Dedra Buchwald, M.D., UW professor of medicine in the Division of General Internal Medicine, remembers an early meeting of the ITHS, where members discussed potential partners for community-based research. There were many choices, she says, given the enormous breadth of WWAMI — roughly one-quarter of the American landmass.
Buchwald, who has worked with American Indian and Alaskan Native communities for more than 20 years, suggested that the ITHS focus on those groups. Given a broad range of challenges and special circumstances, including poverty, poor health literacy, limited educational opportunities, widely dispersed populations, and the need to respect tribal sovereignty, American Indian and Alaskan Native communities suffer from major health disparities.
“If we can make a difference with this population,” argued Buchwald, “we can make a change for the better in almost any population.” Her colleagues agreed, and the American Indian/Alaska Native Community Outreach & Research Translation Core was launched.
Buchwald mentions the success of one ITHS-funded project that focuses on the use of graphic materials to increase health literacy in Native populations. She is developing other projects as well; some are funded by the ITHS, while others are funded by major grantors concerned with issues such as cardiovascular disease, cancer and hepatitis C in Native populations.
Buchwald notes, however, that there’s a challenge in conducting research with tribal communities or other small populations prevalent in WWAMI: numbers. How do you maintain the anonymity of a 90-year-old study participant if, for instance, there are only a handful of 90-year-olds in a tribe?
One answer may be partnering with other tribes to increase the numbers of study participants. Another is conducting qualitative research instead of quantitative. Buchwald hopes the year ahead — with the help of grants from the ITHS and the National Cancer Institute — will provide some answers.