A systematic scoping review for decolonial public and global health: Indigenous frameworks and models of wellbeing from Turtle Island and Moananuiākea.

BACKGROUND: Equitable approaches to public and global health require grounding in diverse ontologies of wellbeing and decolonial theory. Indigenous wellbeing models and frameworks embed holistic values that support ecological thriving. In contrast, Western approaches often individualize and compartmentalize wellbeing, narrowing public and global health practice and contributing to persistent disparities. Despite the proliferation of Indigenous-developed frameworks, no scoping review has synthesized contributions in this area. This review aimed to identify models, frameworks, and theories of wellbeing developed by Indigenous communities and scholars from Turtle Island (North America) and Moananuiākea (the Pacific) to inform more culturally safe and decolonial approaches to public and global health.

METHODS: Guided by the PRISMA-ScR framework, both peer-reviewed publications and grey literature were sourced from five databases (PubMed, Web of Science, EBSCO Academic Search Complete, CINAHL, and ProQuest). Additional articles were hand-sourced. Included articles posed an original model, framework, or theory of wellbeing, developed for Indigenous people, families, or communities, by Indigenous authors from those respective lands in Turtle Island or Moananuiākea.

RESULTS: A total of 1,473 database references and 89 additional references were identified for screening. After 61 full-text reviews, 33 manuscripts were included for analysis. Twenty-one publications originated from Moananuiākea (64%) and 12 originated from Turtle Island (36%). The most common method used to develop the models and frameworks was qualitative (52%). Synthesis of the data yielded seven themes: (1) holistic integration of all life domains; (2) spirituality and the ongoing presence of ancestors; (3) culture and preservation of tradition; (4) collective wellbeing and relationality; (5) reciprocal relationship with land as a source of identity, health, and responsibility; (6) use of place-specific Indigenous metaphors and language; and (7) empowerment and self-determination.

CONCLUSION: Indigenous communities globally are calling for a shift from conceptual discussion of wellbeing toward tangible application in public and global health systems. These findings hold several implications for decolonial theory-development and more equitable health systems. Future research should build on work which moves Indigenous wellbeing frameworks from theory to action.