of American Indian women residing within the Chickasaw Nation boundaries in Oklahoma.

Design and Methods: Grounded theory was used to generate a conceptual model that advances understanding of American Indian women’s health perceptions and health promoting behaviors. Focus group interviews were conducted with registered American Indian women residing within the Chickasaw Nation boundaries in Oklahoma to address their definitions of health, efforts to promote health, and barriers to health promotion.

Data Analysis: Audio-recorded focus group interviews were transcribed verbatim and analyzed according to the methodologies of Glaser and Strauss (1967) using comparative analysis.

Results: Thirty-three participants from five tribes took part in one of five focus groups. Participants identified eight major themes that influenced health and their health promoting behaviors. Themes included definitions of health and not health, contributors to poor health, strategies to promote health, health promotion support, motivation for health promotion, barriers to health promotion, and changes that would promote health. The resulting model reflects the strategies used and barriers that American Indian women face when promoting their health.

Conclusions: Understanding health promotion behaviors in America Indian women could influence health-promoting behaviors and decrease chronic disease prevalence in the American Indian population. The influence of social determinants of health and conditions of social support needs to be further examined in this heterogeneous group. The focus groups identified a need for greater health-related knowledge. Further research on effective family health educations programs in this population is needed, as is similar research with other tribes.

Document Type

Dissertation: Open Access