Building a Sustainable Indian Tribal Infrastructure for Translational Research

描述(由申请人提供)：美国印第安人和阿拉斯加原住民(AI/AN)社区在健康差距中肩负着沉重的负担。虽然健康促进计划已经在人工智能/人工智能社区实施，但基于证据的行为科学转化研究很少见。时间、金钱和资源成本、不信任的历史，以及缺乏准备充分的研究人员在部落社区工作，这些都是在这些群体中进行研究的公认挑战。需要在研究中建立支持学术和部落伙伴关系的基础设施，以建立部落能力，并使护士和其他卫生研究人员做好准备，以便与部落合作进行转化性研究。该项目的目标是在学术卫生中心(密歇根大学护理学院)和两个农村部落(苏卡米什和甘博港S克拉拉姆)之间建立伙伴关系基础设施，以提高部落从事行为科学转化研究的能力。该计划将借鉴社会学习理论，并采用基于社区的参与性研究(CBPR)方法，帮助部落概念化、规划和提交基于证据的社区翻译研究补助金。这项工作将分三个阶段进行。在第一阶段，将成立一个由部落首领、社区代表和学术学者组成的咨询委员会，每个部落的社区研究助理(CRA)将在每个部落内建立规划小组，以评估研究和培训的需求。利用CBPR程序，这些小组将确定部落优先研究领域，包括(但不限于)：癌症筛查和预防、心理健康和/或促进老年人的身体活动和健康生活方式。在第二阶段，来自华盛顿大学的部落成员、学生、护理教师和专家将在研究培训和指导计划中合作，在准备研究提案的所有步骤中提供正式指导和实践协助。在第三阶段，这名训练有素的部落成员、学生和教职员工将支持部落制定和提交至少一至两份小额赠款和一份R01，以满足确定的需求。该计划的评估包括基于所述计划目标的过程和结果测量。研究结果将促进将CBPR作为基础设施建设的一种方法的科学和理解，为减少这些服务不足的社区的健康差距做出宝贵贡献，并在翻译研究方面提供亟需的学术/部落合作模式。将通过以下方式促进可持续性：1)在部落和华盛顿大学护理学院内建立与现有结构相联系的基础设施和政策；2)与社区机构和大学内其他学校和系建立联系；3)记录培训模块；4)部落与华盛顿大学护理学院和研究经费来源之间的网络技术联系。 公共卫生相关性：这项提案涉及一个重大的公共卫生利益问题--缩小美洲印第安人社区的健康差距。我们建议为学术卫生中心(华盛顿大学护理学院)和部落社区(Suquamish和PT)之间的合作研究伙伴关系建立基础设施。博彩S的Klallam)，以建立部落进行转化性健康科学研究的能力，并为护士和其他健康研究人员提供与这些社区合作的机会。该项目的最终目标是建设进行研究的能力，以增加这些服务不足的社区获得文化上合适的、最先进的、基于证据的卫生保健。

DESCRIPTION (provided by applicant): American Indian and Alaska Native (AI/AN) communities shoulder heavy burdens in health disparities. While health promotion programs have been implemented in AI/AN communities, evidence-based behavioral science translational research is rare. Time, monetary and resource costs, a history of mistrust, and a lack of well prepared researchers to work in tribal communities are recognized challenges to research within these groups. Infrastructures to support academic and tribal partnerships in research are needed to build tribal capacity and prepare nurses and other health researchers to collaborate with tribes in translational research. The goal of this project is to establish a partnership infrastructure between an academic health center (the UW School of Nursing) and two rural tribes (Suquamish and Port Gamble S'Klallam) to enhance tribal capacity to engage in behavioral science translational research. The program will draw upon social learning theory and employ a community-based participatory research (CBPR) approach to assist the tribe in conceptualizing, planning, and submitting evidenced-based translational research grants for their communities. The work will be conducted in three phases. In phase one, an advisory committee comprised of tribal leaders, community representatives, and academic scholars will be established, and the Community Research Associate (CRA) in each tribe will establish planning teams within each tribe to assess needs for research and training. Using a CBPR process, these groups will identify tribal priorities for research in areas including (but not limited to): cancer screening and prevention, mental health, and/or promoting physical activity and healthy lifestyles in older adults. In phase two, tribal members, students, nursing faculty, and experts from the UW will collaborate in a research training and mentoring program that provides both formal instruction and hands-on assistance in all steps of preparing a research proposal. In phase three, this trained cadre of tribal members, students and academic faculty will support the tribes to develop and submit at least one to two small grants and one R01 to address identified needs. Evaluation of this program includes both process and outcome measures based on stated program objectives. Findings will advance the science and understanding of CBPR as an approach in infrastructure building, make valuable contributions to reducing health disparities for these underserved communities, and provide a much need academic/tribal model of collaboration in translational research. Sustainability will be facilitated by: 1) development of an infrastructure and policies within the tribes and the University of Washington School of Nursing that are linked to existing structures; 2) establishment of linkages to community agencies and other schools and departments within the University; 3) documented training modules; and 4) web based technology linkages of the tribes to the University of Washington School of Nursing and research funding sources. PUBLIC HEALTH RELEVANCE: This proposal addresses an issue of significant public health interest - reducing health disparities in American Indian communities. We propose to establish an infrastructure for a collaborative research partnership between an academic health center (UW School of Nursing) and tribal communities (Suquamish and Pt. Gamble S'Klallam) to build tribal capacity to conduct translational health sciences research, and to offer opportunities for nurses and other health researchers to collaborate with these communities. The ultimate goal of this project is to build capacity for conducting research to increase the availability of culturally appropriate, state-of-the-art, evidence based health care to these underserved communities.