Cancer Care Project: Addressing Disparities in Cancer Education, Care and Outcomes in Native American Communities

Project Goal

The goal of this project is to work with the Navajo Nation and White Mountain Apache Tribe to reduce disparities in cancer education, care access, and outcomes among Native American families. 

Our Cancer Care Project is currently developing a community-based intervention to promote breast cancer screening. Intervention development is informed by quantitative and qualitative data gathered with the community to understand current epidemiology as well as local barriers and facilitators to screening and care.  Future work will focus on intervention development to promote colorectal cancer screening.

Community Sites

Current project sites are Chinle, AZ (Navajo Nation) and Whiteriver, AZ (White Mountain Apache Tribe).

Project Activities

  • Engaged local Community Advisory Boards and Cross-Site Steering Committee to guide the project.
  • Secured appropriate tribal approvals and IRB approvals for data collection activities.
  • Conducted in-depth interviews to understand barriers and facilitators to screening and connections to care, as well as cultural, familial and community strengths related to cancer screening and treatment.
  • Obtained and analyzed quantitative data from Indian Health Service and other sources, including: screening coverage; cancer incidence; and patient characteristics related to screening and incidence.
  • We are currently leveraging findings from formative data collection to develop, implement and evaluate scalable, culturally relevant interventions. Our first step is to design two motivational tools to address barriers and facilitators to breast cancer screening:

    • Tablet-based Education to Improve Acceptance of Mammography (“TEAM”) to be delivered in the clinic with highly graphic, culturally congruent breast-cancer screening information. 
    • A Patient Navigator Model (“COACH”) with a paraprofessional women’s health coach delivering education and providing one-to-one support to address individuals’ concerns and facilitate scheduling, transportation and completing a mammogram.


Project activities began in 2019. Intervention development for breast cancer screening tools will be completed in 2022. An evaluation study will begin in 2023. 


Chinle Coordinator: Kristin Mitchell, 928-674-3911,

Whiteriver Coordinator: Novalene Goklish, 928-338-5215,

Project Manager: Katie Nelson,

Co-Principal Investigator: Dr. Corrie Joshu

Principal Investigator / Project Director: Dr. Allison Barlow


This project is funded with resources from the Bristol Myers Squibb Foundation, the Ralph Lauren Corporate Foundation, and the Native American Research Centers for Health (NARCH).