xacqanaǂ itkiniǂ (Many Ways of Working on the Same Thing) is a long-term working relationship between Ktunaxa First Nation, Interior Health, University of Victoria, and University of British Columbia – Okanagan. Over the last three years, the xacqanal itkinil team developed a new approach to research that is led by Ktunaxa peoples and reflects Ktunaxa culture. We tested this approach in Ktunaxa communities by hosting a series of gatherings and land-based activities, where community members shared their vision for a healthy community. The team recently received a five-year CIHR Project Grant to build off the first phase of the partnership to work towards Ktunaxa Nation’s vision for a healthy community. We will work with community partners to co-design and implement interventions (i.e. programs, policies, practices), with the aim of transforming the culture of the health system to better serve Indigenous peoples and the wider population. This fellowship will directly contribute to monitoring and evaluating the interventions and their implementation to understand what is working well, what challenges are encountered along the way and how they are addressed, as well as how this work can be carried forward into the future.