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i Dedication  ii Acknowledgements  iii List of Tables  vi List of Figures vii Chapter 1: Introduction 1 Research Purpose 4 Parent Study: Yappallí Choctaw Road to Health  5 My Journey  6 Chapter 2: Literature Review 9 Health Disparities in American Indian Communities 9 American Indians and Substance Use  14 Trauma: Impact on Food and Health 16 American Indians and Social Work  17 American Indian Women Health 20 Social Work and Historical Trauma  24 Information-Motivation-Behaviors Skills Model  25 American Indians Connection to Place, 28 History of the Choctaw 31 Trail of Tears  41 Chapter 3: Theoretical Models 45 Decolonization 45 Tribalist 49 Historical Trauma 55 Conceptual Frameworks of the Yappallí project 63 Conceptual Frameworks for Our Vision of Health 66 Chapter 4: Methodology 73 Sample 73 Data Analysis 76 Indigenizing Methods 83 Chapter 5: Findings 85 Embodiment 87 Motivation 93 Challenges 101 Transformation 108

Our Vision of Health for Future Generations: An Exploration of Proximal and Intermediary Motivations With Women of the Choctaw Nation of Oklahoma