Generating and supporting the use of tribal public health data, supporting surveillance activities for monitoring the health status of AI/ANs in the Great Plains, and responding to outbreaks and emergent tribal public health priorities.
GPTEC’s core activities are those that are included in the work plan accompanying our original Cooperative Agreement with the Indian Health Service’s Division of Epidemiology and Disease Prevention (DEDP).These include: 1) projects to provide data products, services, capacity building, and technical assistance; 2) routine and point-in-time public health surveillance, including implementation of the Behavioral Risk Factor Surveillance System (BRFSS), Pregnancy Risk Assessment Monitoring System (PRAMS), and others; 3) assessing and assisting with response to emergent tribal public health priorities (most recently maternal and child health, behavioral health, and the related issue of drug use during pregnancy); 4) monitoring and responding to outbreaks of infectious disease and other public health concerns; 5) assisting with external quality improvement activities (e.g. Consumer Assessment of Health Care Providers and Systems, or CAHPS) and internal evaluation.
GPTEC initiated two new projects during FY2015-2016 that will continue into the future, both designed to promote discussion surrounding capacity-building within tribal public health data:
- Data Workgroup: the Workgroup will be an ongoing forum to discuss tribal data issues, priorities and areas for innovation. The workgroup will be facilitated by GPTEC data experts, and will include stakeholders at the tribal, state, IHS, and academic levels. Preliminary topics include discussion of existing and potential NPTEC data products, use of the NPTEC website to enhance access to data and other information, elaboration of and brainstorming surrounding tribal data concerns and issues, ways that NPTEC and its partners can innovate within tribal public health data, tribal priorities within data, and other emergent topics. The first meeting of the Data Workgroup was held at the GPTCHB Summit in August, 2016, and additional meetings are planned quarterly.
- Tribal Epidemiology Liaison (TEL) Program: the TEL program is designed to build tribal data capacity by communicating the skills and methodologies that GPTEC uses to generate tribal data reports to tribal partners. The first training associated with the TEL program – regarding how to pull, analyze, and prepare data for the production of Community Health Profiles, or CHPs – was held in May, 2016 with great success (more information can be found here). Additional training associated with this program is planned for the future.
Responding to Tribal Priorities
Assessing and responding to the priorities of its partner tribes is one of GPTEC’s most central and important responsibilities. GPTEC is working to implement a new process by which these priorities can be regularly assessed, and conducts regular outreach to and meetings with its tribal partners to facilitate discussion and alignment.
Within the past several years, the most significant tribal priorities that GPTEC has incorporated into its activities have been maternal and child health and behavioral health, and how these topics combine within the issue of maternal substance use during pregnancy. In response to these priorities, GPTEC has undertaken a multifaceted response that includes: 1) regular calls with national partners and subject matter experts for alignment, coordination, and planning; 2) extensive literature and policy review; 3) coordination with GPTCHB surrounding advocacy and awareness efforts; and 4) community education on trauma as a driver of these issues and how it can be addressed through resilience (“Balanced Parents for a Balanced Family”), as well as community discussions for action planning and information-gathering. In August 2016, GPTEC facilitated completion of a CDC EPI-AID related to this topic within two Great Plains Area communities, data for which is currently being analyzed. GPTEC is also working with a variety of partners to plan a Tribal Medical Law and Policy Forum to discuss and coordinate an evidence-based response to this issue that leverages clinical practice, laws, and policies (tentatively planned for Spring 2017).
Public Health Surveillance
Conducting routine and other surveillance of health issues is a key feature of public health, operationalized in the first and third 10 Public Health Essential Services: “Monitor health status and understand health policies and plans” and “Give people information they need to make healthy choices.”
GPTEC has been involved with numerous public health surveillance opportunities, and is always looking for interest and opportunities to implement surveillance within its partner tribal communities. GPTEC’s past and ongoing public health surveillance activities have included:
- A 2007 South Dakota Tribal Pregnancy Risk Assessment Monitoring System (PRAMS) with all nine South Dakota tribal communities, led by the Yankton Sioux Tribe;
- Behavioral Risk Factor Surveillance System (BRFSS) assessments with three tribal communities in three states, with invaluable assistance from partners at the University of Nebraska Medical Center, the Nebraska Department of Health and Human Services, and the North Dakota Department of Health;
- A 2014-2015 Tribal PRAMS assessment with four tribal communities in three states in partnership with PRAMS experts at South Dakota State University (data dissemination is currently ongoing);
- Alignment with the North Dakota Department of Health and South Dakota Department of Health regarding present and future PRAMS opportunities, including a new 2017-2018 South Dakota Tribal PRAMS to be conducted in four participating tribal communities and coordinated by GPTCHB’s Maternal and Child Health Department, with funding from the Centers for Disease Control and Prevention.
Responding to Infectious Disease
Another of the activities central to GPTEC’s mission is the prevention of and response to infectious disease. As described above, GPTEC regularly works with State Departments of Health to ensure ongoing alignment and facilitate the communication of infectious disease data to the tribal level in a timely fashion. Additionally, GPTEC has led the production of numerous public service announcements (PSAs) regarding infectious disease and other topics, participates in regular internal task force meetings, and has worked with partners at the Great Plains Area IHS to facilitate monthly regional infectious disease calls. GPTEC also contributed to the production of an HIV Resource Guide funded and produced by the Capacity Building Assistance and HIV program at GPTCHB [link]. GPTEC has conducted numerous presentations to promote awareness of tribal infectious disease issues, and the GPTEC Director currently sits on South Dakota’s HIV Prevention Planning Group.
Additionally, GPTEC has worked with national and regional partners and subject matter experts as well as Community Health Representatives (CHRs) with the Great Plains and National CHR Associations to develop messaging and materials to promote adult vaccination in tribal communities. These products and materials can be found here as they become available.
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