Center for Native Population Health Disparities

描述(由申请人提供)：本申请响应RFA-CA-09-001，该申请要求人口健康和健康差距中心(CPHHD)与其他此类中心合作，促进健康差距的跨学科研究。在这项申请中，华盛顿大学(UW)和黑山美国印第安人健康中心(BHCAIH)寻求对土著人口健康差异中心(CNPHD)的支持。我们的目标是直接为改善美洲印第安人/阿拉斯加原住民(AI/AN)人口的癌症健康结果和生活质量做出贡献-这些人口正在经历严重的健康不平等。尽管在改善土著社区的健康和预期寿命方面已经取得了长足的进步，但仍有许多工作要做，正如医学研究所的报告中雄辩地指出的那样，审查国家卫生研究院的健康差异研究计划：未完成的业务‘^和卫生局局长的报告。精神健康：文化、种族和民族。我们的CNPHD将努力解决这些开创性出版物中发现的差距。 我们的研究议程阐明了AI/AN健康和健康差距的模型，该模型以当前理论为基础，与CPHHD的理论一致，并适用于我们所有的项目。参与该中心的许多原住民，以及我们的社区行动委员会和两名人工智能/人工智能社会学家，将帮助我们批判性地检查文化在模型中的作用。我们的调查重申了一个单一的主题--检查遗传、环境、生物、心理社会和文化对癌症健康差异在多个水平和整个生命周期的影响。我们的项目包括儿童、青少年和成人。拟议的CNPHD将填补一个显著的研究空白，因为目前资助的8个CPHHD中没有一个审查AI/AN健康差距，只有1个针对农村人口。我们的中心将真正代表我们的研究合作伙伴社区，有11名人工智能/人工智能在ICEY角色中服务，例如作为项目和核心负责人或联合调查员(见末尾的表5)。最值得注意的是，联合首席调查员是夏延河苏族部落的登记成员，领导着一个以社区为基础的组织。因此，所有拟议的项目都与各自的社区有着深刻和有意义的联系。我们的调查人员和部落社区之间的独特联系为我们的工作注入了一种特殊的动力。研究人员在与他们合作的社区中投入了更多的精力，这种承诺在很大程度上有助于确保参与研究的各方之间的互惠和尊重。最后，CNPHD将真正成为跨学科的。我们汇聚了来自生物、社会和行为科学各个领域的学者。值得一提的是，我们并不将“团队科学”局限于传统的学术界，而是从基于社区的领导者和实体那里引入了思想和本地专业知识。我们设想，这种方法最终将把对AI/AN健康差异的研究从纯粹的描述性转变为有意义的行动。 CNPHD将开展一项综合的、多方面的研究计划，该计划利用几个大型、组织良好的现有努力和数据库，以及许多建立良好和相互尊重的关系，以解决癌症的遗传学、病因学、流行病学、一级和二级预防、临床评估、治疗和生存方面的问题。临床、基础和社会科学与以社区为基础的参与性视角相联系，为AI/AN社区成员、患者、临床医生、研究人员和健康决策者提供具有最高科学和规划水平的跨学科研究计划。值得注意的是，这项申请遵循了CPHHD的总体要求：1)包括基础、临床和社会科学的科学家；2)关注服务不足的人群；3)纳入社区参与性研究的原则；4)包括针对至少两个层次的干预措施；5)提供职业发展机会；6)与其他CPHHD和NIH项目工作人员互动和协调，以进行跨学科、多地点、高度互动的研究。

DESCRIPTION (provided by applicant): This application responds to RFA-CA-09-001, which requests applications for Centers for Population Health and Health Disparities (CPHHD) that will collaborate with other such Centers to promote transdisciplinary research in health disparities. In this application, the University of Washington (UW) and Black Hills Center for American Indian Health (BHCAIH) seek support for a Center for Native Population Health Disparities (CNPHD). Our aim is to directly contribute to improved cancer health outcomes and quality of life for American Indian/Alaska Native (AI/AN) populations - populations that are experiencing dramatic health inequities. Although strides have been made in improving health and life expectancy in Native communities, much work remains, as eloquently argued in the Institute of Medicine report, Examining the Heath Disparities Research Plan of the National Institutes of Health: Unfinished Business'^ and the Surgeon General's report. Mental Health: Culture, Race, and Ethnicity.^ Our CNPHD will strive to address the gaps identified in these seminal publications. Our research agenda articulates a model for AI/AN health and health disparities that is well-grounded in current theory, consistent with that of the CPHHDs, and applicable to all our projects. The many Native people involved in this Center, as well as our Community Action Board and 2 AI/AN sociologists, will help us critically examine the role of culture in the model. Our investigations reiterate a single leitmotif - the examination of genetic, environmental, biological, psychosocial, and cultural influences on cancer health disparities at multiple levels and across the lifespan. Our projects include children, youth, and adults. The proposed CNPHD will fill a striking research gap, since none of the 8 currently funded CPHHDs examines AI/AN health disparities and only 1 targets rural populations. Our Center will truly represent our research partner communities, with 11 AI/ANs serving in Icey roles, for example as Project and Core Leaders or Co-investigators (see Table 5 at end). Most notably, the Co-Principal Investigator is an enrolled member of the Cheyenne River Sioux Tribe and directs a community-based organization. As a result, all proposed projects have deep and meaningful ties to their respective communities. The unique connection between our investigators and the tribal communities imbues our work with a special dynamic. Investigators are more fully invested in the communities with which they work, and this commitment goes a long way to ensuring reciprocity and respect among ail parties involved in the research. Finally, the CNPHD will truly be transdisciplinary. We bring together scholars from across the full spectrum of biological, social, and behavioral sciences. Of special note, we do not limit "team science" to traditional academic circles, but bring in ideas and Native expertise from community-based leaders and entities. We envision that this approach will eventually move research on AI/AN health disparities beyond the purely descriptive into meaningful action. The CNPHD will pursue an integrated, multi-faceted research program that capitalizes on several large, well-organized, existing efforts and databases, as well as numerous well-established and mutually respectful relationships, to address issues in the genetics, etiology, epidemiology, primary and secondary prevention, clinical assessment, treatment, and survivorship of cancer. Clinical, basic, and social sciences are linked with a community-based participatory perspective to provide a transdisciplinary research program of the highest scientific and programmatic caliber for AI/AN community members, patients, clinicians, researchers, and health decision-makers. Notably, this application follows the overarching requirements for CPHHDs to 1) include scientists from basic, clinical, and social sciences; 2) focus on an underserved population; 3) incorporate principles of community-based participatory research; 4) include interventions directed towards at least 2 levels; 5) offer career development opportunities; and 6) interact and harmonize with other CPHHDs and NIH program staff to conduct transdisciplinary, multi-site, highly interactive research.