Background: American Indians (AI) have some of the poorest health outcomes of any group in the United States and are among the least represented in research. The project team has learned from its community partners that historical trauma and mistrust of the medical system and scientific community are two of the main causes for these disparities. Community research training programs have reduced mistrust and encouraged research participation; however, no such program for AI exists.

Proposed Solution to the Problem: The project team proposes development of a one-year training program for AI community members on the importance of participating in research, community-based participatory research (CBPR) methods, ethical conduct of research, and grant writing.

Objectives: The long-term objective of this program is the formation of an ongoing national training program for American Indians who wish to be a part of CBPR teams. It will lead to better-informed tribal members who can lead research in their communities in an ethical and responsible way, thus bringing more AI communities into research and decreasing health disparities. The specific aims of this project are: to create the American Indian Health Research & Education Alliance (AIHREA) Native Research Ambassador Program (N-RAP) together with a project-specific community advisory board during the first six months of the project period; to pilot test N-RAP with an initial cohort of 20 AI community members over a one-year period; to evaluate N-RAP for feasibility, acceptability, and cultural appropriateness; to create a sustainability plan for N-RAP; and to disseminate the results to both scientific and lay communities.

Activities: In the first six months of the project, the program timeline and curriculum, evaluation surveys, and selection of teachers will be completed. Participants will be selected by the end of month 6. The pilot program will run from months 7 through 18. All data collected during the pilot will be cleaned and analyzed by the end of month 22. Results will then be presented to participants, stakeholders, community members, and scientific audiences. A sustainability plan will then be prepared.

Outcomes/Outputs: The most significant outcome of this project is the training of 20 Native Research Ambassadors. These individuals will be able to collaborate effectively with researchers, advocate for research participation in their communities, and spearhead research efforts on behalf of their communities. Ultimately, the N-RAP will become a sustained program that trains AI in research and brings more community engagement to the research process.

Patient and Stakeholder Engagement Plan: All work by AIHREA and its partners is done using CBPR. The N-RAP will not be an exception to this rule. The project involves community members in four primary ways: as primary members of the paid research team; as paid members of the community advisory board; as participants in N-RAP; and as constituents to whom interim and final results are disseminated.

Project Collaborators: AIHREA is a CBPR alliance of educational institutions, community organizations, and tribes focused on improving the health and well-being of AI communities using quality participatory research and education. This application is submitted by the Center for American Indian Community Health at the University of Kansas Medical Center, one of the founding partners of AIHREA, and is led by the founding director of both the center and AIHREA.