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Center for Clinical and Epidemiological Research (CCER)

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Past Projects - Partnership for Native Health

Alcohol Health Disparities in Two Indian Populations

This study, headed by Dr. Douglas Novins of the University of Colorado Health Sciences Center in Denver, Colorado, was funded by the National Institute on Alcohol Abuse and Alcoholism. The project's goal was to analyze data from the recently completed American Indian Service Utilization, Psychiatric Epidemiology, and Risk/Protective Factors Project--the first large-scale, population-based study of American Indians 15 to 54 years of age. Specific aims focused on the epidemiology of alcohol use in two American Indian populations in comparison with the general US population as well as disparities in the epidemiology of alcohol use, drug use, and psychiatric and health conditions. Dr. Buchwald was a co-investigator on this project.

An Innovative and Interactive CVD Curriculum for Native Youth

This project was developing, pilot-testing, and evaluating a culturally appropriate supplemental health education program for grades 7 through 12 that focused on cardiovascular health for American Indian and Alaska Native youth. The curriculum compared knowledge and attitudes about cardiovascular disease and objective outcomes, such as physical activity, in pre- and post-curriculum surveys. Educational materials developed include DVDs, projects, and magazines tailored specifically to Native youth.

Anxiety Disorders in American Indians

This project involved 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 were focused psychiatric risk factors for cardiovascular disease and culturally-relevant expressions of panic and worry in tribal communities. The project was 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.

Assessment of Attitudes Towards Mammography Among Older AI/AN Women

The purpose of this pilot project was 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, used 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.

HIV/STD Prevention Research in Two American Indian Tribes

This study was headed by Dr. Christina Mitchell of the Department of Psychiatry at University of Colorado Health Sciences Center, and was funded by the National Institute of Mental Health. Dr. Buchwald was a co-investigator on this project.

Increasing Activity Levels in Older American Indian and Alaska Native Adults

This project, funded by the Center on Native Elder Health Disparities, was a collaborative effort between investigators at the University of Washington and the Seattle Indian Health Board. The project was 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 were 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 were 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.

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, was designed to help manage diabetes through Internet-assisted contact. Participants in this study received a home computer and access to an online diabetes care module through which they were able to enter diet and activity information. Patients also sent blood sugar values to their diabetes providers at least once weekly and communicate via e-mail regarding diabetes management.

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, was 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.

Relationship Between Post-Traumatic Stress Disorder and Pain in Two American Indian Tribes

In a study using data collected as part of the American Indian Service Utilization, Psychiatric Epidemiology, Risk and Protective Factors Project at the University of Colorado, Dr. Buchwald and colleagues examined the association between lifetime post-traumatic stress disorder and pain as reported on the SF-36.

Strong and Healthy People

This project, which was funded by the Center on Native Elder Health Disparities, was designed to assess the impact of informational calendars on the use of preventive healthcare procedures by active patients at the Seattle Indian Health Board. A Native art calendar was mailed to active patients. Half of the group received a "message" calendar, and half a "placebo" calendar. The message calendar prominently displayed a unique piece of art each month along with a health-related message (e.g., mammography, exercise, etc.). The messages were brief and included a statement of the problem (e.g., 10% of Native American women die of breast cancer), followed by a recommendation (e.g., mammograms can detect early breast cancer; ask your doctor if you need a mammogram). Additionally, all calendars contained a listing of events at the Seattle Indian Health Board such as the annual health fair on Halloween. A research assistant contacted a sub-sample of patients to find out if they had received the calendar. About six months after the calendar mailing, patients' medical charts and pharmacy records were reviewed to assess the use of preventive procedures.

Native People for Cancer Control: Telehealth Network

The Telehealth Network offers tele-oncology services to promote better post-diagnosis cancer care for American Indians and Alaska Natives, to improve support services for cancer sufferers, survivors and families, and to increase awareness of telehealth as a way to efficiently deliver cancer care.

The Promises and Pitfalls of Native Genetic Research

This project was headed by Dr. Paul Spicer of the Department of Psychiatry at the University of Colorado Health Sciences Center, and was funded by the National Institute on Aging. Dr. Buchwald was a co-investigator on this project.

Wounded Spirits

This National Institutes of Health-funded study examined 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 focused on symptoms that are not detected in a clinical setting (i.e., subclinical symptoms) and looked for differences between people with and without post traumatic stress disorder. We looked 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 were 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 were also asked to complete questionnaires that may help identify risk factors for cardiovascular disease. The University of Washington team wase intimately involved in the design of the study, the development of data collection forms, and data management and analysis.