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NWTEC Success Story: Data Hub Application

Success Stories, TEC News
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The Northwest Tribal Epidemiology Center (NWTEC), housed within the Northwest Portland Area Indian Health Board (NPAIHB), is preparing to launch Beta testing of the Northwest Tribal Data Hub application (Data Hub) to an initial cohort of Northwest Tribes during the summer of 2024. This milestone will signify the culmination of three and a half years of planning, learning, and developing the foundational infrastructure of the Data Hub. As we near this milestone, NWTEC’s Data Hub team reflects on the successes and lessons learned from this developmental phase of the platform.

What is the Northwest Tribal Data Hub?

At its core, the Northwest Tribal Data Hub seeks to connect Northwest Tribal Nations with their data. When fully developed, the Data Hub will provide Tribes in Idaho, Oregon, and Washington with secure, direct, and easy access to public health data on topics such as demographics, cancer, substance use and overdose, leading causes of death, and other public health issues within their Tribal areas. The Data Hub utilizes data obtained from state and federal agencies, including vital records, disease registries, and health surveys. When possible, the data have been improved for Tribal communities by correcting the misclassification of AI/AN people. Tribes will access the Data Hub through a secure login and can view, interact with, and download data through visual and interactive dashboards. Each Tribe will be able to view key public health indicators for their Tribal service area, state, and the Northwest region.

Building NWTEC’s Data and Tribal Engagement Infrastructure

The Data Hub represents a significant investment in modernizing NWTEC’s data and information technology infrastructure. The initial planning phase included defining our goals and outcomes for the Data Hub, assessing the feasibility of its development, and engaging four Tribes in a proof of concept to test the underlying technology and gauge interest in further development. As part of that planning phase, the Amazon Web Services (AWS) cloud environment emerged as the best platform to host the Data Hub. The first, foundational step of the development phase was to design, build, and test the Data Hub’s security to ensure confidential data are protected and accessible through the data pipeline. With platform’s security developed and tested, NWTEC’s data assets were migrated to a database and formatted to support the analysis and visualization of public health indicators. The data visualization tool, QuickSight, is used to develop interactive dashboards that report key indicators on Northwest Tribes’ priority health issues. The first dashboard to be launched addresses one of the Northwest Tribes’ highest priority issues – drug overdoses.

 


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TECPHI Success Story: Investing in Infrastructure

Success Stories, TEC News
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The COVID-19 pandemic underscored many strengths of the Alaska Tribal Health System (ATHS) and the Alaska Native Tribal Health Consortium (ANTHC), however it also brought to light opportunities for improvement in Tribal public health infrastructure throughout the state and emphasized the need for ANTHC and the ATHS to be better prepared for future public health emergencies.

Supported by TECPHI funding from the Centers for Disease Control and Prevention, the Alaska Native Epidemiology Center (ANEC) contributed to ANTHC’s efforts to invest purposefully in infrastructure to improve public health and strengthen its capacity. Using Tribal public health assessments, ANEC staff worked throughout FY23 and FY24 to evaluate the ATHS’s capacity to deliver the essential public health services and inform ANTHC’s efforts to align its public health initiatives with its strategic direction.

As a result of the information gained in these assessments, ANTHC identified areas for which an immediate was response was possible including funding additional positions in Emergency Preparedness, establishing Tribal public health infrastructure sub-award funding opportunities, creating a Research Advisory Network, and strengthening partnerships and networking relationships with partners such as the State of Alaska. Additional work continues on these assessments, and the results continue to provide valuable insights for the Alaska Native EpiCenter, the ANTHC Division of Community Health Services, and the organization as a whole.

Maria Caruso presents on Tribal Public Health Assessment processes and results and the 2023 EpiCenter Scientific Advisory Council.
Maria Caruso presents on Tribal Public Health Assessment processes and results and the 2023 EpiCenter Scientific Advisory Council.


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ITCA TEC Success Story: Public Health Working Group

Success Stories, TEC News
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The Inter Tribal Council of Arizona, Inc. (ITCA) Tribal Epidemiology Center Public Health Infrastructure (TECPHI) Team holds Public Health Working Group (PHWG) Meetings to provide a gathering space for collaboration among Tribal public health programs. Through a strategic planning meeting held in March 2023, the TECPHI Team established 3 main goals for the working group meeting series:

  1. Provide a collaborative public space to enhance relationships,
  2. Promote and improve awareness of Tribal Epidemiology Center services, and
  3. Provide public health/health data training and education at no cost.

To date, the TECPHI Team has hosted 4 PHWG meetings during this 5-year funding cycle, with attendees from Tribal organizations in Arizona, Nevada, and Utah, along with presenters traveling from across the country to provide trainings or present on various public health programs. The TECPHI Team is currently planning the 5th PHWG meeting, which will be held on June 4, 2024 on the topic of Substance Use and Overdose Prevention.

 

The first PHWG meeting of the series was held virtually. It has since shifted to in-person meetings after receiving feedback that participants preferred an in-person format.

 

During the course of the 4 PHWG meetings that have been held, the gathering has expanded from a 4-hour virtual meeting to a full-day (or 2-day) in-person meeting. Additionally, due to the success of the first two PHWG meetings held in Year 1, the TECPHI Team has moved forward with offering the meetings every quarter in Year 2. Speakers have included Tribal health program leadership and staff, medical providers, the Arizona Department of Health Services, and our fellow colleagues from other Tribal Epidemiology Centers. These presenters provided information about their programs or gave trainings pertaining to the meeting topics.

Through these presentations and breakout discussions, attendees have been able to share information, opportunities, and resources with each other. Of note, the most recent PHWG meeting on Maternal and Child Health enabled participants to provide invaluable information and recommendations for updates to an Arizona Tribal Maternal and Child Health Needs Assessment that the TECPHI Team is currently working on.

PHWG Meeting attendance has increased from 20 to 43 people (see tables for more information), many of whom have been returning attendees. The most recent working group meeting had so many registrants that the number of attendees had to be limited due to conference room capacity. Meeting participants provide helpful feedback and insight to the TECPHI Team via evaluation surveys after each meeting. The surveys include questions about the format and content of the meetings to improve future gatherings and ensure they are useful to our Tribal public health partners. To date, the TECPHI Team has received 80 survey responses across the 4 meetings, enabling them to integrate participant feedback into their planning and implementation. For example, when asked if the meeting provided a collaborative environment for discussion, 73% of survey respondents strongly agreed, 27% agreed, and 0% were neutral, disagreed, or strongly disagreed.

Additionally, the TECPHI PHWG Meetings series has strengthened the relationships and partnerships between the TECPHI Team and other ITCA Departments, including the Social Media Manager, Assistant Director, Maternal Health Innovation Department, and Health and Human Services Department. The PHWG meetings have also enabled the TECPHI Team to connect with and collaborate with other TECs around the country, including the Northwest Portland Area Indian Health Board, Southern Plains Tribal Health Board, and the Albuquerque Area Southwest Tribal Epidemiology Center.

The TECPHI Team has found that the PHWG meeting series has greatly expanded opportunities for collaboration with our public health partners. Overall, the PHWG meetings have been successful in providing an environment for discussion, collaboration, sharing information, and building relationships between the ITCA TECPHI Team, Tribal health programs, ITCA departments, Tribal Epidemiology Centers, and other public health partners.

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ITCA TEC Public Health Working Group 01
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UIHI TECPHI/BRANCH Success Story

Success Stories, TEC News
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All Nations Health Center: Improving Community Health Through a Needs Assessment

The Urban Indian Health Institute was recently able to utilize funding from the Building Resilience and Action to Nurture Community Health (BRANCH) program to support the Sweetgrass Community Grants Program (CGP). The CGP funds cohorts of subgrantees to promote public health infrastructure and capacity building in Urban Indian Organizations throughout the country. All Nations Health Center was recognized for its demonstrated commitment to advancing public health infrastructure for urban Indian populations and was selected as a 2022-2023 Sweetgrass Grant awardee.

All Nations Health Center (All Nations), an urban Indian organization in Missoula, Montana, focuses on providing comprehensive healthcare services and programming for chronic disease prevention and management to promote health and social well-being of its clients. Programming and clinical practices at All Nations draw upon Western medicine, as well as community, cultural, and familial strengths. All Nations also places a strong emphasis on Indigenous knowledge, methods, and remedies as critical components to the health and wellness of its clients.

All Nations conducted a community needs assessment to better understand the needs and health landscape of Missoula’s Indigenous community. All Nations has a rich history of conducting needs assessments to better understand and address the community’s evolving needs, though with recent organizational changes as well as the COVID-19 pandemic, eight years had passed since the last one. BRANCH funding helped support the current needs assessment, which provides valuable insights into the impact of recent organizational changes, assesses the adequacy of existing services, and guides future initiatives in alignment with the community’s dynamic requirements.

The Community Needs Assessment project was facilitated by the All Nations Cultural Epidemiologist and Research Assistant. The process also included a dedicated Community Advisory Board (CAB) whose members each played a pivotal role in decision making. While the assessment ultimately prioritized Indigenous youth ages 16-26, the process recognized and emphasized the interconnectedness between generations in the community. Key informant conversations, focus groups, voting with coffee cans, and a comprehensive survey shaped the research methodology, providing insights into community priorities and challenges. The survey, comprising 106 items, was distributed electronically and on paper, yielding 216 responses. The Sweetgrass Community Grant, made available through BRANCH, funded essential components, including support for CAB meetings, CAB member honoraria, and incentives for focus group and survey participants. Each of these financial supports helped reinforce involvement and investment in the success of the needs assessment.

The highest goal of the assessment was to offer important, realistic, and actionable recommendations for All Nations to implement that follow the aim to build upon existing strengths and address identified gaps, fostering a community-centric approach to well-being.

The project resulted in a report which outlines four important and realistic recommendations to achieve lasting impact on supporting the community’s health needs. All Nations gathered information about existing services, preferred communication channels, interest in potential services, and barriers to attending activities. This information was collected from key informant conversations, focus groups, survey responses, and conversation among the CAB.

Key findings highlighted the prevalent unmet basic needs, with 70% of participants reporting challenges meeting their basic needs over the last 12 months. Survey participants showcased a strong engagement with and high interest in existing services provided by All Nations, with medical care, harvesting/picking, Traditional Ecological Knowledge, Wellness Wednesdays in summer, dental services, and vaccines being most popular. Participants also indicated high interest in several potential services including fitness activities and Native dancing classes, among others. Addressing barriers to service utilization, participants stressed the importance of advanced event awareness and clarity about activity expectations.

After considering this information, All Nations developed nine draft recommendations and the CAB met several times to finalize the recommendations. Considerations made in determining the final recommendations included community priority as identified from the survey, feasibility, All Nations capacity, and alignment with All Nations core values, vision, and mission. The recommendations are listed below:

  • A. “101” Media Series: Introduce a media series aiming to increase community awareness and understanding of available services, fostering inclusivity and trust.
  • B. Nations Calendar: Implement a digital calendar on the All Nations website, detailing events one month in advance. Weekly communications via various channels, including email, text, and social media, will keep the community informed about upcoming events, addressing the identified need for improved outreach.
  • C. Social Services Companionship: Leverage the Community Health Workers program to provide social services companionship. This initiative focuses on guiding community members through resources access processes, improving navigation of services, and ensuring a supportive environment.
  • D. Multi-purpose Space in New Building: Design and incorporate a versatile multi-purpose space in the new building. This space should accommodate a range of activities, meeting the community’s interests in fitness and cultural classes, among other activities. Features like collapsible walls, storage, and technology should be considered for optimal functionality.

These initiatives aim to improve community awareness and knowledge about existing programming, addressing concerns about expectations at events. Additionally, the social services companionship recommendation leverages the existing Community Health Workers program to provide support and navigation for community members facing difficulties meeting basic needs. The recommendation for a multi-purpose space in the new building aligns with community interests, offering versatile amenities to cater to activities like physical fitness activities and cultural classes. These recommendations collectively address immediate challenges identified through the assessment, providing a strategic framework for All Nations to enhance its services and foster community health and well-being.

This needs assessment showcased the effectiveness of a strong community engagement model. In summary, its findings and recommendations celebrate the community’s engagement with existing services, reveal untapped potential, and provide a comprehensive understanding of preferences and needs.


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