Pilot Project 1: A Partnership to Advance Liver Cancer Prevention with Pascua Yaqui Tribal Communities

American Indian Alaska Native (AIAN) communities experience high rates of liver cancer incidence and mortality. Common risk factors for liver cancer include having hepatitis B or hepatitis C, cirrhosis, excessive alcohol consumption, lack of physical activity, non-alcoholic fatty liver disease (NAFLD), and obesity. Notably, a high rate of obesity-related diseases is experienced by AIAN people in the U.S., making their health status a key public health issue. To address these challenging health outcomes, the interdisciplinary team and AIAN community partners will investigate strategies to improve liver cancer prevention. This high impact effort will advance research for liver cancer prevention in a high-risk group that carries a high liver cancer burden. The Specific Aims are to: 1) examine AIAN adults’ attitudes and beliefs of liver cancer health risk (e.g., lifestyle, diet, lived experiences, biological, environmental); 2) assess the prevalence and characterize risk factors for NAFLD, a known risk factor for liver cancer, in a sample of 150 adults recruited from AIAN clinics; and 3) determine the potential for the implementation and dissemination with reciprocity of an existing evidence-based lifestyle-based intervention (DPTP) tailored for NAFLD risk reduction in clinic-based settings. The study team’s efforts are centered in developing a sustainable research agenda for AIAN communities that fosters interdisciplinary, collaborative research, education, and outreach. This proposed study directly benefits the community by 1) creating representative scientific evidence that can inform health policy and clinical guidelines, 2) increasing access to health services (e.g., liver disease screening) that improve understanding of risk factors related to liver cancer, 3) building culturally relevant research capacity within AIAN communities that experience a high burden of obesity-related health outcomes, and 4) providing valuable research training to community members and early-career investigators. Further, this study will provide the interdisciplinary research team, led by Dr. David O. Garcia (Co-Leader/UA) and Dr. Priscilla R. Sanderson (Co-Leader/NAU), in partnership with Dr. Adalberto Renteria (Pascua Yaqui Medical Director; Co-I), with the preliminary data to develop an R01 proposal to test the effectiveness of a culturally and clinically relevant intervention. The goal is to reduce liver cancer health risks among AIAN adult men and women who are considered at high-risk.