A Cultural Approach GHWIC Component 2 - Background: Alaska Native and American Indian (AN/AI) people suffer from a high chronic disease burden and multiple chronic disease disparities. Four of the top seven causes of death for AN people are the chronic diseases of cancer, heart disease, chronic obstructive pulmonary disease (COPD), and cerebrovascular disease. AN adults experience significantly higher rates of oral disease, tobacco use, obesity, and social isolation, all of which are major contributors to these chronic diseases. These risk factors are closely associated with the disruption to AN health and culture that came with colonization and assimilation. The Alaska Native Tribal Health Consortium (ANTHC) is a statewide, Tribally owned and operated, non-profit health organization that serves the nearly 170,000 AN/AI people and all 229 federally recognized tribes in the Alaska Indian Health Service (IHS) Area. Purpose: The ANTHC’s Wellness and Prevention (WP) is applying for Component 2 of A Cultural Approach to Good Health and Wellness in Indian Country (GHWIC), CDC-RFA-DP-24-0025. The purpose of this project is to reduce rates of death and disability from chronic diseases and to reduce the prevalence of commercial tobacco use, prediabetes and diabetes, high blood pressure, obesity, oral disease and other chronic disease risk factors and conditions among AN/AI people in the Alaska IHS Area. Through partnerships with Tribes, Villages and eligible Tribal organizations (TVeOs), WP will implement evidence-informed, culturally attuned policy, systems, and environmental change strategies and activities to: 1) increase and strengthen community linkages with clinical systems, 2) support the development of team-based care, and 3) implement holistic, culturally responsive and community-driven strategies and activities. This work will reinforce and build on previous and current successful GHWIC work. WP will achieve the following short-term outcomes of the Component 2 strategies: 1) Increased reach of technical assistance (TA), training, and resources to all TVeOs and other Tribal entities within our award area across all C1 strategies and activities, and increased reach of evidence-based PSE changes that promote health and wellness and encourage healthier behaviors, 2)increased partnerships with TVeOs and other Tribal entities within our award area to support activities across all C1 strategies, 3) increased reach of tailored messages to encourage healthier behaviors, and 4) increased support for PSE changes that promote wellness and prevent chronic diseases and their risk factors. WP will also achieve the intermediate outcomes of 1) Increased reach of GHWIC C1 strategies and activities and PSE changes that promote wellness and prevent chronic diseases and their risk factors within our award area (PSE changes for strengthening culture and reducing tobacco use, prediabetes and diabetes, high blood pressure, obesity, and oral disease), 2) increased capacity among all TVeOs and other Tribal entities within our award area to implement GHWIC C1 strategies and activities., and 3) increased adoption of PSE changes to promote health and prevent chronic diseases and their risk factors. WP will also make progress toward long-term outcomes beyond the timeline of this project period, including reduced morbidity/ mortality due to chronic diseases and their risk factors; increased resilience and use of cultural practices to prevent, manage, and control chronic diseases; increased sense of mental, emotional, and physical wellbeing among community members; increased effective chronic disease self-management; and increased implementation of PSE changes that promote health and wellness and prevent chronic diseases. These improvements will, in turn, help ANTHC achieve its vision that “Alaska Native people are the healthiest people in the world.”