# The Báa nnilah Program: Results of a Chronic-Illness Self-Management Cluster Randomized Trial with the Apsáalooke Nation

## TL;DR

A culturally tailored self-management program for chronic illness was developed with the Apsáalooke Nation in Montana, showing positive qualitative outcomes despite limited quantitative support.

## Contribution

The Báa nnilah program is a novel, culturally appropriate chronic illness self-management intervention co-developed with the Apsáalooke community.

## Key findings

- Qualitative data showed substantial positive outcomes across multiple areas.
- Quantitative hypotheses were not supported, except for one.
- The study highlights the importance of culturally consonant health interventions.

## Abstract

Indigenous people in Montana are disproportionately affected by chronic illness (CI), a legacy of settler colonialism. Existing programs addressing CI self-management are not appropriate because they are not consonant with Indigenous cultures in general and the Apsáalooke culture specifically. A research partnership between the Apsáalooke (Crow Nation) non-profit organization Messengers for Health and Montana State University co-developed, implemented, and evaluated a CI self-management program for community members. This article examines qualitative and quantitative program impacts using a pragmatic cluster randomized clinical trial design with intervention and waitlist control arms. The quantitative and qualitative data resulted in different stories on the impact of the Báa nnilah program. Neither of the quantitative hypotheses were supported with one exception. The qualitative data showed substantial positive outcomes across multiple areas. We examine why the data sets led to two very different stories, and provide study strengths and limitations, recommendations, and future directions.