Project Summary: Overall Three premises underlie the development of our NW NARCH. First, despite longstanding efforts by tribal, federal, and state health care programs, the available data show substantial disparities in health for NW American Indian and Alaska Native people (AI/ANs) compared to non-AI/ANs. NW tribal leaders fear that their health status is getting worse instead of better; this fear unfortunately has been substantiated with health data that show increases in key chronic disease conditions, instead of decreases, over the past 20 years. Second, Indian communities distrust health research because of negative experiences with non-AI/AN researchers who did not respect tribal needs or sensitivities, even though carefully implemented health research has the potential to provide solutions to reduce, and ultimately eliminate, existing health disparities. Third, health research done by highly skilled AI/ANs who are sensitive to the culture and specific concerns of NW and other Indian communities can bridge the gap between academia and community, though currently we lack the critical mass of AI/AN researchers necessary to accomplish this task. In response to these three issues, we have established the NW NARCH to form a tribal-academic partnership for community-based health research focused on eliminating racial health disparities and will continue this partnership with this application. The 43 NW Indian communities represented by NPAIHB have a long track record of coordinated efforts to improve their health status; our tribal-academic partnerships with Oregon Health & Science University and Portland State University will build a wide-reaching and multi-layered infrastructure to increase the skills of AI/AN researchers, and address health problems of critical importance to the tribes. Our Board delegates and Board of Advisors have directed us to pursue three training projects in this application: 1) a fellowship program that will increase the numbers of tribal people who are trained to conduct cancer prevention research among tribal people, 2) continuation of our Summer Research Training Institute for AI/AN health professionals, so that they can develop the skills needed to function as researchers in their current roles with their tribal organizations 3) an applied biostatistics fellowship designed to train a cadre of AI/AN people to conduct a variety of analyses with their own tribal data or through accessing administrative datasets, and 4) a pilot research project on fall prevention using very high technology methods for balance assessments. We trust that we will have substantial impact on AI/AN communities through supporting trainees and increasing the number of rigorously trained tribal people in conducting health and biomedical research of relevance to the tribes…consistent with the NIH Strategic Plan for Tribal Health Research FY 2019-2023.

Project Narrative The Northwest Portland Area Indian Health Board (NPAIHB) has a long-standing health research relationship with Oregon Health & Science University and Portland State University. With its two academic partners, the NPAIHB will implement three training programs for American Indian and Alaska Native researchers designed to help reduce disparities for tribal people nationwide, including a graduate fellowship program in cancer prevention research, a fellowship in applied biostatistics, and our Summer Research Training Institute for AI/AN health professionals…a program that has included over 1000 trainees so far. In addition to the training grants, we will evaluate the feasibility of an elders’ fall intervention program that makes use of technology only available in Portland for balance testing and monitoring.