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Findings from in-depth interviews show high satisfaction with the program and suggest extending the class time and adding cooking demonstrations. Conclusions The culturally adapted HHAL proved feasible and was positively received by the participants. Future studies will evaluate the effectiveness of the program.The United States is bearing witness as a crisis-within-a-crisis unfolds across Indian Country, where a persistently underfunded system with inadequate resources and outdated facilities set the stage for coronav