Training Services

These topics are to assist with evaluating the effectiveness or impact of a program or intervention.

• Using NACI Care© (90 minutes)
• Evaluation strategies: do's and don’ts (40 minutes)
• How to write effective knowledge, attitude, self-efficacy and behavior questions (45 minutes)
• Using Audience Response Systems (ARS) (60 minutes)
• How to write and use effective qualitative questions & responses (30 minutes)
• Criterion-referenced scoring for qualitative responses (45 minutes)

These topics are to help staff who are new to making public presentations improve their  skills when working with small or large audiences. NACR staff all are trained, credential educators and each have taught in academic and community settings for more than forty years.

• Oral presentations (45 minutes)
• Creating effective Power Point® slides (45 minutes)
• Integrating effective participant interactive activities (45 minutes)

These sessions were created to help staff who have little to no experience working with computers. They are tailored to the participants’ needs. These can be held as separate, small group sessions for beginners or intermediate computer users in conjunction with other training topics.

• Word (60 minutes)
• Literacy (how to use and avoid common errors within Word’s Flesch-Kincaid software) (40 minutes)
• Excel (60 minutes)
• Power Point® (60 minutes)
• Email (45 minutes)
• Internet (valid vs. questionable cancer websites) (45 minutes)

CTENA provides easy-to-understand, interactive educational workshops to increase Native Americans’ awareness and understanding of clinical trials and to facilitate decision making about clinical trials participation. The curriculum includes twelve objectives. These workshops have been held in geographically diverse settings with intertribal participants (e.g., Anchorage, AK, Albuquerque, NM, Denver, CO, and Rapid City, SD).  The average increase in knowledge was 25%. Each objective includes a participant interactive activity:

• NA-1.    Examine common reasons for and against Native American communities’ participation in research studies. (30 minutes)
• NA-2.    Describe the importance of including Native Americans in cancer care trials. (30 minutes)
• NA-3.    State the purpose and importance of clinical trials. (30 minutes)
• NA-4.    Describe the types and purposes of cancer clinical trials. (45 minutes)
• NA-5.    Explain the phases of cancer clinical trials. (45 minutes)
• NA-6.    Examine common Native American myths and beliefs related to cancer clinical trials. (30 minutes)
• NA-7.    Identify local and national resources for accurate cancer and clinical trials information. (30 minutes)
• NA-8.    Examine the potential benefits and drawbacks of participation in cancer treatment clinical trials. (30 minutes)
• NA-9.    Describe the impact of Native cultural perspectives on health and the experience of cancer and clinical trials. (45 minutes)
• NA-10.    Examine selected ethical, social, cultural, spiritual and legal issues related to Native American's participation in clinical trials. (45 minutes)
• NA-11.    Describe benefits and drawbacks in using traditional Indian medicine in cancer care. (30 minutes)
• NA-12.    Identify the Tribal Research Approval Process relevant to clinical trials. (60 minutes)

GENA®, provides a Native-specific science curriculum comprised of 29 objectives. These objectives can be individually combined to create an educational program on genetic science that is tailored to a program’s specific needs. The focus of GENA® is to help workshop participants increase their genetic knowledge to assist with informed decision-making regarding genetic science, testing, or research opportunities. All objectives include interactive participant exercises created to increase learning. GENA® workshops have been evaluated for success with Native American college students and with selected intertribal community meetings from 1999 through 2003.  The increase in genetic and cultural knowledge averaged 30% and was statistically significant (p=.001) and received high praise from participants. 

NACR staff and consultants (Linda B and Lynne Bemis, PhD) continue to conduct an average of three GENA® tailored workshops each year throughout the USA. Although there originally were 29 objectives, over the last decade, some were combined together and others, were of no interest to I/T/U communities (e.g., 3 HapMap objectives). The subsequent 18 GENA® objectives grouped as commonly presented, follow:

ETHICAL, LEGAL, SOCIAL, CULTURAL ISSUES

• Distinguish between facts and myths of genetic issues of concern to Natives. (60 minutes)

BASICS

• Describe parts of a cell (45 minutes)
• Review basic principles of cell biology and genetics (e.g., cell structure, location of DNA and RNA, protein expression, transcription, and translation) (45 minutes)
• Identify the types of genetic research that are of interest / priority to their home Native communities (45 minutes)
• Review genetic concepts. (45 minutes)
• Understand classical patterns of inheritance and cultural traditions related to these patterns. (60 minutes)

GENETIC TESTING

• Describe genetic testing. (30 minutes)
• Examine selected Native American cultural and ethical issues related to genetic testing (60 minutes)
• Identify common misconceptions related to genetic testing. (30 minutes)
• Analyze the benefits and risks of genetic testing. (30 minutes)
• Determine factors that should be considered when deciding whether or not to take part in genetic testing. (10 minutes)

CONTEMPORARY SCIENCE

• Examine current genetic research-related issues and their potential impact for Native communities. This objective has 3 different versions:  stem cells, microRNA or nanotechnology (60 minutes each version)
• Describes benefits and drawbacks to pharmacogenetics (60 minutes)
• Identify advantages and limitations of selected models for human diseases. (60 minutes)

TRIBAL RESEARCH APPROVAL PROCESSES

• Analyze the Tribal Research Approval Process relevant to genetic research. (60 minutes)

GENETIC COUNSELING

• Recognize the roles of the health care team involved with cancer genetic counseling.  (20 minutes)
• Describe culturally acceptable methods of collecting a family history. (45 minutes)
• Examine selected ethical, legal, and cultural issues of genetic counseling (30 minutes)

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Tailored Workshops Faculty

• Linda Burhansstipanov, Native American Cancer Initiatives, Incorporated (NACI)
• Lynne Bemis, PhD, University of Minnesota

Contact Information:

• Native American Cancer Initiatives, Incorporated (NACI)
• 3022 South Nova Road
• Pine, CO 80470-7830
• 303-550-5181

National genetic education leaders (videos);  Advise from Experts

• In 1999-2000, Native American Cancer Research Corporation videotaped ten scientists; 8 were Indigenous and 2 were Latino, Hispanic or Chicano:

1. John Alderete, PhD, Chicano
2. David Baines, MD - Tlingit & Tsimshian Alaska Native Tribal Nations
3. David Burgess, PhD - Western Cherokee Nation
4. Alicia Carson, BS, Graduate student, Creek Tribal Nation
5. Wilfred Denetclaw, Jr., PhD, Navajo Nation
6. Frank C. Dukepoo, PhD, Hopi and Laguna Tribal Nations (1943-1999)
7. Judith Salmon Kaur, MD, Choctaw and Cherokee Nation
8. Clifton Poodry, PhD, Seneca Nation
9. Tachene Scott, PhD, Navajo Nation
10. Maggie Werner Washburn, PhD, Hispanic

Each was asked the following questions:

1. Introduction
2. In general, how and/or why did you become interested in your current career?
3. How has being a minority affected your professional experience?
4. On the average, how many hours do you work a week?
5. How do you balance your professional and personal life?
6. What characteristics of your current position do you continue to find exciting and rewarding?
7. What aspects of your current position do you find unexciting and unappealing?
8. How does your job help society, under-served populations and/or your community?
9. How has your culture helped you in your current career?
10. How has your culture created challenges for you?
11. Have you ever seriously considered terminating your education, or dropping out of school?
12. What types of science careers do you feel are going to be in great demand in the next 20 years?
13. What types of jobs would you recommend university students have while enrolled in school?
14. What recommendations do you have for university minority science students?

Their advice remains relevant to university students today. 

• If the viewer is interested in one individual only, select search for their name and you can review all of their answers to the questions
• If the viewer is interested in responses to a specific question, search for key phrases within the questions.
• Linda B apologizes for the poor quality of the videos. They were saved as Flash software and did not convert well. 

Background for GENA

• The "National Human Genome Research Institute, Ethical, Legal and Social Issues" (NHGRI/ELSI) funded "Genetic Education for Native Americans" (GENA®) [PI: Burhansstipanov, HG01866] from 1998 to 2003
• GENA® was designed to provide a unique genetics education program for Native American college and university students
• The decision to focus on students was based on recommendations from intertribal leaders' on how to effectively integrate genetic education into Native American communities
• Based upon multiple intertribal focus groups with tribal elders, the initial priority targets population of GENA® was Native college students
• Tribal elders believed that these students would be able to return to their respective communities to help them understand genetic research requests from academic and clinical research settings
• Ultimately, it was hoped that this instruction would help to improve informed decision-making about genetics and genetics research in Native American communities and to encourage students to seek genetic science career opportunities

Overview

• GENA®, provides a Native-specific science curriculum originally comprised of 29 objectives
• These objectives can be individually combined to create an educational program on genetic science that is tailored to a program’s specific needs
• The focus of GENA® is to help workshop participants increase their genetic knowledge to assist with informed decision-making regarding genetic science, testing, or research opportunities
• All objectives include interactive participant exercises created to increase learning
• GENA® workshops have been evaluated for success with Native American college students and with selected intertribal community meetings from 1999 through 2003
  • The increase in genetic and cultural knowledge averaged 30% and was statistically significant (p=.001) and received high praise from participants
• Faculty continue to conduct an average of three GENA® tailored workshops each year throughout the USA
• Although there originally were 29 objectives, over the last decade, some were combined together and others, were of no interest to I/T/U communities (e.g., 3 HapMap objectives); the subsequent 18 GENA® objectives grouped as commonly presented, follow:

ETHICAL, LEGAL, SOCIAL, CULTURAL ISSUES
Objective 29.    Distinguish between facts and myths of genetic issues of concern to Natives. (60 minutes)

BASICS
Objective 26.    Describe parts of a cell (45 minutes)
Objective 2.    Review basic principles of cell biology and genetics (e.g., cell structure, location of DNA and RNA, protein expression, transcription, and translation) (45 minutes)
Objective 5.    Identify the types of genetic research that are of interest / priority to their home Native communities (45 minutes)
Objective 7.    Review genetic concepts. (45 minutes)
Objective 8.    Understand classical patterns of inheritance and cultural traditions related to these patterns. (60 minutes)

GENETIC TESTING
Objective 9.    Describe genetic testing. (30 minutes)
Objective 10.    Examine selected Native American cultural and ethical issues related to genetic testing (60 minutes)
Objective 11.    Identify common misconceptions related to genetic testing. (30 minutes)
Objective 12.    Analyze the benefits and risks of genetic testing. (30 minutes)
Objective 13.    Determine factors that should be considered when deciding whether or not to take part in genetic testing. (10 minutes)

CONTEMPORARY SCIENCE
Objective 14.    Examine current genetic research-related issues and their potential impact for Native communities. This objective has 3 different versions:  stem cells, microRNA or nanotechnology (60 minutes each version)
Objective 16.    Describes benefits and drawbacks to pharmacogenetics (60 minutes)
Objective 25.    Identify advantages and limitations of selected models for human diseases. (60 minutes)

TRIBAL RESEARCH APPROVAL PROCESSES
Objective 19.    Analyze the Tribal Research Approval Process relevant to genetic research. (60 minutes)

GENETIC COUNSELING
Objective 21.    Recognize the roles of the health care team involved with cancer genetic counseling.  (20 minutes)
Objective 22.    Describe culturally acceptable methods of collecting a family history. (45 minutes)
Objective 23.    Examine selected ethical, legal, and cultural issues of genetic counseling (30 minutes)

To schedule Tailored GENA® workshops:

• Please review the list of objectives and estimated time for each for your desired workshop
• You select the objectives most relevant to your audience for the designated time period
• The GENA faculty will create and evaluate (using ARS) the tailored workshop
• The workshop will be held at your location
• Most workshops are 3-5 hours long and may have up to 50 participants
• At least two faculty (one scientist and one cultural specialist) will present the workshop

NOTE:

• Workshops need to be scheduled about 6 months ahead of time
• Travel, per diem and fee need to be supported for GENA® Faculty

NACR staff initially based this 2002-2005 program (after receiving permission) on Module 4 of the “End-of-Life Nursing Education Curriculum” (ELNEC) as a model. Several unique features evolved as the project team attempted to modify the curriculum to be culturally relevant to Native Communities.  Based on intertribal working group and pretest findings, rarely does the Native community have access to trained professionals to assist the family when someone is dying. Thus, the focus of the "Native American Palliative Care" Curriculum shifted from relying on trained and qualified nurses to provide palliative or end-of-life care to focusing on family members who are likely to have no medical background at all.  The five initial objectives of the "Native American Palliative Care" gradually were modified to:

• Describe what palliative care is and how it helps the patient. (20 minutes)
• Describe what types of care are included in palliative care and who is the likely recipient of palliative care. (50 minutes)
• Describe the parts that should be included in Advanced Directives and Wills and their value to each of us. (40 minutes)
• Identify who should have a will and living will (20 minutes)

This training originally was developed in 2007 with funding and continuing education credits from the Centers for Disease Control and Prevention. The Project Team conducted the trainings at CDC in Atlanta, GA, state departments and tribal communities primarily throughout the Northern and Southern Plains, West Coast and Rocky Mountain regions.

• Objective 1. Summarize the need for culturally appropriate actions based on the historical perspective of Native American populations (includes US Census, Tribal Sovereignty, historical events and distrust of government, historical trauma). (60 minutes)
  • Sub-Objective: Distinguish among factors affecting AIAN racial misclassification. (30 minutes)
  • Sub-Objective: Delineate AIAN regional cancer incidence and mortality differences. (30 minutes)
  • Identify barriers that affect AI/AN ability to create, access or use cancer prevention and control programs (20 minutes)
• Objective 2.  Identify health service systems and delivery methods available to Native American populations (includes patterns, IHS CHS/PRC, effective messaging, materials development, and literacy issues). (160 minutes)
• Objective 3. Identify culturally sensitive communication methods for Native American outreach efforts. (120 minutes)
• Objective 4. Identify culturally sensitive education and intervention strategies for Native American outreach efforts. (120 minutes) 
  • Sub-Objective:  Identify factors that increase the successfulness of navigation models (Native Sisters) in Indian Country.

This workshop is designed for public health professionals, Native program directors and staff who are working with health and cancer prevention / early detection programs. The overarching goals of this 6.5 hour training are: (1) To educate public health professionals on the initial steps in building tribal and government relationships to improve health outcomes for Native American populations; (2) To educate public health professionals in building relationships with tribal and urban programs to improve interactions and communications related to health and health outcomes for Native American populations; and (3) To increase understanding of successful and effective AIAN cancer public health program planning, implementation and evaluation. Participants will develop skills in culturally respectful strategies for effective working relationships between (1) Native health programs and (2) state public health programs, academic or clinical health settings; modifying evidence-based interventions, understanding AIAN learning styles, and working with electronic evaluation programs.  Sessions will include interactive activities and problem-solving exercises focused on specific challenges and solutions. It is helpful to have completed Cultural Competence 101 prior to enrolling in this training. The objectives follow: 

• Objective A. Identify communication methods and literacy issues that affect interactions among providers, patients, public health educators and AIAN community members (90 minutes).
• Objective B. Identify how styles of learning and educational programs can facilitate communication for Native American community (60 minutes).
• Objective C.  Identify selected issues in NDN Country that affect successful cancer program implementation (120 minutes)
• Objective D.  Identify characteristics of scientific evidence interventions that affect the ability to appropriately translate science within AIAN communities (60 minutes).
• Objective E.  Identify ways technology can improve the evaluation of the success and effectiveness of AIAN public health programs (60 minutes).

• Foundation and Service / Education types of grants (national, regional and local)
  • Potential to support AI/AN education and/or service grants 
  • Example:  Robert Woods Johnson Foundation
• Principles:  Community-based participatory approach (CBPA)  
• Intended project participants
  • Inclusion and exclusion criteria
• Elevator speech (emphasis on talking with funding agency prior to grant submission)
• Project goals
• SMART objectives
• Grant Evaluation Overview
  • Evaluation Do's and Don't's
  • LOGIC Model and measures
  • Timeline, Tasks, measures
• Project plans & / or detailed timelines with deliverables 
• Budgets and budget justifications
  • Common budget mistakes
  • Participant interactive Activity:  draft travel budget for project staff (3 members) to attend the annual NIHB Consumer Conference
• Grant loose ends (LOS, bios from project team)
• Surveys or other tools

This course is designed for students who have already had some training in basic epidemiology. The overall goal of this short course is to familiarize students with development of a research idea into the NIH format, using a 2-page grant summary template to help guide this development.  Students will develop skills in developing research proposals using National Institutes of Health (NIH) federal grant submission format.   Sessions will include practical exercises and time to work on grant components.  Sessions will address specific challenges that are commonly encountered in developing and submitting NIH federal research proposals.  Interactive activities will include critiquing one another’s drafts for designated components within a grant. Different types of grants and key elements of their construction will be summarized, but the focus will be on NIH grants.  Examples of topics include:

• Overview of the National Institutes of Health (NIH) and the beginning of a grant idea
• Community collaboration (community-based participatory research (CBPR) and community-driven research)
• NIH grant review processes (review criteria)
• NIH Forms F (effective May 2020)
• ASSIST User Guide
• Overview of Department of Health and Human Services and grant challenges
• Government Terminology (translations)
• Navigating the NIH Grants.gov website for helpful resources (Cancer Planet, Community Guide)
• Funding mechanisms (types: F, K, R, U) 
• Matching study idea to appropriate NIH FOA, PA, PAR, RFA, RFP
• Budget worksheets and excerpts of justification   
• Partnerships and collaboration
• Problem to be addressed and / or health-relatedness of the project
• Research Strategy
  • Grant Titles
  • Goal
  • Specific aims
  • Research Question or Hypotheses or Purpose
  • Research design and method 
    • Public Health Theories
    • Study Designs
    • Study Population
    • Recruitment Strategies
    • Evidence-based interventions 
    • Evaluation strategies
    • Study Outcomes
• Significance and potential impact on field of science
• Innovativeness
• Narrative
• Project Summary
• Investigative Team (Senior Personnel biosketches)
• Environment
• Loose Ends, Study Group Assignments
• Letters of Support

• Confidentiality versus Privacy (45 minutes)
• HIPAA (30 minutes)
• Protection of Human Subjects (NIH or CITI online courses) and IRB issues specific to Indian Country (90 minutes)
  • Tribal IRBs and approval processes
  • Protocols for meeting with Tribal Council or Health Boards
• AI/AN protocols for abstract, publication approvals and for dissemination of preliminary and final findings (45 minutes)
• Processes for sharing findings (45 minutes) with the:
  • Drafting summary sheets
  • Participants
  • Community
  • Indian Health Service / Tribal / Urban leadership
  • Professionals
• Communication strategies among all partners throughout the grant (45 minutes)
• Community-based participatory research (CBPR) versus Community-driven grants(45 minutes)
• In-service training (tailored specific to grant) (45-90 minutes)
• Invoicing processes (30 minutes)
• Creating subcontracts (do’s and don’ts) (45 minutes)
• Interviewing and hiring using case situation-based questions (45 minutes)

• Native Cancer 101 (diagnosing & staging) (60 mins)
• Native Cancer 102 (treatments) (60 mins)
• Native Cancer 103 (side effects, short, long and late-term) (60 mins)
• Survivorship Care Plans (SCP) (60 mins)
• Native American Cancer Education for Survivors (NACES) (60 mins)
• Becoming a Thriver (30 mins)
• Survivorship 101 (60 mins)