Improving Cancer Outcomes In Native American Communities (ICON)

OVERALL COMPONENT: PROJECT SUMMARY American Indian and Alaska Native (AI/AN) communities experience cancer incidence and mortality rates that are strikingly worse than those of the overall US population. In Oklahoma, which has the second highest population of AI/AN persons in the US and is the home to 39 Tribal Nations, the overall cancer incidence among the AI/AN population is 36% higher and cancer mortality 73% higher than the US general population. To reduce the major impact cancer has in the lives of AI/AN persons in Oklahoma and beyond, the Native American Center for Cancer Health Equity (NACCHE) at Stephenson Cancer Center (SCC) seeks to establish the Improving Cancer Outcomes in Native American Communities (ICON) U19 Center. ICON includes Indigenous investigators and community partners across all elements of the grant to support bidirectional, meaningful, generalizable, and tribally-engaged research studies. NACCHE in close consultation with its Tribal Advisory Council (TAC) has conducted an ongoing needs assessment of AI/AN community member perceptions of cancer research priorities that has identified three leading priorities for AIAN cancer research – prevention, screening, and care coordination. Thus, ICON is forwarding research projects that address each priority area. Water for Health: Strengthening Tribal Action for Cancer Prevention proposes a comprehensive drinking water exposure assessment for arsenic/uranium, followed by developing intervention plans with Tribes to reduce these exposures. Lung Cancer Screening to Improve Equity in Tribal Communities in Oklahoma extends and refines our community-engaged clinical trial implementing a multi-faceted lung cancer screening (LCS) program (R01CA225439) to the nation's largest tribal health system. Care Coordination and Communication Program in Oncology for Tribal Health Systems will enhance cancer care coordination between SCC and referring Indian Health Service, Tribal, and urban Indian (ITU) facilities, and features a novel collaborative care intervention centered on telehealth “Huddles” that jointly involve the patient's healthcare teams at SCC and the ITU facility. ICON's Overall Component specific aims include: (1) To provide administrative infrastructure, guided by the TAC, that will ensure the successful execution of ICON research projects and career enhancement activities in ways that foster genuine tribal partnerships; (2) To engage Tribal Nations and related organizations in ICON to enhance and sustain our long-term, trust-based relationships to address cancer-related concerns; (3) To conduct tribally engaged research to improve cancer outcomes in culturally respectful and practical ways among AI/AN persons living in Oklahoma and beyond; and (4) To monitor and assess progress of ICON performance to ensure successful completion of each project component.