Walking Forward
American Indians on the Northern Plains have one of the highest rates of cancer deaths in the United States. That’s why, in 2002, Walking Forward was created through a National Cancer Institute community cancer grant with Monument Health radiation oncologist Daniel Petereit, MD, as its principal investigator. In 2014, Walking Forward became a community research program of Avera.
Cancer Research for American Indians
To accomplish its mission, Walking Forward provides tribal communities with access to a variety of cancer-related services:
- Cancer Education: Increase knowledge about the causes of cancer and related health issues through community discussions and workshops to address concerns and misconceptions surrounding diagnosis, treatment and survivorship.
- Community Navigation: Provide culturally responsive navigation services to guide American Indians through the complexity of cancer care.
- Cancer Screening: Increase cancer screening rates by providing information about the availability and benefits of cancer screening and assistance in obtaining these services and resources.
- Earlier Diagnosis: Increase patient survival rates by earlier detection and presentation of cancer (stage migration), earlier treatment, and ultimately a better outcome.
- Clinical Trials: Increased enrollment in clinical trials and research studies by educating about clinical trial opportunities and encouraging participation.
Barriers & Challenges to Overcome
In-depth community research provided insights about barriers to cancer care that exist within the demographics of western South Dakota, including:
- Additional costs associated with treatment such as gas, food and lodging. Average travel distance to cancer care is 145 miles one way.
- Cultural beliefs regarding medical treatment
- Home to four of the top 10 poorest counties in the U.S., with poverty rates over 45%
- Negative attitudes and mistrust toward local caregivers
Promising Outcomes
Despite the challenges that patients face, Walking Forward has achieved success as evident from measured outcomes over the last several years, such as:
- Creation of a robust research infrastructure adding new research partners
- Higher completion rates for treatment, which often leads to higher survival rates
- Higher participation rate in clinical trials with over 4,000 American Indian participants to date
- Increased trust among the tribal community
- Integrating patient navigators into Indian Health Service facilities in South Dakota
Recent data analysis suggests that cancer patients with screen-detectable cancers are now presenting with earlier stages of disease and experience higher cure rates. In the future, Walking Forward plans to step beyond cancer treatment issues and encourage American Indians of western South Dakota to focus on all health issues throughout the continuum. Walking Forward also hopes to expand research to all frontier populations.
