G-2307-19190

The Southern Plains Tribal Health Board (SPTHB) is a non-profit organization based in Oklahoma City, Oklahoma. The Health Board was established in 1972 to provide a unified voice on tribal public health needs and policy for the 43 federally recognized tribes located in the states of Kansas, Oklahoma, and Texas. Board membership includes representatives from the 12 service units in the Indian Health Service (IHS) Oklahoma Area.

The SPTHB’s proposal builds on CareQuest Institute for Oral Health’s first grant, made for 2022-2023, for phase one of this project, during which SPTHB conducted a systematic literature review and authored a manuscript on racial misclassification among American Indians and Alaska Natives in cancer surveillance, specifically pertaining to oral health. This manuscript was published in the Health Equity journal in July 2024. Other key outcomes of the grant included a preliminary database investigation for racial misclassification, outlined in a data repository, and the (re)development of the American Indian Data Community of Practice (AIDCoP) that produced a solid foundation that expanded the organization’s understanding of racial misclassification and the preliminary effects on oral health equity.

The key aims for this grant year will include: 1) establishing this Racial Misclassification Advisory Group (RMAG) to interpret research findings from phase I and guide actions of the SPTHB’s work, and 2) facilitating and guiding the RMAG through the initial development of an oral health record mapping project targeting community members and clinics. For phase two of this work, the SPTHB is proposing to leverage its research and findings to develop a racial misclassification advisory group (RMAG) that is representative of the tribes and patient populations across Oklahoma, Texas, and Kansas. Most of the advisory group recruitment will come from the AIDCoP, as this group includes Tribes, Tribal organizations, and the Oklahoma State Department of Health, among other key stakeholders, and SPTHB will work with these representatives to equip them with information and opportunities to testify to their lived experience of racial misclassification. Regular meetings and networking will also be organized to encourage participants to relay feedback and learnings to their agencies to better inform public health work on the state- level while also discussing challenges and barriers they are facing in collecting race data within the oral health sector.

SPTHB’s proposal notes that misclassification continues to be a significant issue and one that Indian Health Services (IHS) cannot solve alone, as not all American Indian or Alaska Natives seek care at IHS, Tribal Programs or Urban Indian Clinics. The RMAG will also meet consistently throughout the grant year to guide an oral health mapping project that aims to illustrate how the oral health records of individuals travel from clinics to national federal Medicaid reporting data and how racial misclassification can be introduced at ever step between the clinic and federal agency. The resulting framework will be used to educate community members and clinical professionals on the importance of correctly identifying patient race/ethnicity on oral health records. Finally, SPTHB has developed a website dedicated to racial misclassification and it is a resource that will be used to publish relevant work from the RMAG.

The SPTHB’s proposed project is being recommended for $125,000 in funding, which will support SPTHB project staff/personnel as well as stipends of $2,000 each for members of the RMAG, who will be engaged at least monthly throughout the project period. A smaller portion of the budgeted funds will be applied toward meeting expenses and communication materials. Oral health will continue to be a central topic of discussion with respect to SPTHB’s work and the RMAG. This request represents less than 1% of the organization’s operating budget.