Additional Information   Case 51. Vulnerable Populations   A
state health agency has asked Dr. Maggiano to assist in setting
up a data base to monitor health risk behaviors among pregnant
women. Data will be collected from centers across the state
which provide nutritional support to pregnant low-income women.
The agency director, Sam Klench, indicates that one requirement
of the grant is that they over sample the Native American
population of the state. However, the director informs Dr.
Maggiano that they have been refused access to three reservation
clinics by the Tribal Councils. The director wants to develop a
strategy to attract Native American women to off-reservation
clinics. This will allow them to meet the grant requirements and
provide nutritional support.     1. What are the federal
guidelines for working with Native American research subjects?
Is the direct consent of tribal representatives a barrier which
can be circumvented? If so, under what circumstances?   2. Do
the nutritional needs of pregn