Current Grants

EARTH (Education and Research Towards Health)
 
The Education And Research Towards Health (EARTH) study is a 5-year prospective study of American Indians
and Alaska Natives to determine how diet, physical activity, and other lifestyle and cultural factors relate to the development and progression of chronic diseases such as cancer, cardiovascular disease, stroke, Type 2 diabetes, chronic lung and respiratory diseases, and related mortality from these diseases. The study is funded by the National Cancer Institute of the National Institutes of Health. The Black Hills Center for American Indian Health (BHCAIH) has worked with local communities to develop site specific culturally appropriate questionnaires that will accurately capture dietary intake, physical activity patterns, lifestyle and cultural habits, and have developed relationships with local health providers and the Indian Health Service to establish ways to access relevant study-related data from medical records. BHCAIH has recently finished recruitment at its sites in South Dakota and Arizona. In all, BHCAIH examined 5,212 American Indians from two reservations in western South Dakota and one in the Southwest. Participants completed a computerized, touchscreen questionnaire, had physiological measurements, and had medical history information obtained from IHS records as necessary. Referrals to local health care providers were made for follow-up of identified medical problems. Study data will be used to assess health status and identify groups of the population at risk for various health conditions. Longitudinal data will be used to identify factors that contribute to health and prevent disease. Although the existing proposal is a five-year study that enrolls 20,000 participants, we hope to expand the study (through a competing continuation) so that 80,000+ American Indians and Alaska Natives will ultimately be enrolled into a cohort that can be followed long-term. This will be accomplished by including additional participants from tribes enrolled in Phase II and expanding to other tribes. Information from the cohort will help document the health status of American Indians and Alaska Natives, determine prevalence of risk factors, and identify ways to improve the health of American Indians and Alaska Natives.

For more information about Education And Research Towards Health (EARTH)E-Mail: Dr. Jeff Henderson at jhenderson@bhcaih.org.
   
 
NARCH (Native American Research Centers for Health)
 
The Indian Health Service (IHS) and the National Institute of General Medical Sciences of the National Institutes of Health, both agencies of the US Department of Health and Human Services, have announced the recipients of approximately $3 million in grant funding to support American Indian and Alaska Native health research efforts. Eight Tribes or tribally sanctioned organizations have been selected to receive NARCH grants for proposals submitted for FY 2001, the inaugural year of the NARCH initiative. BHCAIH was awarded $131,731 to study the attitudes of the Lakota Sioux toward being a participant in health research. A review of the literature and our experience in working with diverse Indian and Native communities suggests that it is possible to move beyond broad recommendations for
a process of community consultation to describe, in more specific ways, factors likely to operate at the level of individual members’ concerns regarding research and their decision to participate or not in studies sanctioned by
their respective tribal governments. We believe that this undertaking represents a critical next step toward framing
and pursuing culturally relevant, locally meaningful health research in Native communities. Without well-grounded empirical findings to guide us, future conversations about these matters are likely to be plagued by abstract claims
that will forestall the constructive education of prospective investigators, of community participants, as well as the knowledge acquisition process in general. This research project, recently completed, provides us with critical information about who decides to participate in health-related research among Native people—and why. We have disseminated these findings through a variety of mechanisms, including relevant coursework at the tribal colleges and universities, through Institutional Review Board training and via an instructional seminar targeted to investigators seeking tribal approval to pursue research within these Lakota communities. We also are now positioned to develop and test specific recruitment and retention strategies in cross-cultural health research, with special reference to members of the Lakota Nation and related research activities sponsored under the auspices of this grant application. BHCAIH has also recently received funding from the third phase of the NARCH initiative, in FY2005, for a study of contextual issues in traditional Lakota healing.

For additional information on this initiative contact Dianne Hammack, IHS Public Affairs, at (301) 433-3593. Additional information about the IHS is available on the IHS website at www.ihs.gov and info.ihs.gov. Information on the NIH/NIGMS is at www.nigms.nih.gov.

 
SANDS (Stop Atherosclerosis in Native Diabetes Study)
 
The Stop Atherosclerosis in Native Diabetics Study (SANDS) is a 5-year, multi-center, randomized clinical trial
focused on cardiovascular disease prevention in American Indians and Alaska Natives with Type 2 diabetes 40 years of age and older. The study is a subcontract between the MedStar Research Institute and BHCAIH, with funding from the National Institutes of Health/National Heart, Lung and Blood Institute. BHCAIH is home to the only clinical site
for this study on the Northern Plains. American Indians have the highest rates of diabetes in the United States. Although once felt to be protected from cardiovascular disease (CVD) they now have incidence rates higher than that of the general US population. The majority of CVD cases in American Indians occur in individuals with diabetes. It is therefore imperative that intervention strategies to reduce CVD be developed and validated in this population. The primary endpoint of the SANDS Study is carotid intimal-medial thickness. Secondary endpoints include cardiac function measures by echocardiography, lipoproteins, albuminuria, and C-reactive protein. In addition to Rapid City, the study is also conducted in Indian Health Service/Tribal primary care facilities in Phoenix/Sacaton, Arizona; Chinle, Arizona; and Lawton, Oklahoma, with input from American Indian physicians and community members. The results
of this study will provide the evidence needed to develop community-based programs to treat and prevent the epidemic of CVD among American Indians and Alaska Natives. The data will also be valuable in understanding the effects of intensive risk-factor reduction on atherosclerotic burden and cardiac function in diabetic individuals in all US populations.
 
For more information about the Stop Atherosclerosis in Native Diabetes Study E-Mail: Stephanie Big Crow at Stephanie.BigCrow@ihs.gov or call (605) 355-2425, 3200 Canyon Lake Rd. Rapid City, SD 57701