Breaking Colonial Barriers: Culturally Grounded Approaches to IPV Healthcare for Native American Women

Native American (NA) women experience some of the highest rates and severest forms of intimate partner violence (IPV) of any demographic group in the United States. Despite this, they face significant barriers to receiving timely, safe, and culturally responsive healthcare. This integrative review aims to identify and synthesize empirical evidence on the barriers and facilitators to IPV-related healthcare for NA women, addressing a critical gap in the literature on culturally grounded IPV interventions. Drawing on 63 empirical studies published between 2000 and 2023, this review is guided by Indigenist frameworks and the Framework of Historical Oppression, Resilience, and Transcendence (FHORT). Findings reveal how settler colonial structures-such as jurisdictional fragmentation, institutional racism, and policy neglect-continue to undermine the accessibility and quality of IPV services. Additional barriers include mistrust of formal systems, normalization of violence, and culturally unsafe care environments. Conversely, culturally grounded practices, strong community and kinship networks, and Indigenous-led interventions emerge as vital facilitators of healing and access to care. This review underscores the urgent need for community-driven, culturally congruent models of IPV care that honor Indigenous Knowledge (IK) and relational worldviews. Recommendations include expanding trauma- and violence-informed care, investing in Indigenous capacity-building, and dismantling systemic inequities within healthcare and social service institutions. This review affirms that culturally responsive IPV care must be rooted in collective healing and Indigenous self-determination.