Regional Native American Community Networks Program
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 second leading cause of death for American Indians and the leading cause of death among Alaska Natives. American Indians/Alaska Natives 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 American Indians/Alaska Natives having the poorest survival from all cancers combined compared with all other racial/ethnic groups. The Pacific Northwest and Northern Plains states are among those with the highest percentage of American Indian/Alaska Native residents, respectively: Alaska, 16.4%; South Dakota, 8.2%; Montana, 6.5%; North Dakota, 4.8%; Wyoming, 2.3%; and Washington, 1.8%. Although cancer rates and mortality vary geographically, many of the most striking cancer-related health disparities are experienced by American Indians/Alaska Natives 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, stepwise strategy to achieve these Specific Aims: (1) increase cancer education activities among American Indians/Alaska Natives; (2) build the capacity of tribal colleges and universities to become partners in and leaders of cancer-related investigative and dissemination efforts; (3) enhance cancer training opportunities for American Indian/Alaska Native researchers; (4) conduct community-based research into access to care, health promotion, and disease prevention activities targeting key cancer disparity issues in American Indians/Alaska Natives; and (5) reduce cancer-related health disparities by increasing access to and use of feasible interventions among American Indians/Alaska Natives. 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 American Indian/Alaska Native lay persons and professionals.