Integrating Public Health Critical Race Praxis into Indigenous Evaluation: A Scoping Review to Advance Indigenous Health Equity and Sovereignty

Background and Purpose

Indigenous health inequities remain a persistent public health concern, reflecting the influence of structural determinants including racism, historical trauma, and policy contexts affecting Tribal sovereignty. Indigenous evaluation and Community/Tribally Based Participatory Research (CBPR/TBPR) have advanced decolonizing and Indigenist methodologies that center Indigenous knowledge systems, relational accountability, and community-defined indicators of wellbeing. Concurrently, Public Health Critical Race Praxis (PHCRP) has been proposed as a framework to guide antiracist public health research by examining the role of power, racism, and knowledge production.

Despite these developments, there has been limited synthesis of how PHCRP aligns with or is integrated into Indigenous evaluation within Tribal health systems, Indigenous policy contexts, and community-based research. This study conducts a systematic scoping review to examine the integration, application, and conceptual alignment of PHCRP within Indigenous evaluation practices. Research questions include: (1) how PHCRP and related frameworks are incorporated into Indigenous evaluation; (2) how these approaches are applied across Tribal health care and policy contexts; and (3) what gaps exist in advancing sovereignty-centered, antiracist evaluation.

Methods

A scoping review methodology was employed, following Arksey and O’Malley, Levac et al., and the Joanna Briggs Institute guidance, with reporting aligned with PRISMA-ScR standards. A comprehensive search was conducted across PubMed, Scopus, Web of Science, and PsycINFO using terms related to PHCRP, Critical Race Theory, antiracism, Indigenous evaluation, CBPR/TBPR, and Indigenous health. Eligible sources included peer-reviewed and select gray literature addressing Indigenous populations, evaluation practices, and antiracist or decolonizing frameworks. Studies were screened through a two-stage process, and data were extracted on study characteristics, populations, settings (including Tribal health systems), methodologies, and conceptual frameworks. Data were synthesized using descriptive statistics and thematic analysis.

Results

The review identified a multidisciplinary body of literature spanning public health, social work, Indigenous studies, and evaluation science. Findings indicate that although Indigenous evaluation and PHCRP share commitments to structural analysis, equity, and community-centered approaches, explicit integration remains limited. Indigenous methodologies and CBPR/TBPR approaches were widely used to center community voice and sovereignty; however, few studies explicitly incorporated PHCRP or articulated antiracist frameworks in evaluation design. Applications in Tribal health care systems and Indigenous policy contexts were present but inconsistently theorized. Key gaps include limited AI/AN-specific applications, insufficient attention to institutional and policy barriers, and a lack of integrative frameworks that bridge antiracism and Indigenous sovereignty.

Conclusions and Implications

This study offers a structured synthesis of literature at the intersection of PHCRP and Indigenous evaluation, framed by a decolonizing lens. Findings underscore the need for integrative frameworks that advance both antiracist public health praxis and Tribal sovereignty. Implications for social work research, policy, and practice include strengthening culturally grounded evaluation approaches within Tribal health systems, supporting sovereignty-centered, community-driven research, and informing Indigenous health policy and workforce development. This work lays a foundation for future systematic and qualitative research examining multilevel factors that shape the adoption of PHCRP-informed Indigenous evaluation practices to address Indigenous health inequities, and, more broadly, contributes to anti-racist scholarship and health equity.