Program Summary As promises to ensure the health of American Indian and Alaska Native (AIAN) people in the United States continue to be broken, we propose our Northwest Indian College (NWIC) NARCH XI application as a hedge against the rising tide of racial inequity and social injustice impacting the lives and ultimately the health and mortality of the Indigenous people in this nation. The etiology of AIAN health disparities is complex and includes social, biological, economic, cultural, and historical factors contributing to health risks and poorer health outcomes among AIANs that are related to structural and racial inequities and racial trauma. Gains have been made in AIAN health promotion and effective practice, but advances are not happening quickly enough and lives are being lost to preventable and treatable diseases and conditions. Research has certainly not always been viewed by AIAN people and tribes as a key part of a healing journey, but over the last two decades, tribes, tribal organizations and tribal community members in the US have begun to emerge as leaders of their own self-determined research agendas to address health priorities and eliminate disparities and inequities. AIAN communities and tribal organizations in Washington state have been leading research efforts to address health disparities and racial inequities in health care through partnerships with research intensive universities and with AIAN investigators positioned at these sites. The Northwest Indian College (NWIC) is the only accredited tribal college serving the states of Washington, Oregon and Idaho, and has an established history of partnering to conduct tribally owned and controlled research. NWIC has an active NARCH program that focuses on addressing the opioid public health crisis in Coast Salish communities through recovery factors research. The proposed NWIC NARCH XI has the goals to expand capacity at NWIC to allow more rapid and real-time response to tribal council and AIAN community requests to conduct research in emergent, high priority areas including addressing the consequences of the COVID-19 pandemic crisis on health, resilience and recovery. Overall, this proposed NARCH XI application aims to support three tribally-led research projects that address high priority health issues identified by AIAN tribes or tribal organizations, and provide opportunities for AIAN student health careers development and research training.

Project Narrative The proposed NWIC NARCH XI has the goals to expand capacity at NWIC to allow more rapid and real- time response to tribal council and AIAN community requests to conduct research in emergent, high priority areas including addressing the consequences of the COVID-19 pandemic crisis on health, resilience and recovery. We propose our Northwest Indian College (NWIC) NARCH XI application as a hedge against the rising tide of racial inequity and social injustice impacting the lives and ultimately the health and mortality of AIAN people. Overall, the application aims to support three tribally-led research projects that address high priority health issues identified by AIAN tribes or tribal organizations, and provide opportunities for AIAN student health careers development and research training.