Research Methods with Alaska Native Rural Communities: A Study of Nicotine and Carcinogen Exposure and Genetic Variation among Alaska Native Tobacco Users

Community Based Participatory Research (CBPR) is infrequently employed among Alaska Native communities. The prevalence of tobacco use among Alaska Native (AN) people is among the highest of any ethnic group in the United States. This was a CBPR project initiated by regional Alaska Native health leaders and a multidisciplinary team of scientists to better understand factors that may be associated with the high rates of tobacco use and cancer. We will describe the methods by which the research was planned, designed, approved, and conducted working with and among Alaska Native people and how the study aims, data collection tools and consents were jointly written to answer the questions of importance to both the AN and scientific communities. Further, we will outline how communication over the study timeline included working side by side with community members to enable the team to determine levels of carcinogens and nicotine in smokeless and smoked tobacco products and biomarkers of exposure associated with use of these products.  We will also describe how, at the request of the community, genetic profiles associated with nicotine and carcinogen metabolism among the AN population was undertaken, and how long term specimen storage was included as an option to participants. Furthermore, we will describe how easily understandable descriptions of the findings are being approved, disseminated to the community members of the rural region in which the study was conducted. Finally we will describe how the outcomes of the CBPR activities are leading to the next steps for the team.