NC-AINSCO (American Indian Network Study of Clinical Ou*

描述（由申请人提供）：本提案的主要目标是在北卡罗来纳州罗伯逊县创建一个初级保健提供者研究网络。北卡罗来纳州拥有密西西比河以东最大的美洲印第安人人口，其中90%是非保留地印第安人（非保留地部落无法获得IMS护理）。伦比部落（超过50，000名成员）是北卡罗来纳州八个州和/或联邦承认的部落中最大的部落，也是密西西比河以东最大的部落，也是全国第九大部落，绝大多数人居住在罗伯逊县。该县也是该州最偏远、经济最贫困的县之一，失业率为10%。关于北卡罗来纳州美国印第安人健康状况的数据很少，大多来自自我报告调查，如北卡罗来纳州的行为风险因素监测系统（BRFSS）。BRFSS仅根据电话采访的样本对健康状况进行估计。大多数数据是针对该州所有美洲印第安人报告的，代表成年人，而不是按部落具体。对此RFA的回应汇集了罗伯逊伯爵15个实践地点中的54个供应商; 21个是美洲印第安人。从最初的咨询理事会发展而来的这一提案将致力于建立初级保健实践网络，以便收集疾病特异性和部落特异性数据。该提案的目的有两个：（1）在主要为美洲印第安人患者服务的实践中试点建立初级保健提供者和患者网络;（2）估计成人和儿童的糖尿病患病率，并在罗伯逊县的主要种族/族裔群体中试点收集成人和儿童糖尿病护理过程的数据（美国印第安人（40%），非洲裔美国人（25%）和西班牙裔（5%）。该网络的建立、患病率的测量和试点研究的结果将导致对进一步工作的需求进行评估，以改善社区糖尿病的识别和护理。 公共卫生相关性很大，因为最终这项工作将转化为更好的医疗保健服务和临床结果，为美洲印第安人和其他服务不足的患者。

DESCRIPTION (Provided by the Applicant): The major goal of this proposal is to create a research network of primary care providers in Robeson County, North Carolina. NC has the largest population of American Indians east of the Mississippi River, who are 90% non-reservation Indians (non-reservation tribes do not have access to IMS care)is There is very little national data on the health status of American Indians who receive their health care outside the Indian Health Service (IMS). The Lumbee Tribe (50,000+ members) is the largest of the eight state and/or federally recognized tribes in North Carolina, the largest tribe east of the Mississippi River and the ninth largest in the nation, and the great majority live in Robeson County. The county is also one of the most rural and most economically deprived counties in the state,-with a 10% unemployment rate. Data on the health of American Indians in NC are sparse and mostly come from self-report surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) of NC. The BRFSS only has estimates of the health status, based on a sample that was interviewed by telephone. Most data are reported for all American Indians in the state, represent adults, and are not specific by tribe. Response to this RFA has brought together 54 providers among 15 practice locations in Robeson Count; 21 are American Indian. This proposal developed from the initial Advisory Council will address creating the network of primary care practices where disease specific and tribe specific data can be collected. The purpose of this proposal is two-fold: (1) to pilot the creation or a network of primary care providers and patients in practices that serve mainly American Indian patients; (2) to estimate diabetes prevalence in adult and children and to pilot collection of data on processes of diabetic care among adults and children in Robeson Counties' major racial/ethnic groups (American Indians (40%), African Americans (25%) and Hispanics (5%). The creation of the network, measurement of prevalence and results of the pilot study will result in assessment of the needs for further work to improve the identification and care for diabetes in the community. Public health relevance is great as ultimately this work will translate into better health care delivery and clinical outcomes for American Indians and other underserved patients.