California Tribal Comprehensive Cancer Control Program - The California Rural Indian Health Board, Inc. (CRIHB) proposes implementing the second five-year iteration of the California Tribal Comprehensive Cancer Control Program (CTCCCP) to enhance prevention and management strategies intended to combat and reduce the prevalence of cancer in California Tribal communities. The CTCCCP aims to assist rural Tribal Health Programs (THP) spanning the state of California in preventing and controlling cancer within their communities to improve health outcomes, strengthen collaborative partnerships, and implement a comprehensive and coordinated California Cancer Control Plan. The goal is to decrease cancer incidence, morbidity, and mortality in Tribal communities. The CTCCCP will focus on underserved populations with increased cancer risk due to health disparities. CTCCCP will leverage its multi-sectoral CTCCCP Coalition, hereafter referred to as the Coalition, and two subcommittees to enhance partnerships with other local, community, and government organizations to improve the use of scarce resources and increase collaborations among organizations involved with American Indian Alaska Native (AIANs) and cancer programs. This will be accomplished by continuing and establishing new collaborative partnerships with 20 subawardees, the Coalition members, other state cancer programs, and local,state, and national stakeholders. Through the 20 subawards, CRIHB will assist up to 63 Tribes and their THPs to develop, plan, implement, and evaluate projects that focus on the five National Comprehensive Cancer Control Program (NCCCP) grant strategies to meet the short, intermediate, and long-term objectives. THPs and Coalition members will aim to improve equitable access to cancer care through primary prevention, early screening and detection, and the promotion of cancer survivorship care services in primary health care settings. CRIHB will implement and evaluate the progress of the evidence-based strategies over five years. The aim is to assess the interventions' impact to decrease the mortality, incidence, and risk of the top five cancers, including determinants to reduce breast cancer, prostate cancer, and liver cancer. Additionally, it aims to determine the impact of interventions in increasing human papillomavirus vaccination rates among AIAN youth, decreasing alcohol intake, and increasing cancer survivorship service delivery among rural AIANs. CTCCCP has developed an evaluation and performance measurement plan that will be essential in tracking progress and measuring outputs and outcomes at the overall program and site-specific levels. The evaluation will assess the extent to which activities and strategies are successfully implemented, demonstrate whether actions led to expected outputs and the projected outcomes, and inform program planning, decision making, and continuous program quality improvement. Program partners and stakeholder feedback will be collected during the evaluation process to ensure their priorities are represented, evaluation results are maximized, and program recommendations are guided by their perspectives. The evaluation of this project will focus on four key areas 1) the NCCCP Work plan Implementation, 2) the NCCCP Interventions, 3) the California Cancer Control Plan, and 4) the Coalition. CRIHB will disseminate evaluation findings to all program partners and stakeholders annually and upon request.