Partnership for Public Health Research in the Oglala Sioux Tribe

描述(由申请人提供)：与其他美国人相比，美国印第安人和阿拉斯加原住民(AI/ANS)存在明显的健康差距；与药物使用、事故、糖尿病、凶杀和自杀相关的死亡率高得令人无法接受。虽然使卫生服务更容易获得是解决健康差距的关键，但动员社区走向健康生活是另一个重要的--而且往往没有得到充分利用--的工具。当我们考虑到许多健康差距的行为基础，以及预防在中断青年中危险行为(例如，使用药物、危险性行为、肥胖)的发展以及支持养成健康行为(例如，锻炼、健康饮食)方面的潜在作用时，情况尤其如此，这些行为可以预防晚年的严重健康问题。人们越来越认识到，社区参与对于有效解决健康差距至关重要，基于社区的参与性研究(CBPR)和部落参与性研究(TPR)方法得到了应有的认可。然而，大多数健康研究仍然是由学术健康中心发起的，很少或根本没有社区的参与。我们认为，如果充分采用这些方法，让社区参与预防工作，帮助他们的年轻人养成健康的行为，避免不健康的选择，将是最成功的。这种方法特别适合人工智能/人工智能社区，特别是由文化群体和地点定义的保留地或村庄社区。松岭保护区的Oglala Suoux部落(OST)是一个面临严重健康差距的社区；OST成员是我国最贫穷的群体之一，许多疾病的发病率明显高于全国。为了建立近20年的伙伴关系，科罗拉多丹佛大学美洲印第安人和阿拉斯加原住民健康中心(CAIANH)的研究人员和奥格拉拉苏族部落卫生管理局(OSTHA)的合作伙伴试图通过解决4个具体目标来改造OST的社区研究基础设施：1)扩大和详细阐述卫生研究议程，预计最初将侧重于预防青少年药物滥用的计划；2)开发双向机制，培训研究人员；3)培养将研究成果返回当地社区的有效传播方法，向部落、其他研究人员、服务提供者和政策制定者提供关于OST健康的最佳可用信息；以及4)系统化这里制定的程序，为在土著社区和其他社区建立可持续的研究基础设施提供模板。这里提出的工作建立在OSTHA在提供研究指导和监督方面所表现出的果断领导以及他们发展自己的研究队伍的愿望的基础上。它还利用了CAIANH中经验丰富的研究人员和社区倡导者的优势，他们与OST和全国其他AI/AN社区有着长期的合作历史。 公共卫生相关性：奥格拉拉苏族部落面临着许多健康挑战，其中许多与儿童和青少年时期出现的行为有关。该项目将巩固科罗拉多丹佛大学美洲印第安人和阿拉斯加土著健康中心与部落卫生管理局之间的伙伴关系，采取具体步骤在部落内部建立研究基础设施，重点可能放在部落青年中的预防活动上。这将开创该社区基于社区的参与性健康研究的新阶段，并为其他美洲印第安人和阿拉斯加土著社区发展部落参与研究开创先例。

DESCRIPTION (provided by applicant): American Indians and Alaska Natives (AI/ANs) suffer from marked health disparities when compared to other Americans; mortality rates associated with substance use, accidents, diabetes, homicide, and suicide are unacceptably high. While making health services more accessible is critical in addressing health disparities, mobilizing communities towards healthy living is another important - and often underutilized - tool. This is especially true when we consider the behavioral underpinnings of many health disparities and the potential role of prevention in interrupting the development, among youth, of risk behaviors (e.g., substance use, risky sex, obesity) and in supporting the development of healthy behaviors (e.g., exercise, healthy eating) that can forestall serious health problems in later life. It is becoming increasingly recognized that community involvement is critical in effectively addressing health disparities, with community-based participatory research (CBPR) and Tribal Participatory Research (TPR) methods gaining deserved recognition. Yet most health research is still initiated by academic health centers with little or no community input. We believe that efforts to involve communities in prevention efforts to help their youth develop healthy behaviors and avoid unhealthy choices will be most successful if these methods are fully embraced. Such approaches are particularly well suited for AI/AN communities, especially reservation- or village-based communities defined by both cultural group and location. The Oglala Sioux Tribe (OST) of the Pine Ridge Reservation is a community facing significant health disparities; OST members are among the poorest in our nation with rates of many diseases markedly higher here than in the nation as a whole. Seeking to build on an almost 20-year partnership, researchers at the Centers for American Indian and Alaska Native Health (CAIANH) at the University of Colorado Denver (UCD) and partners within the Oglala Sioux Tribe's Health Administration (OSTHA) seek to transform OST's community research infrastructure through addressing 4 specific aims: 1) To expand and elaborate upon a health research agenda, expected to be initially focused on substance abuse prevention programs for youth; 2) to develop bidirectional mechanisms for training the research workforce; 3) to cultivate effective dissemination methods for returning research findings to the local community, providing the tribe, other researchers, service providers, and policy makers with the best available information about OST health; and 4) to systematize procedures developed here to provide templates for building sustainable research infrastructure in Native and other communities. The work proposed here builds on the assertive leadership the OSTHA has shown in providing direction and oversight of research and their desire to develop their own research workforce. It also draws on the strengths of seasoned researchers and community advocates in the CAIANH, who have long histories of collaboration with the OST and other AI/AN communities nationwide. PUBLIC HEALTH RELEVANCE: The Oglala Sioux Tribe faces numerous health challenges, many of which are related to behaviors that emerge during childhood and adolescence. This project will solidify the partnership between Centers for American Indian and Alaska Native Health at the University of Colorado Denver and the Tribe's Health Administration, taking concrete steps to build research infrastructure within the Tribe, with a likely focus on prevention activities among the Tribe's youth. It will usher in a new phase in community-based participatory research for health in this community and set a precedent for the development of tribal participation in research in other American Indian and Alaska Native communities as well.