INDIAN HEALTH SERVICE NATIONAL INSTITUTES OF HEALTH

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INDIAN HEALTH SERVICE / NATIONAL INSTITUTES OF
HEALTH RESEARCH PROGRAM PARTNERSHIP
NARCH
NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH
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Native American Research Centers for Health
(NARCH) A Brief History
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National Institutes of Health The IHS
Partnership

• The NARCH Program was developed in response to
  concerns raised at the American Indian Research
  Training Needs Meeting held on the NIH campus in
  August 1999.

• The meeting, co-sponsored by NIGMS and the IHS,
  brought NIH scientists and health policy makers
  together with American Indian scientists from
  around the country to discuss the needs of
  American Indians and Alaska Natives (AI/AN) with
  regard to biomedical research training and to
  develop a plan of action.

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National Institutes of Health The IHS
Partnership

• The NARCH collaborative is the IHS/NIH response
  to the advice from the Native research community
  to find ways to include American Indians as
  researchers, not merely as subjects
• Research should be done by, for and with AI/AN,
  rather than on them or about them.
• And now AHRQ et al.

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From Helicopter Research
NIH
NARCH
IHS
Student Faculty TD
Partnerships Tribal/Universities
CBPR
To TRIBALLY CONTROLLED RESEARCH!
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HISTORICAL RESEARCH PARADIGM
Research Institution
Funding Agency
LAB
(COMMUNITY)
Results
Courtesy Don Warne, MD, MPH
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COMMUNITY PARTICIPATORY RESEARCH PARADIGM
Research Institution
Funding Agency
Results
Community
Courtesy Don Warne, MD, MPH
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NARCH RESEARCH PARADIGM
Research Institution
Funding Agency
Results
Community
Courtesy Don Warne, MD, MPH
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National Institutes of Health Indian Health
Service (NIH/IHS) Partnership

• NARCH was launched in 2000.
• Funds were made available to
• support Tribally initiated,
• scientifically meritorious research projects,
  including pilot research projects
• supports projects designed to increase the
  research skills and numbers of Native American
  science students and researchers.

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The NIH/IHS Partnership

• The program ensures that the participating
  American Indian and Alaskan Native (AI/AN)
  communities will direct and control research on
  their own behalf.
• Program Goals
• To develop a cadre of AI/AN biomedical and
  behavioral scientists and health professionals
  who are able to compete successfully for NIH (and
  other PHS research) funding.
• To increase the capacity of both the
  research-intensive organizations (mostly
  universities) and the Indian organizations to
  work in partnership to produce competitive
  research proposals.
• To encourage research on diseases and health
  conditions of importance to American Indians and
  Alaskan Natives.

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The NIH/IHS Partnership
Participating Partners NIGMS, CSR, NIDA, NIAAA,
NIMH, NHLBI, NCI, NIAID, NHGRI, NIAMS, NCCAM,
NCMHD, NIDCR, NIDDK, ORWH, AHRQ (new in NARCH
IV) NIGMS-provides bulk of funds and general
oversight. CSR-Convenes special review group
(SRG) annually. NIDA NIDA has been a major
funder and involved since the onset of NARCH
NIDA staff assisted in Technical Assistance for
the 1st cohort. (NIDA Office of Special
Populations NIDA Division of Epidemiology,
Services and Prevention Research) Other
Partners-Provide funds and oversight for NARCH
research projects within their scientific
jurisdiction.
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NIGMS, Other ICDs, AHRQ Budget Staffs
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IHS Research Program Staff
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NIGMS, Other ICDs, AHRQ Budget Staffs
NIGMS, Other ICDs, AHRQ Budget Staffs
IHS Grants Policy Management
NARCH Grantees
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IHS Research Program Staff
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(No Transcript)
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BUDGET EXPENDITURES
FSRs (269s)
All Funds Expended by 4th Qtr
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4th QTR
Application Continuation
Annual FSRs Narrative Reports
FINAL BUDGET FOR NEXT FISCAL YEAR
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GRANTEE
2006 TECHNICAL ASSISTANCE PLAN
IHS RESEARCH PROGRAM
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Grantee MILESTONES
Project Management
R E P O R T
Gather Aims/Milestones
CORASWORKS
Summarize
Division Briefing
Submit Report
NIH
IHS Research Program Staff
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PARTNERSHIPS IHS NIH TRIBES / TRIBAL
ORGANIZATIONS UNIVERSITIES
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NARCH PROGRAMS
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(No Transcript)
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Establishment of the Native American Research
Centers for Health NARCH I - 2000

• On August 21, 2000 the Announcement for the
  NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH
• Under RFA GM-00-007, Applicants submit a letter
  of Intent by October 1, 2000
• Application were sent to NIH on or before
  December 12, 2000.
• Funding Cycle for NARCH I Annual applicants for
  four year funding
• Initial NIH/NIGMS Funding Amount of 3.0 Million
• This first cohort of NARCH is now finishing

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Establishment of the Native American Research
Centers for Health NARCH I - 2000

• Eight NARCH I Programs were funded in 2000
• Northwest Portland Area Health Board
• Alaska Native Tribal Health Consortium
• Inter Tribal Council of Arizona
• Five Civilized Tribes
• Black Hills Center for American Indian Health
• White Mountain Apache Tribe
• New Mexico Tribal Healthcare Alliance
• Indian Health Council (Southern California)

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• Northwest Portland Area Health Board
• Toddler Overweight Tooth Decay Study (TOTS)
  Community and family Interventions to Reduce
  Childhood Obesity and Caries in NW AI/AN
• Barriers to the Use Child Safety Seats in NW
  Indian Community

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• Alaska Native Tribal Health Consortium
• Prevalence of Disparities and Mortality in
  Alaska Native Children
• Myringotomy and Pressure-Equalizer Tube Post
  Surgery
• Chronic Hepatitis B in Alaska Natives
• Influence of Maternal Nutrition on Pregnancy
  Outcomes
• AN Dietary Subsistence Food Assessment
• Pneumococcal Disease Prevention in AK Natives
• Reinfection Rates H Pylori in Rural Alaska
  Natives
• Role of Defective DNA Mismatch Repair in
  Colorectal Cancer in AN Population

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• Inter-Tribal Council of Arizona
• Alternative Medicine Use By Pascua Yaqui
  Patients with Diabetes
• Building a Community's Capacity to Develop,
  Implement, and Sustain a School Wellness Program

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• Five Civilized Tribes
• A School-Based Intervention For Reducing Risk of
  Type-2 Diabetes Among Oklahoma Indian Children
• Use of Alcohol Services By Parents of Neglected
  Children
• The Barriers and Facilitators to Recruiting NA
  for Research Studies
• Validation of Reported Family History Cancer in
  Cherokees

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• Black Hills Center for American Indian Health
• Understanding Lakota Attitudes Toward Research

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• White Mountain Apache Tribe
• Preventing Pneumococcal Disease in Apache
  Families

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Growth of the Native American Research Centers
for Health NARCH I - 2000

• Indian Health Council (Southern California)
• Diabetes Project

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Growth of the Native American Research Centers
for Health NARCH II - 2002

• Three more NARCH Programs were funded in 2001
• Great Lakes InterTribal Council
• Confederated Tribes of Siletz Indians of Oregon
• Navajo Nation

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Growth of the Native American Research Centers
for Health NARCH II - 2002

• Great Lakes InterTribal Council
• Obesity Prevention in American Indian Children
• Reproductive Outcomes and Cost-Effectiveness
  among Native Americans in Wisconsin
• Protective Effects of Traditional Diets
  Mercury-Selenium
• GLNarch Student Development Continuum Program

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Growth of the Native American Research Centers
for Health NARCH II - 2002

• Confederated Tribes of Siletz Indians of Oregon
• Increase Research Capacity and Infrastructure of
  Four Tribes
• Develop Tribally Specific Culturally relevant
  and Historically Sensitive Models of AIAN
  Behavioral Health that Builds upon Existing Epi
  Methodology by Investigating 1 of 5 Factors
• Increase research Capacity of Early Career
  American Indian Scientists through Individual
  Training and Presentations at University Seminars

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Growth of the Native American Research Centers
for Health NARCH II - 2002

• The Navajo Nation
• Student Faculty Development Projects

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Native American Research Centers for Health NARCH
III - 2005

• Eleven NARCH III Programs were funded in 2005
• Northwest Portland Area Health Board
• Alaska Native Tribal Health Consortium
• Inter Tribal Council of Arizona
• Black Hills Center for American Indian Health
• White Mountain Apache Tribe
• Albuquerque Area Indian Health Board
• Indian Health Council (Southern California)
• California Rural Indian Health Board (Northern
  Cal)
• Aberdeen Area Tribal Chairmen's Health Council
• Chickasaw Nation Health System
• Navajo Nation

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Native American Research Centers for Health NARCH
IV - 2006

• Six NARCH IV Programs were funded in FY06
• Northwest Portland Area Health Board
• Black Hills Center for American Indian Health
• Albuquerque Area Indian Health Board
• Aberdeen Area Tribal Chairmen's Health Council
• Chickasaw Nation Health System
• Southcentral Foundation (Alaska)-New NARCH

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Native American Research Centers for Health NARCH
I, III IV

• Northwest Portland Area Health Board
• Improving research skills for Indian health
  professionals
• Research Training for American Indian Students
• Studying community intervention methods to
  reduce childhood obesity and dental caries
• Determining the barriers to the use of child
  safety seats
• Studying the use of evidence-based medicine to
  improve health care. 
• Internet-Assisted Diabetes Care in Rural
  Indians and Alaska Natives

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Native American Research Centers for
Health NARCH I and III

• Alaska Native Tribal Health Consortium
• Autoimmune Liver Disease in Alaska Natives
  (w/NIAID)
• Nicotine Exposure/Metabolism in Alaska Natives
  (w/NIDA)
• Tobacco-Free Alaska Native Families
• Bronchiectasis in Alaska Native Children
  (w/NHLBI)
• Prenatal Alcohol Exposure Among Al/AN Infants
  (w/NIAAA)
• Disabilities in children, telemedicine, maternal
  nutrition and Dietary assessment. 

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Native American Research Centers for Health NARCH
I, III IV

• Black Hills Center for American Indian Health
• Attitudes of Lakota Indians toward research
• Contextual Issues in Traditional Lakota Healing
• Theory Based Colorectal Cancer Screening
  Interventions Among the Lakota (NARCH IV)

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Native American Research Centers for Health NARCH
I and III

• White Mountain Apache Tribe
• Preventive methods for Pneumococcal disease in
  Apache families (w/NIAID)
• Youth suicide prevention using community-based,
  participatory research (CBPR) methods (w/ORWH)
• Student and Faculty Researcher Development
  Projects

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Native American Research Centers for
Health NARCH III Project

• California Rural Indian Health Board (CRIHB)
• Variation in Preventable Hospitalization Outcomes
  in Tribal Health Programs (w/AHRQ)

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Aberdeen Area Chairmens Health Council Native
American Research Centers for Health NARCH III
IV Projects

• Predicting Insulin Resistance in American Indian
  Youth
• Screening for Asthma Among Children in Northern
  Plains Tribal Communities (Children with
  undiagnosed or uncontrolled asthma)
• Validation Study of Depression and Anxiety
  Measures with Northern Plains Indians (NARCH IV)

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Oklahoma Native American Research Center for
Health (ONARCH) NARCH I, III IV

• Five Civilized Tribes Chickasaw (Now replacing
  Cherokee as lead Tribe for N III), Choctaw,
  Creek, and Seminole Nations
• School-based interventions for reducing risk of
  type-2 diabetes among children
• The use of substance abuse services by parents
  of neglected children
• The barriers and facilitators to recruiting
  American Indians for research studies. 
• Cancer Registry and Family History
• Student Faculty Development Projects
• Understanding Rheumatic Disease in Oklahoma
  Tribal Members (NARCH IV)

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NAVAJO NATION Native American Research Centers
for Health NARCH II III Projects
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ALBUQUERQUE AREA INDIAN HEALTH BOARD
Native American Research Centers for Health NARCH
I III Projects

• Social Protective Factors Research Project
• Listening to Each Other-Substance Abuse
  lntervention
• Tribal Cancer Control Project
• Juvenile Justice Program Incarcerated Youth at
  Risk
• Student Development Project

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NARCH I III Projects

• Pediatric Pilot Project in Obesity and Diabetes
• Pilot Study on Palliative Cancer Care in Native
  Americans
• Student Faculty Development

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Native American Research Centers for Health NARCH
I III Projects

• Use of Alternative Medicine by Pascua Yaqui
  Patients with Diabetes
• Building a Community's Capacity, A Project of
  the Hualapai Tribe
• American Indian Research Center for Health
  Training Program

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Native American Research Centers for Health NARCH
II Projects

• Build the Research Structure Infrastructure of
  the Participating Tribes
• Develop Tribally Specific Culturally Relevant
  and Historically Sensitive AIAN Behavioral
  Health Models that builds upon Existing
  Epidemiological Methodology by Investigating 5
  Factors
• Intergenerational Trauma and Unresolved Grief
• Substance Abuse and Family Transmission of
  Cultural Values
• Communicative Norms in Expressing distress
• Complicated Bereavement Culturally Competent
  Clinicians
• Spirituality and Rehabilitation
• Student Faculty Development

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NARCH II IV Projects

• Protective Effects of Traditional Diets Mercury
  Selenium
• GLNARCH Student Development Continuum Program
• Obesity Prevention in Native American Children
• Improving American Indian Cancer Surveillance
  Data Reporting in Wisconsin
• Reproductive Outcomes Cost Effectiveness for
  American Indians in Wisconsin
• Breast Cancer Risk and Screening patterns in
  Bemidji Area American Indian Women (NARCH IV)

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A New NARCH (NARCH IV)

• Ethical and Cultural Implications of Specimen
  Banking among Alaska Native People
• A strong partnership with the Ethical, Legal
  Social Implications (ELSI) Program at the
  National Institute for Human Genome Research
  (NHGRI)

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Phillip Smith, MD, MPH Director, Division of
Planning, Evaluation and Research Alan
Trachtenberg, MD, MPH NARCH Project Officer, IHS
Human Research Protections Administrator Teresa
Sappier, MA Program Management Analyst