Several chronic pain conditions are more prevalent among American Indians/Alaska Natives (AI/ANs) than any other group in the United States. AI/ANs have higher rates of nonmedical prescription drug use, including opioids, and higher rates of accidental overdose than do whites, and suicide risk is nearly doubled among people living with chronic pain. Few culturally appropriate alternatives to opioid therapy are available to AI/ANs in northern Arizona, where 91 percent of residents live in rural, medically underserved areas on or near the lands of 11 federally recognized tribes.
The proposed project will build on existing partnerships to engage local, regional, and national stakeholders in taking culturally informed and evidence-based first steps toward addressing this health disparity.
Months 1–3: Invite stakeholders to join the new coalition (INSPiRE); establish a Community Advisory Board (CAB); and design a series of research skill–building and knowledge exchange workshops determined by CAB members’ interests and priorities.
Months 4–6: Implement the first workshops; conduct literature searches and key informant interviews nationwide to investigate the current state of evidence for nonpharmacologic chronic pain therapies that have been or could be successfully integrated with native healing beliefs and practices.
Months 7–10: Review evidence-based approaches with the CAB and in community forums; negotiate comparative effectiveness research questions and patient-centered approaches with the greatest potential to address stakeholders’ interests.
Months 11–12: Invite local and national stakeholders to participate in a mini-conference to discuss evidence and cultural perspectives and to provide input into a Tier B proposal. A draft collaborative research agenda is one anticipated outcome of this effort.