University of Washington (UW) and Black Hills Center for American Indian Health (BHCAIH) seek support for Native People for Cancer Control (NPCC), a currently-funded regional Community Networks Program (CNP). NPCC is organized into an Administrative Core and Community Outreach, Research, and Training Programs. Directorship of NPCC will be shared by Dedra Buchwald, MD, Professor of Medicine and Director, Partnerships for Native Health, UW;and Jeffrey Henderson (Cheyenne River Sioux), MD, MPH, President and CEO of the community-based, non-profit BHCAIH in Rapid City, SD. NPCC serves an 8-state region and is headquartered at UW in Seattle, with 3 additional sites that align geographically with the conduct of our Community Outreach Program activities. Site 1 includes Washington, Alaska, and Oregon;Site 2 includes Idaho, Montana, and Wyoming;and Site 3 includes North and South Dakota. NPCC will include 15 American Indian/Alaska Native (AI/AN) investigators, staff, and partners. AI/ANs have the poorest 5-year survival from all cancers combined among all U.S. racial/ethnic groups,(12) and access to cancer clinical trials is difficult. Our overarching aim, therefore, is to directly contribute to improved cancer health outcomes and quality of life for AI/AN populations, which experience dramatic health inequities. Our central strategy is to capitalize on opportunities and leverage existing resources to pursue an integrated, multifaceted research program that is catalyzed by tight partnerships with Native communities. We will address cancer health issues ranging from prevention and clinical trials to survivorship. Our long-term goal is to generate findings that can be translated into practices and policies that will reduce AI/AN cancer-related health disparities. Thus, our Specific Aims are to: 1) increase cancer education, outreach, health promotion, and prevention efforts among urban and rural AI/ANs through the activities of the Community Outreach Program;2) conduct 1 Research Project, 2 CNP Pilot Projects, and 2 Training Projects using community-based participatory methods that focus on colorectal cancer screening, health literacy and communication, cancer risk factors and care, and clinical trials education among Al/ANs;3) train at least 5 AI/AN junior faculty members to conduct research through the efforts of the Training Program;and 4) reduce cancer health disparities by increasing access to, and use of, interventions among AI/AN populations through all NPCC activities. These activities will be coordinated by the Administrative Core. With a wide network of partners, 25 funded cancer-related grants and 54 publications by NPCC-affiliated investigators, NPPC has the essential elements of a successful CNP, both as an individual site and as a member of the CNP network.
Healthy People 2010 focuses on health disparities, yet progress reports revealed minimal improvement for Al/ANs in areas previously identified as problematic. For example, only 62% of AI/ANs had health insurance, virtually unchanged over the previous 4 years, and life expectancy for AI/ANs was up to 8 years shorter than for non-Al/ANs. Cancer morbidity, mortality, risk prevalence, and barriers to care remain major problems in Native communities. Concerted, coordinated, multidisciplinary efforts are needed to redress the striking cancer-related disparities experienced by this vulnerable population.