# Presentation: 666107

## NARCH

**RESEARCH PROGRAM **
**PARTNERSHIP **

**NARCH**

**NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH**

## Native American Research Centers for Health (NARCH)

**A Brief History**

## National Institutes of Health & The IHS Partnership

-  The meeting, co-sponsored by NIGMS and the IHS, brought NIH scientists and health policy makers together with American Indian scientists from around the country to discuss the needs of American Indians and Alaska Natives (AI/AN) with regard to biomedical research training and to develop a plan of action.

-  The NARCH Program was developed in response to concerns raised at the American Indian Research Training Needs Meeting held on the NIH campus in August 1999.

## National Institutes of Health & The IHS Partnership

-  The NARCH collaborative is the IHS/NIH* response to the advice from the Native research community to find ways to include American Indians as researchers, not merely as subjects;
-  Research should be done by, for and with AI/AN, rather than on them or about them.
- * And now AHRQ et al.

## NARCH

- From Helicopter Research

**NARCH**

**To TRIBALLY CONTROLLED RESEARCH!**

- IHS

- NIH

- Student & Faculty T&D

- CBPR

- Partnerships Tribal/Universities

## Results

**Research Institution**

**Funding Agency**

_**Results**_

**LAB**

** ****(COMMUNITY) **

_**HISTORICAL RESEARCH PARADIGM**_

- Courtesy Don Warne, MD, MPH

## COMMUNITY PARTICIPATORY RESEARCH PARADIGM

**Research Institution**

**Funding Agency**

**Community**

_**Results**_

_**COMMUNITY PARTICIPATORY RESEARCH PARADIGM**_

- Courtesy Don Warne, MD, MPH

## NARCH RESEARCH PARADIGM

**Research Institution**

**Funding Agency**

**Community**

_**Results**_

_**NARCH RESEARCH PARADIGM**_

- Courtesy Don Warne, MD, MPH

## National Institutes of Health & Indian Health Service (NIH/IHS) Partnership

-   NARCH was launched in 2000.
-  Funds were made available to:
-  support Tribally initiated,
-  scientifically meritorious research projects, including pilot research projects
-  supports projects designed to increase the research skills and numbers of Native American science students and researchers.

## The NIH/IHS Partnership

- The program ensures that the participating American Indian and Alaskan Native (AI/AN) communities will direct and control research on their own behalf.
- _Program Goals_:
-  **To develop a cadre of  AI/AN biomedical and behavioral scientists and health professionals who are able to compete successfully for NIH (and other PHS research) funding.**
** ****To increase the capacity of both the research-intensive organizations (mostly universities) and the Indian organizations to work in partnership to produce competitive research proposals. **
**To encourage research on diseases and health conditions of importance to American Indians and Alaskan Natives.**

## The NIH/IHS Partnership

_**Participating Partners**_**:**
**NIGMS, CSR, NIDA, NIAAA, NIMH, NHLBI, NCI, NIAID, *NHGRI, *NIAMS, NCCAM, NCMHD, NIDCR, NIDDK, ORWH, AHRQ  ****	****(*new in NARCH IV)**
**  ****NIGMS-provides bulk of funds and general oversight.**
**  ****CSR-Convenes special review group (SRG) annually. **
**  ****NIDA – NIDA has been a major funder and involved since the onset of NARCH; NIDA staff assisted in Technical Assistance for the 1****st**** cohort. (NIDA Office of Special Populations & NIDA Division of Epidemiology, Services and Prevention Research)**
**  ****Other Partners-Provide funds and oversight for NARCH research projects within their scientific jurisdiction.**

## #1

**#1**

## # 1

**# 1**

**# 2**

## # 1

**# 1**

**# 2**

- NIGMS, Other ICDs, AHRQ & Budget Staffs

- IHS Research Program Staff

**#3**

## # 1

**# 1**

**# 2**

- NIGMS, Other ICDs, AHRQ & Budget Staffs

- IHS Research Program Staff

**#3**

- IHS Grants Policy & Management

**#4**

- NIGMS, Other ICDs, AHRQ & Budget Staffs

- NARCH Grantees

## Slide 16

## BUDGET EXPENDITURES

**FSRs (269s)**

**All Funds Expended by 4****th**** Qtr**

## 4th QTR

**Annual FSRs & **
**Narrative**** Reports**

**4****th**** QTR**

**Application Continuation**

- FINAL BUDGET FOR NEXT FISCAL YEAR

## GRANTEE

- IHS RESEARCH PROGRAM

- 2006 TECHNICAL ASSISTANCE PLAN

## NIH

- Project Management

- Grantee MILESTONES

**R**
**E**
**P**
**O**
**R**
**T**

**CORASWORKS**

**NIH**

- Gather Aims/Milestones

- Summarize

**IHS Research Program Staff**** **

- Submit Report

- Division Briefing

## PARTNERSHIPS

**PARTNERSHIPS**
**IHS & NIH**
**TRIBES / TRIBAL ORGANIZATIONS & UNIVERSITIES**** **

## NARCH PROGRAMS

**NARCH PROGRAMS**

## Slide 23

## Establishment of the Native American Research Centers for Health

**NARCH I - 2000**

-  **On August 21, 2000 the Announcement for the**** ****NATIVE AMERICAN RESEARCH CENTERS FOR HEALTH **
** ****Under RFA GM-00-007, Applicants submit a letter of Intent by October 1, 2000**
** ****Application were sent to NIH on or before December 12, 2000.**
** ****Funding Cycle for NARCH I: Annual applicants for four year funding**
** ****Initial NIH/NIGMS Funding Amount of $3.0 Million**
**This first cohort of NARCH is now finishing**

## Establishment of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Eight NARCH I Programs were funded in 2000**
-  **Northwest Portland Area Health Board**
**  ****Alaska Native Tribal Health Consortium**
**  ****Inter Tribal Council of Arizona **
**  ****Five Civilized Tribes**
**  ****Black Hills Center for American Indian Health**
**  ****White Mountain Apache Tribe**
**  ****New Mexico Tribal Healthcare Alliance**
**  ****Indian Health Council (Southern California)**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Northwest Portland Area Health Board**
** ****Toddler Overweight & Tooth Decay Study (TOTS): ****Community and family Interventions to** **Reduce Childhood Obesity and Caries in NW AI/AN**
** ****Barriers to the Use Child Safety Seats in NW Indian Community**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Alaska Native Tribal Health Consortium**
** ****Prevalence of  Disparities and Mortality in Alaska Native Children**
** ****Myringotomy and Pressure-Equalizer Tube Post Surgery**
** ****Chronic Hepatitis B in Alaska Natives**
** ****Influence of Maternal Nutrition on Pregnancy Outcomes**
** ****AN Dietary & Subsistence Food Assessment**
** ****Pneumococcal Disease Prevention in AK Natives**
** ****Reinfection Rates H Pylori in Rural Alaska Natives**
** ****Role of Defective DNA Mismatch Repair in** **Colorectal Cancer in AN Population**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Inter-Tribal Council of Arizona**
** ****Alternative Medicine Use By Pascua Yaqui Patients with Diabetes**
**Building a Community's Capacity to Develop, Implement, and Sustain a School Wellness Program**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Five Civilized Tribes**
** ****A School-Based Intervention For Reducing Risk of Type-2 Diabetes Among Oklahoma Indian Children**
** ****Use of Alcohol Services By Parents of  Neglected Children**
** ****The Barriers and Facilitators to Recruiting  NA for Research Studies**
**Validation of Reported Family History Cancer in Cherokees**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Black Hills Center for American Indian Health**
** ****Understanding Lakota Attitudes Toward Research**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **White Mountain Apache Tribe**
** ****Preventing** **Pneumococcal Disease in Apache Families**

## Growth of the Native American Research Centers for Health

**NARCH I - 2000**

-  **Indian Health Council (Southern California)**
** ****Diabetes Project**

## Growth of the Native American Research Centers for Health

**NARCH II - 2002**

-  **Three more NARCH Programs were funded in 2001**
-  **Great Lakes InterTribal Council**
**  ****Confederated Tribes of Siletz Indians of Oregon**
**  ****Navajo Nation**

## Growth of the Native American Research Centers for Health

**NARCH II - 2002**

-  **Great Lakes InterTribal Council**
** ****Obesity Prevention in American Indian Children**
** ****Reproductive Outcomes and Cost-Effectiveness among Native Americans in Wisconsin**
** ****Protective Effects of Traditional Diets: Mercury-Selenium**
** ****GLNarch Student Development Continuum Program**

## Growth of the Native American Research Centers for Health

**NARCH II - 2002**

-  **Confederated Tribes of Siletz Indians of Oregon**
-  **Increase Research Capacity and Infrastructure of Four Tribes**
** ****Develop Tribally Specific Culturally relevant and Historically Sensitive Models of AIAN Behavioral Health that Builds upon Existing Epi Methodology by Investigating 1 of 5 Factors**
** ****Increase research Capacity of Early Career American Indian Scientists through Individual Training and Presentations at University Seminars**

## Growth of the Native American Research Centers for Health

**NARCH II - 2002**

-  **The Navajo Nation**
** ****Student & Faculty Development Projects**

## Native American Research Centers for Health

**NARCH III - 2005**

-  **Eleven NARCH III Programs were funded in 2005**
-  **Northwest Portland Area Health Board**
**  ****Alaska Native Tribal Health Consortium**
**  ****Inter Tribal Council of Arizona **
**  ****Black Hills Center for American Indian Health**
**  ****White Mountain Apache Tribe**
**  ****Albuquerque Area Indian Health Board **
**  ****Indian Health Council (Southern California)**
**  ****California Rural Indian Health Board (Northern Cal)**
**  ****Aberdeen Area Tribal Chairmen's Health Council**
**  ****Chickasaw Nation Health System **
**  ****Navajo Nation**

## Native American Research Centers for Health

**NARCH IV - 2006**

-  **Six NARCH IV Programs were funded in FY06**
-  **Northwest Portland Area Health Board**
**  ****Black Hills Center for American Indian Health**
** ****Albuquerque Area Indian Health Board **
** ****Aberdeen Area Tribal Chairmen's Health Council**
**  ****Chickasaw Nation Health System **
**  ****Southcentral Foundation (Alaska)-**_**New NARCH**_

## Northwest Portland Area Health Board 

** ****Improving research skills for Indian health professionals**
** ****Research Training for American Indian Students**
** ****Studying community intervention methods to reduce childhood obesity and dental caries**
** ****Determining the barriers to the use of child safety seats**
** ****Studying the use of evidence-based medicine to improve health care. **
**  ****Internet-Assisted Diabetes Care in Rural Indians and Alaska Natives**

**Native American Research Centers for Health**
**NARCH I, III & IV**

## Native American Research Centers for Health

**Native American Research Centers for Health**
**NARCH I and III**

**Alaska Native Tribal Health Consortium **
**Autoimmune Liver Disease in Alaska Natives (w/NIAID)**
**Nicotine Exposure/Metabolism in Alaska Natives (w/NIDA)**
**Tobacco-Free Alaska Native Families**
**Bronchiectasis in Alaska Native Children (w/NHLBI)**
**Prenatal Alcohol Exposure Among Al/AN Infants (w/NIAAA)**
**Disabilities in children, telemedicine, maternal nutrition and Dietary assessment. **

## Native American Research Centers for Health

**NARCH I, III & IV**

**Black Hills Center for American Indian Health **
** ****Attitudes of Lakota Indians toward research**
**Contextual Issues in Traditional Lakota Healing**
**Theory Based Colorectal Cancer Screening Interventions Among the Lakota (NARCH IV)**

## Native American Research Centers for Health

**NARCH I and III**

**White Mountain Apache Tribe **
** ****Preventive methods for Pneumococcal disease in Apache families (w/NIAID)**
**Youth suicide prevention using community-based, participatory research (CBPR) methods (w/ORWH)**
**Student and Faculty Researcher Development Projects**

## Native American Research Centers for Health

**Native American Research Centers for Health**
**NARCH III Project**

**California Rural Indian Health Board (CRIHB)**
**Variation in Preventable Hospitalization Outcomes in Tribal Health Programs (w/AHRQ)**

## Aberdeen Area Chairmen’s Health Council

**Aberdeen Area Chairmen’s Health Council**
**Native American Research Centers for Health**
**NARCH III & IV Projects**

**Predicting Insulin Resistance in American Indian Youth**
**Screening for Asthma Among Children in Northern Plains Tribal Communities (Children with undiagnosed or uncontrolled asthma)**
**Validation Study of Depression and Anxiety Measures with Northern Plains Indians (NARCH IV) **

## Oklahoma Native American Research 

**Center for Health (ONARCH) **
**NARCH I, III & IV**

**Five Civilized Tribes**: **Chickasaw (Now replacing Cherokee as lead Tribe for N III), Choctaw, Creek, and Seminole Nations **
** ****School-based interventions for reducing risk of type-2 diabetes among children**
** ****The use of substance abuse services by parents of neglected children**
** ****The barriers and facilitators to recruiting American Indians for research studies. **
**Cancer Registry and Family History**
** ****Student & Faculty Development Projects**
**  ****Understanding Rheumatic Disease in Oklahoma Tribal Members (NARCH IV)**

## NAVAJO NATION

**NAVAJO NATION**
**Native American Research Centers for Health**
**NARCH II & III Projects**

|   Navajo Ethno-Medical Encyclopedia Research Project |
| --- |

## Native American Research Centers for Health

**ALBUQUERQUE AREA INDIAN HEALTH BOARD**

**Native American Research Centers for Health**
**NARCH I & III Projects**

** ****Social Protective Factors Research Project**
** ****Listening to Each Other-Substance Abuse lntervention**
** ****Tribal Cancer Control Project**
** ****Juvenile Justice Program: Incarcerated Youth**** at Risk**
** ****Student Development Project**

## NARCH I & III Projects

**Pediatric Pilot Project in Obesity and Diabetes **
**Pilot Study on Palliative Cancer Care in Native Americans **
**Student  & Faculty  Development **

## Native American Research Centers for Health

**Native American Research Centers for Health**
**NARCH I & III Projects**

-  **Use of Alternative Medicine by Pascua Yaqui Patients with Diabetes**
-  **Building a Community's Capacity, A Project of the Hualapai Tribe**
-  **American Indian Research Center for Health Training Program**

## Native American Research Centers for Health

**Native American Research Centers for Health**
**NARCH II Projects**

** ****Build the Research Structure & Infrastructure of the Participating Tribes**
** ****Develop Tribally Specific Culturally  Relevant and Historically Sensitive  AIAN Behavioral Health Models that builds upon Existing Epidemiological Methodology by Investigating 5 Factors: **
** ****Intergenerational Trauma and Unresolved Grief**
** ****Substance Abuse and Family Transmission of Cultural Values**
** ****Communicative Norms in Expressing distress**
** ****Complicated Bereavement & Culturally Competent Clinicians**
** ****Spirituality and Rehabilitation**
** ****Student & Faculty Development**

## NARCH II & IV Projects

-  **Protective Effects of Traditional Diets: Mercury – Selenium**
** ****GLNARCH Student Development Continuum Program**
** ****Obesity Prevention in Native American Children**
** ****Improving American Indian Cancer Surveillance & Data Reporting in Wisconsin**
** ****Reproductive Outcomes & Cost Effectiveness for American Indians in Wisconsin**
**Breast Cancer Risk and Screening patterns in Bemidji Area American Indian Women (NARCH IV)**

## A New NARCH (NARCH IV)

-  **Ethical and Cultural Implications of Specimen Banking among Alaska Native People  **
**A strong partnership with the Ethical, Legal & Social Implications (ELSI) Program at the National Institute for Human Genome Research (NHGRI)**

## Phillip Smith, MD, MPH

**Phillip Smith, MD, MPH**
**Director,**
**Division of Planning, Evaluation and Research**
**Alan Trachtenberg, MD, MPH**
**NARCH Project Officer,**
**IHS Human Research Protections Administrator**
**Teresa Sappier, MA**
**Program Management Analyst**