Great Plains Tribal Disease Intervention Training Center (GP-TDITC) - Since 2020, the Great Plains Area (GPA) states of Iowa, Nebraska, North Dakota, and South Dakota have seen increased rates of syphilis and congenital syphilis and a disproportionate increase in reported cases among the AI/AN population. According to a report produced by the Centers for Disease Control and Prevention (CDC) in response to an Epi Aid request by GPTLHB, between 2020 to 2022, AI/AN syphilis rates increased 6,800% (3 to 204/100,000 persons) in Iowa, 845% (33 to 279/100,000 persons) in Nebraska, 100% (32 to 66/100,000) in North Dakota, and 2,245% in South Dakota (71 to 1,665/100,000 persons). According to that same report, AI/ANs had the highest rate of increase in syphilis rates in every GPA state, widening the disparities in rates between AI/ANs and non-Hispanic whites. For example, in South Dakota, AI/ANs experienced 1,635 more syphilis cases per 100,000 persons than non-Hispanic whites in 2022. Though Tribes have established their public health departments in the face of emergent adversity, they face a continued lack of comparative resources held by their state partners. The limited resources available to tribal public health departments result in workforce shortages and antiquated data management systems, which hinder both tribal and non-tribal public health departments' response to public health threats. Beyond the current syphilis epidemic, Tribes in the GPA do not have the public health capacity to perform essential public health functions like general disease intervention services. Instead, they must rely on state or local health departments to provide these services. But, as the syphilis epidemic has illustrated, these current systems are insufficient to meet tribal public health needs. GPTLHB is long familiar with the challenges and strengths related to tribal public health capacity in the region. Founded in 1986, GPTLHB is a formal representative board of the seventeen tribal nations and one service unit in the GPA. The mission of GPTLHB, a 501(c)(3) community-based tribal entity, is to work with tribal communities and provide quality public health support and healthcare advocacy to improve the health status and eradicate health disparities among the region's tribal members. The vision of the GPTLHB is for all tribal nations and communities to reach optimum health and wellness through lasting partnerships and culturally significant values empowered by tribal sovereignty. GPTEC is one of six departments within GPTLHB and one of 12 congressionally mandated public health authorities that provide public health services and support to Tribes. Founded in 2003, GPTEC provides and builds capacity within a wide variety of epidemiological and technical assistance services as a core component of GPTLHB. The proposed Great Plains – Tribal Disease Intervention Training Center (GP-TDITC) aims to increase the tribal public health workforce's capacity to investigate, diagnose, and address health problems impacting tribal communities in alignment with EPHS 8 (build and support a diverse and skilled public health workforce). To reach this objective, program staff will develop a tribally focused, culturally responsive disease intervention specialist (DIS) certification training program. GP-TDITC’s training program will comprise virtual and in-person components, with educational modules designed for teaching evidence-based best practices and cultural sensitivity in the diagnosis and treatment of sexually transmitted infections (STIs), such as syphilis. By focusing on both the education and training materials, as well as the training audience, GP-TDITC will further develop a culturally competent public health workforce that practices cultural humility, supports a range of public health competencies, and reflects tribal communities across the GPA.
