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When there is an absence of evidence to provide confidence that there is benefit from implementing a new prevention service or when a conclusion of possible benefit requires a high level of speculation on linkages of uncertain evidence, but there is high certainty that some patients would be harmed or scarce health care resources expended, the task force may make a strong recommendation against service implementation

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Native tradition and knowledge creates this valuable practice-based evidence, techniques and practices designed by these communities themselves to address a disparity where mainstream public health has failed to deliver results It is also important to recognize that the word policy may also be perceived negatively in some Native communities given that federal policies have that caused so much historical trauma and harm to them