Cancer is now the leading cause of death for Alaska Natives (AN) surpassing trauma and infectious diseases that were the leading causes of death for many years. As recently as 1950,cancer was considered a rare disease in AN. While still below US Whites, the life expectancy of AN has increased. As a result, there is a substantial increase in the incidence of diseases of aging, chronic illnesses such as cancer. Thus, in addition to other factors, e.g. lifestyle choices, environmental issues, increasing Alaska Native age expectancy will undoubtedly result in a continued increase in the number of cancer cases in the near future. Healthcare providers are ill-prepared to provide palliative care to patients nearing the end-of-life as most of their training and experience in caring for AN is in primary and acute care. Healthcare to AN is provided in a unique healthcare delivery model r with the majority of basic primary care provided by village-based workers, Community Health Aides (CHA) with additional primary and secondary healthcare services provided by physicians, mid-level practitioners, nurses and others at regional hospitals and at the only AN tertiary care facility, the Alaska Native Medical Center in Anchorage. Palliative Care Education for Healthcare Providers of Alaska Natives is designed to address educational needs related to system-wide implementation of a comprehensive palliative care program for AN. There is no centralized source of expertise in palliative care within the Alaska Native health care delivery system. The project will provide:1) a centralized, integrated, culturally sensitive palliative care training curriculum and delivery system for multi-levels of healthcare providers of AN, components of which are transfer able to other Native American and rural communities. The program will also include an outreach component where in palliative care training will be provided at regional hospitals with mid-level providers at regional clinics invited to participate. Continuing education credits will be available; 2) institutionalization of the curriculum and education program to ensure the continuous availability of healthcare providers trained in palliative care throughout the Alaska Native healthcare system. This is a physician-driven project designed to address an overall need identified by ANMC physicians and six outlying regional Alaska Native hospital physicians. A project advisory team that includes physicians (ANMC and rural), mid-level practitioner, nurse, CHA and project staff will be designated to over see the development and implementation of the project. The impact of the project will be measured through the administration of survey tools and record analysis at the beginning of the project, years 3 and 5. Curriculum development will utilize existing physician and nurse materials adapted to the AN healthcare delivery system. The CHA curriculum will utilize the CHA training centers and proven education techniques. A well-trained Palliative Care Team will become the core trainers once the program is implemented.
