INTRODUCTION: American Indian and Alaska Native elders aged ≥ 65 years are experiencing increased life expectancy. Elders are critical to intergenerational knowledge, yet limited data exist on the health challenges faced by this group.METHODS: This study engaged individuals attending the National Indian Council on Aging 2021 Annual Meeting in Reno, Nevada. A 19‐question survey, designed to examine perceptions about cognitive decline and to identify comfort with potential risk and protective factors, was disseminated to 50 participants.RESULTS: Participants indicated that they are concerned about cognitive decline, are willing to plan for their future care and cognitive testing, and articulated a desire for Tribally led long‐term support services.DISCUSSION: This study found similar results to studies on White individuals, which include a lack of knowledge, stigma around the aging process, and gaps in services available. More work is necessary to address the gap in literature and policy.Highlights: American Indian and Alaska Natives (AI/ANs) are underrepresented in literature on Alzheimer's disease and related dementia (ADRD). AI/ANs believe that they will experience cognitive decline as they age. AI/ANs indicate a willingness to plan for future care and participate in future research on ADRD.

Indigenous Peoples’ inherent right to self-determination includes authority over research, yet university systems centralize control in ways that constrain Indigenous sovereignty. This article examines how academic institutional structures and processes–well beyond the actions of individual researchers—shape the possibilities and limitations of Indigenous-focused research within universities. Drawing on a collaborative, story-based process involving Indigenous and non-Indigenous researchers working with Indigenous communities across diverse regions and contexts internationally, we synthesize shared experiences to identify recurrent challenges and the systemic conditions that produce them. We describe both barriers and solutions within five themes: governance, institutional fit, burden, capacity, and relationships. Examples of barriers include paternalizing ethics boards, cumbersome financial systems, rigid timelines, and narrow evaluation metrics, which often conflict with community-defined governance and relational approaches to research. Examples of solutions include Indigenous-governed funding pathways, community ethics bodies, Indigenous-led research units, and institution-level efforts to embed relational accountability. We argue that strengthening Indigenous research sovereignty requires universities and funders to redesign their infrastructures (not simply adjust procedures), meaningfully share authority, align practices with Indigenous governance, and support long-term relationship building. By centering community leadership and relational accountability, universities can move beyond symbolic or superficial commitments to Indigenous self-determination in research, toward research environments rooted in respect, reciprocity, and community-defined outcomes.

The U.S. health care system presents American Indian/Alaska Native populations with inequitable challenges that result in some of the worst health outcomes in the country. The literature indicates that increasing the proportion of American Indian/Alaska Native health professionals can improve these health disparities. This study aimed to explore the severe under-representation of American Indians and Alaska Natives in Nebraska’s health professions workforce by examining barriers and facilitators in this population’s pursuit of health professions careers. We conducted demographic questionnaires and three talking circles with students in reservation and urban settings to better understand their lived experiences of pursuing health professions careers. We analyzed these qualitative data through content analysis and identified eight emergent themes—four barriers and four facilitators. These findings can inform the development of strategies to improve Indigenous education, research, and pathways that promote increased American Indian/Alaska Native representation in health care.

The U.S. Preventive Services Task Force recommends annual lung cancer screening (LCS) for adults who meet specific age and smoking history criteria. To evaluate race-, ethnicity-, and rurality-based differences in distance to the nearest LCS facility. Cross-sectional ecological study. U.S. census tracts. 71 691 census tracts. The outcome variable was road network distance in miles between a census tract and the nearest LCS facility. Distance was log-transformed, and geometric means are reported. Census tracts were classified as majority (>50%) American Indian/Alaska Native (AI/AN), Asian, Black, non-Hispanic White (NHW), no single race, or Hispanic. Rurality was defined using the rural-urban commuting area codes. Ordinary least-squares regression examined the associations between distance and census tract race, ethnicity, and rurality. Geometric mean distance to the nearest LCS facility was 6.5 miles. Compared with NHW-majority census tracts, distance to the nearest LCS facility was 5.26 times (426%) longer in AI/AN-majority census tracts and 7% to 39% shorter in Asian-, Black-, and Hispanic-majority census tracts. Adjustment for rurality reduced the mean distance in AI/AN-majority census tracts, but the mean distance was still 3.16 times the distance in NHW-majority census tracts. Adjustment for rurality reduced the observed advantage in Asian- and Black-majority census tracts and changed the direction of associations in Hispanic-majority census tracts. Analyses did not account for travel time or cost. Differences exist in distance to LCS facilities by race and ethnicity that can only be partially explained by rurality. Lung Ambition Alliance and the Center for Lung Research in Honor of Wayne Gittinger.

Background and Objectives: American Indian and Alaska Natives experience disproportionately high rates of Alzheimer’s disease and related dementias, yet little research examines caregiving experiences and service needs within these communities. Guided by the Sociocultural Stress and Coping Model, this study explored dementia caregiving experiences, cultural contexts, and service needs among American Indian community members, tribal health professionals, and leaders in a Northern Plains tribal community using a community-based participatory research approach. Research Design and Methods: In 2024, 7 focus groups were conducted with 60 American Indian adults (48 community members, 12 health professionals/tribal leaders) living in the Northern Plains. Semi-structured focus groups explored caregiving experiences, cultural beliefs, and service needs. A participant background survey captured demographics and care characteristics. Qualitative data were analyzed using conceptual content analysis with iterative team-based coding. Results: 3 themes emerged across positive, negative, and service need domains. Community members emphasized cultural duty, love/reciprocity, and humor as coping mechanisms. Negative experiences included emotional and intergenerational trauma from childhood dementia exposure, and safety/supervision challenges. Critical service needs included medical guidance, community-based education, and respite services. Health professionals and tribal leaders navigated dual clinician-caregiver identities while advocating for system-level reforms. Both groups identified geographic barriers and resource scarcity. Discussion and Implications: Findings reveal cultural strengths sustaining caregiving amid substantial systemic barriers. Effective interventions must be family-centered, community-based, and strength-focused. Healthcare systems require fundamental realignment to accommodate Indigenous epistemologies.