Northwest Portland Area Indian Health Board (BOLD Implementation, Component 2) - For many years, American Indian and Alaska Native (AI/AN) people have experienced health disparities that have increased morbidity and mortality from various chronic diseases. These disparities contribute to the reduced quality and longevity of life. Older AI/AN adults and aging communities have a disproportion burden of many established modifiable risk factors for Alzheimer’s Disease and Related Dementias (ADRD), including diabetes, obesity, depression, tobacco use, binge drinking, hearing loss, hypertension, lack of physical activity, and traumatic brain injuries. ADRD is underdiagnosed in Indian country; only 31% of AI/ANs aged 65 and older who experience memory loss have talked about this issue with their healthcare provider. This Component 2 proposal focuses primarily on the implementation of the Northwest Portland Area Indian Health Board (NPAIHB)’s Northwest Tribal Elders Project (NTEP)/Building Our Largest Dementia (BOLD) project’s strategic plan to address and improve Northwest tribal communities’ responses to ADRD in their communities and jurisdictions. Our project proposes three areas: 1) NTEP-BOLD will continue to build on current BOLD capacity and community development throughout our regional jurisdiction, within our 43 member tribes’ elder and other tribal programs supporting older adults and to address ADRD among Indian Health Service (IHS) and Tribal and Urban Indian Clinics (I/T/U); 2) NTEP-BOLD will increase awareness and understanding among our tribal health programs, tribal health providers, tribal leaders, communities, and caregivers of elders experiencing memory loss, cognitive decline and dementias by providing technical assistance, training, and systems change interventions; 3) NTEP will provide additional practical ADRD resources to our member tribes, as well as to the public, in collaboration with regional state healthcare agencies, Alzheimer’s Association chapters, academic partners, and other stakeholders and subject matter experts, through our Tribal Advisory Committee (TAC) to promote prevention and intervention priorities, including screenings and assessments, and education and awareness of ADRD through cross-sector partnerships and tribal policy development. NTEP will implement cultural and traditional teachings and practices that have been shared and taught by Northwest tribes through the capacity building phase. This will ensure that services are designed and accessible through culturally-tailored services that honor traditional ways of living and are being practiced when patients are accessing healthcare. The intended impact of the NTEP-BOLD project is to implement the BOLD project Strategic Plan to address ADRD strategic planning, increase inclusion of primary, secondary, and tertiary prevention in program planning and priority setting, and increase the inclusion of the use of data, including BRFSS, among I/T/U to inform public health priorities and actions articulated in the NPAIHB, NTEP-BOLD strategic plan.
