Cancer Prevention and Control

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Project Summary Few studies of cancer prevention and control or of cancer etiology among American Indians and Alaska Natives (AI/ANs) in the US have included AI/AN people as investigators. AI/ANs in Principal Investigator roles in cancer research have been particularly uncommon. Although many cancer control studies by non-AI/ANs in tribal communities have been conducted with good intentions toward reduction of cancer incidence and mortality, they have often failed to achieve a reduction in cancer-related disparities among tribal populations. This lack of progress is partly related to the many challenges that 'outsiders' experience in working with AI/AN communities, including the lack of trust that may take many years to establish. AI/AN investigators in key roles in cancer control projects are clearly needed to more effectively address the cancer burden in AI/AN communities, both reservation-based and urban. The rationale for the project is that well-trained AI/AN researchers will have cultural competency and will be viewed as trustworthy and credible researchers by community members who will participate in, or be affected by, research projects implemented by the AI/AN participants in this program. Not only are the trainees likely to be working and living in their respective communities, but they are more likely than non-AI/ANs to know the indigenous language and are more motivated to stay in their communities long-term. Building on our earlier success in this area, our aims are: 1) to recruit and retain 40 qualified AI/AN researchers who seek additional training in cancer control research and in the implementation of cancer control projects; 2) to design and offer a tailored three-week cancer control research curriculum using experienced and qualified faculty and consultants, leading to a capstone cancer prevention research project for each trainee; 3) to provide follow-up support, including field support, distance learning opportunities, and mentoring to the trainees after they complete the formal curriculum in cancer control research; and 4) to provide cancer control research internships to interested trainees who complete the three-week curriculum, so that they can master additional research skills relevant to careers in community-based cancer control under close mentorship. Impact: Our earlier efforts, while showing measureable success among our graduate trainees, are simply not enough. We need a larger federal investment in well trained AI/AN cancer control researchers who can bring scientific rigor to studies they will design and implement in AI/AN populations, to improve cancer rates and risks.