Building Capacity for Dissemination and Implementation Research in a Tribal Healthcare System

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PROJECT SUMMARY - Overall Average life expectancy for Alaska Native and American Indian (ANAI) people is 10 years shorter than non- Hispanic Whites, and ANAIs have higher death rates from conditions such as diabetes, heart disease, and cancer. Yet, healthcare services in ANAI communities are significantly underfunded. Tribes and health organizations serving ANAI patients need evidence about the successful implementation of effective interventions to improve ANAI health outcomes. Southcentral Foundation (SCF), a tribally-owned and operated healthcare organization with an award-winning model of healthcare delivery and redesign, thus proposes a set of five independent yet related efforts in this Center application, “Building Capacity for Dissemination and Implementation Research in a Tribal Healthcare System.” SCF is the primary applicant and will lead these efforts with local partners at the Alaska Native Tribal Health Consortium and University of Alaska, as well as national partners at the University of Washington, Mayo Clinic, and University of Arkansas Medical Sciences. Other experts within and outside of Alaska will provide additional support. Implementing a Diabetes Screening and Referral Services Developed for Dental Clinics Within an Urban Alaska Native Health Care Setting (RP1) will study the implementation of an evidence-based intervention to identify ANAIs at risk for diabetes; Metabolism-Informed Care to Aid Alaska Native People to Quit Smoking (RP2) will assess the acceptability and feasibility of using a nicotine metabolite ratio test to select smoking cessation treatment; and Jumpstarting Culturally-informed Advance Care Planning with ANAI People in Primary Care (RP3) will evaluate the effectiveness and implementation of an evidence- based, culturally-tailored palliative care intervention in ANAIs with serious illness. Two capacity building efforts will optimize success of the RPs and Center as a whole. The Researcher Career Enhancement Project will provide ongoing training and mentoring in foundational research skills and build new capacity in D&I research. The Administrative Core will support communication and coordination, implement a unified evaluation strategy, and create a new career pathway for ANAI Research Administrators. All Center components will be evaluated using two well-recognized D&I research frameworks: Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) and the Consolidated Framework for Implementation Research (CFIR). The proposed Center will expand research capacity within an established ANAI-led and -operated Research Department. Fulfillment of the specific aims will advance the capacity the tribal healthcare organization and ANAI researchers to lead future research focused on improving the health of ANAIs.