Dr. Daniel Petereit developed the NCI-funded Walking Forward (WF) Program in 2002. WF was developed to address the high cancer incidence and mortality rates that American Indians (AIs) suffer who live in Western South Dakota. We have been investigating the following methods to address these disparities: 1) culturally-tailored patient navigation program facilitating access to cancer education, screening and clinical trials 2) surveys evaluating barriers to health care; 3) current RCT using mHealth and nicotine replacement as smoking rates are 50% 4) ongoing lung cancer project. Critical outcomes include establishing trust with tribal communities, identification of barriers to cancer screening, creation of research infrastructure, higher completion rates and patient satisfaction for patients undergoing cancer treatment, establishing research partnerships, and enrolling over 4,000 AIs on research studies. Other metrics include 14 million dollars in federal funding and the publication of over 30 manuscripts in peer reviewed journals.