title: Outreach by the Hanford Tribal Service Program to Indian communities around the Hanford Nuclear Reservation.
abstract: BACKGROUND
  The Hanford Tribal Service Program offers technical assistance and health education to American Indian tribes in an area reported to be affected by radiation from the Hanford Nuclear Reservation, which was developed and operated by the United States federal government. This article describes strategies used to reach out to communities to tell them about Hanford's history and the potential health effects of radioactive materials emitted from Hanford. Two health effects of concern are thyroid disease and cancer. Based in Portland, Oregon, the Hanford program is administered by the Northwest Portland Area Indian Health Board, a tribal organization serving 39 federally recognized tribes in Idaho, Oregon, and Washington on health issues.
  
  
  METHODS
  This article describes outreach strategies used by the health educator. They include informational resource kits, community visits, postage-paid response cards, and a toll-free telephone line. The staff made presentations to tribal councils and then reached out to health care providers and general community members, with special attention given to elders.
  
  
  CONCLUSIONS
  The staff faced obstacles in delivering the message about Hanford's history and the potential health effects of the radioactive emissions from Hanford. One such obstacle is the uncertain and controversial nature linking Hanford and health effects due to its releases of radioactive materials. Another is that Hanford concerns represent only one of many issues vying for communities' attention. However, communities welcomed the efforts of the Hanford Tribal Service Program. After decades of secrecy, people wanted to know what happened at Hanford and how its operations might have affected their health.
authors.affiliation: Northwest Portland Area Indian Health Board, Oregon, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Jensen
mesh_terms: D003159:Community-Institutional Relations; D006266:Health Education; D006801:Humans; D007061:Idaho; D007198:Indians, North American; D009381:Neoplasms, Radiation-Induced / Q000209:etiology; D009688:Nuclear Reactors; D009922:Oregon; D011830:Radiation Effects; D012307:Risk Factors; D013964:Thyroid Neoplasms / Q000209:etiology; D014481:United States; D016549:United States Indian Health Service; D014861:Washington