American Indians and Alaska Native groups share a history of conquest, decimation from disease, genocide, forced cultural and land-based loss, and the evolution of alcohol use, violence, and chronic disease. In light of the history and maintenance of cultural identity among these groups, a working knowledge of respective histories, traumatic losses, cultural frameworks, and culture change is critical in the development of violence prevention programs. Such an approach may help determine which combinations of risk and protective factors prove most useful for the prevention of child maltreatment in these groups. Certain risk factors include parental alcohol abuse, the movement of a child from one family to another, and chaotic family situations due to depression. Intervention programs have found cultural and historical factors within therapeutic contexts that could be integrated into prevention programs. These include cultural identification, cultural shame, intergenerational familial and interpersonal trauma, and reluctance to put the welfare of the individual ahead of the extended family and community. Child maltreatment is considered a sensitive issue by tribal communities. Also, the history of research conducted in these communities has left many tribal members reluctant to participate in any research conducted by outsiders. The public health model can be enhanced to fit cultural frameworks and belief systems to help these communities prevent violence. Of utmost importance is that this be done with mutual cooperation and collaboration, based on expressed need in the respective community. Community members need to be active participants in program planning, implementation, and dissemination. 1 figure, 2 tables, 1 note, 100 references.