A Model for Clinician and Staff Education in the Engagement of American Indians in Genomic Research

Despite notable differences in cancer incidence and outcomes, fewer American Indians have participated in cancer research and genomic testing relative to their population size. Contributing factors include historical scientific mistrust, lack of culturally appropriate research methodologies, and limited access. With the launch of a cancer genomic sequencing trial in American Indians from the Southwestern United States (US), clinicians and staff encountered challenges engaging patients, recognizing the complexity of research in this population. We describe a novel approach to educate study team members regarding genomic cancer testing and research in American Indian populations. Clinical faculty and staff investigators participated in (1) hands-on experiential workshops related to core beliefs and healthcare in American Indians and (2) the development of provider-facing educational materials. After participation in the workshops, investigators, including American Indian researchers, created two sets of provider-facing materials and implemented them in clinic. The first provided a summary detailing trial eligibility, procedures, and privacy safeguards. The second outlined topics fostering respectful engagement of American Indians in research, outlining core beliefs including the importance of family and community in decisions, a framework of inherent cycles in human life and nature, the importance of visual aids, and the complementary nature of traditional healing. An approach incorporating cultural training for clinicians and staff is feasible when engaging American Indians of the Southwestern US in genomic research. This methodology may serve as a model for future initiatives to engage with American Indians in cancer research and in both clinical and research related genomic testing.