Interview with Priyanka Manghani, Sneha Jaiswal, California Tribal Epidemiology Center, housed within the California Rural Indian Health Board (CTEC, CRIHB)
The California Tribal Epidemiology Center (CTEC) was established in 2005 to assist in collecting and interpreting health information for American Indians and Alaska Natives (AIAN) in California (from website). While Sneha and Priyanka are primarily involved in Opioid Response, the team works on a variety of health issues; for example, to address the burden of HIV, STIs, and gaps in prevention.”
Within the Tribal Opioid Overdose Program, CTEC has 2 main goals: to build and strengthen local opioid surveillance systems and implement the Overdose Detection Mapping Application Program (ODMAP). “ODMAP is kind of a novel thing; you record data right as overdose is happening. With other data sets, you must rely on state-level information, which can take a long time to access.” They note, “ODMAP is something that’s a game-changer because we’re getting real-time data and immediate response. We met with tribal communities that are excited to be able to access overdose data quickly.”
“A lot of people don’t know about this tool. With ODMAP, you can set up a spike alert and learn where the burden is highest from state to state. One of the Tribal health programs told us that previously, they waited two years to receive data on overdoses. We were surprised when we heard that from them. Now, they’re one of our Tribal health programs that is going to implement ODMAP.”
Implementing ODMAP is a new grant project for CTEC, so they are still working on recruitment, though “a lot of Tribal health programs have reached out. We’re looking forward to connecting with more communities.” To publicize their ODMAP recruitment, they are holding informational webinars for recruitment, and outreach. “We’re trying to get as many Tribal health programs involved as possible to implement opioid surveillance systems as opioids are one of the major issues in our community.”
During the informational webinars, CTEC mainly covers methodological procedures to strengthen the surveillance program and evaluation to ensure Tribal programs are assessing information in the same way.” In addition, “it’s a snapshot of what the project will be, meaning the deadlines and deliverables. Then, the Tribal health programs apply to us if they would like funding.” From the applications they’ve already received, the CTEC team has “learned a lot from them directly about what they’re planning to do. As the projects roll out and we gather more information, then we’ll have better insight into what’s been working in the field.”
They continue, “Through these projects, we’re trying to collect as much data as possible, as we currently rely on state-level data. For example, we’d like to know if there are other agencies where opioids are being prescribed much more frequently.”
Regarding challenges with their work, CTEC expressed, “I think one of the most challenging things is the response rate is on the lower side. There are a lot of reservations where the internet is not great, so it takes longer for messages to get to them.” They’ve also noted that many Tribes struggle with infrastructure and staffing requirements, as “some Tribes may not have the infrastructure to staff a first responder to go out and collect the data.”
To other Tribal Epidemiology Centers doing this work, CTEC recommends, “Start early as possible, because it takes time to communicate information the Tribes need before they apply.”
The implementation of the project brought about a range of significant outcomes that strengthened Tribal communities’ ability to address the opioid epidemic. One of the most notable successes was the establishment of stronger, more coordinated collaboration with a variety of key partners. These included first responders, law enforcement agencies, and state health departments—stakeholders who play a vital role in both prevention and response efforts.
Another important outcome was the increased sharing and integration of culturally relevant health promotion strategies and best practices. These efforts were tailored to resonate with Native communities, helping ensure that education around overdose prevention was both relevant and effective. In addition, the project prioritized the capacity building of Tribal Public Health Staff. Through training, technical assistance, and increased resource access, staff were better equipped to strengthen the surveillance system.
A key structural achievement was the creation of local surveillance systems within Tribal Health Programs. These systems have laid the groundwork for improved data collection and monitoring, enabling tribes to track trends, identify at-risk populations, and tailor interventions more precisely.
Outcomes of the Project:
The project’s implementation led to several impactful outcomes that enhanced Tribal communities’ capacity to combat the opioid epidemic. One of the most significant achievements was the development of stronger, more coordinated partnerships with essential stakeholders, including first responders, law enforcement, and state health departments. Another major success was the increased community engagement in harm reduction by distributing Narcan and providing culturally appropriate health promotion strategies and best practices. The project also emphasized building the capacity of Tribal Public Health staff. Through targeted training, and improved access to resources, staff members gained the tools and knowledge needed to enhance overdose surveillance and response efforts. Lastly, the key achievement was the development of local opioid surveillance systems within Tribal Health Programs. These systems have improved data collection, allowing for better tracking of opioid-related trends, identification of populations at risk, and the design of more targeted, community-specific interventions.