American Indian and Alaska Native communities have experienced a dramatic epidemic of cardiovascular disease, linked disproportionately to high rates of obesity, high blood pressure, high cholesterol, and diabetes, with rates of heart disease nearly twice as high as the overall U.S. population. Tribal members are often keenly aware that these health disparities are closely tied to the social and economic challenges their communities face. For many American Indian and Alaska Native individuals, barriers to health services and self-management are rooted in larger structural challenges that are difficult to overcome, even for the most knowledgeable and motivated. This article discusses a program in Navajo Nation that aims to help individuals overcome these structural barriers. The Navajo Nation Community Health Representative (CHR) Outreach Program employs tribal outreach workers to provide home-based support to high-risk clients. The CHR program offers the unique asset of health representatives who are members of the communities that they serve, who speak Navajo and belong to the community’s clan network, and therefore share strong bonds of trust, respect, and culture with their clients.