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Authors
Proulx, Jeffrey https://orcid.org/0000-0002-4251-2608
Cooley, Chelsea
Wagle, Sojas
O’Brien, Kelly
Croff, Raina
Bergen-Cico, Dessa
Ukpik, Aislyn
Turner, Chris
Super, Monica
Warren, Megan
Cramblit, Andre
Cousin, Jacob
Feil, Kathy
Koerbel, Lynn
Jones, Emily
McCage, Shondra
Brooks, Jada L.
Bryer, Chase M.
Bird, Michael Yellow
Loucks, Eric B.
Idoate, Regina
Okawa, Marinna C.
Acharya, Dikchit
Oken, Barry
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Funding
Funding for this research was provided by:
National Center for Complementary and Integrative Health (R0099AT009570-03)
National Center for Complementary and Integrative Health (AT002688)
Mind and Life Institute (Varela)
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Article History
Received: 19 November 2024
Accepted: 16 December 2025
First Online: 25 February 2026
Declarations
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: The authors declare no competing interests.
: This study was approved by the Oregon Health & Science University Institutional Review Board, the Brown University Institutional Review Board, the California Rural Indian Health Board Institutional Review Board, and the Northwest Portland Area Indian Health Board Institutional Review Board.
: All participants provided informed consent in accordance with institutional and community ethical standards. Consent procedures were developed collaboratively with community partners to align with local cultural protocols. Participants were given detailed information about the study’s purpose, procedures, risks, and benefits both orally and in writing. Tribal health leaders and community advisory boards reviewed and approved these procedures to ensure cultural appropriateness and transparency.
: Artificial intelligence tools were used only for citation formatting and minor language editing to ensure adherence to APA style.
