The overall objective of this project is to test a new method that combines qualitative and quantitative measures in the development of Indigenous Health Indicators (IHIs), with which to better evaluate the cultural health and well being of Indigenous communities. The specific aims are: 1) To work with four culturally distinct Indigenous communities across the United States to establish a broad, common set of Indigenous Health Indicators (IHIs) that can be drawn from to accurately represent community members' diverse meanings and prioritizations of health; 2) To test the accuracy and acceptance of the IHIs through facilitated small group discussions in each of the communities; 3) To couple the verbal information gathered in each community with a quantitative and qualitative, verbal and visual mixed-scale depiction of what health means to each community; and 4) To evaluate the usefulness of the multi-scaled IHIs by reviewing the results of the tests with each of the participating communities. Earlier work on the IHIs has resulted in an initial set of six health indicators reflective of several Tribes in the Pacific Northwest. The proposed project seeks to broaden the narratives developed to date by working with four geographically and culturally distinct Indigenous communities to develop a generalized IHI. template that can be tailored to reflect each community's cultural health beliefs and values. Testing will occur in facilitated small group discussions using structured deliberations and hand-held polling devices that allow individual community members to anonymously record their opinions while also encouraging thoughts to be voiced verbally if the participant chooses to do so. The qualitative data from small groups will be coded, which allows for difficult-to-quantify, less tangible information to be grouped and compared with results from quantitative and narrative descriptive scales in a comprehensible manner (e.g., low to high). Photography sessions will occur in order to visually depict meanings and prioritizations of health in each community as an additional method to capture difficult-to-quantify health considerations. The specific results will be presented to the governing bodies of each participating community for review and approval prior to dissemination.