PROJECT SUMMARY The overall goals of the CA-NARCH Administrative Core are to support the research efforts of the NARCH XII projects and to provide critical ongoing community-based participatory tribal direction. Projects aim to address critical issues in the local tribal communities with innovative and timely strategies. They aim to incorporate AIAN community stakeholder perspectives into core elements of practice, thus indigenizing evidence-based approaches that can move the fields of trauma informed care, cancer prevention, opioid care and population health to better serve AIANs. The administrative structure of the CA-NARCH has evolved through funding from NARCH III, V, VII, and X and consists of the Indian Health Council Executive Team, Scientific Advisory Board, CA-NARCH Tribal IRB, and a Research and Student Development Director. The specific aims of the CA-NARCH XII are: Specific Aim 1. Provide administrative, fiscal, and management direction and oversight; coordinate communication; and guide the CA-NARCH XII research projects in evaluation planning. Specific Aim 2. To help gauge community readiness to implement trauma informed care; and refine trauma informed care in the clinic through clinic and community engaged methods. Specific Aim 3. To help assess and characterize HPV- associated cancers, cervical cancer screening and HPV vaccination among patients; identify facilitators and barriers to screening and vaccination; and implement multi-level interventions to increase screening and vaccination. Specific Aim 4. To help identify the epidemic profile of individuals at risk for opioid misuse and opioid overdose; examine community assets and capacity to address prevention and treatment of opioid use/misuse; develop community-based surveillance tool to inform community action towards reducing opioid overdose fatalities. Specific Aim 5. To increase institutional capacity to optimize the use of electronic health data, establish methods by which research questions may be identified and prioritized for analysis; and train Native students in research. The above specific aims will support the efforts of the NARCH initiative and CA-NARCH mission of conducting highly relevant, American Indian/Alaskan Native (AI/AN) community-based research that also supports career enhancement opportunities. This work serves as a model for tribal nations and academic organizations doing collaborative research.

PROJECT NARRATIVE Indian Health Council, Inc., in collaboration the University of California San Diego, San Diego State University, California State University San Marcos and the Pacific Institute for Research and Evaluation, proposes to support the research efforts of the NARCH XII projects: • ACEs Aware: Indigenizing Trauma-Informed Care in Clinical Practice • CHAIN Community Health through Analysis of Internal Numbers • IHC HPV-Associated Cancer Prevention Project • Examination of Evolving Opioid Misuse and Overdose Risk Among American Indi- ans The projects aim to address critical issues in the local tribal communities with innovative and timely strategies. They aim to incorporate AIAN community stakeholder perspectives into core elements of practice, thus indigenizing approaches that can move the fields of trauma informed care, cancer prevention, opioid care, and population health to better serve American Indians.