Abstract (1 Page)
The Lumbee tribe of North Carolina is a state-recognized tribe of approximately 60,000 enrolled
members, making it the largest American Indian tribe in the eastern United States and one of the largest
tribes in the nation. The tribal homeland for the Lumbee tribe is situated in Robeson County, a rural
county in southeastern North Carolina that ranks last among North Carolina’s 100 counties in health
outcomes and is adversely impacted by social determinants of health. For the past ten years, tribal
leadership has been working with universities and community agencies to better understand the health of
tribal members; but to date there has been no intentional effort to develop a comprehensive research
infrastructure. Data from the North Carolina Division of Health and Human Services Injury and Violence
Prevention Branch indicate that American Indians in North Carolina have the highest rates of substance
misuse deaths and emergency room visits of all the racial/ethnic groups in the state. North Carolina’s
American Indian population consists of eight recognized tribes, only one of which, the Eastern Band of
Cherokee Indians, is federally recognized with access to resources from the Indian Health Services. This
proposed 2-year planning initiative, led by the Lumbee Tribe, brings together an internationally
recognized community relief organization (CORE), a state agency focused on substance misuse
epidemiology and prevention (NC DHHS IVP) and five research organizations with national and
international reputation in community-based participatory research, substance misuse prevention research
and policy development and implementation (UNC DPOP, UNC IPRC, RTI, WFU, UNCP). Our overall
objective is to create the research infrastructure to develop and implement evidence-based, community-
informed and culturally-appropriate interventions to address the substance misuse epidemic in the
Lumbee tribe. Our team will draw on previous substance misuse programming in the Lumbee
community to respond to this epidemic, as well as prior efforts to understand the health challenges in
tribal communities, including the Native Pathways to Health and the State and Tribal Injury Data Sharing
Summit in 2019. Our Specific Aims include: (1) Development of a Substance Misuse Research and
Community Advisory Committees from representatives of the Lumbee community and from our five
research organizations, with the goal of developing community-driven action research strategies to
understand and address substance misuse; (2) Creation of a Lumbee Substance Misuse Data Dashboard
and Storyboard to understand the epidemiology of substance misuse and community impact of substance
misuse in the Lumbee tribe and identify key driving factors; (3) Formulation of a research training
protocol for Lumbee tribal members and ally representatives to evaluation evidence-based interventions
currently implemented in the community and programming needs; (4) Laying the groundwork for an
indigenous-informed cultural adaptation of an evidence-based pain management intervention to be pilot-
tested among Lumbee patients experiencing chronic pain. At the end of this funding, we anticipate being
well positioned to have a strong research infrastructure to understand and address substance misuse
disparities in the Lumbee community.