Dr. Anna Epperson's TRDRP Funded Research

California Rural Indian Health Board: https://crihb.org/

California Tribal Epidemiology Center: https://crihb.org/ctec/

Research Overview & Main Aims: 

American Indian and Alaska Native (AIAN; also referred to as Native American and Indigenous) communities have the highest rate of commercial tobacco use compared to other racial/ethnic groups. In addition, AIAN tobacco users have one of the lowest rates of successful cessation and are less likely to report intentions to quit tobacco use in future. Data also indicate that AIANs may be less likely to use evidence based tobacco quitting tools, such as the state tobacco quitline and nicotine replacement therapy (NRT). Previous research has found that AIAN tobacco users are more skeptical towards cessation aids (e.g., NRT) and perceive cessation programs more generally, and quitlines specifically, as not culturally-relevant, lacking acknowledgement about the roles of ceremonial versus commercial tobacco use, leading to decreased cessation. A few AIAN culturally-tailored cessation programs have been previously developed, showing promise in improving quit intentions and successful quitting, however, most have not accounted for the rise of electronic cigarettes (ecigarettes) and subsequent dual use with combustible commercial cigarettes (cigarettes) nor have most focused on increasing use of cessation resources. To date, limited studies have focused on AIAN communities in California, despite acknowledged heterogeneity of AIAN Tribal communities across the United States (U.S.). Urgent questions remain about what factors serve as facilitators (and barriers) for use of these evidence-based cessation resources for both cigarettes and e-cigarettes, and how these factors can be used to design a culturally-relevant health message intervention to increase use the state quitline and NRT by AIAN smokers (using cigarettes, e-cigarettes or a both) residing in California.

This community–university partnership brings together the California Rural Indian Health Board (CRIHB), the California Tribal Epidemiology Center (CTEC)—a federally recognized Tribal Epidemiology Center housed at CRIHB—and the University of California, Merced (UC Merced). The project is co-led by CTEC Director and CRIHB Director of Research and Evaluation, Nicamer Tolentino, and AIAN tobacco researcher and UC Merced faculty member, Anna Epperson. Together, this team combines extensive experience in AIAN health, participatory health research, and community engagement. Guided by a project-specific AIAN Community Advisory Board (CAB), the partnership will ensure that all project activities are responsive to AIAN community priorities. This partnership is distinctive in that in brings together CRIHB, a consortium of 20 Tribal health programs serving 70 Tribes in California and governed by an AIAN Board of Directors, CTEC, a federal Tribal epidemiology center with oversight from an AIAN Advisory Council, and UC Merced, a University of California research-focused university, to tackle a significant health disparity, tobacco cessation among AIAN communities.

Specifically, this collaborative and project aims to:

The partnership and findings from this study will provide a strong foundation for future state and federal funding to expand this research. The proposed research has the potential to impact the field of tobacco research and could help shape health policy by shedding further light on why commercial tobacco quit rates are low among AIAN communities in California. Findings may also inform larger specific statewide initiatives to increase AIAN use of quit resources aligning with California’s Endgame goal to eliminate commercial tobacco use and reduce related health inequities.

To read the scientific Abstract click the link below

Grant Information: