Researchers receive $1M grant to train Native American communities improve their health

UC Davis School of Medicine researchers will train Native American communities in Northern California to develop and implement culturally appropriate interventions to improve their health by decreasing obesity and type-2 diabetes, through a $1 million research grant from the National Institute of Diabetes and Kidney Diseases of the National Institutes of Health.

The communities include the Round Valley Indian Tribes of Covelo, Calif., Mendocino County, and communities served by Northern Valley Indian Health, Inc., which include Glenn County and portions of Butte, Tehama and Colusa counties.

"This will be a unique situation in which university health researchers will collaborate with community members to teach them how to perform research on their own communities, to ensure that the research is culturally appropriate, acceptable and helpful," said Dennis Styne, study principal investigator and the Yocha Dehe Endowed Chair in Pediatric Endocrinology.

"Community members will collect data about their community's health habits to, for example, learn what kinds of healthy foods and exercise resources are most helpful, and select and design the most effective interventions," Styne said.

Over one-third of all American Indian adults nationwide are obese, compared with about 22 percent of non-Hispanic whites. Among the Native American communities participating in the study, nearly 68 percent of adults are obese and 24 percent of children between 2 and 5 years old have body mass indexes in the 95th percentile for their ages.

Obesity is associated with type-2 diabetes, which can result in heart and kidney disease, nerve damage and blindness and lead to premature death. The condition has been described as a "disease of disparity," disproportionately affecting low-income and ethnic minority populations. American Indians are 2.6 times as likely to be diagnosed with diabetes as non-Hispanic whites. Nationwide, the number of Native Americans diagnosed with diabetes doubled between 1991 and 2001. In the Round Valley and Northern Valley Native American communities, 11 percent are affected by type-2 diabetes.

"The Native American community is disproportionately affected by diabetes and heart disease, hypertension, lipid problems and other diseases of disparity," Styne said. "They are aware of the importance of the conditions and are committed to working to turn the tide."

Styne said that the two-year research initiative will train community members as research associates in the use of community-based and community-governed participatory research techniques, to ensure engagement in improving their health. The UC Davis researchers will work collaboratively with two established community-health centers that serve the Native American communities, the Round Valley Indian Health Center and Northern Valley Indian Health, Inc., with the full support of their boards of directors.

Partners at Round Valley will include Edward Whipple, outreach prevention coordinator at Round Valley Unified School District, fitness and health instructor at Mendocino Community College and an enrolled member of the Round Valley tribe; and Diann Simmons, a consultant with the Round Valley Sustainability Program. At Northern Valley Indian Health, UC Davis will partner with Vicki Shively, a nurse and member of the Choctaw Nation who has served for seven years as the center's community health director.

The study's co-investigators will be: Valarie Blue Bird Jernigan, training director of community-based participatory research for the project and a member of the Choctow Nation who is a senior research fellow at the University of Washington and a visiting assistant researcher at UC Davis; Diana Cassady, associate professor of public health sciences, who will collaborate on evaluation of the FitKid and FitTeen programs in Round Valley schools; and Karen Jetter, assistant research economist at the Agricultural Issues Center at UC Davis, who will direct training in socioeconomic survey methods.

An important aspect of the research - and a longtime goal for Styne and his partners - is development of a Northern California Institutional Review Board, the Nor Cal Tribal Institutional Review Board, to review and approve research projects identified by these communities. This work will be supported by the UC Davis Health System Institutional Review Board. Another important feature of the partnership will be the use of telemedicine through the UC Davis Center for Health and Technology, which uses real-time video conferencing to provide education and group interaction as well as specialist and subspecialist consultation for patients and physicians in remote rural areas throughout the state. James Marcin, professor of pediatrics and director of the UC Davis Pediatric Telemedicine Program, will direct this work.

"Tribal communities across California have been involved in various studies for decades, but lack of involvement in the planning of studies and the transient presence of researchers often has led to distrust of health research among some members of the American Indian community," Styne said. The direct involvement of community members in the future research should help to overcome this tendency and foster improvement in their health, he said.

Styne's commitment to improving health for Northern California Native American communities stretches back more than 15 years, including seven years with the Round Valley and Northern Valley communities. He has helped Native American communities implement a variety of health-care intervention programs, including the Fit Kid and Fit Teen pediatric obesity programs developed for children at UC Davis and adapted for the Indian community.

"I realized long ago that childhood obesity was going to cause major problems for Native American communities and was able to discuss this with the Yocha Dehe Wintun Nation (previously known as the Rumsey Band of Wintun Indians)," Styne said. "They had the foresight to recognize how important this issue was for their community and started supporting our work with annual gifts and then with the endowment of the Yocha Dehe Endowed Chair in Pediatric Endocrinology to ensure its continuation long into the future."

Styne said the Fit Kid program has been introduced into the Round Valley school system and now is a part of science class in the 6th grade. "The community members have said that the programs that we have worked on together have definitely enhanced their quality of life and their health," he said.

Source: University of California - Davis - Health System