# Community-informed interventions to address the large burden of Staphylococcus aureus infections on the White Mountain Apache Tribal lands

> **NIH NIH S06** · WHITE MOUNTAIN APACHE TRIBE · 2023 · $232,491

## Abstract

PROJECT SUMMARY
Staphylococcus aureus is a common cause of bacterial infections in the United States, causing non-invasive
skin and soft tissue infections as well as invasive infections, including sepsis, pneumonia and necrotizing
fasciitis. In the Southwest US, the American Indian population is disproportionately affected by morbidity and
mortality related to S. aureus infections. Existing strategies have not been sufficient to control S. aureus
disease and new approaches are urgently needed. Through a partnership between the White Mountain
Apache Tribe, the Whiteriver Service Unit of the Indian Health Service, and the Johns Hopkins Center for
American Indian Health, the proposed research will design and evaluate a community-informed approach to
education and S. aureus decolonization to prevent S. aureus disease in high-risk individuals. In Year 1,
formative work will be completed to: 1) develop culturally tailored educational materials for prevention and early
recognition of S. aureus infections; and 2) assess the acceptability and feasibility of decolonization regimens in
a rural American Indian community. This will be accomplished through focus-group discussions and in-depth
interviews with key stakeholders, including healthcare providers and patients. At the end of the formative work,
we will have educational materials and a decolonization protocol tailored for American Indian communities to
optimize acceptability, adherence, and sustainability. In Years 2 to 4, the educational materials and
decolonization protocol will be evaluated in a randomized controlled trial to evaluate the efficacy of an
intermittent compared to a one-time decolonization protocol in decreasing S. aureus colonization and
preventing S. aureus infections. Adults at high risk for S. aureus infection attending the Whiteriver Service Unit
(index participants; n=200) will be enrolled along with their household members (n=1000) and followed for 12
months. Index participants will be randomized in a ratio of 1:1 to either: 1) education plus intermittent
decolonization (E+iD); or 2) education plus one-time decolonization (E+1D; control group). Index participants
randomized to the E+1D group will receive educational materials and one administration of the decolonization
protocol at the baseline visit only. Index participants randomized to the E+iD group will receive educational
materials at the baseline visit and will be provided with six administrations of the decolonization protocol to be
performed at the baseline visit and then every other month. Household members from groups will receive the
E+1D intervention. The primary outcome will be colonization among index participants 6 months after
randomization. Secondary outcomes will include: 1) prevalence of colonization among index participants at 12
months; and 2) incidence of S. aureus and all-cause infections among index participants at 6 and 12 months. If
found to be efficacious, this intervention could be broadly used in hi...

## Key facts

- **NIH application ID:** 10494072
- **Project number:** 5S06GM142120-02
- **Recipient organization:** WHITE MOUNTAIN APACHE TRIBE
- **Principal Investigator:** Laura Hammitt
- **Activity code:** S06 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2023
- **Award amount:** $232,491
- **Award type:** 5
- **Project period:** 2021-09-24 → 2026-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10494072

## Citation

> US National Institutes of Health, RePORTER application 10494072, Community-informed interventions to address the large burden of Staphylococcus aureus infections on the White Mountain Apache Tribal lands (5S06GM142120-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10494072. Licensed CC0.

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