Some populations are labeled “hard-to-reach,” but more often than not, it’s not because they’re disengaged or unwilling. It’s because the messages weren’t developed with them in mind.
American Indian and Alaska Native (AI/AN) populations aren’t hard to reach, they’re just rarely reached most effectively. That’s why it is important to take a culturally grounded, reflective messaging approach that speaks with them, not at them.
Table of Contents
Key Takeaways
- Hard-to-reach populations, including American Indian and Alaska Native (AI/AN) communities, often face barriers like geographic isolation and historical mistrust that limit health communication.
- Traditional outreach frequently fails because it overlooks culture and lived experience.
- Reflective messaging, which is communication that mirrors a community’s identity, builds trust and drives action. Native Reach™ helps organizations connect meaningfully with Indigenous audiences through culturally aligned content.
What Are Hard-to-Reach Populations?
According to the National Library of Medicine, hard-to-reach populations are often underserved or overlooked by traditional public health efforts. These individuals or subgroups are difficult to identify, contact, or engage due to a combination of social, linguistic, geographic, and historical barriers.
Populations may be considered hard to reach because they:
- Have limited English proficiency
- Live in remote or geographically isolated areas, such as reservations
- Lack reliable access to communication technology
- Have experienced historic discrimination, leading to mistrust of public institutions
- Are impacted by poverty or stigma, which may cause them to avoid mainstream systems
It’s also important to recognize that “hard-to-reach” is not a one-size-fits-all category. These communities are not the same and lumping them under a single label oversimplifies their identities and ignores their unique histories and needs.
Why Indigenous Populations Are Considered Hard-to-Reach
American Indian and Alaska Native (AI/AN) populations are considered hard to reach because of:
- Geographic Isolation: 40% of AI/AN people live in rural areas with transportation and infrastructure challenges.
- Historical Mistrust: underfunded services and culturally insensitive outreach have eroded trust in mainstream institutions, with about a quarter of AI/AN people report experiencing bias and discrimination in healthcare settings.
- Generic Messaging: one-size-fits-all messaging campaigns that ignore Indigenous values, or languages often feel irrelevant or intrusive to Native audiences.
What is Reflective Messaging? And Why it Works
Reflective messaging goes beyond surface level representation. It’s a communication approach that mirrors a community’s culture, values, and lived experiences back to them. Rather than broadcasting generic messages to a broad audience, reflective messaging shows people they are seen and heard which builds trust and drives engagement.
For hard to reach AI/AN communities, this means creating content that feels not only familiar but genuinely respectful and aligned with their worldview.
When AI/AN viewers see content that is reflective they are more likely to:
- Trust the source
- Engage with the message
- Act on the information
Examples of Reflective Messaging That Resonate
At Native Reach™, we’ve seen firsthand how culturally tailored health communication leads to real impact for hard to reach populations. Here are a few examples that work:
Use Indigenous Imagery and Language
Incorporating Native symbols, regalia, language not only catches attention, it signals respect and fosters connection. Like in this example from a GoodHealthTV® monitor.
Feature Native Voices and Faces
Featuring community members humanizes the message and inspires trust. In this video, SaNoah’s powerful narrative—from a childhood marked by poverty and trauma to success at Harvard and work in tribal financial consulting—exemplifies resilience, cultural pride, and giving back.
Incorporate Culturally Contextual Storytelling
Frame public health messages around family and community makes the information more relevant and actionable.
This PSA opens with a powerful acknowledgment of historical trauma and moves into a collective call for healing with highlighting unity, inviting viewers to lean on community while seeking help.
Embrace Local Partnerships
Partner with tribal health and community programs to ensure content is aligned with local priorities.
When it comes to health communication, reflective messaging is a bridge to trust. For hard to reach populations like AI/AN communities, seeing themselves reflected in the message builds a sense of respect and connection. That connection leads to behavior change and healthier outcomes.
Let’s Build Real Connection
At Native Reach™, we specialize in culturally reflective outreach for hard to reach populations like Indigenous audiences and AI/AN communities. From GoodHealthTV® content to custom apps and point of care campaigns, we help you reach the communities that matter most with messages that feel like they belong.
Ready to connect with hard to reach audiences in a way that actually works? Contact us to get started.