Grantee Research Project Results
Final Report: Central Plains Center for American Indian Health Disparities (CPC-AIHD) Revision
EPA Grant Number: NIMHD003Title: Central Plains Center for American Indian Health Disparities (CPC-AIHD) Revision
Investigators: Daley, Christine Makosky , Greiner, K. Allen , Choi, Won S , Gajewski, Byron , Barnes, Charles , Kennedy, Kevin
Institution: University of Kansas Medical Center
EPA Project Officer: Hahn, Intaek
Project Period: August 1, 2011 through July 31, 2014
Project Amount: $791,461
RFA: Transdisciplinary Networks of Excellence on the Environment and Health Disparities (2012) RFA Text | Recipients Lists
Research Category: Environmental Justice , Human Health
Objective:
- To create an Environmental Health Subcore in the Center for American Indian Community Health (CAICH) Community Engagement Core to support current and future research projects.
- To provide opportunities for research positions for M.P.H. students in our environmental health track and undergraduate students majoring in environmental science.
- To provide healthy homes assessments to AI community members.
- To provide environmental health education to AI community members, facilities/building managers, and providers.
- To expand our research project examining tribal college students’ tobacco use to include exposure to environmental tobacco smoke (ETS) and tobacco marketing and availability of tobacco products.
- To understand tribal college students’ exposure to environmental tobacco smoke (ETS) and marketing of recreational tobacco products.
- To identify locations where tribal college students purchase recreational tobacco products through Geographic Information Systems (GIS) mapping.
Summary/Accomplishments (Outputs/Outcomes):
Specific Aim 1: An Environmental Health Subcore, GreeNation, has been established in the CAICH at the University of Kansas Medical Center (KUMC), formerly known as the Central Plains Center for American Indian Health Disparities. The Subcore is directed by Dr. Christine Daley, one of the Principal Investigators on the grant; it is coordinated by Joseph Pacheco, M.P.H., our first graduate in the newly established Environmental Track in the KUMC Master in Public Health program and one of our original trainees for GreeNation. GreeNation has provided educational opportunities for M.P.H. students and undergraduate students at both Haskell Indian Nations University and the University of Kansas. Two of our M.P.H. students have completed their degree programs, including Joseph Pacheco, who focused on male breast cancer and exposure to environmental estrogens, and Tara Hammer (also a Haskell graduate), who focused on female breast cancer incidence and atrazine exposure on a reservation. Joe’s work has led to the development of a culturally appropriate brochure about male breast cancer and environmental exposures and an accompanying website, which is currently being revised to be uploaded onto our GreeNation site. Both the brochure and the website will be available this fall. In Tara’s project, samples taken from water, soil, and air on the reservation were analyzed through our partners at the Children’s Mercy Hospital and our Healthy Homes program. High levels of atrazine were found, particularly in the water, and this has been reported to the Tribal Council, who are currently in the process of bringing it to the attention of their water treatment plant to fix the problem. Two additional students will be completing their degrees this year. Over 20 undergraduate students have participated in GreeNation through both our research team and our summer internship program, assisting with all of the activities described.
Our Environmental Health M.P.H. students provide Healthy Homes assessments to American Indian community members who both own and rent their homes. These assessments are done according to the EPA Healthy Homes guidelines and examine safety and exposure issues; our students have been fully trained in these assessments through Region 7 and the Children’s Mercy Hospital (our subcontract on this project). At the request of community members, we have broadened our scope of assessments to include tribal facilities and schools on multiple reservations in two states. Analyses of samples collected in the homes and facilities are done by the Children’s Mercy Hospital. Some of our students have assisted in sample analyses. We have provided over 50 home and facilities assessments and continue to provide them as requested by community members. We have identified problems in over half of the homes/facilities assessed, many of which have required simple solutions by home owners/renters. If larger problems are found, we help people into programs that assist with the cost of renovations or other solutions.
We have provided environmental health education focusing on healthy homes to nearly 300 American Indian community members and 30 facilities maintenance workers. In addition, through our partners at the Children’s Mercy Hospital, we have provided 30 providers with education about treating children with asthma and providing education about their home environment to them and their parents.
Specific Aim 2: There are two primary components to this specific aim, including a large cross-sectional survey of tribal college students and GIS mapping. Through one of our research projects, we are surveying over 1,200 tribal college students at three colleges in two states through a longitudinal survey focused on tobacco use and other health behaviors. We have added a series of questions focused on exposure to environmental tobacco smoke, tobacco marketing, and tobacco products. We are currently approximately half-way through recruitment for that project with over 600 students recruited. Because these questions have been added to a larger ongoing study as a part of the parent Center grant, analyses are not yet available.
We have conducted a GIS mapping project, largely through our students, looking at the availability of tobacco products and tobacco marketing in Lawrence, KS, which has two colleges (the University of Kansas and Haskell Indian Nations University). Our students have mapped locations where tobacco is available for purchase and have examined the marketing that accompanies tobacco products. In addition, they have broadened the project to include other built environment assessments to examine health behaviors that are often related to tobacco use, including healthy eating and activities. Assessments included supermarkets, restaurants, and other food outlets, locations where alcohol can be purchased, and locations for physical activity (e.g., parks and other recreational facilities, gyms, etc.). Bus routes are also mapped. We have conducted mapping activities during each of the four seasons of the year to account for seasonality of produce availability and price, as well as seasonal variation in physical activity locations. Preliminary analyses show, not unexpectedly, that students at the University of Kansas have a wider range of options for healthy foods and activities. Tobacco products are widely available throughout the city and there is significant marketing to which college students are exposed. Our students are in the process of taking the data from this project and creating reports designed for the college and students to see the variety of options available in town and on bus routes for healthy eating and activities. These data will be combined with data from the larger parent study for a comprehensive understanding of tribal college students’ built environment and health behaviors.
Conclusions:
Because our activities are part of a larger grant, much of our work will continue though this grant period is complete. Because we have trained multiple students in healthy home assessments and education for community members and facilities personnel and have been able to purchase all of the necessary equipment, we will continue these activities as a service to the community. We are able to provide students with course credit. Our ongoing work with the Children’s Mercy Hospital allows us to continue to use their lab space and services for analyzing samples. This project has allowed us to build our community service activities greatly, as well as opportunities for our students. These will not go away as funding ends.
Our research activities are ongoing as a part of our larger Center grant. We will continue to collect our survey data over the next 2 years and, at project completion, will have longitudinal data from tribal college students detailing tobacco use and exposure, as well as marketing, combined with significant data on other health behaviors and built environment. These data will provide insight on potential policy and behavioral interventions for college students on multiple health outcomes.
Journal Articles:
No journal articles submitted with this report: View all 4 publications for this projectSupplemental Keywords:
Native American, home safety, community-based participatory research, central plains, health disparities;Relevant Websites:
http://www.caich.org/greenation/ ExitProgress and Final Reports:
Original AbstractThe perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Conclusions drawn by the principal investigators have not been reviewed by the Agency.