This study examines how a community coalition strategy for childhood obesity prevention was implemented through Healthy Kids Tribal Community (HKTC) in an American Indian community in the rural southwest. HKTC conceptualized health promotion using indigenous epistemology connecting past, present, and future. HKTC has been able to engage people in the community using a novel approach that integrates message framing and prevention strategies with local cultural meanings, language, and symbols. These innovations affected the implementation and outcomes of the initiative. The experience of implementing a childhood obesity coalition in a tribal context provides unique insights for understanding how community members can effectively adapt and "culturally situate" imported strategies to be meaningful for implementation in a small, relatively cohesive community. However, lack of funding and participation challenges remain obstacles to greater integration and coordination of HKTC within the tribal community.

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