Voices from the Field featuring Candis Hunter

In this NCEH/ATSDR blog series titled “Voices from the Field,” readers gain first-hand accounts of NCEH/ATSDR staff experiences working in communities to protect public health. This post features LCDR Candis M. Hunter, a project officer and environmental epidemiologist in the Division of Toxicology and Human Health Sciences, Environmental Epidemiology Branch. Read on to learn more about her personal experience working with ATSDR’s Navajo Birth Cohort Study (NBCS).

Background: The Navajo Birth Cohort Study

I am LCDR Candis M. Hunter, an environmental epidemiologist and project officer for the cooperative research agreement, “A Prospective Birth Cohort Study Involving Environmental Uranium Exposure in the Navajo Nation.” The study is also known as the Navajo Birth Cohort Study (NBCS). The goal of the study is to better understand the relationship between uranium exposures and birth outcomes and early developmental delays on the Navajo Nation. My primary role is to provide epidemiological support and project management and oversight to ensure that the study meets its objectives. The NBCS is a collaborative effort involving the following primary partners:

• ATSDR,
• University of New Mexico Community Environmental Health Program (principal investigator),
• Navajo Nation Department of Health,
• Navajo Area Indian Health Service.

Other collaborators include

• Southwest Research and Information Center,
• Navajo Nation Growing in Beauty Program
• Navajo Nation Environmental Protection Agency,
• ATSDR Region 9,
• US EPA Region 9, and
• Navajo culture and language specialists.

My Role in the NBCS

In the summer of 2014, I had the incredible opportunity to serve on a temporary duty (TDY) assignment to the Navajo Area Indian Health Service to provide onsite technical assistance for the NBCS. My primary activities and responsibilities included the following:

• conducting medical record abstractions at multiple study hospitals and clinics
• evaluating and characterizing trends in study participant recruitment and participant engagement,
• identifying best practices for medical record abstraction and community engagement,
• participating in innovative community outreach recruitment activities, such as a “Just Move IT Run” and “NBCS Community Awareness Walk.”

One of the most meaningful aspects of the TDY was working directly with our NBCS staff and other tribal partners. They are on the frontlines of study participant engagement, outreach, and sample collection/processing. I’m deeply humbled to have had the opportunity to learn from and work with them. Additionally, my candid discussions with the field and clinical staff immensely broadened my perspective of the field work. For example, the discussions allowed me to gain perspective about potential challenges and opportunities that our partners face daily.

Positive Outcomes

Because of the action items we identified during the TDY and input from our study partners, we planned follow-up “best practices meetings.” These ongoing meetings contribute to increasing communication among study stakeholders and identifying effective practices for medical record abstraction, home environmental assessments, and data entry.

Besides fulfilling my duties, I was able to experience the beauty and splendor of the diverse landscape of the Navajo Nation. I also learned more about the important connections between the culture and the natural environment. I obtained a more holistic view of the present environment and historical events that shaped the context for the study. I am extremely grateful to be able to serve on this project and work with extraordinary and dedicated staff.

Learn More

Hope you enjoyed reading about LCDR Candis M. Hunter, project officer and environmental epidemiologist. Learn more about the NCBS and ATSDR’s involvement in the study.

Interested in other Voices from the Field experiences or NCEH/ATSDR accomplishments? Visit the NCEH/ATSDR Your Health, Your Environment blog!