TECPHI

TECPHI

Tribal Epidemiology Centers Public Health Infrastructure Program (TECPHI)
TECPHI is the Tribal Epidemiology Centers Public Health Infrastructure Program. TECPHI was initially funded by a CDC cooperative agreement in 2017 and complements Indian Health Services (IHS) funding to increase TEC public health capacity and infrastructure to perform their seven core functions. The TECPHI Program will strengthen TECs, Tribal communities, Tribes, T/TO/UIOs ability to deliver their core functions and public health services.

With input from a Tribal advisory committee, the CDC designed TECPHI to supplement the 12 Tribal Epidemiology Centers (TECs) to strengthen public health infrastructure and capacity, improve health by identifying and addressing health risks, and support disease prevention and control.12

What does TECPHI do?

Although each TEC’s project is unique, they are all engaging in the following key strategies to contribute to overall health for AIAN people nationwide:
Strengthen public health capacity and infrastructure;
Implement activities to improve the effectiveness of health promotion and disease prevention;
Collaborate with Tribal and other partners to achieve collective action; and
Engage in sustainability activities.

The TECPHI Model

The TECPHI Model illustrates how collaboration, engagement, and connecting resources across the 12 TECs can address common priorities while tailoring public health services to meet regional and local needs.

Who does TECPHI Serve?

574 Tribes
41 Urban Indian Organizations
9.7 million American Indian and Alaska Native people


12Reece, J., Skelton-Wilson, S., Mitchell-Box, K., Groom, A., & Thomas, C. (2023). Building a roadmap to health equity: strengthening public health infrastructure in Indian Country. Public Health Reports, 00333549231186579.

 

NCC Logic Model
TECPHI Program Logic Model (PDF 110KB)

 

How were public health capacity, infrastructure, and sustainability defined for the TECPHI Program? Public health capacity, infrastructure, and sustainability have been described in the literature but had not been defined or described for TECs or in the Tribal health context. Definitions were tailored to the TECPHI Program and relate to TEC public health work in a Tribal health context. The following definitions were initially drafted after a literature review of current established definitions and have been reviewed and further refined on an annual basis to reflect how the TECPHI Program has evolved.

Public Health Capacity The ability to respond to public health needs by possessing the “skills, motivation, knowledge, and attitude” needed to perform the TEC seven core functions:
1. collecting data and monitoring health;
2. evaluating data and programs;
3. identifying health priorities;
4. making recommendations for health service needs;
5. making recommendations for improving health care delivery systems;
6. providing epidemiologic and other technical assistance; and
7. providing disease surveillance.
 
Public Health Infrastructure The foundation and framework that enables a functioning public health system to include:

  • a workforce trained in public health core competencies;
  • an information and data systems to rapidly analyze, assess, and communicate information;
  • an ability to respond in a culturally relevant way to AIAN public health needs; and
  • an established plan to sustain a program’s efforts once funding has ended.
Sustainability The ability of a public health program to:

  • maintain core program components and activities consistent with goals and objectives;
  • respond and adapt to AIAN public health needs; and
  • provide continued benefits and value to those they serve.
Approach All 12 of the TECs were funded under the TECPHI program. Each of the TECs’ projects are unique, however they all feature three key strategies to contribute to reductions in chronic diseases and risk factors, reductions in disparities in health outcomes, and improvements in overall health:

  1. Strengthen public health capacity and infrastructure
  2. Implement activities to improve effectiveness of health promotion and disease prevention; and
  3. Engage in sustainability activities.

 

 

TECPHI Projects Click on each of the TECs below for a description of their project and activities:

TECPHI-ANECProject Title:
Building Public Health Infrastructure for Alaska Native People

Project Summary:
During Year 1, in collaboration with Alaska Native tribal health organizations (THOs) and other statewide and external partners, the Alaska Native Epidemiology Center (ANEC), will work to build public health capacity and infrastructure by:
• Updating and enhancing the production process for creating Alaska Native health status fact sheets;
• Submitting at least one manuscript for publication;
• Providing technical assistance (TA) to THOs;
• Assessing and increasing access to data sources related specifically to injuries, maternal child health (MCH), and chronic diseases such as cancer and cardiovascular disease;
• Educating and disseminating information on the 25 Leading Health Indicators, health priorities, and strategies from the Healthy Alaskans 2020 State Health Improvement Plan;
• Assessing capacity to provide more comprehensive evaluation services for THOs;
• Increasing staff expertise related to TEC core functions;
• Supporting workforce development with training opportunities and scholarships;
• Identifying public health priorities by conducting community health assessments (CHA), or using previous CHAs or other available data;
• Cultivating multi-sector collaborations at Area tribe, state, and federal levels; and
• Implementing activities to improve the sustainability of tribal public health efforts.

Estimated number of people to be served as a result of this award: 166,146

TECPHI-AASTECProject Title:
Strengthening Tribal Public Health Infrastructure for Chronic Disease Prevention & Management Program

Project Summary:
In partnership with the Albuquerque Area Indian Health Board, Inc. (AAIHB), the 27 Albuquerque Area Tribes, and external partners, the Albuquerque Area Southwest Tribal Epidemiology Center (AASTEC), will work to build public health capacity and infrastructure by:
• Establishing a Tribal Data Users Workgroup to identify tribal data priorities and improve data capacity;
• Creating a regional Native Wellness Think Tank to identify chronic disease priority areas and related best practices;
• Enhancing tribal data quality and public health surveillance systems;
• Distributing sub awards to Area tribes to implement community health assessment activities;
• Providing training opportunities for tribal partners to build sustainable public health capacity in the domains of epidemiology, community health assessment, strategic action planning, indigenous statistics and methodologies, public health program planning, implementation, and evaluation, grant writing, and evidence-based best practices for chronic disease prevention/management;
• Providing data-related and evaluation technical assistance to determine local health priorities; and
• Providing student internships with a structured 12-week curriculum.

Estimated number of people to be served as a result of this award: 104,000

TECPHI-CTECProject Title:
California Tribal Epidemiology Center Building Public Health Infrastructure Initiative

Project Summary:
In collaboration with 74 of the 109 California tribes (67% of tribes), the California Tribal Epidemiology Center (CTEC), housed within the California Rural Indian Health Board (CRIHB), will work to build public health capacity and infrastructure by:
• Enhancing adult and youth Behavioral Risk Factor Surveillance Survey (BRFSS) and Adverse Childhood Experiences (ACE) data, including oversampling of AI/AN data that will be comparable to data from other populations;
• Conducting Community Needs Assessments with Tribal and Urban Indian health programs to identify local chronic disease health concerns and priorities;
• Increasing CTEC staff statistical capacity to prioritize and report on surveillance data; and
• Providing data, evaluation, and grant writing training and technical assistance to California Indian health programs, tribes, and current CDC-funded CRIHB program sites.

Estimated number of people to be served as a result of this award: 192,211

TECPHI-GLITECProject Title:
Bemidji Area Thriving (BAT) Project

Project Summary:
In collaboration with 34 Tribes, four urban Indian areas, and three IHS Service Units in the Bemidji IHS Area (Michigan, Minnesota, Wisconsin, and Chicago), the Great Lakes Inter-Tribal Epidemiology Center will work to build public health capacity and infrastructure by:
• Providing grant writing training and technical assistance for Bemidji Area communities;
• Providing evaluation training and technical assistance for Bemidji Area communities;
• Actively participating in the TECPHI Community of Practice;
• Producing at least one ad hoc Area-level data report each year to examine a specific topic on AI/AN health in greater depth;
• Developing and implementing the Bemidji Area Childhood Immunization Project (BACIP);
• Supporting Bemidji Area communities in developing scientific publications and presentations on chronic disease prevention and other health priority areas; and
• Increasing GLITEC staff capacity through professional development opportunities.

Estimated number of people to be served as a result of this award: 340,000

TECPHI-GPTECProject Title:
Building Public Health Infrastructure in Tribal Communities to Accelerate Disease Prevention and Health Promotion in Indian Country

Project Summary:
In collaboration with 17 Tribes and 1 Service Area in serving the Great Plains IHS Area (South Dakota, North Dakota, Nebraska and Iowa), the Great Plains Tribal Epidemiology Center (GPTEC), housed within the Great Plains Tribal Chairmen’s Health Board (GPTCHB), will work to build public health capacity and infrastructure by:
• Expanding the Data Coordinating Unit, including digital assets, data products, and services;
• Expanding the Great Plains Area Data Workgroup;
• Expanding the Tribal Public Health Liaison program to enhance tribal-level public health practice and support workforce development;
• Developing tracking and response procedures for response to requests for technical assistance;
• Providing funding and technical assistance in support of Tribal Public Health Projects;
• Creating a Tribal Health Evaluation Toolkit and providing training and technical assistance;
• Preparing publications for the promotion of tribal public health practices;
• Building capacity for mapping Great Plains health systems, plans, and policies; and
• Conducting site visits to tribal partners throughout South Dakota, North Dakota, Nebraska and Iowa.

Estimated number of people to be served as a result of the award of this grant: 179,400

TECPHI-ITCA-TECProject Title:
Building Public Health Infrastructure in Tribal Communities

Project Summary:
In collaboration with 44 Tribes, Inter Tribal Council of Arizona Tribal Epidemiology Center (ITCA TEC), housed within Inter Tribal Council of Arizona, Inc. (ITCA), will work to build public health capacity and infrastructure by:
• Establishing Memorandums of Agreement, funding, and advanced training and technical assistance to eight tribes;
• Coordinating a Public Health Working Group open to all Area tribes;
• Reviewing Area Community Health Assessments for health indicator identification, prioritization, and local data quality improvement;
• Conducting evaluation of data sources used for Tribal public health;
• Developing health profiles, health improvement plans, and other needed tribal health reports and presentations;
• Coordinating strategic planning training and grant writing training for all Area tribes; and
• Developing Annual and Final Reports for partners.

Estimated number of people to be served as a result of this award: 446,700

TECPHI-NECProject Title:
Navajo Nation: Public Health Infrastructure

Project Summary:
In collaboration with the Navajo Nation extending across Arizona, New Mexico, and Utah, the Navajo Epidemiology Center (NEC), housed within the Navajo Department of Health (NDOH), will work to build public health capacity and infrastructure by:
• Implementing an Indicator-Based Information System (IBIS) for public health on the Navajo Nation for data collection and health status surveillance and monitoring;
• Organizing a Navajo Nation Health Data Symposium (NNHDS) with tribal partners to identify key data indicators and use and access of IBIS;
• Assessing the needs and resources of the System and Area;
• Cultivating multi-sector collaborations; and
• Providing technical assistance, including site visits, throughout the Area.

Estimated number of people to be served as a result of this award: 100,000

TECPHI-NWTECProject Title:
Improving Data and Enhancing Access-Northwest (IDEA-NW)

Project Summary:
In collaboration with the 43 federally recognized tribes of Idaho, Oregon, and Washington, the Northwest Tribal Epidemiology Center (NWTEC), housed within the Northwest Portland Area Indian Health Board (NPAIHB), will work to build public health capacity and infrastructure by:
• Expanding NWTEC’s access to linkage-corrected datasets that can be used to assess community health and AI/AN health disparities;
• Organizing technical and project staff into workgroups to improve coordination on priority issues, including a Biostatistical Core and Maternal and Child Health Workgroup;
• Expanding training, technical assistance, and epidemiology services to improve Tribes’ access and utilization of health data for community health improvement activities;
• Developing an electronic monitoring system to improve the collection and reporting of evaluation data; and
• Providing grant writing training and technical assistance among Portland Area Tribes.

Estimated number of people to be served as a result of this award: 353,000

TECPHI-OKTECProject Title:
Southern Plains Tribal Health Board Public Health Infrastructure Project

Project Summary:
The Oklahoma Area Tribal Epidemiology Center (OKTEC), housed in the Southern Plains Tribal Health Board (SPTHB), serves the 43 federally recognized tribes in Kansas, Oklahoma, and Texas. The Public Health Infrastructure Project aims to build and strengthen public health capacity and infrastructure within tribal communities, as well as, increase the internal capacity of the OKTEC to assist the tribes they serve by:
• Integrating OKTEC staff with the Cherokee Nation Public Health Services project to provide infrastructure and expertise for tribal partners who are interested in accreditation;
• Enhancing training and technical assistance for area tribes surrounding public health;
• Increasing the chronic disease prevention education and training opportunities for the Kansas tribes;
• Initiating an Inter-Tribal Oral Health Community of Practice (ITOHCoP) to build a network of tribal oral health stakeholders;
• Collaboratively working with Oklahoma City Indian Clinic to improve colorectal cancer screening processes and outcomes, and sharing the experience and knowledge with area tribal clinics;
• Implementing and evaluating Wellness Around Traditional Community Health, a public health program for 2-5 year olds in tribal early childhood education facilities, which is centered around improving nutrition and physical activity among Native youth; and
• Providing grant writing training and technical assistance to area tribes.

Estimated number of people to be served as a result of this award: 877,475

TECPHI-RMTECProject Title:
Rocky Mountain Tribal Epidemiology Center – Public Health Infrastructure (RMTEC-PHI)

Project Summary:
In collaboration with 10 Tribes located in Montana and Wyoming, the Rocky Mountain Tribal Epidemiology Center (RMTEC), housed within Rocky Mountain Tribal Leaders Council (RMTLC), will work to build public health capacity through:
• Increasing access to local, state, and national surveillance systems and datasets;
• Creating an inventory of existing disease surveillance datasets, variables, and identifying gaps;
• Establishing Rocky Mountain Community of Practice (RMCoP), a group of public health professionals to help steer the project;
• Identifying public health priorities of the Tribes;
• Providing technical assistance to Tribes in Montana and Wyoming on their health priority areas;
• Increasing staff capacity through trainings and other professional development opportunities;
• Building capacity to develop periodic reports that reflect topics of interest to the Tribes;
• Establishing a structure to strengthen the collaborative process around grant writing training and support with Tribes; and
• Strengthening partnerships with Tribes to better address and respond to their health priority areas.

Estimated number of people to be served as a result of this award: 77,000

TECPHI-USET-TECProject Title:
USET Community Health Infrastructure Project (CHIP)

Project Summary:
In collaboration with 27 of the 30 federally recognized Tribal Nations within the (IHS) Nashville Area that encompasses 13 States, the United South and Eastern Tribes, Inc. (USET) Tribal Epidemiology Center (TEC), will work to build public health capacity and infrastructure by:
• Conducting Tribal Public Health Infrastructure Assessments (TPHIA) to evaluate and increase IHS Nashville Area-wide public health infrastructure and capacity at both the USET TEC and Tribal Nation level;
• Coordinating with IHS Nashville Area Tribal Nations to identify infrastructure, public health assets, and deficits to design, implement and grow health promotion and disease prevention (HPDP) programs;
• Producing and sharing reports detailing the results of the TPHIA with appropriate partners;
• Addressing the needs identified by the TPHIA by planning and implementing HPDP programs, infrastructure, technical assistance, and public health knowledge/communication;
• Using the results of the TPHIA, to identify and apply for resources and funding opportunities to improve the sustainability of this project within both the USET TEC and Tribal Nations;
• Identifying and recruiting IHS Nashville Area Tribal Nations that could benefit from a TPHIA to further define their public health needs; and
• Assisting identified IHS Nashville Area Tribal Nations in completing their own TPHIA to eventually improve each Tribal Nation’s health policies, systems, and environments (PSE).

Estimated number of people to be served as a result of this award: 85,440

TECPHI-UIHIProject Title:
Building Resilience and Action to Nurture Community Health (BRANCH)

Project Summary:
In collaboration with 62 urban American Indian and Alaska Native serving organizations, the Urban Indian Health Institute (UIHI) will reclaim traditional values of data, evaluation, and research to strengthen public health capacity, address health disparities, and promote health resilience in urban Indian communities.

The UIHI BRANCH initiative will provide urban Indian health organizations with:
• Technical assistance in the areas of grant writing, indigenous evaluation, data collection, and data usage.
• Trainings on topics like epidemiology, evaluation, and grants; cultural knowledge systems; indigenous methodologies; chronic disease prevention and addressing disease states.
• Funding for four competitive community grants per year, focused on indigenous approaches to chronic disease prevention and management.
• Increased access to reliable and quality data on the health status of urban Indian communities.
• Formalized internships to train and encourage an American Indian and Alaska Native public health workforce.

Estimated number of people to be served as a result of this award: 1,500,000

TECPHI-NCCProject Title:
Building Tribal Public Health Infrastructure Component B

Project Summary:
In collaboration with the Centers for Disease Control and twelve TECPHI Component A Awardees (CAA), the Network Coordinating Center, housed within the Alaska Native Epidemiology Center (ANEC), will work to build public health capacity and infrastructure by:
• Establishing an ongoing network of CAA funded organizations and partners;
• Establishing a coordinated, collaborative community of practice to facilitate knowledge-sharing, problem-solving, and communication across the network;
• Engaging the network of CAA organizations and CDC in preparing meetings for the project;
• Coordinating collaborative activities to optimize the ability of the network of CAAs to strengthen public health capacity and infrastructure;
• Developing and maintaining an internal and external website for the network;
• Developing and implementing a plan for tracking and disseminating network-related publications, presentation, products, and other materials;
• Creating a plan to sustain program efforts after grant period ends;
• Developing and implementing an evaluation plan to coordinate monitoring of TECPHI accomplishments and outcomes; and
• Providing technical assistance to CAAs on program evaluation and quality improvement activities.


Year 1 Progress Report (PDF 7 MB)
Year 1 Photo Narrative (PDF 6 MB)

Year 2 Progress Report (PDF 2 MB)
Year 2 Photo Narrative (PDF 9 MB)

Year 3 Progress Report (PDF 4 MB)
Year 3 Photo Narrative (PDF 8 MB)
Year 3 Qualitative Projects (PDF 6 MB)

TECPHI Year Final Brief Report (PDF 925 KB)
TECPHI Year 4 & 5 Progress Report (PDF 2 MB)

TECPHI Year 4 Photo Narrative (PDF 5 MB)
TECPHI Year 5 Photo Narrative (PDF 4 MB)

TECPHI Year 4 Qualitative Projects (PDF 5 MB)
TECPHI Year 5 Qualitative Projects (PDF 2 MB)

TECPHI Brochure/Inserts (PDF 2 MB)

For a full print-friendly description of the TECPHI program, click here to download a PDF (8.6MB)
(Print as a booklet for best results).

Visit CDC’s TECPHI page here: https://www.cdc.gov/healthy-tribes-tecphi/php/about/