Southern Plains Inter-Tribal Epidemiology Center:
OMH AI/AN Health Disparities Program Grant Summary Overview

There are four objectives that this grant aims to achieve. These are: 1) Increase the quality and availability of research, evaluation, and surveillance data including those in electronic formats; 2) To create career pathways in public health practice and prevention oriented research for tribal members; 3) To provide training to leadership at all levels in the areas of cultural competency and issues specific to AI/AN health disparities; and 4) To disseminate information and results that are obtained.

The first objective will be met by working in partnership with the Oklahoma State Department of Health (OSDH) Chronic Disease, Acute Disease, and HIV/STD Divisions and the Indian Health Service - Oklahoma City Area Office (IHS-OCAO) on two disease reporting enhancement projects. The aim of this collaborative is to enhance the reporting of reportable diseases. Currently there are more than 60 reportable pathogens in Oklahoma. There are also several reportable injuries such as traumatic brain and spinal cord injury, burns, drownings and near drownings. However, during the first partners meeting it was "discovered" that injury is an active surveillance program with participation from the I/T/U's. Therefore, there is virtually 100% reporting from all facilities involved. So it was decided that injury did not need to be part of the enhancement project. As for communicable conditions there were ten diseases/conditions that were selected as possibilities for the enhancement project. These are: HIV, CD4 Cell Count, HIV viral load, Hepatitis B, Rocky Mountain Spotted Fever, salmonella, campylobacter, tuberculosis, shigella, and syphilis. The methodology for this enhancement project is still to be determined. But some suggestions have been to use the Linkplus software as well as manual laboratory audits and chart reviews.

The same type of enhancement will be done for cancer reporting as well. Right now it is thought that all of the cancer treatment data may not be captured. Therefore, this portion of the project will seek to compare the information I/T/U facilities have with what the states cancer registry has. This will be done by probabilistic matching with Linkplus software as well as some methodologies that are still to be determined. For both the communicable disease and cancer enhancement projects, it is a goal of the SPIEC to use the model developed in Oklahoma and apply it in both Kansas and Texas.

Our partner for the second objective is the University of Oklahoma, College of Public Health. This objective will be met by recruiting and encouraging Native American students to enter the public health field, especially epidemiology and biostatistics. It will be up to the SPIEC to actively recruit students, help them to apply to the OU College of Public Health (CoPH), help with finding funding for tuition, fees, and room and board. A steering committee consisting of faculty from the Biostatistics and Epidemiology (BSE) Department of the OU CoPH, Oklahoma State Department of Health personnel, and IHS - OCAO has been formed to help select a student for an internship or Graduate Research Assistantship with SPIEC. While a Native American student is preferred, a non-Native student with interest in Native issues may be selected due to the small number of Native American students in the BSE Department. Once the student has been admitted to the CoPH and has been accepted into BSE, s/he will pick a mentor from the steering committee based on the mentor's research background and the students interests. The masters programs, whether it be an MPH or an MS, is usually a two year program. SPIEC will sponsor one paid internship/GRA student at a time. By the end of the grant period, there will be a total of 2 Native American students that will possess the desired and sought after epidemiology and biostatistics education. It is the hope of SPIEC that the new graduates will either return to their tribal community, work for another tribal community, work for a Native American organization or remain with SPIEC.

This third objective also involves partners from OU-CoPH and OSDH and in addition, the National Indian Women's Health Resource Center. The Training and Intervention Coordinator for SPIEC, in conjunction with NIWHC will be conducting focus groups at the CoPH and the OSDH as well as with tribes across Oklahoma. The results of these focus groups will be used to develop a cultural awareness curriculum. This curriculum will then be used to provide cultural awareness training for faculty and staff at both the CoPH and the OSDH.

The fourth objective consists of disseminating information. Under this objective, SPIEC will disseminate information via trainings, presentations, publications, journals, conferences and other meetings. Disseminations of reports on all database linkage findings (communicable disease and cancer) to Oklahoma, Kansas, and Texas I/T/U's (no identification of facilities will be made public). The SPIEC staff and partners will develop articles for publication in professional/peer reviewed journals. All information will be submitted for approval to IHS and Tribal Institutional Review Boards (IRB) prior to submission to any journals. This may be one or more papers and may include findings from all projects.

Information regarding the methodology and logistics of the SPIEC AI/AN Health Disparities Program (including information about the TEC Internship program) will be presented at National Conferences (APHA, IHS Research Conference, Centers for Disease Control and Prevention, etc).

Dissemination of cultural awareness training will occur via the web. It may also be available to private health entities that work with AI/AN people. At the end of the five year program period, a seminar highlighting the I/T/U health facilities that have developed this training will be held so experiences can be shared and documented.