Most American Indian/Alaska Native (AI/AN) languages do not have a word for cancer, perhaps because until recently, cancer was a rare disease in their communities. In the past 50 years, however, cancer has become the 2nd leading cause of death for Als and the leading cause of death among ANs. AI/ANs also experience the worst cancer-related disparities of any minority group in terms of poverty, lack of access to screening and high quality care, encouragement for health promoting behaviors, and access to clinical cancer trials. These factors have resulted in AI/ANs having the poorest survival from all cancers combined compared with all other racial/ethnic groups. Pacific Northwest and Northern Plains states are among those with the highest percent of AI/ANs: AK (16.4%), SD (8.2%), MT (6.5%), ND (4.8%), WY (2.3%), and WA (1.8%). Although cancer rates and mortality vary geographically, many of the most striking cancer-related health disparities are experienced by AI/ANs living in these areas. Yet, this region also has many strengths that can improve cancer disparities such as active community organizations, networks of tribal colleges, excellent training programs, committed Native researchers, and world-class academic institutions. We, therefore, propose a regional Community Networks Program that will enhance existing relationships and programs, and build new bridges to improve community-based participatory education, training, and research for AI/ANs in these areas. Our Regional Native American Community Networks Program will use community-based participatory methods in an integrated, thoughtful, step-wise strategy to achieve these Specific Aims: 1) increase cancer education activities among AI/ANs, 2) build the capacity of tribal colleges and universities to become partners and leaders of cancer-related investigative and dissemination efforts, 3) enhance cancer training opportunities for AI/ANs researchers, 4) conduct community-based research into access to care, health promotion, and disease prevention activities targeting key cancer disparity issues in AI/ANs, and 5) reduce cancer-related health disparities by increasing access to, and use of, feasible interventions among AI/ANs. To achieve these aims, we will organize participants into several cores and units, each with distinct but connected functions. We will also rigorously evaluate our efforts to determine the efficacy of our interventions to reduce cancer disparities and to create educational opportunities for AI/AN lay persons and professionals.
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