Native American Women: Reducing the Cancer Risks

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Native American Women Reducing the Cancer Risks

• Linda Burhansstipanov, MSPH, DrPH (Cherokee
  Nation of OK)
• Executive Director
• Native American Cancer Research
• 3022 South Nova Road
• Pine, CO 80470-7830
• Phone [phone] Fax [phone]
• Native Cancer Survivors Support Network
  1-800-537-8295
• Web Page http//NatAmCancer.org

Denver staff Lisa Castro, Judy Hariton, Lisa
Harjo, Rose Lee, Terri Rattler
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OBJECTIVESBy the end of this segment, the
learner will be able to

1. Identify at least 3 factors that increase your
   risks for developing cancer.
2. Identify at least 3 components of successful
   cancer prevention / early detection programs
   among Native Americans.

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Updated data from IHS
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Five Geographic Regions
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Special thanks to Indian Health Service National
Epidemiology Program Roberta Paisano, MHSA and
David Epsey, M.D
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Special thanks to Indian Health Service National
Epidemiology Program Roberta Paisano, MHSA and
David Epsey, M.D
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Special thanks to Indian Health Service National
Epidemiology Program Roberta Paisano, MHSA and
David Epsey, M.D
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Special thanks to Indian Health Service National
Epidemiology Program Roberta Paisano, MHSA and
David Epsey, M.D
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(No Transcript)
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Who develops cancer?
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Cancer develops over time...
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What makes a factor a bigger risk for cancer?
Frequency
how often are you exposed to the factor?
Duration
how long have you used or been exposed to the
factor?
Intensity
how strong is the dosage of the factor?
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What are examples of cancer risk factors?
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Examples of cancer risk factors
Alaska Native Women and colon cancer
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Examples of cancer risk factors
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Examples of cancer risk factors
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Increasing Mammography Re-screening Among Urban
American Indian Women

• Funded by the NCI R25 CA77665

• Preliminary research with CMAP showed that lt16
  of American Indian women participated in
  re-screening within 24 months of their last
  mammogram

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The women in the study

• American Indian women age 40 and older
• live in the Denver metropolitan area
• received at least one mammogram

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Research Design
GROUP No. BASELINE INTERVENTION POSTTEST
1 132 0 X1 0 2 132 0 X2 0
3 132 0 Observation Only 0 X1 NAWWA
breast education intervention X2 Telephone
breast education intervention
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Findings
Pretest Telephone 29.0
Pretest Face-to-Face 34.4
Pretest CMAP (comparison) 51.9
Posttest Telephone 41.3
Posttest Face-to-Face 45.2
Posttest CMAP (comparison) 50.0
Pre vs Post for Navigator interventions, p.013 Telephone vs. Face-to-Face, p.83 Pre vs Post for Navigator interventions, p.013 Telephone vs. Face-to-Face, p.83 Pre vs Post for Navigator interventions, p.013 Telephone vs. Face-to-Face, p.83
Comparison Group had no change Comparison Group had no change Comparison Group had no change
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Summary

• Intervention may have had a greater impact on
  women with lower educational levels
• Improvement in screening from pretest (32) to
  posttest (43)
• Greatest increase in adherence seen in women age
  65
• No difference between intervention modalities
• Telephone intervention was not more cost
  effective than was the face-to-face

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Conclusions

• The cultural education intervention had an
  increase in screening
• The number of women who lose access to a
  functioning private phone was higher than
  anticipated
• None of the existing data surveillance programs
  were appropriate

50 within 24 months
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Mission of NAWWA
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Mission of NAWWA
Works to engage program participants through
culturally sensitive strategies.
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Yvgvbvgets Lets Walk! Guiding Principles

• Make good choices
• Make a promise (to self as well as to others)
• Set Goals (for self)
• Get Support (group)

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Yvgvbvgets Lets Walk!
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Yvgvbvgets Lets Walk!
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Yvgvbvgets Lets Walk!
Perseverance! Takes time for the community to
trust and accept
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Healthy Eating Guiding Principles

• Reduce fats
• Control Serving Size
• Vary Food Preparation
• Steam
• Bake/Broil
• Sauté

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Benefit of Healthy Eating

• Eat a variety of healthy foods.
• Includes at least five servings of fruits and
  vegetables each day.
• This will
• Increase energy
• Increase weight loss
• Strengthen the heart
• Prevent cancer

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Local Healthy Recipes
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What is an American Indian Cancer Survivor
Support Circle?
A place where
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How does a support circle work?
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Native Survivors Support Circles
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Tips for Successful Support Circles
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Tips for Successful Support Circles
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Tips for Successful Support Circles
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Tips for Successful Support Circles
Be patient may take 1-2 years to get going
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Sample Topic List
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Annual Wellness Event Purposes
Behaviors that help prevent/reduce diabetes also
prevent/reduce cancer, heart disease, obesity
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What else can I do about my health?
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Daily Healthy Behaviors Donts
Smoke cigarettes (i.e., misuses the sacred gift
of tobacco) Drink more than 1 drink of any
alcoholic beverage in a day Use medicines
(over-the-counter and prescriptions)
inappropriately Use recreational drugs
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Daily Healthy Behaviors Donts
Over-consume caffeine (less than 4 cups of
coffee, tea, cola soda -- chocolate)
Gossip / trash family, neighbors, friends
brings evil back onto yourself
Beat yourself up for mistakes but take action
to NOT repeat those errors
Feed a grudge whose path are you on?
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Daily Healthy Behaviors Dos
Pray (greet the sun) Get vigorous weight-bearing
physical activity (like walking, biking,
dancing) Drink lots of water Eat foods that are
low fat / low calorie / low sugar Eat foods that
have folic acid and iron vitamins A, B1, B2, B6,
C, D, E
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Daily Healthy Behaviors Dos
Eat foods that are high in dietary fiber (e.g.,
vegetables, fruits)
Take at least 15 minutes every day to do
something you personally enjoy (e.g., dance?
weave? bead? sing?)
Take medications and vitamin supplements as
recommended
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Daily Healthy Behaviors Dos
Practice healthy stress relief Compliment family,
neighbors, friends for something they have done
or do that you appreciate Dedicate at least 15
minutes of uninterrupted time to be with your
husband /wife /parent /child. Total
concentration!! Laugh
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Daily Healthy Behaviors Dos
Practice responsible sexual behavior
Planned pregnancy (use birth control)
Avoid exposure to sexually transmitted diseases
(e.g., HIV, herpes minimize number of partners)
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Daily Healthy Behaviors Dos
Summarize your day by identifying something
good that happened that day you did that was
good someone else did that was good
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Daily Healthy Behaviors Dos
Pray (sundown prayers and songs) Thank the
Creator for our blessings
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Weekly / Monthly Healthy Behaviors Dos
Ceremonial / spiritual growth
Maintenance of healthy weight
Sufficient consumption of water / fluids
Sufficient consumption of vitamins and minerals
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Weekly / Monthly Healthy Behaviors Dos
Healthy balance of family, work, community
If not, develop a plan for how you can do a
better job bringing balance into your life
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Annual Healthy Behaviors Dos
Immunizations
Vaccinations
Maintenance of healthy weight
Ceremonial / spiritual growth