Research Program and Administrative Center

A.中心概况 A.1结构和重点为响应RFA DE-08-008，美国印第安人/阿拉斯加土著人方案 在医学院（SOM）和牙科医学院（SODM）在大学的AIANP 丹佛的科罗拉多和健康科学中心（UCDHSC），与我们的合作伙伴， 布法罗SODM建议建立一个减少口腔健康差异研究中心（CRRDOH），由 NIDCR作为合作研究中心（U 54）。与我们合作的其他高等教育机构 建立关系，重点是招募学生在口腔健康差异研究的潜在职业生涯 包括刘易斯堡学院，该学院的任务是为美洲印第安人和阿拉斯加学生提供服务; 几所部落学院，包括位于南达科他州玫瑰花蕾保留地的圣格莱斯卡大学，奥格拉拉 松岭的拉科塔学院和纳瓦霍族的戴恩学院。松岭卫生署 政府和松树岭印第安人健康服务（IHS）单位与我们合作， 组成部分1（RC 1）。信息和通信系统的阿尔伯克基地区服务股将参加区域协调中心2;塔利希纳服务 单位（俄克拉荷马州/乔托民族）也可能参加。纳瓦霍族饮食教育部和 Head Start预计将参加RC 3。科罗拉多公共卫生学院的倡议，其中包括 由科罗拉多大学、科罗拉多州立大学和北方大学联合提供的课程 科罗拉多也将与我们合作，特别是在开发新的培训和职业机会方面。 注：本申请中使用的缩写请参见附录RPAC-1。 虽然其他群体存在差异，但AI/AN的健康状况在许多方面都是无与伦比的。 预期寿命几乎比一般人口少6年，发病率和死亡率都较高 用于广泛的疾病和健康问题，包括糖尿病、肺结核、肺炎和某些形式的 1口腔感染（龋齿和牙周病）及其后遗症，如缺牙症，也是 在AI/AN中显著高于普通人群。2随着证据的建立， 口腔健康状况和全身健康状况之间的关系，例如，牙周病和糖尿病 这些差距的严重性更为复杂。 这里提议的中心将被称为土著口腔健康研究中心（hocHR），并将 重点关注AI/AN人群的口腔健康差异。(The美国印第安人和阿拉斯加原住民（American Indian and Alaska Native） 在本申请书中，“土著人/原住民”指的是那些可追溯到大陆土著人民的人。 US;“Native”与AI/AN同义使用。缩略语词汇表见附录RPAC-1。）初始 研究计划将针对两种最常见的口腔感染，龋齿和牙周病，并将 在合并症的显著模式或口腔系统联系的背景下这样做。特别注意 将给予行为和社会因素，影响和构成整个口腔健康的危险因素， 寿命确保制定能够被接受和推广的对文化敏感的干预措施 被邀请参加干预研究的AI/AN社区、部落和社区 一直并将继续参与这些干预措施的规划和传播。 除了在现有的研究基础上发展和进行跨学科干预外， 研究，将导致医疗保健政策，实践的变化，并最终口腔健康，hocHR将 开发培训机会，目标是培养一批自我维持的学者， 准备解决这里所指出的差异。hocHR还提供经验和承诺， 发展持久的社区关系和支持是必要的， 与部落和其他AI/AN社区/组织的研究的政治背景。最后，HocHR将 作为国家资源，鼓励和支持合作研究、研究培训、信息 传播和技术援助，以更大的AI/AN口腔健康社区。通过扩大 研究开发和支持其他健康差异调查，hocHR将提高能力， 致力于改善美国原住民口腔健康的研究。

A. DESCRIPTION OF THE CENTER OVERALL A.1 STRUCTURE AND FOCUS. In response to RFA DE-08-008, the American Indian/Alaska Native Programs (AIANP) within the School of Medicine (SOM) and the School of Dental Medicine (SODM) at the University of Colorado at Denver and Health Sciences Center (UCDHSC), with our collaborating partner, the University at Buffalo SODM, propose a Center for Research to Reduce Disparities in Oral Health (CRRDOH), to be funded by the NIDCR as a Cooperative Research Center (U54). Other higher education institutions with which we have established relationships focused on recruiting students for potential careers in oral health disparities research include Fort Lewis College, which has a mandate to serve American Indian and Alaska (AI/AN) students; and several tribal colleges, including Sinte Gleska University on the Rosebud Reservation in South Dakota, Oglala Lakota College at Pine Ridge, and Dine College of the Navajo Nation. The Pine Ridge Department of Health Administration and the Pine Ridge Indian Health Service (IHS) Unit have worked with us to develop Research Component 1 (RC1). The Albuquerque Area Service Unit of the IHS will participate in RC2; the Talihina Service Unit (Oklahoma/Choctaw Nation) may also take part. The Navajo Nation Departments of Dine Education and Head Start are expected to participate in RC3. The Colorado School of Public Health Initiative, which includes programs offered jointly by the University of Colorado, Colorado State University, and the University of Northern Colorado, will work with us as well, particularly in the development of new training and career opportunities. Note: Please see Appendix RPAC-1 for abbreviations used in this application. Although disparities exist for other groups, the poor health status of AI/ANs is unparalleled in many respects. Life expectancy is almost 6 years less than for the general population and both morbidity and mortality are higher for a broad range of diseases and health problems, including diabetes, tuberculosis, pneumonia, and some forms of cancer.1 Oral infections (caries and periodontal disease) and their sequelae, such as edentulism, also are significantly higher among AI/ANs than among the general population.2 As evidence builds to substantiate a link between oral health status and systemic health conditions¿e.g., periodontal disease and diabetes, the seriousness of these disparities is compounded. The center proposed here will be known as the Center for Native Oral Health Research (CNOHR) and will focus on oral health disparities among AI/AN populations. (The term "American Indian and Alaska Native" or "AI/AN" will refer in this application to those who trace their origins to the indigenous peoples of the continental US; "Native" is used synonymously with AI/AN. See Appendix RPAC-1 for glossary of abbreviations.) The initial program of research will address the 2 most common oral infections, caries and periodontal disease, and will do so within the context of salient patterns of comorbidities, or oral-systemic connections. Special attention will be given to behavioral and social factors that influence and constitute risk factors for oral health across the lifespan. To ensure the development of culturally sensitive interventions that will be accepted and promoted by AI/AN communities, tribes and communities that have been invited to participate in intervention studies have been, and will continue to be, engaged in planning and dissemination of those interventions. In addition to building on the current research base to develop and conduct interdisciplinary intervention research that will lead to changes in health care policies, practices, and ultimately oral health, CNOHR will develop training opportunities, with the goal of cultivating a self-sustaining critical mass of scholars who are prepared to address the disparities identified here. CNOHR also offers the experience and commitment necessary to develop the enduring community relations and support essential for working in the sometimes politically charged context of research with tribal and other AI/AN communities/organizations. Finally, CNOHR will serve as a national resource to encourage and support collaborative research, research training, information dissemination, and technical assistance to the larger AI/AN oral health community. By extending opportunities for research development and support to other health disparities investigators, CNOHR will enhance capacity for research dedicated to improving the oral health of America's First Peoples.