DESCRIPTION (provided by applicant): Obesity and diabetes, among other related illnesses, affect American Indians disproportionately. Often it's the built environment of the areas in which American Indians live that contributes to this problem. While these issues are important topics of research, too often American Indian communities feel that outside researchers come in to evaluate the situation but do not stay to improve it. Further, they feel that they have little control over this process, which in turn, limits their interest in participating in research or even learning about it. Our objectives are to enhance the ability of several American Indian communities in Northern California to direct the type of research that might be carried out among them to improve their health. Specific aims include: 1. Training community research associates (CRAs), community leaders serving as the liaison between their communities and the academic researchers who will respond to the wishes of the community in terms of relevance for health and who will enhance community support of the projects chosen. 2. Train CRAs and community members in the use of Community Based Participatory Research (CBPR) to allow the communities to determine and rank their research priorities according to anticipation of improved health results. 3. Train CRAs and community members in the development of surveys and other data collection techniques to allow future research into the effects of the built environment on community health in order to improve it. 4. Enhance and extend the existing telecommunications network established between UCDMC and the communities over seven years ago to enable education and collaboration between UCDavis and community based and clinically based endeavors for the benefit of the community. 5. Develop the Nor-Cal Tribal Institutional Review Board, to review and determine the relevance of research projects which are identified by and include northern California Indian communities. This process will be bi-directional with communities having a strong voice in the process and direction of future studies developed to improve their health. With a cadre of trained personnel in these communities, sustainability of future research will be likely, as social scientists and health researchers will find not only a rich environment for studies on the built environment but a welcoming environment in which members understand how important such research is for their own health. Such future studies will provide important sources of health information. We expect that the results of such an interaction be far-reaching and affect other American Indian communities and the general population impacted by obesity and comorbidities.
PUBLIC HEALTH RELEVANCE: The obesity epidemic and resulting illnesses affect American Indian communities disproportionately; proven public health measure to improve the built environment that encourages unhealthy dietary habits and activity levels can have great and far ranging impact. Our project aims to empower the community to determine the course of health research carried out among them by teaching them the rationale and methods of community- based research and to develop an institutional review board composed of community members who will establish the level of safety and appropriateness of future health research that may occur in their communities. This will be accomplished by enhancing the long term academic/community partnership that we developed over more than five years and by expanding our telehealth network which we have used to great advantage with our community partners to develop programs that improve their health.