CDC Cooperative Agreements

Tribal Public Health Capacity Building and Quality Improvement (2013–2018)

OSTLTS has announced the six tribal and Native-serving awardees for its five-year Tribal Public Health Capacity Building and Quality Improvement Cooperative Agreement (2013–2018). Activities will focus on strengthening and improving the infrastructure and performance of tribal public health agencies and systems through capacity building and quality improvement. 

Awardees, Priority Area 1: Tribal Public Health Capacity Building

Bad River Band of Lake Superior Tribe of Chippewa Indians (Wisconsin)
The Journey Towards Wellness Initiative will address cancer disease and prevention, decrease the incidence of late-stage cancer diagnosis, carry out quality improvement measures, and help the Bad River Health Center progress toward public health accreditation. Funding will be used to create and put into effect resources and disease intervention programming currently unavailable due to limited resources.

Inter-Tribal Council of Michigan (Michigan)
The Upper Peninsula Tribal Breast Health Project will carry out quality improvement projects to integrate evidence-based population interventions into the tribal public health system within four federally recognized tribes in Michigan’s rural Upper Peninsula. Project goals are to improve health outcomes and reduce breast cancer incidence and deaths in American Indian women by

• Increasing breast health screening rates by 20% among those aged 40-49 years
• Decreasing the time between breast cancer screening, diagnosis, and treatment

Kalispel Tribe of Indians (Washington)
Kalispel Tribe has developed a comprehensive array of health services, but these programs and services typically operate in isolation from one another. Funding will be used to

• Conduct a practice assessment to better understand opportunities for system improvement
• Develop a system for data analysis to better integrate information, including financial and operational information, from various systems for the purposes of data mining
• Provide training for the board of directors as well as staff members and tribal leaders on health services, health system reform, and leadership requirements for a successful integrated healthcare system
• Develop partnerships with experts—including the Spokane Regional Health District—around quality improvement
• Achieve national accreditation by the Public Health Accreditation Board
• Achieve an integrated system of continuous quality improvement that allows the tribe to realize its vision of healthy and active lifestyles

Pascua Yaqui Tribe (Arizona)
This public health project is focused on identifying, treating, and preventing hepatitis C virus (HCV) infection among tribal members living in the New Pascua community. This project will provide opportunities for the tribe to

• Expand capacity and infrastructure, including nurturing relationships with multiple jurisdictions (private, local, county, and state health agencies) to mine, analyze, and integrate HCV-related medical records data
• Use existing programs (e.g., ambulatory care, contracted health services, HIV/AIDS prevention, methadone clinic) to develop and carry out a culturally appropriate approach to identifying clients infected with, or at risk for, HCV
• Expand the tribe’s capability to recognize and respond to public health threats and emerging issues

Toiyabe Indian Health Project (California)
The Toiyabe Indian Health Project is a community medical center founded by nine tribes to bring medical care to tribal members in the remote high desert region of eastern California. Funds will allow community health representatives to

• Provide in-home specialized primary prevention diabetes programs
• Work collaboratively with other programs within Toiyabe to provide specialized services for families at high risk of developing diabetes
• Undergo additional training in evidence-based methodology, motivational interviewing, and diabetes education 

Awardee, Project Area 2: Project Evaluation

Native American Cancer Research Corporation (Colorado)
The Native American Cancer Research Corporation will collaborate with the five Priority 1 awardees to evaluate the effectiveness of their respective culturally adapted, evidence-based public health interventions. The goals of the project are to

• Assess evaluation plans of Priority 1 projects
• Evaluate tribal public health capacity building among Priority 1 awardees
• Disseminate lessons learned through Priority 1 projects
• Provide technical assistance 

Capacity Building Assistance to Improve Health in Tribal Populations (2012–2013)

National Native American AIDS Prevention Center (NNAAPC)
Awarded $288,400 to provide capacity building and technical assistance to five tribal health departments. Funding will support

• Strengthening organizational infrastructure and programmatic skills
• Providing culturally responsive HIV counseling, testing, and referral services
• Applying a link-to-care protocol based on the Antiretroviral Treatment Access Studies model through multifaceted capacity building assistance
• Partnering with these communities:
  • Confederated Tribes of the Colville Reservation (Washington)
  • Fort Peck Assiniboine and Sioux Tribes (Montana)
  • Shoshone Bannock Tribes (Idaho)
  • Standing Rock Sioux Tribe (North and South Dakotas)
  • White Earth Reservation (Minnesota)

Awarded $200,000 in supplemental funds from CDC's National Center for HIV, Viral Hepatitis, STD, and Tuberculosis Prevention. Funding will support

• STD prevention in urban Indian populations
• Partnering with these communities:
  • Denver Indian Health and Family Services
  • Billings

Southcentral Foundation
Awarded $300,000 to assist in reducing childhood obesity among American Indian/Alaska Native youth in Alaska. Southcentral Foundation’s capacity building assistance will support

• A breastfeeding education class for pregnant women
• A support group for women after childbirth
• Lactation education courses and certification for three health educators
• Revisions to the InJoy curriculum to ensure it is culturally relevant and teaches breastfeeding basics
• The Snuggle Time weekly support group, a behavioral health consultant, and a certified lactation educator
• The Physical Activity Club for Kids, an after-school program for overweight/obese children, led by two Alaska Native clinical exercise specialists

National Partners

CDC's Tribal Support Unit serves as subject matter expert and technical monitor for all tribal-related activities under the cooperative agreements managed through the OSTLTS Partnership Support Unit.

Other Tribal Cooperative Agreements

Other CDC Centers, Institutes, and Offices and ATSDR also fund tribes and Native-serving organizations.