This report is an annual update of population-level data on trends and patterns in natality and mortality among American Indians who are residents of specified tribal communities on reservations, and those who reside off reservation in Arizona. American Indian births are determined by mother's race as indicated on a birth certificate, that is, these are the births to American Indian mothers. American Indian deaths are determined by decedent's race as stated on the death certificate.

Community-Based Participatory Research was identified as the foundation for developing collaborative, team based engagements among their organizations and communities in Arizona. Native Americans communities were chosen as the initial focus for this initiative. This document is the culmination of one of the goals of this initiative--the creation of a handbook to familiarize and guide investigators in the principles and applications of Community-Based Participatory Research.