Current Projects of American Indian and Alaska Native Health
Wounded Spirits, Healing Hearts
This National Institutes of Health-funded study examines a group of Northern Plains Indians to see if post-traumatic stress disorder is associated with cardiovascular disease. Headed by Drs. Manson and Buchwald, the study focuses on symptoms that are not detected in a clinical setting (i.e., subclinical symptoms) and looks for differences between people with and without post traumatic stress disorder. We are also looking at the possible roles that heart rate variability, lifestyle factors (e.g., smoking, exercise, and obesity), cultural factors (e.g., religiosity, and acculturation), and biological mediators (e.g., blood pressure, and concentration of fat and sugar in the blood) may play in the relationship between post traumatic stress disorder and subclinical cardiovascular disease. Participants are brought from tribal reservation homes to Denver, Colorado, for a three-day evaluation consisting of a PET scan, an ultrasound scan, blood tests, a physical examination, and other procedures. Participants are also asked to complete questionnaires that may help identify risk factors for cardiovascular disease. The University of Washington team has been intimately involved in the design of the study, the development of data collection forms, and data management and analysis.
View Wounded Spirits, Healing Hearts Abstract.
Native Elder Research Center/Resource Center for Minority Aging Research
This program is a 10-year effort funded by the National Institute on Aging, focused on Native elder health. Native elders are at greater risk for numerous acute and chronic illnesses than non-native elders. In addition, they have less access to needed services. To better address these disparities, this program trains American Indian and Alaska Native PhDs and MDs to conduct research on these and related topics. While the Center is based at the University of Colorado, Drs. Buchwald and Goldberg from the University of Washington CCER are two of the main faculty, and Dr. Buchwald leads the Investigator Development Core. Additionally, biostatistical support for the native investigators is provided by University of Washington CCER.
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Project EXPORT
This program project is funded by the National Center for Minority Health and Health Disparities, with the primary goal of conducting high quality, interdisciplinary, culturally grounded, problem-oriented research of importance to the health status and functioning of American Indians and Alaska Natives. The primary projects focus on quality of diabetic care for youth; telepsychiatry (treatment and consultation by telephone); obesity among infants and children; cancer and chlamydia screening; increasing fitness among urban youth; encouraging smoking cessation; and assessing and improving the quality of mental health care for children. An interdisciplinary team of health scientists, many of them Native, has been assembled from across an existing collaborative network to address these aims. The program is based at the University of Colorado.
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The Center on Native Elder Health Disparities
This Center is a 5-year, program project grant funded by the Agency for Healthcare Research on Quality. The Center is designated as one of the nine Excellence Centers to Eliminate Ethnic/Racial Health Disparities, and provides an administrative structure that promotes excellence in research and research capacity-building specific to improving the health and well-being of older adults in American Indian and Alaska Native communities. The work of the center is organized in terms of 4 core components and 3 research projects. Drs. Buchwald and Goldberg are Core leaders.
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Increasing Activity Levels in Older American Indian and Alaska Native Adults
This project, funded by the Center on Native Elder Health Disparities, has been a collaborative effort between investigators at the University of Washington and the Seattle Indian Health Board. The project is designed to investigate the use of pedometers in increasing physical activity levels in a community sample of urban dwelling, older American Indian patients. A total of 125 American Indians between the ages of 50 and 74 have been randomized into one of two groups: (1) daily monitoring of physical activities; and (2) daily monitoring of physical activities plus using a pedometer to record daily step counts. After an initial baseline interview with education in improving physical activity levels, participants are asked to monitor their physical activities for a six-week period. Participants then return to the Seattle Indian Health Board to complete assessments of self-reported changes in activities and a standardized fitness test known as the six-minute walk. Dr. Craig Sawchuk is the principal investigator.
View Activity in Older Adults Abstract.
Anxiety Disorders in American Indians
This project involves secondary analyses of the data collected as part of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project at the University of Colorado. The analyses are focused psychiatric risk factors for cardiovascular disease and culturally-relevant expressions of panic and worry in tribal communities. The project is spearheaded by Dr. Sawchuk. The first set of analyses found that post traumatic stress disorder, but not major depression as found in Caucasians, was significantly associated with physician-diagnosed cardiovascular disease, even after accounting for traditional cardiovascular risk factors such as age, gender, and smoking. Dr. Sawchuk is now examining characteristic panic symptoms reported by American Indian men and women to see how these symptoms may differentiate American Indians with panic disorder from those who have a history of panic attacks but without the disorder. His next project will examine characteristic worry themes in American Indians to see how these themes may vary across different age groups.
View Anxiety Disorders in American Indians Abstract.
Participation of Underrepresented Populations in Cancer Clinical Trials
This research supplement from the National Cancer Institute, awarded to Dr. Donna LaVallie of the University of Washington, is designed to address participation levels of underrepresented populations in completed cancer clinical trials and to assess potential barriers and enablers to recruitment and participation of underrepresented populations in cancer clinical trials from the perspective of providers and potential trial participants.
View Cancer Clinical Trials Abstract.
Internet-Assisted Diabetes Management in Rural American Indian Population
This project, led by Dr. Donna LaVallie and funded by the Portland Northwest Area Indian Health Board Native American Research Centers for Health project, is designed to help manage diabetes through Internet-assisted contact. Participants in this study will receive a home computer and will be able to access an online diabetes care module through which they will be able to enter diet and activity information. Patients also will be able to send blood sugar values to their diabetes providers at least once weekly and communicate via e-mail regarding diabetes management.
View Diabetes Management Abstract.
Health Communication with American Indian Elders
This project is a career development award to Dr. Eva Garroutte at Boston College. Dr. Buchwald serves as a mentor on this grant.
View Health Communication with American Indian Elders Abstract.
UW Multidisciplinary Clinical Research Training
Dr. Buchwald is a co-investigator on this project.
View UW Clinical Research Training Abstract.
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Genomic Health Care and the Medically Underserved
Dr. Buchwald is a co-investigator on this project.
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An Innovative and Interactive Supplemental Tobacco Curriculum for Native Youth
This pilot project, funded by the National Cancer Institute, focuses on developing a school-based program to reduce the relatively high smoking rates of Native American youth in Washington State. Project Director Rosemary Gibbons from the Native Voices documentary film group at the University of Washington and Dr. Dedra Buchwald are designing and piloting an interactive, video-based, seventh-grade curriculum for use in a school district in south central
View An Innovative and Interactive Supplemental Tobacco Curriculum for Native Youth Abstract.
An Innovative and Interactive CVD Curriculum for Native Youth
This project, funded by the Centers for Disease Control and Prevention, is being carried out in partnership with the University of Washington Health Promotion Research Center directed by Dr. James Logerfo. The project goals are to develop, pilot test, and evaluate a culturally appropriate health education curriculum for American Indians and Alaskan Natives in grades seven through twelve. The emphasis is on improving cardiovascular health in these youth. Program effectiveness will be assessed by comparing knowledge, attitudes, and behaviors in regard to exercise, body mass index, and dietary intake before and after implementation of the curriculum.
View An Innovative and Interactive CVD Curriculum for Native Youth Abstract.
Web-Based, Patient-Centered Approach to CVD Risk-Factor Management and Reduction
This project, funded by the National Heart, Lung, and Blood Institute, will be carried out in collaboration with Dr. Jeff Henderson of the Black Hills Center for American Indian Health. The project’s goal is to implement a culturally tailored, home-based approach to assist Americans Indians in the Northern Plains prevent and manage cardiovascular disease. Both the control and intervention groups will receive usual clinic care and identical communications hardware, software, and training. The intervention group will also be engaged in chronic disease co-management with health providers. The researchers will then assess the differences between the two groups in adherence to therapies and lifestyle changes, as well as the cost effectiveness of the home-based approach.
View Web-Based, Patient-Centered Approach to CVD Risk-Factor Management and Reduction.
Assessment of Attitudes Towards Mammography Among Older AI/AN Women
The purpose of this pilot project is to investigate why older American Indian and Alaska Native women, despite high breast cancer mortality rates, do not take advantage of free breast cancer early screening services provided to many tribal communities. With funding from the National Cancer Institute, Dr. Rose James, in collaboration with Dr. Dedra Buchwald, will use quantitative techniques to gather information on the knowledge, attitudes, and beliefs about mammography and breast cancer screening in two groups: American Indian and Alaska Native women 50 and over, and the staff of 13 tribal breast and cervical cancer prevention programs. Results will be used to design more effective outreach and intervention programs that will increase mammography screening among older women and reduce American Indian and Alaska Native breast cancer mortality.
View Assessment of Attitudes Towards Mammography Among Older AI/AN Women Abstract.
Native People for Cancer Control Telehealth Network
Rural telehealth networks offer a promising opportunity to provide health care and information to rural areas in the U.S. but until now have not really focused on American Indian and Alaska Native populations or on cancer care. The goal of this project, funded by the Health Resources and Services Administration, is to improve cancer services to American Indians and Alaska Natives in Washington and Alaska. The University of Washington, Seattle Cancer Care Alliance, and two Native organizations—the South Puget Intertribal Planning Agency (SPIPA) and the Alaska Native Tribal Health Consortium (ANTHC)—will use real-time teleconferencing to provide consultations and training on follow-up care, cancer pain, psychological problems in cancer patients and survivors, end-of-life issues, and cancer patient support activities. Dr. Ardith Doorenbos and Cara Towle, director of the University of Washington’s Telehealth Services, will be collaborating with Dr. Dedra Buchwald on this project.
View Native People for Cancer Control Telehealth Network Abstract.
Planning Grant for Institutional Clinical and Translational Science Award
Translational research applies research findings from the laboratory to the doctor’s office or the patient’s bedside. In the field of cancer research, for example, this means taking what has been learned about cancer in the lab and developing more effective cancer treatments for patients. The goal of the planning grant for Institutional Clinical and Translational Science Award is to form a translational and clinical partnership between the University of Washington, Children’s Hospital and Regional Medical Center, and Fred Hutchinson Cancer Research Center. In collaboration with Group Health Cooperative’s Center for Health studies, one aim is to partner with American Indian and Alaska Native communities in Washington, Wyoming, Alaska, Idaho, and Montana and the primarily rural WWAMI practice network. The ultimate goal of this project is to speed the translation of research discoveries into improvements in healthcare practices and health status for individuals in these communities. Dr. Dedra Buchwald is a co-investigator with Dr. M. Nora Disis on this project, funded by the National Center for Research Resources.
View Planning Grant for Institutional Clinical and Translational Science Award Abstract.
A Randomized Trial of Workplace Interventions to Improve the Health of Alaska Natives
This study, funded by the National Cancer Institute, is a collaborative effort between the University of Washington and the Alaska Native Tribal Health Consortium. The goal of this five-year study is to improve the health of Alaska Native people through a culturally tailored workplace intervention. Designed as a randomized control trial, this study will test the efficacy of Alaska Workplace Solutions, an evidence-based package of culturally appropriate workplace disease prevention and health promotion strategies. Forty businesses, with 20 percent or higher Alaska Native employees, will be randomized to an immediate or delayed intervention group and surveyed for baseline and follow-up assessment. Health education specialists in Alaska will work with workplace committees, structures, and employees to adapt and implement Alaska Workplace Solutions and provide technical assistance. Prevention and health promotion areas include colon cancer screening, healthy eating, influenza immunization, mammography use, Pap smear use, physical activity, and tobacco cessation. Dr. Dedra Buchwald, principal investigator, and co-investigators, Dr. Gary Ferguson, Alaska Native Tribal Health Consortium and Dr. Debra Bowen, Boston University, are collaborating on this project.
A Targeted Approach to Increasing American Indian Tissue and Organ Donation
The purpose of this five-year project, funded by the National Institutes of Health, is to work with Tribal Colleges and Universities in Washington, Montana, North Dakota and Alaska to create culturally tailored organ donation educational material (brochures, posters, and digital stores) and to increase awareness of the need for organ donors among American Indians. In an effort to understand the knowledge, beliefs and attitudes regarding organ donation among American Indians, focus groups will be conducted on Tribal College and University campuses. The information gathered will be used to develop localized and culturally appropriate organ donation educational material. These educational materials will be used over the course of the study in organ donation awareness programs on campus and in surrounding communities. The project will measure the rate of American Indians who consent to donate kidneys as documented by signed donor cards or organ donation registry over a three-year period. Dr. Dedra Buchwald, principal investigator, and co-investigator Dr. Connie Davis, Medical Director of the University of Washington kidney transplant program, are collaborating with Tribal Colleges and Universities on this project.
