A chronic illness self-management program developed by and for the Apsáalooke (Crow) people of Montana has received an evidence-based designation from the National Council on Aging (NCOA).
The program, called Báa nnilah — meaning “advice that we receive from others” in the Apsáalooke language — was developed by Messengers for Health, a nonprofit based on the Crow Reservation.
“Having our Báa nnilah program recognized as an evidence-based program is very significant for us as a tribal nation,” Alma McCormick, Executive Director of Messengers for Health and member of the Apsáalooke Nation said in a statement. “This program was developed and led by Apsáalooke people rooted in our rich cultural ways, and that is why it was effective. Now, we can share this not only with other tribal nations but also nationwide with other populations who also face health disparities. This is truly a blessing!”
Báa nnilah is built with Apsáalooke stories, values, and traditional practices of mutual support. The seven-session program is led by local community members who themselves live with chronic illnesses, bringing lived experience and cultural knowledge that McCormick notes is often absent from mainstream medical settings.
Christiane Woody, the program’s manager and an Apsáalooke tribal member, points to hands-on teaching tools as key to the program’s success. One example: using sugar cubes to visually demonstrate how much sugar is in participants’ favorite drinks. “This impactful visual tool makes nutrition concepts more tangible and helps community members better understand their sugar intake,” Woody said.
Participants have reported wide-ranging improvements: stronger relationships with their healthcare providers, better understanding of and adherence to medications, more physical activity, healthier diets, and reduced consumption of sugary drinks. One participant was able to discontinue certain medications under a doctor’s supervision after their health improved. Another described losing 50 pounds and resolving multiple health problems as a result.
The evidence-based designation carries practical weight beyond recognition. It positions Messengers for Health to partner with other tribal nations who want to adapt Báa nnilah to reflect their own languages, traditions, and cultural values.
The program has already been adapted with the Chippewa Cree tribes of the Rocky Boy Reservation in Montana, and is currently being adapted with the Confederated Salish and Kootenai tribes of the Flathead Reservation. Messengers for Health hopes to expand access to more communities across Indian Country.
