DIN COLLEGE The Institution of Higher Education of the Navajo Nation Presenters : EDWARD R' GARRISON

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DINÉ COLLEGEThe Institution of Higher Education
of the Navajo NationPresenters EDWARD R.
GARRISON, PhD, MPHMARK C. BAUER, PhD

• MEETING THE NEEDS OF TRIBAL HEALTH
  PROGRAMS DINÉ COLLEGE COLLABORATION WITH
  THE NAVAJO NATION DIVISION OF HEALTH,
  ESPECIALLY WITH RESPECT TO MOU DEVELOPMENT
  WITH NAVAJO CHR PROGRAM

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History of Funding Support

• ATSDR 5-Year Cooperative Agreement, 1999
  2004
• ATSDR 5-Year Cooperative Agreement, 2004
  2009
• CDC Funding from NCHSTP
  (National Center for HIV, STD and TB Prevention)
• 2002 Oct. 2006 (1-year awards)

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CDC Support through NCHSTP

• Primary Focus Personnel position for a
  Public Health Curriculum Developer
  to work with Diné College Faculty
• developed seven (7) new courses and
• a new Associate of Science degree program
  in Public Health
  
  all of which entered the Diné College
  General Catalog in the Fall 2004 Semester,
  exactly 25 years since the first two Public
  Health courses appeared in our General Catalog
  in 1979.

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Structural Goals of Public Health Degree Program

• Provide an A.S. degree that articulates with and
  transfers into existing Bachelors degree
  programs at regional state universities, but
  also, for those who do not or cannot transfer
  to a university or do not complete the A.S.
  degree,
• Fulfill the educational requirements for
  immediate employment in Navajo Nation service
  agencies such as Community Health Representatives
  (CHRs), Food Stamps and WIC, which the Navajo
  Nation administers under federal and state
  contracts.
• Provide a Certificate documenting completion of
  major component(s) of the sequence, for those who
  are not able to complete the full 2-year
  program.

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Navajo Nation Partnerships

• CHR/Outreach Program,
  Navajo Nation Division of Health
• More than 160 tribal employees, including
  supervisors, office support staff and Community
  Health Representatives. Outreach includes the
  Navajo Nations HIV/AIDS, STD and TB
  Prevention Programs.

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CHR Participation

• By administrative directive of the Navajo Nation
  CHR/Outreach Program, and in accordance with
  their adopted Scope of Work
• a. All Supervisors (both at the central office
  in Window Rock and at each of the 8 Service
  Units) are required to complete the entire A. S.
  degree program in Public Health at Diné College,
  and
• b. All other staff in the program, both
  Community Health Workers as well as
  administrative assistants and secretarial staff,
  are required to complete at least the 12-credit
  Certificate.

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CHR Program Partnership MOU

• MOU between Diné College and CHR/Outreach
  Program, signed August 2004, provides
• Administrative directive for all program
  employees to enroll in Diné Colleges Public
  Health program
• Release Time to attend class during working
  hrs.
• Encouragement to take other liberal arts
  courses
• Diné College to provide timely course offerings
• Diné College to support its interactive
  television Distance Education services for the
  CHR students

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Distance Education with the CHR /
Outreach Program

• All courses are offered via interactive
  television simultaneously to four (4) sites
• Shiprock, New Mexico (where most
  originate)
• Tsaile, Arizona (64 to 100 miles from
  Shiprock)
• Window Rock, Arizona (95 miles from Shiprock)
• either Crownpoint, NM or Tuba City, AZ
• (112 miles)
  (173 miles)

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Other Collaborations with Navajo Nation
Division of Health1998 - Present

• NIDP Navajo Infectious Disease Program
• NNHRRB Navajo Nation Human Research
  Review Board
• PHAC Public Health Advisory Committee
• Uranium Interagency Task Force
• NARCH Native American Research
• 
  Centers for Health
• Navajo Nation Epidemiology Center

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Navajo Nation Partnerships

• Navajo Infectious Disease Project funded to
• Navajo Nation Division of Health by CDC
  (Ralph Bryan, MD and Consuelo
  Beck Sague, PhD, tech. monitors)
• Seminar in Public Health Fall 1998 and
  Spring 2000, began the modern era of Public
  Health course offerings

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Navajo Infectious Disease Program

• Contract from CDC to the Navajo Nation to
  enhance NNDOH capabilities in developing and
  delivering public health programs
• Included a Continuing Education / Staff
  Development component, which was implemented
  as a joint project between NNDOH and Dine
  College
• PUH 191 Seminar in Public Health
• offered Fall 1998 and Spring 2000 at
  Tsaile,
• with PictureTel connection to
  Shiprock
• ( Diné Colleges first Distance Education
  classes )

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Navajo Nation Human Research Review Board

• Established by the Navajo Nation Research Act to
  regulate conduct of research that involves
  Navajo persons as human subjects
• Constituted in accordance with regulations from
  the National
• Institutes of Health for Institutional Review
  Boards ( IRBs )
• Reviews all research and coordinates with the
  NNDOH Office of Research, Planning
  and Evaluation
• Mark C. Bauer, PhD, of the Faculty of Diné
  College, is a member
• of the NNHRRB, appointed by the President
  of the Navajo Nation.

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Public Health Advisory Committee

• Established during Summer 2002 on invitation
  from the NNDOH, to provide advice and guidance
  to facilitate the transition of NNDOH to a
  proposed Navajo Navajo Department of Health
  (comparable to a State Health Department)
• Participants
• - Representatives from County and
• State Health Depts. AZ, NM, UT
• - Regional Colleges and Universities with
• Public Health expertise Univ. of Arizona,
  Diné College
• - Others CDC Tribal Liaison Office in
  Albuquerque

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Inter-Agency Planning Meetings on Education and
Health Exams for People Who Were
Exposed to Uranium Mining and Radiation

• Jointly convened by Taylor McKenzie, MD, as
  Navajo Nation Vice-President, and Douglas
  Peter, MD, Chief Medical Officer, Navajo Area
  IHS, in 2000
• Develop Action Plans
• Community-Based Health and Risk Assessment in
  Impacted Areas
• Community Education / Resource Information
• IHS Medical Staff Continuing Education
• Survey Uranium-Contaminated Homes
• Ecological Risk Assessment

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Native American Research Centers for Health

• NIH funding transferred to and administered by
  Indian Health Service (IHS) program officers.
• Two established NARCHs in Arizona
• Inter-Tribal Council of Arizona (Phoenix)
• with projects at Tohono OOdham and Hualapai
• White Mountain Apache.
• Navajo Nation NARCH, funded August 2002, with
  Taylor McKenzie, MD, as Principal Investigator.

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Navajo Nation NARCH

• One current research activity
• Navajo Ethno-Medical Encyclopedia (NEME)
  Project.
• Projected as a 10-volume compilation of
  traditional Navajo healing knowledge, actively
  funded during the 1960s and 1970s and suspended
  in 1981 when funding was no longer available.
  Was at that time intended to become part of the
  teaching curriculum of the American Indian School
  of Medicine, which was authorized under Title VI
  of the Indian Health Care Improvement Act (PL
  94-437), which was signed into law on September
  30, 1976.
• Principal Investigator Martha A.
  Austin-Garrison
• Diné College (subcontract)

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Navajo Ethno-Medical Encyclopedia

• The complete projected scope of the Navajo
  Ethno-Medical Encyclopedia (NEME) was sketched
  out in ten volumes, as follows
• I. Nílhchih The Sacred Wind Spirit
• II. Nitsáhákees Thought and Mind Processes, or
  Mental Health
• III. Iigeh dóó Ootsá dóó Achí Marriage,
  Conception, Pregnancy and Birth
• IV. Chiyáán Food and Nutrition
• V. Doo Álíinii Prescriptions for a Healthy
  Life
• VI. Ajoolhéii Incompatibilities of Mind and
  Body
• VII. Tsííhniidóóh Disease and Sickness
• VIII. Tídílhté Injuries
• IX. Lhóód Sores
• X. Aniné Death

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Navajo Nation NARCH

• Also substantial curriculum development and
  workforce enhancement activities involving the
  two institutions that are subcontracting with
  the Navajo Nation in the implementation of this
  project
• a. Diné College and
• b. Mel and Enid Zuckerman College of Public
  Health
• at the University of Arizona.

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Navajo Nation NARCH Project

• Interaction between Navajo Nation Division of
  Health, Diné College and the College of
  Public Health at Univ. of Arizona (AzCOPH) led to
  AzCOPH support for
• a. development of Diné Colleges new degree
  program in Public Health
• b. a new Certificate in Public Health
  (12 Diné College credits in Public Health)
  which was awarded (for the first time) to 17
  CHRs at a ceremony in Gallup, NM on July 7,
  2006
• c. AzCOPH support of our SREP Program and of
  our Public Health courses, including
  numerous guest lectures

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Navajo Nation Epidemiology Center

• Began operations September 15, 2005 with
  two Navajo professionals on 2-year
  assignment from Navajo Area Indian Health
  Service
• Cheryl Mason, MPH Ben
  Muneta, MD
• Diné College Partnerships
• 1. Placed one SREP student intern in Summer
  2006, who was subsequently promptly
  hired as staff
• 2. Discussions underway for Diné College to
  provide GIS expertise and services
• 3. MOU will likely be developed to formalize
  relationship

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Memoranda of Understandingwith Regional
Universities

• College of Public Health, University of Arizona
  5-2003
• Institute for Public Health , Univ. of New Mexico
  8-2005
• College of Health and Social Services,
• New Mexico State University
  9-2005
• Loma Linda University School of Public Health
  11-2005
• Department of Health Sciences, Northern Arizona
  University (in process)