Partnership for Public Health Research in the Oglala Sioux Tribe

描述（由申请人提供）：美国印第安人和阿拉斯加原住民（AI/ANs）与其他美国人相比，存在明显的健康差异；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。虽然使保健服务更容易获得对于解决健康差距至关重要，但动员社区实现健康生活是另一个重要的工具，但往往没有得到充分利用。当我们考虑到许多健康差异的行为基础，以及预防在中断青少年危险行为（如物质使用、危险性行为、肥胖）的发展和支持健康行为（如运动、健康饮食）的发展方面的潜在作用时，这一点尤其正确，这些行为可以预防以后生活中严重的健康问题。人们日益认识到，社区参与对于有效解决保健差距至关重要，社区参与性研究和部落参与性研究方法获得了应有的认可。然而，大多数健康研究仍然是由学术卫生中心发起的，很少或根本没有社区投入。我们相信，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，如果这些方法得到充分接受，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位置定义的保留地或基于村庄的社区。松岭保留地的奥格拉拉苏族部落（OST）是一个面临严重健康差异的社区；OST成员是我们国家最贫穷的人之一，许多疾病的发病率在这里明显高于整个国家。科罗拉多丹佛大学（UCD）美洲印第安人和阿拉斯加原住民健康中心（CAIANH）的研究人员与奥格拉苏族部落健康管理局（OSTHA）的合作伙伴寻求建立近20年的合作关系，通过解决4个具体目标，寻求改变OST的社区研究基础设施：1)扩大和详细制定健康研究议程，预计最初将侧重于青少年药物滥用预防计划；2)建立培养科研人才的双向机制；3)培养有效的传播方法，将研究成果回馈当地社区，为部落、其他研究人员、服务提供者和决策者提供有关OST健康的最佳信息；4)将这里开发的程序系统化，为在土著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在提供研究方向和监督以及发展自己的研究队伍方面所表现出的自信领导的基础上。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。

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.