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Hale JW, Pacheco JA, Lewis CS, Swimmer L, Daley SM, Nazir N, Daley CM, Choi WS. Everyday discrimination for American Indian tribal college students enrolled in the Internet All Nations Breath of Life program. J Am Coll Health 2023; 71:2679-2685. [PMID: 34871137 PMCID: PMC9167892 DOI: 10.1080/07448481.2021.1987246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/06/2021] [Accepted: 09/26/2021] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Identify factors associated with perceived discrimination, including depression, body image satisfaction, body mass index (BMI), social support, stress, and self-reported social status. PARTICIPANTS A total of 249 American Indian tribal college students. METHODS Students were recruited for an Internet-based smoking cessation program. A total of 249 students answered the Everyday Discrimination Scale questions to assess perceived discrimination. We conducted bivariate analyses to determine potential significant associations between perceived discrimination and health outcomes at baseline. RESULTS We found 63% of the sample reported racial discrimination. Among those who reported moderate/severe depression, 87% reported discrimination. Among those who were not satisfied with their body image, 70% reported racial discrimination. CONCLUSION Reports of racial discrimination are highly prevalent among our participants. We found reports of discrimination are significantly associated with depression and dissatisfaction with body image. Our study highlights a high priority population that perceives racial discrimination, potentially increasing their risk for adverse health outcomes.
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Affiliation(s)
- Jason W Hale
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Joseph A Pacheco
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Charley S Lewis
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Luke Swimmer
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Sean M Daley
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Niaman Nazir
- American Indian Health Research & Education Alliance, Inc., Center for American Indian Community Health, Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
| | - Christine M Daley
- American Indian Health Research & Education Alliance, Inc., Institute for Indigenous Studies, College of Health, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Won S Choi
- American Indian Health Research & Education Alliance, Inc., Center for American Indian Community Health, Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Lumpkins CY, Goeckner R, Hale J, Lewis C, Gunville J, Gunville R, Daley CM, Daley SM. In Our Sacred Voice - An Exploration of Tribal and Community Leader Perceptions as Health Communicators of Disease Prevention among American Indians in the Plains. Health Commun 2022; 37:1180-1191. [PMID: 34949125 DOI: 10.1080/10410236.2021.2008108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
American Indians (AI) are disproportionately and significantly impacted by disease morbidity, mortalityand poor behavioral health outcomes. Health promotion and health communication programs exist to address these health disparities and health conditions; however, few programs fully integrate holistic approaches when targeting AI populations. The objective of this study was to explore how tribal and community leaders throughout the Central Plains (Kansas, Iowa, Missouri, and South Dakota) viewed themselves as health communicators and health promoters within their communities. Members of the Center for American Indian Community Health (CAICH) conducted 39 in-depth interviews with members of federally recognized tribes living in reservation communities as well as urban tribal communities across the region. Results from the sample show that these individuals do not necessarily see themselves as the "authority" health communicator or health promoter within their tribe or community. They did perceive themselves and others as gatekeepers of pertinent health information. Social and cultural authority within culturally centered messaging and collective delivery of this type of health information from trusted sources within tribes and communities is perceived to bolster health communication programs and positively impact health outcomes among AI populations.
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Affiliation(s)
- Crystal Y Lumpkins
- Department of Family Medicine and Community Health, University of Kansas Medical Center
- William Allen White School of Journalism and Mass Communications, University of Kansas-Lawrence
| | | | - Jason Hale
- Lehigh College of Health, Institute for Indigenous Studies
| | - Charley Lewis
- Lehigh College of Health, Institute for Indigenous Studies
| | | | - River Gunville
- Lehigh College of Health, Institute for Indigenous Studies
| | - Chris M Daley
- Lehigh College of Health, Institute for Indigenous Studies
| | - Sean M Daley
- Lehigh College of Health, Institute for Indigenous Studies
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Daley CM, Lewis C, Nazir N, Daley SM, Goeckner R, Hale J, Gunville J, Faseru B, Greiner KA, Choi WS. Pilot Testing All Nations Snuff Out Smokeless (ANSOS): A Culturally Tailored Smokeless Tobacco Cessation Program for American Indians. J Health Care Poor Underserved 2021; 32:2154-2166. [PMID: 34803065 DOI: 10.1353/hpu.2021.0188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
American Indians have the highest rates of smokeless tobacco (SLT) use of any racial/ethnic group in the United States, yet no proven effective cessation programs exist for them. Because tobacco is a sacred plant to many American Indians, cessation programs must not portray it in a completely negative manner. Based on our successful All Nations Breath of Life smoking cessation program, we developed and pilot-tested the All Nations Snuff Out Smokeless (ANSOS) program. Of 48 participants who began the program, 33 completed to six months (68.8% retention rate). Among participants who completed the program, 11 (34%) self-reported abstinence. When those lost to follow-up are considered current users, the cessation rate is 22.9%. An additional 14 individuals reported decreasing use (29.2% of all participants), with an average of 3.4 days per week decrease. All Nations Snuff Out Smokeless shows promise as a culturally appropriate SLT cessation program and is ready for efficacy testing.
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Lewis CS, Nazir N, Daley SM, Pacheco J, Goeckner RT, Hale JW, Gunville JA, Rahman F, Choi WS, Daley CM. Baseline characteristics of American Indian smokeless tobacco users participating in two pilot cessation studies. J Community Health 2020; 45:812-819. [PMID: 32279158 DOI: 10.1007/s10900-020-00797-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
American Indians have higher rates of smokeless tobacco (SLT) use than other racial/ethnic groups in the US, yet no efficacious cessation program exists for them. Because tobacco is a sacred plant to many American Indians, it is imperative that a program respect the scared nature of tobacco while encouraging quitting recreational use. All Nations Snuff Out Smokeless (ANSOS) was designed to help American Indian SLT users quit recreational tobacco use while still using it for traditional purposes. We pilot tested the ANSOS 6-month group-based counseling program (N = 48) and a shortened version consisting of a one-time education session (N = 80). Here, we discuss the tobacco characteristics of participants at baseline in both studies. Participants across studies were more likely to be male (74.2%) and have at least a college education (65%). Participants in the one-time education sessions were younger (age 35 vs age 39) and used SLT fewer days per week (4.9 vs 5.7). Two-thirds of those in the full program reported that they often substitute SLT in locations where smoking is not allowed compared to 26%. Participants in the education sessions were more likely to report daily use of traditional tobacco (20% versus 0%). Results suggest that dual use of SLT and cigarettes needs to be addressed, as does the use of SLT to circumvent public smoking rules. The role of traditional tobacco and its relationship to lower SLT use also warrants further investigation.
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Affiliation(s)
- Charley S Lewis
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA. .,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA. .,Department of Family Medicine & Community Health, University of Kansas Medical Center, Kansas City, KS, USA.
| | - Niaman Nazir
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sean M Daley
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Studies, Johnson County Community College, Overland Park, KS, USA.,Department of Anthropology, Johnson County Community College, Overland Park, KS, USA
| | - Joseph Pacheco
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Ryan T Goeckner
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jason W Hale
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Family Medicine & Community Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Jordyn A Gunville
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Fatima Rahman
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Won S Choi
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christine Makosky Daley
- American Indian Health Research & Education Alliance, Inc, Kansas City, KS, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Family Medicine & Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA.,Indigenous Studies Program, University of Kansas, Lawrence, KS, USA
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Hale JW, Lewis C, Nazir N, Daley SM, Goeckner R, Gunville J, Faseru B, Greiner KA, Choi WS, Daley CM. One-Time Education Sessions to Help American Indian Smokeless Tobacco Users Quit. J Community Health 2019; 45:526-533. [PMID: 31773565 DOI: 10.1007/s10900-019-00771-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
American Indian (AI) smokeless tobacco use rates are the highest of all racial/ethnic groups within the United States. Despite this, no effective cessation program currently exists that acknowledges the cultural significance of tobacco among many American Indian tribal nations. Participants were smokeless tobacco users, over 18 years of age, and were recruited through community partners. We modified the All Nations Snuff Out Smokeless Tobacco group-based program to be delivered as a one-time education session intervention. This was delivered to 80 participants and follow-up data was collected by self-report at 6-months. The mean age of participants was 35 and most were male (70%). A majority (69%) grew up on a AI reservation; the mean age of first smokeless tobacco use was 16 years of age. Of program completers reached for 6-month post baseline, 46% reported 0 days of SLT use; 13.5% of participants reduced; while 36% reported continued daily use. In intention to treat analysis those lost to follow-up are considered current users, the quit rate was 12.5% and among those who were still using, 4.0% reduced their use. In this study, a one-time education session intervention was effective for those who prefer an individual based approach to quitting SLT use. Follow up strategies to increase participant retention at 6-months should be explored.
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Affiliation(s)
- Jason W Hale
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA. .,Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS, USA. .,American Indian Health Research and Education Alliance, Inc., Kansas City, KS, USA.
| | - Charley Lewis
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA.,American Indian Health Research and Education Alliance, Inc., Kansas City, KS, USA
| | - Niaman Nazir
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Sean M Daley
- Center for American Indian Studies, Johnson County Community College, Overland Park, KS, USA.,American Indian Health Research and Education Alliance, Inc., Kansas City, KS, USA.,Department of Anthropology, Johnson County Community College, Overland Park, KS, USA
| | - Ryan Goeckner
- American Indian Health Research and Education Alliance, Inc., Kansas City, KS, USA
| | - Jordyn Gunville
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA.,American Indian Health Research and Education Alliance, Inc., Kansas City, KS, USA
| | - Babalola Faseru
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - K Allen Greiner
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Won S Choi
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA
| | - Christine Makosky Daley
- Center for American Indian Community Health, University of Kansas Medical Center, MS 1030, 3901 Rainbow Blvd., Kansas City, KS, 66160, USA.,Department of Family Medicine and Community Health, University of Kansas Medical Center, Kansas City, KS, USA.,Department of Population Health, University of Kansas Medical Center, Kansas City, KS, USA.,American Indian Health Research and Education Alliance, Inc., Kansas City, KS, USA.,Indigenous Studies Program, University of Kansas, Lawrence, KS, USA
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Lumpkins CY, Filippi MK, Nazir N, Pacheco CM, Hester CM, Daley SM, Choi WS, Daley CM. It's not just about recruitment: An exploratory look at tobacco education sessions to increase participation into smoking cessation programs among American Indians. ACTA ACUST UNITED AC 2018; 3:1-4. [PMID: 34095515 PMCID: PMC8174104 DOI: 10.15761/hec.1000137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
American Indians (AI) have the highest smoking rates and lowest quit rates of any racial/ethnic group in the U.S. Researchers and community members from the American Indian Health Research and Education Alliance (AIHREA) created and evaluated a culturally-tailored smoking cessation program, All Nations Breath of Life (ANBL) as a recruitment tool for smoking cessation programs among AI. To increase enrollment in ANBL, AI smokers were approached at cultural events and asked to attend a 30-minute educational session (in-person, n= 179; tele-video, n=97). Tele-video (30%) and in-person (9%) session participants were recruited into ANBL. Pre- and post-tests showed participants in both sessions demonstrated increased motivation and confidence to quit smoking but significant differences were present in both sessions (p < 0.0001). Results indicate that theoretically guided and culturally tailored education sessions are viable approaches to educate and recruit underserved populations into programs that promote smoking cessation.
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Affiliation(s)
- C Y Lumpkins
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | | | - N Nazir
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | | | - C M Hester
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - S M Daley
- Center for American Indian Studies, Johnson County Community College, Kansas City, KS, 66210, USA
| | - W S Choi
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA
| | - C M Daley
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA.,Department of Preventive Medicine & Public Health, University of Kansas Medical Center, Kansas City, KS, 66160, USA
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Daley CM, Daley SM, Pacheco CM, Smith TE, Talawyma M, McCloskey C, Choi WS, Nazir N, Filippi MK, McKinney D, Gunville J, Greiner KA. Feasibility of Implementing the All Nations Breath of Life Culturally Tailored Smoking Cessation Program for American Indians in Multi-Tribal Urban Communities. Nicotine Tob Res 2018; 20:552-560. [PMID: 28177511 DOI: 10.1093/ntr/ntx030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 01/30/2017] [Indexed: 11/14/2022]
Abstract
Introduction Prevalence of cigarette smoking is highest among American Indians, yet few culturally appropriate smoking cessation programs have yet been developed and tested for multi-tribal American Indian adult populations. This study examined implementation of the All Nations Breath of Life culturally tailored smoking cessation program in multi-tribal urban and suburban American Indian communities in seven locations across five states (N = 312). Methods This single-arm study used community-based participatory research to conduct a 12-week intervention whose primary purpose was to curb commercial tobacco use among American Indians. Participants were followed through month 6 in person and month 12 via telephone. The primary outcome was continuous abstinence from recreational cigarette smoking at 6 months post-baseline, verified through voluntary provision of salivary cotinine levels. Results At program completion (12 weeks post-baseline), 53.3% of program completers remained abstinent; labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline (primary endpoint), 31.1% of retained participants quit smoking (p < .0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% labeling those lost to follow-up as smokers (p = .002). Retention rate at endpoint was 71.2%. 12-month follow-up was attempted with all participants and had a retention rate of 49.0%. Of those participants reached, 34.0% were smoke-free. Conclusions All Nations Breath of Life shows promise as a smoking cessation program for multi-tribal urban American Indian communities. It can be successfully implemented in a variety of urban settings. Implications This is the first large feasibility study of a culturally tailored smoking cessation program for American Indians with good cessation and retention rates in a multi-tribal urban American Indian population. It shows that All Nations Breath of Life can be implemented in multiple urban settings across five states. To our knowledge, this is the first program of its kind to be implemented across multiple heterogeneous urban locations and to include salivary cotinine testing for verification of self-report data across these locations.
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Affiliation(s)
- Christine Makosky Daley
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS
| | - Sean M Daley
- Department of Anthropology, Center for American Indian Studies, Johnson County Community College, Overland Park, KS
| | - Christina M Pacheco
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS
| | - T Edward Smith
- Department of Anthropology, Center for American Indian Studies, Johnson County Community College, Overland Park, KS
| | - Myrietta Talawyma
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS
| | | | - Won S Choi
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS
| | - Niaman Nazir
- Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Kansas City, KS
| | - Melissa K Filippi
- Center for American Indian Community Health, University of Kansas Medical Center, Kansas City, KS
| | - Dona McKinney
- Department of Defense Programs Office, Lincoln University, Jefferson City, MO
| | - Jordyn Gunville
- Department of Anthropology, Center for American Indian Studies, Johnson County Community College, Overland Park, KS
| | - K Allen Greiner
- Department of Family Medicine, University of Kansas Medical Center, Kansas City, KS
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Rollins K, Lewis C, Edward Smith T, Goeckner RT, Hale JW, Nazir N, Faseru B, Allen Greiner K, Daley SM, Choi WS, Daley CM. Development of a Culturally Appropriate Smokeless Tobacco Cessation Program for American Indians. J Health Dispar Res Pract 2018; 11:45-55. [PMID: 30906672 PMCID: PMC6426307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This study describes a multiphasic approach to the development of a smokeless tobacco cessation program targeted for American Indians (AI) of different tribal nations. The authors gathered formative data from a series of focus groups and interviews to investigate the knowledge, attitudes, and beliefs of AI and smokeless tobacco (SLT) use. Predominant themes emerged from four major topic areas (SLT use, initiation and barriers, policy, and program development) across both studies. This study further assessed educational materials developed for the cessation program for scientific accuracy, readability, and cultural appropriateness. Program materials were scientifically accurate and culturally appropriate. The average corrected reading grade level was 6.3 using the Fry formula and 7.1 using the SMOG formula. Based on this research, a detailed approach to formative research can be used in combination with input from community members to develop health interventions that address health disparities for a specific population.
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Rollins K, JD CMP, Daley SM, Nazir N, Lewis C, Choi WS, Daley CM. American Indian Tribal College Student's Knowledge, Attitudes and Beliefs about Recreational and Traditional Tobacco Use. Juniper Online J Public Health 2017; 2:555580. [PMID: 30637377 PMCID: PMC6329452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION American Indians (AI) have the highest smoking rates of any racial/ethnic group in the U.S., in addition to low success rates of tobacco cessation. The substitution of commercial tobacco for traditional tobacco may have played a role in the prevalence rates of recreational tobacco use among AI. The present study explored the impact of tribal college students' knowledge, attitudes and beliefs about traditional tobacco use on their recreational cigarette smoking behaviors. METHODS Multiple methods were used to recruit participants attending a tribal college. A total of 101 AI tribal college students completed a demographic survey and participated in focus groups or individual interviews assessing traditional and recreational tobacco use. RESULTS AI tribal college student's recreational smoking has an influence on various health behaviors, including poor eating habits, decreased physical activity, and elevated tobacco use in association with alcohol consumption. Differences between the use of and motivation behind smokeless tobacco and cigarette use were seen. In addition, participants reported differences between using tobacco for traditional purposes such as in ceremony or during prayer in comparison to recreational tobacco use. Conclusion: These findings highlight AI students' beliefs about recreational tobacco, smokeless tobacco, and traditional tobacco use. Differences related to behaviors associated with traditional tobacco use have important implications for future cessation efforts for AI smokers.
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Affiliation(s)
- Kathryn Rollins
- Center for American Indian Community Health, University of Kansas Medical Center, USA,Department of Family Medicine, University of Kansas Medical Center, USA,American Indian Health Research and Education Alliance, Inc Shawnee, USA,Corresponding author: Kathryn Rollins, Center for American Indian Community Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 1030, KS 66160, Kansas City, USA,
| | - Christina M Pacheco JD
- Center for American Indian Community Health, University of Kansas Medical Center, USA,Department of Family Medicine, University of Kansas Medical Center, USA,American Indian Health Research and Education Alliance, Inc Shawnee, USA
| | - Sean M Daley
- American Indian Health Research and Education Alliance, Inc Shawnee, USA,Center for American Indian Studies, Johnson County Community College, USA,Department of Anthropology, Johnson County Community College, USA
| | - Niaman Nazir
- Center for American Indian Community Health, University of Kansas Medical Center, USA,Department of Family Medicine, University of Kansas Medical Center, USA
| | - Charley Lewis
- Center for American Indian Community Health, University of Kansas Medical Center, USA,Department of Family Medicine, University of Kansas Medical Center, USA,American Indian Health Research and Education Alliance, Inc Shawnee, USA
| | - Won S Choi
- Center for American Indian Community Health, University of Kansas Medical Center, USA,Department of Preventive Medicine and Public Health, University of Kansas Medical Center, USA
| | - Christine M Daley
- Center for American Indian Community Health, University of Kansas Medical Center, USA,Department of Family Medicine, University of Kansas Medical Center, USA,American Indian Health Research and Education Alliance, Inc Shawnee, USA,Department of Preventive Medicine and Public Health, University of Kansas Medical Center, USA
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Goeckner R, Gunville J, Smith TE, Nazir N, Daley SM, Choi W, Daley C. Abstract A44: Tobacco education sessions as a recruitment tool for a culturally tailored smoking cessation program for American Indians: All Nations Breath of Life. Cancer Epidemiol Biomarkers Prev 2017. [DOI: 10.1158/1538-7755.disp16-a44] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
American Indians have the highest smoking rates and lowest quit rates of any racial/ethnic group in the US. Researchers and community members from the American Indian Health Research and Education Alliance (AIHREA) created and tested a culturally-tailored smoking cessation program, All Nations Breath of Life (ANBL). ANBL is designed to help American Indians quit smoking while respecting the sacred nature of tobacco. To increase enrollment in ANBL, American Indian smokers were approached at cultural events and asked to attend a 30-minute educational session (in-person, n = 179; televideo, n = 97). The educational sessions were developed using the Health Belief Model as a framework and focused on smoking facts and American Indian health. In pre- and post-tests, participants in both sessions demonstrated increased motivation and confidence to quit smoking. Approximately 9% of in-person session participants and 30% of televideo participants were recruited into ANBL. The results indicate that education sessions are an excellent way to educate American Indians about smoking, its related outcomes, and American Indian health. More importantly, these sessions were a successful recruitment tool for ANBL. In conclusion, hosting informational sessions at cultural events about smoking are an effective way to recruit people into a smoking cessation program.
Citation Format: Ryan Goeckner, Jordyn Gunville, T Edward Smith, Niaman Nazir, Sean M. Daley, Won Choi, Christine Daley. Tobacco education sessions as a recruitment tool for a culturally tailored smoking cessation program for American Indians: All Nations Breath of Life. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A44.
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Affiliation(s)
- Ryan Goeckner
- 1University of Kansas Medical Center, Kansas City, KS,
| | | | | | - Niaman Nazir
- 1University of Kansas Medical Center, Kansas City, KS,
| | - Sean M. Daley
- 2Johnson County Community College, Overland Park, KS
| | - Won Choi
- 1University of Kansas Medical Center, Kansas City, KS,
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Pacheco JA, Gunville J, Niaman N, Smith TE, Daley SM, Choi WS, Daley CM. Abstract A34: Understanding the Predictors of Smoking Cessation in a Culturally Tailored Smoking Cession Program Created for American Indians. Cancer Epidemiol Biomarkers Prev 2017. [DOI: 10.1158/1538-7755.disp16-a34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Abstract
The purpose of this study was to test the effectiveness of the All Nations Breath of Life program (ANBL); a 12-week culturally-tailored smoking cessation program designed for use in a heterogeneous urban and suburban American Indian (AI) population. Through this process we looked at the secondary outcome: predictors of successful smoking cessation. ANBL was developed, implemented, and tested using a community-based participatory research (CBPR) approach in which AI community members were involved in all phases of the research. Participants in ANBL (N=312) self-selected into the study. Participants self-identified as AI (tribal enrollment was not required). Additional inclusion criteria included being 18 years of age or older, cotinine verified current cigarette smoker, self-expressed interest in quitting smoking in the 30 days following the informed consent process. The vast majority of ANBL group sessions were located primarily in the Heartland/Midwest and surrounding areas. ANBL has five primary components, as follows: Group Support Sessions, Individual Telephone Counseling, Educational Curriculum, Pharmacotherapy, and Participant Incentives. The primary endpoint was salivary cotinine verified continuous abstinence at 6-months. Participants were asked to self-report smoking status, “Since your quit date in ANBL, have you ever smoked at least part of a cigarette?” Those participants answering “no” to this question were asked to provide saliva for cotinine verification. At program completion, 53.3% of program completers remained abstinent; using an intent-to-treat analysis labeling those lost to follow-up as smokers resulted in a 41.4% quit rate. At 6 months post-baseline, 31.1% of retained participants quit smoking (p<0.0001 compared to the highest quit rates among multi-tribal populations reported in the literature, 7%); final quit rate was 22.1% using an intent-to-treat analysis (p=0.002). Few items were found to be predictive of ability to quit at the primary endpoint. The most significant predictor of cessation was participation in one of the groups run in Mid-Missouri, all of which were run by one facilitator (OR=0.24, p=0.0005). An additional predictor of cessation included participants who had some form of home smoking rule (partial or full) (OR=0.35, p=0.0004). Other items that approached significance in relationship to quitting included use of traditional tobacco, which negatively impacted quit rates (OR=1.70, p=0.08), having higher self-confidence in one's ability to quit at baseline positively impacted quit rates (OR=2.20, p=0.16), and lack of use of other recreational tobacco products positively impacted quit rates (OR=2.42, p=0.07). Participants who had the longest history of smoking (greater than 20 years) were least likely to quit (OR=0.26; p=0.03). The data found will be incorporated into modifications to the program to assist other participants with successful cessation. Understanding the predictors of smoking cessation can ensure participant success in tailored smoking cession programs.
Citation Format: Joseph A. Pacheco, Jordyn Gunville, Nazir Niaman, T. Edward Smith, Sean M. Daley, Won S. Choi, Christine M. Daley. Understanding the Predictors of Smoking Cessation in a Culturally Tailored Smoking Cession Program Created for American Indians. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr A34.
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Affiliation(s)
| | | | - Nazir Niaman
- 1University of Kansas Medical Center, Kansas City, KS,
| | | | - Sean M. Daley
- 2Johnson County Community College, Overland Park, KS
| | - Won S. Choi
- 1University of Kansas Medical Center, Kansas City, KS,
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Plakke MJ, Maisonave Y, Daley SM. Radiofrequency Scanning for Retained Surgical Items Can Cause Electromagnetic Interference and Pacing Inhibition if an Asynchronous Pacing Mode Is Not Applied. ACTA ACUST UNITED AC 2016; 6:143-5. [DOI: 10.1213/xaa.0000000000000229] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Maxwell CD, Daley SM, Swaminathan M, Nicoara A. Intraoperative, Real-Time Three-Dimensional Transesophageal Echocardiography for the Transcatheter Placement of an Edwards SAPIEN Aortic Valve in the Mitral Position for Severe Mitral Stenosis. Anesth Analg 2015; 121:1456-9. [PMID: 26579652 DOI: 10.1213/ane.0000000000000973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Cory D Maxwell
- From the Department of Anesthesiology, Duke University, Durham, North Carolina
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Pacheco CM, Daley SM, Brown T, Filippi M, Greiner KA, Daley CM. Moving forward: breaking the cycle of mistrust between American Indians and researchers. Am J Public Health 2013; 103:2152-9. [PMID: 24134368 DOI: 10.2105/ajph.2013.301480] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
American Indians (AIs) have some of the poorest documented health outcomes of any racial/ethnic group. Research plays a vital role in addressing these health disparities. Historical and recent instances of unethical research, specifically the Havasupai diabetes project, have generated mistrust in AI communities. To address the concerns about unethical research held by some AIs in the Heartland (Midwest), the Center for American Indian Community Health (CAICH) has launched a series of efforts to inform AIs about research participants' rights. CAICH educates health researchers about the importance of learning and respecting a community's history, culture, values, and wishes when engaging in research with that community. Through community-based participatory research, CAICH is also empowering AIs to assert their rights as research participants.
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Affiliation(s)
- Christina M Pacheco
- Christina M. Pacheco, Travis Brown, Melissa Filippi, K. Allen Greiner, and Christine M. Daley are with the Center for American Indian Community Health, University of Kansas Medical Center, Kansas City. Sean M. Daley is with the Center for American Indian Studies, Johnson County Community College, Overland Park, KS
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Daley CM, Greiner KA, Nazir N, Daley SM, Solomon CL, Braiuca SL, Smith TE, Choi WS. All Nations Breath of Life: using community-based participatory research to address health disparities in cigarette smoking among American Indians. Ethn Dis 2010; 20:334-338. [PMID: 21305818 PMCID: PMC3061617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
Abstract
Using a community-based participatory research (CBPR) approach, we developed the All Nations Breath of Life smoking cessation program and pilot-tested it in urban and reservation communities. The program combines weekly in-person group support sessions with individual telephone calls using motivational interviewing. All sessions include discussion of sacred tobacco and information about quitting and health. We have assessed the scientific validity, cultural-appropriateness, and readability of our program materials and found them to be adequate; participant satisfaction is high. The program shows promise for improving quit rates among American Indians, who have the highest smoking rates and lowest quit rates of any ethnic group. Our preliminary self-report data show quit rates of 65% at program completion and 25% at six months post-baseline.
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Affiliation(s)
- Christine Makosky Daley
- Department of Preventive Medicine and Public Health, MS-1008, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA.
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