Northwest Tribal Comprehensive Cancer Control Program
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1 Northwest Tribal Comprehensive Cancer Control Program Kerri Lopez NTCCP History and Activities Institute of Medicine 2012 Northwest Portland Area Indian Health Board Indian Leadership for Indian Health Northwest Portland Area Indian Health Board 1
2 NPAIHB Organization Chart Northwest Portland Area Indian Health Board Executive Committee Members NPAIHB Joe Finkbonner, Executive Director Northwest Tribal Epidemology Center Victoria Warren-Mears Director WTDP & NTCCP Kerri Lopez, Director Northwest Diabetes Project NTCCP & WHPP National Diabetes Project
3 Northwest Portland Area Indian Health Board Founded in Federally Recognized Tribes in OR, WA, ID Mission: To assist Northwest tribes to improve the health status and quality of life of members tribes and Indian people in their delivery of culturally appropriate and holistic health care.
4 Northwest Tribal Comprehensive Cancer History 2000 Yakama offered tribe site for presidents panel NW hosted presidents cancer panel Yakama 2002 First tribal comprehensive cancer program funded First tribal cancer coalition 11/19/2012 Northwest Portland Area Indian Health Board 4
5 Northwest Tribal Comprehensive Cancer History Navigator Project Report Brfss tribes Repeat brfss 2012 Four tribes 11/19/2012 Northwest Portland Area Indian Health Board 5
6 Northwest Tribal Comprehensive Cancer Program NW Tribal Cancer Coalition Formed in 1998 Tribal Cancer Coalition meetings 100 participants 34 Tribes represented 11/19/2012 Northwest Portland Area Indian Health Board 6
7 Successes Coalition 3 meetings Clinical update Evaluation Trainings Clinicians update (pcp s) Risky Business Colorectal Cancer Training Tribal Mini Grants Community Implementation 2001 BRFSS 2011 BRFSS (4 tribes) Cancer 101 Curriculum NW Cancer Report CDC change tool summary report 11/19/2012 Northwest Portland Area Indian Health Board 7
8 Clinicians Cancer Update Clinical Cancer Update 35 participants (2012) CEU accreditation Topics: Colorectal Cancer RPMS/EHR Tools for follow up, tracking, screening and documentation Colorectal cancer screening survivorship AI/AN Cancer Policy Cancer patient education Characteristics Associated with Longevity Following Colorectal Cancer
9 Risky Business NPAIHB projects Tobacco, Diabetes, Cancer, STD s HIV, Suicide Prevention, Injury Prevention, Immunizations, MCH 3 trainings per year tribal participants 11/19/2012 Northwest Portland Area Indian Health Board 9
10 Take away - resources Tribal Tobacco Policy Workbook Cancer 101 and Resource guide DST and childhood obesity curriculums Injury Prevention AI/AN Toolkit STD/HIV advocacy toolkit CARS resources child safety seat 11/19/2012 Northwest Portland Area Indian Health Board 10
11 Activities at tribal sites Tribal site visits Cancer 101 Grant writing mini grants Development tribal action plan Participation in tribal prevention, screening and education activity Visits from Kiki Phone and technical assistance Dissemination of resource materials Cancer Minigrant $80K for 75 Tribal Cancer Activities ( )
12 Urban, Tribal, IHS Clinics on BCCP for Clinical Services = Chehalis Tribe = Coeur d'alene = Colville Tribe - Inchelium & Keller Clinics = Colville Tribe - Nespelem IHS = Confederated Tribes of Siletz = Confederated Tribes of Umatilla = Confederated Tribes of Warm Springs = Cowlitz Indian Tribe = Jamestown S Klallam Tribe = Kalispell Tribe = Klamath Tribes = Lummi Nation = NATIVE Project = Nez Perce Tribe = Nisqually Tribe* = Nooksack Tribe* = Puyallup Tribe = Quinault Nation* = Sauk Suiattle Tribe = Seattle Urban Indian Health Board = Shoalwater Bay Tribe* = Shoshone Bannock Tribal Health = Skokomish Tribe* = Snoqualmie Tribe = Spokane Tribe Wellpinit HIS = Squaxin Island Tribe* = Stillaguamish Tribe = Swinomish Tribe = Tulalip Tribes = Upper Skagit Tribe = Yakama Nation - Yakama IHS * Covered by SPIPA BCCP
13 Continued Tribal & IHS Clinics on BCCP for Outreach Suquamish Tribe Not covered by BCCP 12 Tribes Some don t have clinical services 11/19/2012 Northwest Portland Area Indian Health Board 13
14 Leading incidence cancer sites by sex and race in Idaho, Oregon, and Washington AmericanIndian /Alaska Native Non-Hispanic White Rank Male Female Male Female 1 Prostate (21.7%) Breast (27.4%) Prostate (28.8%) Breast (29.9%) 2 Lung & bronchus (14.8%) Lung & bronchus (14.6%) Lung & bronchus (13.7%) Lung & bronchus (14.0%) 3 Colorectal (12.0%) Colorectal (9.6%) Colorectal (9.2%) Colorectal (9.3%) 4 NHL Lymphoma (5.8%) Endometrium (5.6%) Bladder (7.0%) Endometrium (5.51%)
15 Leading mortality cancer sites by sex and race in Idaho, Oregon, and Washington AmericanIndian /Alaska Native Non-Hispanic White Rank Male Female Male Female 1 Lung & bronchus (31.6%) Lung & bronchus (26.5%) Lung & bronchus (30.4%) Lung & bronchus (29.0%) 2 Colorectal (15.2%) Breast (13.0%) Colorectal (8.8%) Breast (12.2%) 3 Prostate (9.9%) Colorectal (9.1%) Prostate (8.3%) Colorectal (9.5%) 4 Pancreas (8.1%) Pancreas (6.4%) Pancreas (6.1%) Pancreas (6.5%)
16 The Adventures of Kiki Umatilla Burns Chehalis Nisqually Squaxin Island Shoalwater Bay Quileute Warm Springs Makah Cow Creek
17 NTCCP Tools and Resources Twenty Year Northwest Tribal Comprehensive Cancer Control Plan Northwest Tribal Cancer Resource Guide Cancer 101 Cancer Fact Sheets Appointment Companion Tribal Cancer Action Planning Evaluation of Cancer 101: An Educational Program for Native Settings. Hill TG, Briant KJ, Bowen D, Boerner V, Vu T, Lopez K, Vinson E. J Cancer Educ Feb 10. The past, present, and future of comprehensive cancer control from the state and tribal perspective. Miller SE, Hager P, Lopez K, Salinas J, Shepherd WL. Prev Chronic Dis Oct;6(4):A112. Cancer Care of American Indians and Alaska Natives and Other Racial Groups Enrolled in Public and Private Insurance Plans. Ramsey S, Zeliadt S, Blough D, Lopez K, Buchwald D. Poverty & Public Policy Vol. 2: Iss. 1, Article 3.
18 Partnerships Tribal programs and activities Tribal CCP and BCCP State CCP and NBCCP State Tobacco and Diabetes Coalitions NPAIHB projects Foundations and Non profits Komen Grants to Tribes $284K ( ) National CDC 13 NTCCP project presentations: National, State, Regional and Tribal
19 Partner Activities Colorectal Cancer Screening Toolkit PRC and Knight Cancer Center AIMS cancer survivor interview study Fred Hutchinson Cancer Institute SOE NACR New cancer 101 modules Oregon Healthy Communities Oregon Tribal policy work Cdc change tool aggregate report Healthy communities 11/19/2012 Northwest Portland Area Indian Health Board 19
20 Future Activities NTCCP Cancer Coalition meeting February 2013 in Portland Tobacco focus training NTCCP Tribal Clinicians Update October 2013 in Portland NTCCP Tribal Cancer Mini-grants Ongoing Kiki s travels 11/19/2012 Northwest Portland Area Indian Health Board 20
21 Future of Cancer Control & Epidemiology in Indian Country Demonstrated need for better clinical data Charts audits, Northwest Tribal Cancer Navigation Project, many others! Cancer surveillance established and ongoing NPAIHB, ANTHC, IHS National Epicenter, others Cancer data capacity for RPMS/EHR Documentation (treatment & side effects) Reminders (keep people from falling through cracks) 11/19/2012 Northwest Portland Area Indian Health Board 21
22 Benefits of Cancer EHR Module Clinical Patient and PCP know what is happening in one place Know of side effects (CVD impact from radiation or chemo, lymphedaema from lymph node removal, etc) Case mgmt/care mgmt functions for concerned PCP Remind provider it s time for patient referral so Contract Health can generate it Real time quality of care assessment/improvement possible Epidemiologic Are AI/AN patients getting standard of care? Check the dataj What care are they getting? It s in the dataj Save money from circuitous data linkages to Medicaid or Medicare to research impact of cancer to figure out treatment Prevention
23 Prevention - prevention Youth activities Nutrition Physical activity Tobacco cessation Wellness in the workplace 11/19/2012 Northwest Portland Area Indian Health Board 23
24 Northwest Tribes Meet the Challenge Pap-a-thon Pink Paddle Project Aerobics Video Pink Shawl Mother daughter tea/lunch Golf tournament Cancer awareness day Cancer 101 Great American Smoke out Men s health day Relay on the Rez Cooking classes/healthy eating Just Move It Tribal cancer coalition Women and Wellness Lifestyle Intervention Classes Breast Cancer Awareness Bingo Colorectal Cancer Poker Walk
25 Contact Information Northwest Tribal Comprehensive Cancer Program Kerri Lopez (Tolowa), Project Director Eric Vinson (Cherokee), Project Coordinator Elizabeth Viles, Project Assistant Tom Becker, MD, PhD, Medical Epidemiologist Northwest Tribal Registry and IDEA Projects Megan Hoopes, MPH, Project Director Phone:
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