Adapting the 4Ms Framework for American Indian and Alaska Native Communities

TL;DR

This paper adapts the 4Ms health framework for older adults to better align with the cultural values of American Indian and Alaska Native communities.

Contribution

The study introduces a culturally adapted version of the 4Ms framework with visual and linguistic elements specific to American Indian and Alaska Native communities.

Findings

The 4Ms framework was adapted through discussions and listening sessions with tribal organizations and experts.

A central tree metaphor was developed to represent traditional values and the 4Ms components.

The adapted framework allows for further customization to reflect local tribal elements.

Abstract

The 4Ms (Matters Most, Medication, Mentation/Mind, Mobility) provide a valuable framework for older individuals, and their caregivers and clinicians, for consideration of factors influencing health, daily function, and well-being. Through an iterative process involving internal discussions and external listening sessions including tribal organizations, brain health advocates and experts, we sought to adapt the language and visual imagery associated with the 4Ms to be more relatable and relevant to American Indian and Alaska Native communities. The final version reflects the individual 4M components and also incorporates cultural elements: a tree at the center, roots representing traditional core values, branches representing the 4Ms, and leaves depicting the daily activities and expressions of the 4Ms. The resulting visual images and terms can be further modified and adapted to reflect local tribal geographic elements, language, and traditions.