The primordial power spectrum is written as
P(k) = k^n
where n is the spectral index we are talking about. So less than unity indicates less fluctuations at high k, which corresponds to small scales. So the 0.97 tells you the tilt is against small scale power in favour of larger scales.
But, there is a big caveat. This is is primordial power spectrum, which we don't access directly but have to infer from what we observe in the CMB, which involves taking into account all the details of the plasma physics that goes on before re-combination. The spectrum that really matters for structure formation is the post re-combination one, which you can tweak in a variety of ways since you observe it via the angular power spectrum of the CMB and need to convert to a physical one via the cosmologically dependant angular diameter distance.
Shifting the primordial index alone would put you away from WMAP constraints, although there is probably a degeneracy plane or two that might allow you to move it a reasonable way as long as you change other parameters and not be too far from the WMAP allowed region.
Assuming the LCDM angular distances are not too bad, the CMB constrains the fluctuations on scales relevant to cluster formation pretty well independant of the value of n, so I don't think tweaking this gets you out of any glaring model/observation mismatch.