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Madden EB, Hindorff LA, Bonham VL, Akintobi TH, Burchard EG, Baker KE, Begay RL, Carpten JD, Cox NJ, Di Francesco V, Dillard DA, Fletcher FE, Fullerton SM, Garrison NA, Hammack-Aviran CM, Hiratsuka VY, Hildreth JEK, Horowitz CR, Hughes Halbert CA, Inouye M, Jackson A, Landry LG, Kittles RA, Leek JT, Limdi NA, Lockhart NC, Ofili EO, Pérez-Stable EJ, Sabatello M, Saulsberry L, Schools LE, Troyer JL, Wilfond BS, Wojcik GL, Cho JH, Lee SSJ, Green ED. Advancing genomics to improve health equity. Nat Genet 2024; 56:752-757. [PMID: 38684898 PMCID: PMC11096049 DOI: 10.1038/s41588-024-01711-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/08/2024] [Indexed: 05/02/2024]
Abstract
Health equity is the state in which everyone has fair and just opportunities to attain their highest level of health. The field of human genomics has fallen short in increasing health equity, largely because the diversity of the human population has been inadequately reflected among participants of genomics research. This lack of diversity leads to disparities that can have scientific and clinical consequences. Achieving health equity related to genomics will require greater effort in addressing inequities within the field. As part of the commitment of the National Human Genome Research Institute (NHGRI) to advancing health equity, it convened experts in genomics and health equity research to make recommendations and performed a review of current literature to identify the landscape of gaps and opportunities at the interface between human genomics and health equity research. This Perspective describes these findings and examines health equity within the context of human genomics and genomic medicine.
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Affiliation(s)
- Ebony B Madden
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA.
| | - Lucia A Hindorff
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Vence L Bonham
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Tabia Henry Akintobi
- Department of Community Health and Preventative Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Esteban G Burchard
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, CA, USA
| | | | - Rene L Begay
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John D Carpten
- Comprehensive Cancer Center, City of Hope, Duarte, CA, USA
| | - Nancy J Cox
- Vanderbilt Genetics Institute, Vanderbilt University, Nashville, TN, USA
| | | | - Denise A Dillard
- Department of Medical Education and Clinical Sciences, Washington State University College of Medicine, Seattle, WA, USA
| | - Faith E Fletcher
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | | | - Nanibaa' A Garrison
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Institute for Precision Health, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- Division of General Internal Medicine and Health Services Research, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
| | | | - Vanessa Y Hiratsuka
- Center for Human Development, University of Alaska Anchorage, Anchorage, AK, USA
| | | | | | - Chanita A Hughes Halbert
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Michael Inouye
- Department of Public Health and Primary Care, University of Cambridge Victor Phillip Dahdaleh Heart and Lung Research Institute, Cambridge, UK
| | - Amber Jackson
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Latrice G Landry
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jeff T Leek
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Nita A Limdi
- Department of Neurology, University of Alabama, Birmingham School of Medicine, Birmingham, AL, USA
| | - Nicole C Lockhart
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | - Elizabeth O Ofili
- Department of Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | | | - Maya Sabatello
- Center for Precision Medicine and Genomics, Columbia University, New York, NY, USA
- Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Loren Saulsberry
- Department of Public Health Sciences, The University of Chicago, Chicago, IL, USA
| | | | - Jennifer L Troyer
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
| | | | - Genevieve L Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Judy H Cho
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sandra S-J Lee
- Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Eric D Green
- Office of the Director, National Human Genome Research Institute, Bethesda, MD, USA
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Wick M, Erickson D, Hoffman J, Johnson L, Angradi T. Navigating University Openness in Research Policy Inconsistent with Indigenous Data Sovereignty: A Case Analysis. Ethics Hum Res 2024; 46:2-15. [PMID: 38446108 DOI: 10.1002/eahr.500202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Indigenous nations and communities in the United States have rights as sovereign governments to exercise control and ownership over all data and information generated by or from the tribes, tribal members, or tribal resources. Indigenous nations exercise these rights through data ownership policies established in response to unethical research practices in research involving Indigenous communities. Most universities in the U.S. have "openness in research" policies to ensure academic freedom to publish freely, exercised by retaining university control of data. Here, we describe our study of cultural ecosystem services in the St. Louis River estuary region (Nagaajiwanaang in the language Ojibwemowin) in Duluth, Minnesota, and Superior, Wisconsin, U.S., an area that includes portions of the 1854 and 1842 Ceded Territories and reservation lands of a local band of Ojibwe (hereafter referred to as "the Band"). In this university-led, Band-supported study, both the university and the Band sought ownership of data collected based on their respective policies, resulting in a research delay of nearly a year. We found that open research policies that do not consider Indigenous sovereignty can hamper collaboration between university researchers and tribal nations, even when there is broad agreement on research goals and objectives. University open research policies that do not explicitly address Indigenous sovereignty fall short of the open research principles they intend to support and should be revised. Formal adoption of principles for ethical research with sovereign tribal governments by universities is needed to improve coordination and trust among university and tribal researchers and members.
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Affiliation(s)
- Molly Wick
- PhD candidate at the University of Minnesota Duluth and a student trainee at the U.S. Environmental Protection Agency Great Lakes Toxicology and Ecology Division
| | - Deanna Erickson
- Director of the Lake Superior National Estuarine Research Reserve
| | - Joel Hoffman
- Manager of the Eco-system Services Branch at the U.S. Environmental Protection Agency Great Lakes Toxicology and Ecology Division
| | - Lucinda Johnson
- Senior research fellow at the University of Minnesota Natural Resources Research Institute
| | - Ted Angradi
- Retired research biologist for the U.S. Environmental Protection Agency Great Lakes Toxi-cology and Ecology Division
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Beans JA, Trinidad SB, Shane AL, Wark KA, Avey JP, Apok C, Guinn T, Robler SK, Hirschfeld M, Koeller DM, Dillard DA. The CPT1A Arctic variant: perspectives of community members and providers in two Alaska tribal health settings. J Community Genet 2023; 14:613-620. [PMID: 37847346 PMCID: PMC10725401 DOI: 10.1007/s12687-023-00684-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023] Open
Abstract
Newborn screening in Alaska includes screening for carnitine palmitoyltransferase 1A (CPT1A) deficiency. The CPT1A Arctic variant is a variant highly prevalent among Indigenous peoples in the Arctic. In this study, we sought to elicit Alaska Native (AN) community member and AN-serving healthcare providers' knowledge and perspectives on the CPT1A Arctic variant. Focus groups with community members and healthcare providers were held in two regions of Alaska between October 2018 and January 2019. Thematic analysis was used to identify recurring constructs. Knowledge and understanding about the CPT1A Arctic variant and its health impact varied, and participants were interested in learning more about it. Additional education for healthcare professionals was recommended to improve providers' ability to communicate with family caregivers about the Arctic variant. Engagement with AN community members identified opportunities to improve educational outreach via multiple modalities for providers and caregivers on the Arctic variant, which could help to increase culturally relevant guidance and avoid stigmatization, undue worry, and unnecessary intervention. Education and guidance on the care of infants and children homozygous for the CPT1A Arctic variant could improve care and reduce negative psychosocial effects.
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Affiliation(s)
- Julie A Beans
- Research and Data Services Department, Southcentral Foundation, Anchorage, AK, USA.
| | - Susan Brown Trinidad
- Department of Bioethics & Humanities, University of Washington, Seattle, WA, USA
| | - Aliassa L Shane
- Research and Data Services Department, Southcentral Foundation, Anchorage, AK, USA
| | - Kyle A Wark
- Research and Data Services Department, Southcentral Foundation, Anchorage, AK, USA
| | - Jaedon P Avey
- Research and Data Services Department, Southcentral Foundation, Anchorage, AK, USA
| | | | - Tiffany Guinn
- Research and Data Services Department, Southcentral Foundation, Anchorage, AK, USA
| | | | - Matthew Hirschfeld
- Maternal Child Health Services, Alaska Native Medical Center, Anchorage, AK, USA
| | - David M Koeller
- Department of Molecular & Medical Genetics, Oregon Health & Science University, Portland, OR, USA
| | - Denise A Dillard
- Research and Data Services Department, Southcentral Foundation, Anchorage, AK, USA
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Garba I, Sterling R, Plevel R, Carson W, Cordova-Marks FM, Cummins J, Curley C, David-Chavez D, Fernandez A, Hiraldo D, Hiratsuka V, Hudson M, Jäger MB, Jennings LL, Martinez A, Yracheta J, Garrison NA, Carroll SR. Indigenous Peoples and research: self-determination in research governance. Front Res Metr Anal 2023; 8:1272318. [PMID: 38033627 PMCID: PMC10685893 DOI: 10.3389/frma.2023.1272318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 09/26/2023] [Indexed: 12/02/2023] Open
Abstract
Indigenous Peoples are reimagining their relationship with research and researchers through greater self-determination and involvement in research governance. The emerging discourse around Indigenous Data Sovereignty has provoked discussions about decolonizing data practices and highlighted the importance of Indigenous Data Governance to support Indigenous decision-making and control of data. Given that much data are generated from research, Indigenous research governance and Indigenous Data Governance overlap. In this paper, we broaden the concept of Indigenous Data Sovereignty by using the CARE Principles for Indigenous Data Governance to discuss how research legislation and policy adopted by Indigenous Peoples in the US set expectations around recognizing sovereign relationships, acknowledging rights and interests in data, and enabling Indigenous Peoples' participation in research governance.
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Affiliation(s)
- Ibrahim Garba
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Rogena Sterling
- Living on the lands of Waikato-Tainui, Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
| | - Rebecca Plevel
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
- Lands of the Congaree, Catawba, Muscogee, and Eastern Cherokee, Law Library, School of Law, University of South Carolina, Columbia, SC, United States
| | - William Carson
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Felina M. Cordova-Marks
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Jewel Cummins
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
- Lands of the O'odham and Yaqui peoples, American Indian Studies-Graduate Interdisciplinary Program, College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, United States
| | - Caleigh Curley
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Dominique David-Chavez
- Nunt'zi (Ute), Hinono'eino' (Arapaho), and Tsitsistas (Cheyenne) homelands, Department of Forest and Rangeland Stewardship, Colorado State University, Fort Collins, CO, United States
| | - Adam Fernandez
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Danielle Hiraldo
- Ancestral homeland of Eastern Siouan-speaking Indigenous peoples (Yesàh, “The People”), American Indian Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Vanessa Hiratsuka
- Dena'ina Ełnena, Center for Human Development, College of Health, University of Alaska Anchorage, Anchorage, AK, United States
| | - Maui Hudson
- Living on the lands of Waikato-Tainui, Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
| | - Mary Beth Jäger
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Lydia L. Jennings
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Andrew Martinez
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Joseph Yracheta
- Lands of the Oceti Sakowin (Seven council fires of the Lakota/Nakoda/Dakota), Native BioData Consortium, Eagle Butte, SD, United States
- Ancestral homelands of the Paskestikweya (Piscataway) band of Chaptico, the Moyaone, Nanjemoy, and the Potapoco, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States
| | - Nanibaa' A. Garrison
- Traditional, ancestral and unceded territory of the Gabrielino/Tongva peoples, Institute for Society and Genetics, College of Letters and Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Traditional, ancestral and unceded territory of the Gabrielino/Tongva peoples, Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Traditional, ancestral and unceded territory of the Gabrielino/Tongva peoples, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Stephanie Russo Carroll
- Lands of the O'odham and Yaqui peoples, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Lands of the O'odham and Yaqui peoples, Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
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Taylor JY, Barcelona V, Magny-Normilus C, Wright ML, Jones-Patten A, Prescott L, Potts-Thompson S, Santos HP. A roadmap for social determinants of health and biological nursing research in the National Institute of Nursing Research 2022-2026 Strategic Plan: Optimizing health and advancing health equity using antiracist framing. Nurs Outlook 2023; 71:102059. [PMID: 37863707 PMCID: PMC10803078 DOI: 10.1016/j.outlook.2023.102059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/08/2023] [Accepted: 09/15/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND Health equity is essential for improving the well-being of all individuals and groups, and research remains a critical element for understanding barriers to health equity. While considering how to best support research that acknowledges current health challenges, it is crucial to understand the role of social justice frameworks within health equity research and the contributions of minoritized researchers. Additionally, there should be an increased understanding of the influence of social determinants of health on biological mechanisms. PURPOSE Biological health equity research seeks to understand and address health disparities among historically excluded populations. DISCUSSION While there are examples of studies in this area led by minoritized researchers, some individuals and groups remain understudied due to underfunding. Research within minoritized populations must be prioritized to authentically achieve health equity. Furthermore, there should be increased funding from National Institutes of Health to support minoritized researchers working in this area.
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Affiliation(s)
- Jacquelyn Y Taylor
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY.
| | - Veronica Barcelona
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY
| | | | | | | | - Laura Prescott
- Center for Research on People of Color, Columbia University School of Nursing, New York, NY
| | | | - Hudson P Santos
- School of Nursing & Health Studies, University of Miami, Coral Gables, FL
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White EJ, Demuth MJ, Wiglesworth A, Coser AD, Garrett BA, Kominsky TK, Jernigan V, Thompson WK, Paulus M, Aupperle R. Five recommendations for using large-scale publicly available data to advance health among American Indian peoples: the Adolescent Brain and Cognitive Development (ABCD) Study SM as an illustrative case. Neuropsychopharmacology 2023; 48:263-269. [PMID: 36385331 PMCID: PMC9751109 DOI: 10.1038/s41386-022-01498-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/12/2022] [Accepted: 10/31/2022] [Indexed: 11/18/2022]
Abstract
American Indian and Alaska Native (AIAN) populations have suffered a history of exploitation and abuse within the context of mental health research and related fields. This history is rooted in assimilation policies, historical trauma, and cultural loss, and is promulgated through discrimination and disregard for traditional culture and community knowledge. In recognition of this history, it is imperative for researchers to utilize culturally sensitive approaches that consider the context of tribal communities to better address mental health issues for AIAN individuals. The public availability of data from large-scale studies creates both opportunities and challenges when studying mental health within AIAN populations. This manuscript has two goals; first, showcase an example of problematic use of Adolescent Brain Cognitive Development (ABCD) StudySM data to promulgate stereotypes about AIAN individuals and, second, in partnership with collaborators from Cherokee Nation, we provide five recommendations for utilizing data from publicly available datasets to advance health research in AIAN populations. Specifically, we argue for the consideration of (1) the heterogeneity of the communities represented, (2) the importance of focusing on AIAN health and well-being, (3) engagement of relevant communities and AIAN community leaders, (4) consideration of historical and ongoing injustices, and (5) engagement with AIAN regulatory agencies or review boards. These recommendations are founded on principles from broader indigenous research efforts emphasizing community-engaged research and principles of Indigenous Data Sovereignty and Governance.
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Affiliation(s)
- Evan J White
- Laureate Institute for Brain Research, Tulsa, OK, USA.
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA.
| | - Mara J Demuth
- Laureate Institute for Brain Research, Tulsa, OK, USA
| | | | | | | | | | - Valarie Jernigan
- Center for Indigenous Health Research and Policy, Oklahoma State Universit y Center for Health Sciences, Tulsa, OK, USA
| | | | - Martin Paulus
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
| | - Robin Aupperle
- Laureate Institute for Brain Research, Tulsa, OK, USA
- Oxley School of Community Medicine, University of Tulsa, Tulsa, OK, USA
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Carroll SR, Plevel R, Jennings LL, Garba I, Sterling R, Cordova-Marks FM, Hiratsuka V, Hudson M, Garrison NA. Extending the CARE Principles from tribal research policies to benefit sharing in genomic research. Front Genet 2022; 13:1052620. [PMID: 36437947 PMCID: PMC9691892 DOI: 10.3389/fgene.2022.1052620] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 10/19/2022] [Indexed: 08/11/2023] Open
Abstract
Indigenous Peoples have historically been targets of extractive research that has led to little to no benefit. In genomics, such research not only exposes communities to harms and risks of misuse, but also deprives such communities of potential benefits. Tribes in the US have been exercising their sovereignty to limit this extractive practice by adopting laws and policies to govern research on their territories and with their citizens. Federally and state recognized tribes are in the strongest position to assert research oversight. Other tribes lack the same authority, given that federal and state governments do not recognize their rights to regulate research, resulting in varying levels of oversight by tribes. These governance measures establish collective protections absent from the US federal government's research oversight infrastructure, while setting expectations regarding benefits to tribes as political collectives. Using a legal epidemiology approach, the paper discusses findings from a review of Tribal research legislation, policy, and administrative materials from 26 tribes in the US. The discussion specifies issues viewed by tribes as facilitators and barriers to securing benefits from research for their nations and members/citizens, and describes preemptive and mitigating strategies pursued by tribes in response. These strategies are set within the framing of the CARE Principles for Indigenous Data Governance (Collective Benefit, Authority to Control, Responsibility, Ethics), a set of standards developed to ensure that decisions made about data pertaining to Indigenous communities at the individual and tribal levels are responsive to their values and collective interests. Our findings illustrate gaps to address for benefit sharing and a need to strengthen Responsibility and Ethics in tribal research governance.
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Affiliation(s)
- Stephanie Russo Carroll
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Rebecca Plevel
- Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
- Law Library, School of Law, University of South Carolina, Columbia, SC, United States
| | - Lydia L. Jennings
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Ibrahim Garba
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
- Native Nations Institute, Udall Center for Studies in Public Policy, University of Arizona, Tucson, AZ, United States
| | - Rogena Sterling
- Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
| | - Felina M. Cordova-Marks
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, United States
| | - Vanessa Hiratsuka
- Center for Human Development, College of Health, University of Alaska Anchorage, Anchorage, AK, United States
| | - Maui Hudson
- Te Kotahi Research Institute, University of Waikato, Hamilton, New Zealand
| | - Nanibaa’ A. Garrison
- Institute for Society and Genetics, College of Letters and Sciences, University of California, Los Angeles, Los Angeles, CA, United States
- Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
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Beans JA, Trinidad SB, Blacksher E, Hiratsuka VY, Spicer P, Woodahl EL, Boyer BB, Lewis CM, Gaffney PM, Garrison NA, Burke W. Communicating Precision Medicine Research: Multidisciplinary Teams and Diverse Communities. Public Health Genomics 2022; 25:1-9. [PMID: 35998578 PMCID: PMC9947193 DOI: 10.1159/000525684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 06/21/2022] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Precision medicine research investigates the differences in individuals' genetics, environment, and lifestyle to tailor health prevention and treatment options as part of an emerging model of health care delivery. Advancing precision medicine research will require effective communication across a wide range of scientific and health care disciplines and with research participants who represent diverse segments of the population. METHODS A multidisciplinary group convened over the course of a year and developed precision medicine research case examples to facilitate precision medicine research discussions with communities. RESULTS A shared definition of precision medicine research as well as six case examples of precision medicine research involving genetic risk, pharmacogenetics, epigenetics, the microbiome, mobile health, and electronic health records were developed. DISCUSSION/CONCLUSION The precision medicine research definition and case examples can be used as planning tools to establish a shared understanding of the scope of precision medicine research across multidisciplinary teams and with the diverse communities in which precision medicine research will take place. This shared understanding is vital for successful and equitable progress in precision medicine.
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Affiliation(s)
- Julie A. Beans
- Southcentral Foundation Research Department, Anchorage, Alaska, United States of America
| | - Susan B. Trinidad
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington, United States of America
| | - Erika Blacksher
- Department of History and Philosophy of Medicine, University of Kansas City Medical Center, Kansas City, Kansas, United States of America Center for Practical Bioethics, Kansas City, Missouri, United States of America
| | - Vanessa Y. Hiratsuka
- Southcentral Foundation Research Department, Anchorage, Alaska, United States of America
- Center for Human Development, University of Alaska Anchorage, Anchorage, Alaska, United States of America
| | - Paul Spicer
- Department of Anthropology, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Erica L. Woodahl
- Department of Biomedical and Pharmaceutical Sciences, University of Montana, Missoula, Montana, United States of America
| | - Bert B. Boyer
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, Oregon, United States of America
| | - Cecil M. Lewis
- Department of Anthropology, University of Oklahoma, Norman, Oklahoma, United States of America
- Laboratories of Molecular Anthropology and Microbiome Research, University of Oklahoma, Norman, Oklahoma, United States of America
| | - Patrick M. Gaffney
- Genes and Human Disease Research Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, United States of America
| | - Nanibaa’ A. Garrison
- Institute for Society and Genetics, University of California, Los Angeles, Los Angeles, California, United States of America
- Institute for Precision Health, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
- Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, United States of America
| | - Wylie Burke
- Department of Bioethics and Humanities, University of Washington, Seattle, Washington, United States of America
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Weeks R, White S, Hartner AM, Littlepage S, Wolf J, Masten K, Tingey L. COVID-19 Messaging on Social Media for American Indian and Alaska Native Communities: Thematic Analysis of Audience Reach and Web Behavior. JMIR INFODEMIOLOGY 2022; 2:e38441. [PMID: 36471705 PMCID: PMC9709694 DOI: 10.2196/38441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 09/30/2022] [Accepted: 10/22/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND During the COVID-19 pandemic, tribal and health organizations used social media to rapidly disseminate public health guidance highlighting protective behaviors such as masking and vaccination to mitigate the pandemic's disproportionate burden on American Indian and Alaska Native (AI/AN) communities. OBJECTIVE Seeking to provide guidance for future communication campaigns prioritizing AI/AN audiences, this study aimed to identify Twitter post characteristics associated with higher performance, measured by audience reach (impressions) and web behavior (engagement rate). METHODS We analyzed Twitter posts published by a campaign by the Johns Hopkins Center for Indigenous Health from July 2020 to June 2021. Qualitative analysis was informed by in-depth interviews with members of a Tribal Advisory Board and thematically organized according to the Health Belief Model. A general linearized model was used to analyze associations between Twitter post themes, impressions, and engagement rates. RESULTS The campaign published 162 Twitter messages, which organically generated 425,834 impressions and 6016 engagements. Iterative analysis of these Twitter posts identified 10 unique themes under theory- and culture-related categories of framing knowledge, cultural messaging, normalizing mitigation strategies, and interactive opportunities, which were corroborated by interviews with Tribal Advisory Board members. Statistical analysis of Twitter impressions and engagement rate by theme demonstrated that posts featuring culturally resonant community role models (P=.02), promoting web-based events (P=.002), and with messaging as part of Twitter Chats (P<.001) were likely to generate higher impressions. In the adjusted analysis controlling for the date of posting, only the promotion of web-based events (P=.003) and Twitter Chat messaging (P=.01) remained significant. Visual, explanatory posts promoting self-efficacy (P=.01; P=.01) and humorous posts (P=.02; P=.01) were the most likely to generate high-engagement rates in both the adjusted and unadjusted analysis. CONCLUSIONS Results from the 1-year Twitter campaign provide lessons to inform organizations designing social media messages to reach and engage AI/AN social media audiences. The use of interactive events, instructional graphics, and Indigenous humor are promising practices to engage community members, potentially opening audiences to receiving important and time-sensitive guidance.
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Affiliation(s)
- Rose Weeks
- Center for Indigenous Health Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD United States
| | - Sydney White
- Center for Indigenous Health Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD United States
| | - Anna-Maria Hartner
- Center for Indigenous Health Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD United States
| | - Shea Littlepage
- Center for Indigenous Health Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD United States
| | | | - Kristin Masten
- Center for Indigenous Health Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD United States
| | - Lauren Tingey
- Center for Indigenous Health Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore, MD United States
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10
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Bass MB, Molina RL, Reardon EE, Porcello L, Goldberg J, Nickum A, Lipke L, Zeigen L, Eldredge JD, Wallerstein NB. Trends in…Controlled Vocabulary and Health Equity. Med Ref Serv Q 2022; 41:185-201. [PMID: 35511428 DOI: 10.1080/02763869.2022.2060638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Medical librarians collaborate with physicians and other healthcare professionals to improve the quality and accessibility of medical information, which includes assembling the best evidence to advance health equality through teaching and research. This column brings together brief cases highlighting the experiences and perspectives of medical librarians, educators, and healthcare professionals using their organizational, pedagogical, and information-analysis skills to advance health equality indexing.
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Affiliation(s)
- Michelle B Bass
- Countway Library of Medicine, Harvard Medical School, Boston, Massachussetts, USA
| | - Rose L Molina
- Obstetrics, Gynecology, and Reproductive Biology, Beth Israel Deaconess Medical Center, Boston, Massachussetts, USA
| | - Erin E Reardon
- Health Sciences Library, University of Minnesota, Minneapolis, USA
| | - Lorraine Porcello
- Edward G. Miner Library, University of Rochester Medical Center, New York, USA
| | - Johanna Goldberg
- Medical Library, Memorial Sloan Kettering Cancer Center, New York City, USA
| | - Annie Nickum
- Library of Health Sciences, University of Illinois Chicago, USA
| | - Laura Lipke
- A.T. Still Memorial Library, A.T. Still University, Kirksville, Missouri, USA
| | - Laura Zeigen
- Oregon Health & Science University Library, Portland, USA
| | - Jonathan D Eldredge
- College of Population Health, University of New Mexico, Albuquerque, USA.,Health Sciences Library and Informatics Center, University of New Mexico, Albuquerque, USA
| | - Nina B Wallerstein
- Center for Participatory Research, University of New Mexico, Albuquerque, USA
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11
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Scheinerman N. Deliberative Forums to Bolster Tribal Self-Determination. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:35-37. [PMID: 34554070 PMCID: PMC9131895 DOI: 10.1080/15265161.2021.1965247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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12
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Tilburt JC. Chickens & Eggs, Pigs and Their Lipstick: The Trouble with Asking Principlism to Do Too Much. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:13-14. [PMID: 34554072 DOI: 10.1080/15265161.2021.1965246] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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13
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Resnik DB. Group Solidarity Versus Individual Autonomy in Research Involving American Indian/Alaskan Native Communities. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:17-19. [PMID: 34554073 DOI: 10.1080/15265161.2021.1965256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- David B Resnik
- National Institute of Environmental Health Sciences, National Institutes of Health
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14
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McGregor J, Tsosie R. Rethinking Research Protections for Tribal Communities. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:30-32. [PMID: 34554075 DOI: 10.1080/15265161.2021.1965244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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15
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Tsosie KS, Claw KG, Garrison NA. Considering "Respect for Sovereignty" Beyond the Belmont Report and the Common Rule: Ethical and Legal Implications for American Indian and Alaska Native Peoples. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:27-30. [PMID: 34554064 DOI: 10.1080/15265161.2021.1968068] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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16
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Siddiqui W, Sharp RR. Beyond the Belmont Report. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:1-4. [PMID: 34554060 DOI: 10.1080/15265161.2021.1972649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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17
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Malinowska JK. Methodological and Ethical Risks Associated with the Epistemic Unification of Tribe Members. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:32-34. [PMID: 35426757 DOI: 10.1080/15265161.2021.1965249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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18
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Hull SC, Nez Diné FL, Blome JM. Solidarity as an Aspirational Basis for Partnership with Tribal Communities. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:14-17. [PMID: 34554069 DOI: 10.1080/15265161.2021.1965258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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19
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Yu JH. Solidarity in the Absence of Sovereignty: Expanding Group Protections in New Research Contexts. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:22-24. [PMID: 34554076 PMCID: PMC10124740 DOI: 10.1080/15265161.2021.1965259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Affiliation(s)
- Joon-Ho Yu
- Division of Genetic Medicine, Division of Bioethics and
Palliative Care, Department of Pediatrics; Institute for Public Health Genetics,
Department of Biostatistics, University of Washington, Seattle, WA, USA
- Treuman Katz Center for Pediatric Bioethics, Seattle
Children’s Hospital and Research Institute, Seattle, WA, USA
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20
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Friesen P, Doerksen E, Gunay A. Solidarity without Sovereignty: Extending the Belmont Principles Further? THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2021; 21:25-27. [PMID: 34554062 DOI: 10.1080/15265161.2021.1965250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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21
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Coser A, Kominsky TK, White EJ. For the Good of the Community: Considering the Impact of Evidence-Based Treatment Adaptation on Tribal Communities. THE BEHAVIOR THERAPIST 2021; 44:161-170. [PMID: 34539031 PMCID: PMC8445390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Ongoing discussions among tribal communities, professionals, and mental health organizations have centered on the question of whether evidence-based interventions require adaptations to improve mental health outcomes among American Indian communities. Continued efforts to address these questions have resulted in the development of novel, culturally-grounded interventions, adapted interventions, use of original standard protocols, and/or limited use of evidence-based treatments. Consequently, mental health services in tribal communities may be highly variable from one community to another and the effectiveness of services relatively unknown. The current paper explored the state of the literature on adaptations and their utility among American Indian communities and the broader ethnic minority community. Considerations for the various impacts on tribal communities are presented and recommendations for researchers and practitioners are also discussed.
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Affiliation(s)
| | | | - Evan J. White
- Laureate Insitute for Brain Research, Tulsa, OK, USA
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