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Partnerships for Native Health Washington State University

HONOR Project Summary

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HONOR Project

Partnerships for Native Health is implementing a new alcohol treatment project. We are collaborating with three Native communities in the western United States on one of the largest interventions for alcohol abuse ever conducted with Native people. Our study population consists of 400 American Indian and Alaska Native adults. Our goal is to determine whether a culturally tailored version of a treatment called contingency management, in which people receive rewards for abstaining from alcohol, can reduce alcohol abuse and lead to other positive outcomes.

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Strong Heart Stroke Study

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Strong Heart Stroke Study – Pilot Expansion for Urban American Indian and Alaska Natives

This pilot study expands on the recently completed Strong Heart Stroke Study, which was the largest, most extensive examination of risk and protective factors for cerebrovascular disease ever conducted with American Indians. The research cohort assembled by the Strong Heart Stroke Study included men and women aged 45-74 years from 13 tribes in South Dakota, Oklahoma, and Arizona. Virtually all participants lived in rural areas. Our new pilot effort will further investigate cerebrovascular risk factors in Native people by conducting a feasibility study in an urban environment. The pilot cohort consists of 60 American Indians and Alaska Natives aged 65 and older who live in the Seattle metropolitan area.

We will use the same neurocognitive assessments as the Strong Heart Stroke Study to explore whether this urban cohort is characterized by distinctive risk or protective factors for cerebrovascular health. Our analyses will address a variety of factors. These might include the availability of acute care in urban settings (which can improve stroke survival) and the accessibility of resources related to lifestyle and health behaviors (which might mitigate or delay age-related cognitive decline). This research is urgently needed, since no studies to date have compared the cerebrovascular and cognitive risk profiles of urban versus rural Native populations.

A Targeted Approach to Increasing American Indian Kidney Donation

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A Targeted Approach to Increasing American Indian Kidney Donation 

End-stage kidney disease is a major public health concern for American Indian populations. It is 3.5 times more common among American Indians than among Whites, and it results overwhelmingly from an excess of type 2 diabetes. In treating end-stage kidney disease, transplantation is associated with better quality of life, lower health care costs, and longer life expectancy than is long-term dialysis. Even so, compared to Whites, American Indians experience significant delays in transplantation and remain on transplant waiting lists for longer periods of time. As rates of kidney disease continue to rise, the importance of raising awareness of organ donation becomes increasingly critical.

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The Strong Heart Stroke Study

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The Strong Heart Stroke Study 

In 1988, NHLBI funded the Strong Heart Study: the largest epidemiologic study of American Indians ever undertaken. Its goal was to examine the prevalence of cardiovascular disease and its risk factors in American Indians. This research continues today with studies of the families of the original participants. A recent analysis estimated that the overall incidence of stroke in American Indians is more than double that of the general U.S. population. This finding indicates that cerebrovascular disease, a precursor of stroke, is a public health problem of staggering significance for American Indians. We propose to build on the work of the original Strong Heart Study, which has already collected substantial data relevant to cerebrovascular disease, by conducting the Strong Heart Stroke Study. Our work takes advantage of an important and timely opportunity to study cerebrovascular disease and stroke, with the goal of learning how to prevent and treat these conditions in American Indians. No previous research has specifically addressed these concerns.

Visit the SHSS Publications & Presentations Committee website to learn about our proposal review process, see our index of approved manuscripts, and access additional resources.

We invite you to view the presentation slides from our two-day SHSS Close-Out meeting held in October 2013 in Seattle. Members traveled from sites in Arizona, Oklahoma, and South Dakota to join in collaboration.

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Native People for Cancer Control

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NPCC white logoNative People for Cancer Control

Native People for Cancer Control is a community network program funded by the National Cancer Institute. It includes several research projects designed to alleviate cancer health disparities among American Indians and Alaska Natives. Rates of cancer incidence in Native people have increased in recent years, while remaining steady or declining in other U.S. racial and ethnic groups. After a cancer diagnosis, five-year survival rates in Native people are the lowest of all races. We have worked with tribes and tribal organizations in eight states to address the following issues:

— Cancer education and health promotion activities and interventions, emphasizing traditional foods and ways of wellness.

— Community-level research on colorectal cancer screening, health communication, and reducing cancer risk factors among Native youth.

— Research training opportunities for American Indian and Alaska Native investigators and students.

To date, the work of Native People for Cancer Control has resulted in several community-based research products described here. We have also produced a half-dozen peer-reviewed publications, with more on the way. Our overall goal is to make a direct contribution to better cancer outcomes and quality of life for American Indian and Alaska Native populations.

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Collaborative to Improve Native Cancer Outcomes

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Collaborative to Improve Native Cancer Outcomes (CINCO)

Traditionally, studies of vulnerable populations have focused on specific disease disparities targeted at the individual level. The Collaborative to Improve Native Cancer Outcomes seeks to implement a different approach to cancer outcomes, in that it considers diverse cancer disparities as systemic disorders of society. The key factors targeted in this method range from the micro level to the macro level, from genetic vulnerabilities to health policies.

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Kidney Donation

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Culturally-adapted Strategies to Enhance Kidney Donation in Native Communities

End-stage kidney disease disproportionately affects American Indians. National statistics document that for American Indians, the prevalence of end-stage kidney disease is 3.5 times higher than for White Americans. Despite similar referral rates for kidney transplants, American Indians are less likely than Whites to be placed on a transplant waiting list or to receive a transplant. In 2007, NIDDK funded six academic centers, including ours at the University of Washington, to test ways to increase organ donation in minority populations. We conducted a mixed-methods study that revealed cultural beliefs and barriers to organ donation among rural American Indians. Findings from that study informed our current strategy to conduct a multi-level intervention with tribal dialysis centers and American Indian patients awaiting organ transplants.

 

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Native People for Cancer Control Bioethics

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Regional Native American Community Network Program Center: Native People for Cancer Control – Bioethics Supplement

American Indians and Alaska Natives are extremely diverse in culture, residential location, and health care needs. Despite this diversity, which encompasses rural tribes and villages as well as growing urban communities, all are typically placed in a single category when national, state, and local statistics are calculated. Many published statistics do not even include an enumeration of American Indians and Alaska Natives. Yet accurate demographic data are indispensable, because government policymakers use them to make decisions about funding for education, health, and other community needs. A simple lumping of hundreds of distinct small groups under the unified heading of American Indians/Alaska Natives will likely result in a false picture of health trends, given the unique strengths, resources, histories, and concerns of these varied populations. For final product please see our Guidebook and Visual PowerPoint.

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