Outreach Core

3E.外联核心 主要研究者：Octaviana特鲁希略，博士，教授，NAU Teshia所罗门，博士，副教授，UACC 简介：尽管报告不足，但流行病学数据支持西南部的美洲印第安人（AI）比非西班牙裔白色（NHW）人群的几种癌症类型（包括肝癌，胃癌，胆囊癌和肾癌）的发病率更高。[1]西南部的AI比NHW更容易被诊断为晚期癌症，特别是宫颈癌、结直肠癌和乳腺癌的“可筛查”癌症，因此AI的生存率低于NHW。[1]此外，AI的筛查率通常低于NHW。[2]造成这些差异的因素包括社会决定因素、文化信仰和价值观、卫生保健系统政策以及缺乏有关癌症的信息，这些因素都植根于压迫历史，导致对科学和医学的不信任。[3-4]自2002年以来，美国原住民癌症预防伙伴关系（NACP）社区外展核心一直致力于与亚利桑那州的人工智能社区建立关系，以解决癌症差异。在2009年至2013年的项目期间，我们与合作伙伴一起实施了教育人工智能社区采取行动预防和控制癌症的活动。在与霍皮部落，纳瓦霍民族/弗拉格斯塔夫社区，和Tohono O 'odham民族合作，我们提供了369个记录活动，达到近62,000人，从低影响的活动，如癌症意识，以较高的影响，临床教育。虽然我们通过我们的癌症101培训和会议与我们的培训和研究核心合作，向社区传播研究成果，并为部落指导的研究项目的发展建立关系，但我们的计划本身并不是一个研究计划。然而，NACP与我们的合作伙伴国家进行了七个教师研究项目和两个学生研究项目，以解决社区问题。 在2014-2019年项目期间，我们将包括三个新的目标，建立在我们目前计划的成就基础上，将NACP外展活动从影响个人知识到影响政策和系统，包括社区主导的研究/干预项目。我们将使用基于社区的前瞻性研究（CBPR）[5]方法，并利用社区准备模型（CRM）[5]，为每个参与社区提供实施癌症预防和控制（CPC）计划的能力发展方面的记录进展。虽然每个社区都将领导适合其准备程度的独特举措，但在其文化习俗中，它们之间有共同的活动。在接下来的五年里，社区准备采取跨社会生态水平的癌症干预措施[7-8]并进行研究将进行评估，并与我们的三个合作伙伴部落，三个城市合作伙伴和五个新部落合作，实施导致进展的活动。我们还将向我们的人工智能合作伙伴提供资源和技术援助，通过小额赠款计划实施社区主导的CPC项目，以进一步发展社区一级的基础设施，以实施或加强患者导航系统，癌症幸存者支持小组，男性癌症教育计划和/或其他CPC计划。为了进一步支持他们的能力建设，我们将开发、测试和实施文化能力培训。具体目标：我们的目标反映了过去3年的成功和增长，我们计划与我们的人工智能社区合作，采用文化敏感的方法来实现以下目标。 目标1：在与我们的部落/社区合作伙伴合作，我们将评估他们目前的准备水平，以实施癌症计划活动（从较低的影响意识和教育，以较高的影响临床实践和政策变化），跟踪进展，并提供反馈。 目标2：我们将开发，实施和评估一个工具包和培训计划，可以通过多种方式（面对面和/或电子）提供，为医疗保健提供者和研究人员提供针对癌症的AIAN文化能力培训。 目标3：五个社区项目将由西南AIAN社区开发并为之开发，这些项目将支持更多地使用初级和二级癌症预防战略。 在即将到来的项目期间，我们很高兴能继续反映我们各自部落社区表达的需求和优先事项，并扩大到包括城市中心，以及全州更多的部落和组织，以文化上胜任的方式解决AIAN癌症需求。

3E. Outreach Core Principal Investigators: Octaviana Trujillo, PhD, Professor, NAU Teshia Solomon, PhD, Associate Professor, UACC Introduction: Despite underreporting, epidemiologic data support that American Indians (AI) in the Southwest have higher rates than the non-Hispanic white (NHW) population for several cancer types, including liver, stomach, gallbladder and kidney.[1] AI in the southwest are more likely to be diagnosed with late stage cancers than NHW, especially the "screenable" cancers of cervix, colorectal and breast, and survival is lower in AI than NHW as a result.[1] In addition, screening rates for AI are often lower than NHW.[2] Contributing factors to these disparities include social determinants, cultural beliefs and values, health care system policies, and lack of information about cancer, embedded in a history of oppression leading to distrust of science and medicine.[3-4] The Partnership for Native American Cancer Prevention (NACP) Community Outreach Core has been working to build relationships with AI communities in Arizona to address cancer disparities since 2002. During the 2009-2013 project period, with our partners, we implemented activities to educate AI communities to take action to prevent and control cancer. In collaboration with the Hopi Tribe, Navajo Nation/Flagstaff community, and the Tohono O'odham Nation we provided 369 documented activities reaching almost 62,000 people ranging from low impact activities, like cancer awareness, to higher impact, clinical education. While we collaborate with our training and research cores through our Cancer 101 trainings and conferences to disseminate research findings to the community and build relationships for the development of tribally-directed research projects, our program is not itself a research program. NACP has however conducted seven faculty research projects and two student research projects with our partner Nations to address community concerns. During the 2014-2019 project period, we will include three new aims that build on the achievements of our current program to take NACP Outreach activities from just impacting individual knowledge to influencing policy and systems, that includes community-led research/intervention projects. We will use a Community Based Participatory Research (CBPR)[5] approach and utilize the Community Readiness Model (CRM)[5] that provides each participating community with documented progress in capacity development to implement cancer prevention and control (CPC) programs. While each community will lead its own unique initiatives appropriate for its level of readiness, and within its cultural practices, there are common activities across them. Over the next five years, community readiness to adopt cancer interventions across socio-ecological levels[7-8] and to conduct research will be assessed, and implementing activities leading to progression, in collaboration with our three partner tribes, three urban partners, and five new Tribes. We will also provide resources and technical assistance to our AI partners to implement community-led CPC projects through a small grants initiative to further develop the infrastructure at the community level to implement or enhance patient navigation systems, cancer survivor support groups, men's cancer education programs, and/or other CPC programs. To further support their capacity building, we will develop, test and implement cultural competency training. Specific Aims: Our aims reflect the success and growth experienced over the past 3 years and we plan to use a culturally sensitive approach in partnership with our AI communities to achieve the following aims. AIM 1: In collaboration with our Tribal/community partners we will assess their current level of readiness to implement cancer program activities (from lower impact awareness and education to higher impact clinical practice and policy changes), track progression, and provide feedback. AIM 2: We will develop, implement and evaluate a toolkit and training program that can be delivered through multiple modalities (in-person and/or electronically) to provide an AIAN cultural competency training specific on cancer for healthcare providers, and researchers. AIM 3: Five community projects will be developed by and for Southwest AIAN communities that will support increased use of primary and secondary cancer prevention strategies. in the upcoming project period, we are excited to continue to reflect the needs and priorities expressed by our respective Tribal communities, and to expand to include urban centers, and more Tribes and organizations throughout the state to address AIAN cancer needs in a culturally competent manner.