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Advancing Indigenous Cancer Health Equity through a Community-Centered Framework

Award Number: K99MD018451
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP
PERIOD OF PERFORMANCE START DATE: 09/09/2024
PERIOD OF PERFORMANCE END DATE: 03/31/2026

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Advancing Indigenous Cancer Health Equity through a Community-Centered Framework - This application is a resubmission in response to the Funding Opportunity Announcement (FOA) identified as PAR-21-271. PROJECT SUMMARY In the US, cancer disproportionately affects many racial/ethnic minority communities, defining significant cancer health disparities (CHDs). Across all racial/ethnic groups, American Indians and Alaskan Natives (AIANs) experience one of the most substantial disparities with the highest comorbidity rates and lowest 5-year survival rates for all major cancer types. CHDs are driven by a combination of biological and social determinants of health, but actionable knowledge of both elements remains severely limited for AIANs. In this K99 proposal, I will address two critical problems that have perpetuated CHDs among American Indians/Alaskan Natives (AIANs): underrepresentation in precision medicine that limits discovery translation and race-level trends for outcomes and SDOH that conceal community diversity critical to effective implementation. Neither issue can be successfully addressed without the involvement and voices of Native communities, who have long been subjected to extractive research practices with little to no return on community health. This proposal centers Native communities living within the UCD Comprehensive Cancer Center catchment area (UCDCCC-CA) in a community-based participatory research (CBPR) framework to develop guidelines for appropriate Native community engagement for biomedical research while assessing community-level biological and social determinants of cancer health and care access. In Aim 1, I will utilize whole exome sequencing data from 300 Hispanic/Latino (HL) gastric cancer samples to identify somatic alterations that are associated with Indigenous American (IA) genetic ancestry at both global and local ancestry levels. These may be applicable to AIANs who also share high IA ancestry. Associated loci will be functionally validated in HL patient-derived organoid models in the R00 phase. In Aim 2, I will administer a validated survey and conducted focus groups interviews to identify key factors that contribute to individual decision-making for participation and biospecimen donation in cancer research among AIANs. In the R00 phase, I will work with UCDCCC-CA Native community stakeholders and my Native community advisory board to translate these findings into Native community engagement guidelines for research. In Aim 3, I will utilize cancer risk and health behavior data from the Aim 2 survey and cancer outcomes and sociodemographic data from the California Cancer Registry to elucidate community-level social determinant of health that drive UCDCCC-CA Native community cancer outcomes. In the R00 phase, I will use these findings to identify areas of intervention in collaboration with community and Native-focused health clinic partners to improve Native community cancer health. This proposal fulfills the mission of the National Institute for Minority Health and Health Disparities to understand and reduce health disparities. The results of this proposal will increase understanding of biological vulnerabilities and social determinants of health that lead to greater cancer incidence and mortality among AIANs, while creating the infrastructure to ethically engage Native communities and increase their participation in cancer research.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $150,648 )
2025	2025	UNIVERSITY OF CALIFORNIA, DAVIS	1850 RESEARCH PARK DR STE 300	DAVIS	CA	95618	YOLO	USA	Minority Health and Health Disparities Research	004	2	7/8/2025	NON-COMPETING CONTINUATION	$150,648
2025	2024	UNIVERSITY OF CALIFORNIA, DAVIS	1850 RESEARCH PARK DR STE 300	DAVIS	CA	95618	YOLO	USA	Minority Health and Health Disparities Research	002	1	4/29/2025	NEW	$0
2025	2024	UNIVERSITY OF CALIFORNIA, DAVIS	1850 RESEARCH PARK DR STE 300	DAVIS	CA	95618	YOLO	USA	Minority Health and Health Disparities Research	003	1	6/30/2025	NEW	$0
2025	2024	UNIVERSITY OF CALIFORNIA, DAVIS	1850 RESEARCH PARK DR STE 300	DAVIS	CA	95618	YOLO	USA	Minority Health and Health Disparities Research	001	1	3/18/2025	NEW	$0
2025	2024	UNIVERSITY OF CALIFORNIA, DAVIS	1850 RESEARCH PARK DR STE 300	DAVIS	CA	95618	YOLO	USA	Minority Health and Health Disparities Research	000	1	11/29/2024	NEW	$0
														Subtotal = $150,648

Issue Date FY: 2024 ( Subtotal = $150,648 )
2024	2024	UNIVERSITY OF CALIFORNIA, DAVIS	1850 RESEARCH PARK DR STE 300	DAVIS	CA	95618	YOLO	USA	Minority Health and Health Disparities Research	000	1	9/9/2024	NEW	$150,648
														Subtotal = $150,648

Grand Total All Awards = $301,296

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Advancing Indigenous Cancer Health Equity through a Community-Centered Framework

Award Number: K99MD018451

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: TRAINING/TRAINEESHIP

PERIOD OF PERFORMANCE START DATE: 09/09/2024

PERIOD OF PERFORMANCE END DATE: 03/31/2026

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