CANOE Partnership: Cancer Awareness, Navigation, Outreach, and Equitable Indigenous Health Outcomes

PROJECT SUMMARY/ABSTRACT The CANOE Partnership: Cancer Awareness, Navigation, Outreach, and Equitable Indigenous Health Outcomes U19 Cooperative Agreement is proposed in response to the need to improve cancer outcomes for American Indian and Alaska Native (AI/AN) communities nationally, with an emphasis on the Washington State

(WA) catchment area of the Fred Hutch/University of Washington/Seattle Children’s Cancer Consortium, a National Cancer Institute (NCI) designated Comprehensive Cancer Center. The proposed work builds on the Consortium’s substantial community engagement with Tribes and Tribal Organizations over the past 22-years,

beginning with the Spirit of EAGLES Special Population Network in 2002, up to and including an ongoing R01 “ Digital smoking cessation intervention for nationally-recruited American Indians and Alaska Natives: A full-scale randomized controlled trial ” (R01CA284687; PI: Bricker) Disparities in cancer outcomes for the AI/AN population

are due to multiple social determinants. Three major sources of these disparities, amenable to intervention, are: 1) behaviors to reduce cancer risk (e.g., smoking cessation), 2) access to appropriate screening by way of imaging technologies (e.g., appropriate application of chest computed tomography and mammography) and

colorectal cancer (CRC) screening procedures such as fecal immunochemical test (FIT), and colonoscopy; and 3) primary prevention. We propose a multidimensional approach to addressing these sources of disparate cancer outcomes in partnership with our Tribal and community collaborators at the South Puget Intertribal Planning

Agency (representing the Chehalis, Nisqually, Skokomish, Shoalwater Bay, and Squaxin Island Tribes) and the Black Hills Center for American Indian Health (Rapid City, SD). Together, we will use community based participatory research (CBPR) approaches and the Indigenous Cancer Health Equity Initiative Model to

empower and engage Tribes and Tribal organizations through our three research projects. Our Overall Specific Aims are: 1) Improve rates of cessation of commercial tobacco smoking among a nationally recruited sample of AI/AN adults (Research Project 1); 2) Improve rates of lung, colorectal, and breast cancer screenings among our

Tribal partner populations in the Consortium’s catchment area (Research Projects 2 & 3); 3)Prepare the next generation of researchers in Indigenous cancer equity and provide them with resources to obtain preliminary data to inform future cancer equity research in Indian Country (Pilot Grant Program); and 4) Develop

infrastructure to support equitable engagement of Tribal partners and Indigenous Frameworks in cancer research. (Administrative and Community Engagement Cores). The overall public health impact of the proposed work will be high, given the focus on smoking cessation, cancer screenings and vaccinations that altogether will

prevent and control cancers that are highly prevalent and are responsible for a large share of disparate mortality rates among Indigenous populations. The public health impact of this work will be high, given its focus on modifiable behaviors and on future generations of Indigenous Cancer Health Equity researchers.