Type 2 diabetes, cardiovascular disease (CVD), stroke and their associated risk factors exact a heightened toll on the American Indian/Alaska Native (AI/AN) population in the form of disproportionate morbidity/mortality, exorbitant medical costs, premature death, loss of productivity, and diminished quality of life. Over the past 2 decades, AI/ANs have not experienced the significant decline in chronic disease mortality rates witnessed among non-Hispanic Whites (NHWs). These alarming health trends led the Albuquerque Area Southwest Tribal Epidemiology Center’s (AASTEC) Executive Council, a representative body of tribal leaders and health directors, to designate chronic disease prevention and management as its top strategic priority for the period 2016-2021. Historical events such as dispossession of land and natural resources and unjust U.S. American Indian federal policies (i.e., genocide, extermination, assimilation, religious prohibition, relocation, termination, etc.) cannot be ignored as factors that have contributed to the disproportionate burden of chronic diseases experienced by AI/AN. In order to address the persistent and pervasive health disparities and injustices experienced by AI/ANs, strategies that are driven by tribal core values that are inclusive of tribal beliefs, systems, practices, identities, and histories must emerge and be led by tribes. The purpose of this 5-year Component 2 project is to reduce rates of death and disability from commercial tobacco use, diabetes, heart disease and stroke, and reduce the prevalence of obesity and other chronic disease risk factors and conditions (e.g., oral health, dementia, COPD) in the IHS Albuquerque Area. Specific strategies that will be employed to achieve the aforementioned outcomes include: 1) expand the implementation of Component 1 strategies and activities among IHS Albuquerque Area Tribes and urban Indian organizations; 2) provide technical assistance, training, and resource
s to all 27 Area Tribes and urban Indian organizations to support the planning, development, implementation, and evaluation of activities across all four C1 strategies; 3) assist Area Tribes and urban Indian organizations in developing multi-sector partnerships with organizations to support C1 strategies and activities throughout the region; and 4) work with Area Tribes and urban Indian organizations to develop and implement tailored health communication/messaging strategies to reach AI/AN populations at greatest risk for obesity, commercial tobacco use, type 2 diabetes, and/or heart disease and stroke to increase awareness and encourage healthier behaviors. In addition to training, technical assistance and evaluation support to all 27 Tribes, AASTEC will provide up to 14 tribal sub awards to implement local activities across the four Component 1 strategic areas, which include: 1) implement evidence-informed and culturally adapted policy, system, and environmental changes (PSE) to prevent obesity; 2) implement evidence-informed and culturally adapted policy, system, and environmental changes (PSE) to prevent and control commercial tobacco use; 3) implement evidence-informed and culturally adapted community-clinical linkages (CCL) to support type 2 diabetes prevention; and 4) implement evidence-informed and culturally adapted community-clinical linkages (CCL) to support heart disease and stroke prevention. The ultimate aim of this 5 year project is to build upon prior successes, lessons learned, and partnerships developed in AASTEC’s GHWIC 1.0 project (2014-2019) to reduce the burden of the chronic diseases and improve the health and wellness of AI/AN persons throughout our region.