NARA NW CRCT 2025 - The Native American Rehabilitation Association of the Northwest Inc. (NARA NW) is a Federally Qualified Health Center (FQHC) and an urban Indian organization required by federal statute (25 USC 1651- 1653) to provide access to health care services to American Indians/Alaskan Natives living in urban areas. With over 20 years of experience with chronic disease programming, NARA NW has established multi-disciplinary teams that provide cardiovascular screening, breast and cervical cancer early detection and prevention, colorectal cancer screening, and diabetes treatment and prevention. Through the “Changing Health Systems Using Evidence-based Interventions (EBIs) to Increase Colorectal Cancer Screening” cooperative agreement, NARA NW will expand its existing high-quality NBCCEDP health system partnerships to assist Tribal Health Systems address colorectal cancer (CRC) as well as breast and cervical cancer. American Indians and Alaska Natives face a higher incidence of colorectal cancer, higher mortality rate and have significantly lower screening rates compared to the general population. Although data is limited, colorectal cancer screening rates reported by Indian Health Care Providers (IHCPs) in the Portland Indian Health Service, which includes Oregon, Washington and Idaho, were 17.9% in 2022 and 17.3% in 2023, compared to 72.3% for the national population. In response to these low CRC screening rates, NARA NW will partner with Tribal Health Systems and provide EBI technical assistance to increase colorectal cancer screening among AI/AN people, and any under/uninsured people in our service area. Within our first year of funding, we will achieve the following outcomes among IHCPs: (1) Increased CRC EBI implementation at Health System Partners, (2) Increased CRC screening completion, and (3) Increased CRC Screening Rates. During Year 1, we will partner with the NARA NW Health System and the Cowlitz Indian Tribe Health System, which currently have a 37% screening rate and 28% screening rate, respectively. The NARA NW Colorectal Cancer Team (CRCT) will support the implementation of EBIs—including Patient Navigation, Patient Reminders, Provider Reminders and Feedback, and Reducing Structural Barriers—and assist with enhancing and integrating electronic health records to increase screenings. During Years 2-5, we will analyze population health, surveillance, and other pertinent data to expand our partnerships and include additional Tribal Health Systems with low CRC screening prevalence. By the end of our project period, we will achieve: (A) Increased CRC’s prevented (pre-cancerous), and (B) Increased diagnosis of early stage CRC. Throughout this project, we will implement activities alongside our supporting partners, who each bring additional skills and services to increase CRC screening among our health system partners. Our supporting partners include Kaiser Permanente Center for Healthcare Research, Northwest Portland Area Indian Health Board, Native Journey Woman, American Indian Cancer Foundation, and the Oregon Health Authority Oregon CRC Collaborative.
