Strategies for implementing health promotion programs in multiple American Indian communities.

American Indians experience significant health disparities compared to the general U.S. population. The Steps to a Healthier Anishinaabe program adopted a unique framework to implement health promotion intervention activities in multiple American Indian communities in Michigan. By enabling each community to tailor interventions to their specific culture and health priorities, the program is characterized by a culturally competent and community-driven approach to decrease the impact of chronic diseases on the health of Michigan's American Indians. This article describes the community-based framework and argues that multisite, community-tailored health promotion programs are a promising approach to reducing health disparities in minority populations.