Mammography Needs Assessment
From 2006 to 2008, we conducted a needs assessment of mammography for Native women in the Kansas City and Northeast Kansas. We learned a great deal of information from Native people in the area about barriers to obtaining screening. Results from this needs assessment are being used in two follow-up studies described below, our Mammography Satisfaction study and our Mammography Intervention. Results from this study have been highlighted in some of our newsletters and are available in the following publications:
- Daley, CM, Filippi-Franz, M, Nazir, NN, Braiuca, S, Brokenleg, S, James, AS, Greiner, KA, Choi, WS (2011) Breast cancer screening practices among American Indians in the Midwest. Journal of Health Disparities Research & Practice 4(3):75-81.
- Daley, CM, Filippi-Franz, M, James, AS, Weir, MM, Braiuca, SL, Kaur, B, Choi, WS, Greiner, KA (2012) American Indian community leader and provider views of needs and barriers to mammography. Journal of Community Health 37(2):307-15, ePub ahead of print, Jul 24.
- Daley, CM, Kraemer-Diaz, A, James, AS, Monteau, D, Joseph, S, Pacheco, J, White Bull, J, Cully, A, Choi, WS, Greiner, KA (2012) Breast cancer screening beliefs and behaviors among American Indian women in Kansas and Missouri: a qualitative inquiry. Journal of Cancer Education 27 Suppl 1:S32-40, ePub ahead of print, Feb 16.
- Filippi, MK, Ndikum-Moffor, F, Braiuca, SL, Goodman, T, Hammer, TL, James, AS, Choi, WS, Greiner, KA, Daley, CM (2013) Breast cancer screening perceptions among American Indian women under age 40. Journal of Cancer Education, ePub ahead of print, June 29.
Colorectal Cancer Screening Needs Assessment
From 2006 to 2008, we conducted a needs assessment of colorectal cancer screening for American Indians in the Kansas City and Northeast Kansas region. We learned a great deal of information from Native people in the area about barriers to obtaining screening. Results from this needs assessment are being used in a follow-up study described below, our Colorectal Cancer Screening Intervention. Results from this study have been highlighted in some of our newsletters and are available in the following publications:
- Daley, CM, Nazir, N, Greiner, KA, James, AS, Choi, WS (2010) Colorectal Cancer Screening Behaviors among American Indians in the Midwest. Journal of Health Disparities Research & Practice 4(2):35-40.
- Daley, CM, James, AS, Weir, MM, Filippi-Franz, M, Braiuca, SL, Kaur, B, Choi, WS, Greiner, KA (2012) American Indian community leader and provider views of needs and barriers to colon cancer screening. Journal of Health Disparities Research & Practice 5(2): Article 2.
- Filippi, M, Braiuca, S, Cully, L, James, AS, Choi, WS, Greiner, KA, Daley, CM (2013) American Indian perceptions of colorectal cancer screening: viewpoints from adults under age 50. Journal of Cancer Education 28(1):100-108, ePub ahead of print, Oct 20, 2012.
- Filippi, M, James, AS, Brokenleg, SL, Talawyma, M, Perdue, D, Choi, WS, Greiner, KA, Daley, CM (2013) Views, Barriers, and Suggestions for Colorectal Cancer Screening among American Indian Elder Women. Journal of Primary Care and Community Health 4(3):160-6.
- James, AS, Filippi, MK, Cully, L, Etheridge, J, Perdue, D, Choi, WS, Greiner, KA, Daley, CM (2013) Barriers to Colorectal Cancer Screening among American Indian Men Aged 50 or Older, Kansas and Missouri, 2006-2008. Preventing Chronic Disease, ePub ahead of Print, Oct. 3.
Community Ambassadors to Cancer Research
The Community Ambassadors to Cancer Research project brings together American Indian and Latino community members to learn about research. In our pilot of the program, community members met with researchers once a month for 16 months in 2009-2010, alternating between the Kansas City Indian Center and el Centro Inc. During that time, they learned about different types of research, different cancers, and how to write grants. The goal of the project was to help create teams of community members and researchers who would use community-based participatory research to help reduce cancer-related health disparities in both communities.
Community-based participatory research is the type of research that we use for all of our studies. It involves community members at all phases of the research process, from picking a topic to conducting the research to reporting the findings. Participants in the program formed groups and met with researchers to write grants focused on different cancer-related topics. Project topics included prostate cancer, colorectal cancer, breast cancer, and cervical cancer and HPV. We are now talking with participants to determine the best way to continue the program.
Breast cancer is the most common cancer among women in the United States and ranks second among cancer deaths in women. Because of this, early detection is key to survival. American Indians and Alaska Natives have the poorest recorded five-year cancer survival rates of any ethnic group and the lowest (or near-lowest) screening rates for major cancers. Breast cancer is the second leading cause of cancer death for Native women; and while rates have decreased in other U.S. ethnic groups, they have increased among American Indian and Alaska Native women. Mammograms are recommended annually for average risk women starting at age 40, and Native women have some of the lowest screening rates.
Through this study, we are trying to understand the low rates of mammography among American Indian women. We believe that the experiences and satisfaction surrounding mammography for American Indian women are different from that of women of other ethnic groups because: 1) cultural views may be different 2) the relationship between American Indian women and Indian Health Service and white practitioners may influence the experience 3) contract health services through the Indian Health Service may change the experience of mammography.
The overall goal of this project is to use an approach that considers sociocultural characteristics to identify and understand the mammography experiences and satisfaction of American Indian women and to develop a culturally tailored American Indian mammography satisfaction survey. Thus far, focus groups have been conducted to discuss mammography satisfaction and determine differences in mammography experiences and satisfaction between American Indian women and other racial/ethnic groups. We have also developed a satisfaction survey and are currently testing it. This work will lay the groundwork for a culturally tailored mammography intervention for the American Indian community. To learn more about the study and some of our initial results, you can read some of our publications:
- Engelman, KK, Daley, CM, Gajewski, B, Ndikum-Moffor, F, Faseru, B, Braiuca, S, Joseph, S, Ellerbeck, EF, Greiner, KA (2010) An assessment of American Indian Women's Mammography Experiences. BMC Women's Health 10:34.
- Ndikum-Moffor, F, Braiuca, S, Daley, CM, Gajewski, B, Engelman, K (2013) Assessment of Mammography Experiences and Satisfaction among American Indian/Alaska Native Women. Women's Health Issues 23(6):e395-402.
Cancer Prevention Network
The Kansas Communities Cancer Disparities Network (KCCDN) focuses on reducing cancer disparities in two distinct rural populations: American Indians in northeast Kansas and Latinos in southwest Kansas. Our goal is to work with the communities to improve treatment and increase awareness about cancer prevention, screening, and risk-reduction. In order to facilitate outreach and education, we are training community volunteers to become community health workers in both communities. We are also focusing on educating both communities about clinical trials. The goal is to increase familiarity with clinical trials and their benefits.
Our Mammography Intervention seeks to increase the number of women getting mammograms. The goal is to meet with individuals to create a detailed plan that assists them with navigating the logistics of actually getting to a screening appointment. The entire intervention is being done through touchscreen computers that will be set up in clinics and community locations. We are currently recruiting women to participate in this study. To learn more about it, read our publication:
- Engelman, KK, Cupertino, AP, Daley, CM, Long, T, Cully, A, Mayo, MS, Ellerbeck, EF, Geana, MV, Greiner, KA (2011) Engaging diverse underserved communities to bridge the mammography divide. BMC Public Health 11:47.
Cancer Educational Brochures
During our needs assessments, one of the things we heard from people many times was the need for culturally specific educational information about different cancers, especially information with specifics about how to get screened for cancers in this area. We have searched around the country for this information and have found some Native-specific brochures, which are available free of charge from us upon request. However, we did not find exactly what our participants were asking for. Therefore, we decided to create new brochures that will give people the precise information that they want.
We are developing a series of brochures focusing on different cancers, beginning with breast and colorectal cancer, that have information specific to American Indians and specific to this part of the country where possible. The brochures will also have information about where to get free and low-cost screening and how to contact those locations. Each series will have the following brochures: general facts about the cancer, screening information, the next step after a positive screen, and what to do if someone you love has that cancer. Once we have completed brochures for major cancers, we will develop brochures about other health outcomes. We hope to have our first set of brochures ready for distribution by this summer.
Colorectal Cancer Screening Intervention
Colorectal cancer screening rates among American Indians are lower than for any other ethnic group. This intervention seeks to increase the number of American Indians completing one of the recommended screening tests for colorectal cancer. Similar to our Mammography Intervention, this intervention will be delivered using touchscreen computers in clinics and community locations. It will help people develop a specific plan of how they will get their screening completed. We are very excited that this project also fully covers the cost of screening for all participants, regardless of which screening test they choose! We are currently recruiting participants for this study.