Discipline: Social, Behavioral, and Economic Sciences
Subcategory: Cancer Research
Cornelia Santos - University of Colorado Denver
American Indians and Alaska Natives (AI/AN) face poor survival rates due to medical illness that are contrary to the progress and improvements typical of modern medicine (Pfefferbaum, Pfefferbaum, Rhoades, & Strickland, 1997). Patient navigation addresses barriers/cancer disparities in under-served populations (Freeman & Chu, 2005). Patient navigation can help to build resilience within a community with the goal of alleviating the unequal burden of cancer among American Indians. Resilience within a health disparity context is defined as,” The ability to move forward like a willow with renewed energy, with a positive outlook with attainable goals to achieve one’s dreams, and overcome negative life experiences from current and past political and historical events, with the goal to reduce health disparities …” (CAIR 2016). Hypothesis: Resilience skills can be adopted by AI cancer survivors facing barriers/cancer disparities with peer modeling and coaching. Methods and Controls: Resilience skills were introduced and modeled biweekly among a sample of 26 AI cancer survivors for two eight week sessions. Skills combined both traditional Native and Western medicine approaches focusing on spiritual, mental, emotional, and physical well-being. Two Native Patient Navigators initiated the project and peer educators reinforced resiliency behaviors. Biweekly introduction of new skills combined with follow-up one on one coaching calls reinforced adoption of new behaviors. Topics for healthy resilience behaviors included: how to talk with healthcare providers, how to find accurate health information, medication management, how to ask for support from family, friends and/or employer, how to increase physical activity and nutrition, emotional support and strategies to increase one’s personal emotional support. Collected data: field notes, supporting documents, beginning and ending surveys and in-depth interviews. Results: “Energy Balance” began the program with an increase of 30% for knowledge for participants. Project participants indicated increases of resilience skills and adoption of new behaviors. Resulting project themes- Spirituality, Kinship, Native Ways of Helping and Bridges between Native Traditional Medicine and Western Medicine. Conclusion and Future Research: In spite of the remarkable progress in recent years in Western Medicine, with respect to the health status of AI/AN, in virtually all health measures, the status of Indian health remains below that of other US Citizens (Pfefferbaum, R.L., Pfefferbaum, B., Rhoades, E.R., & Strickland, R.J. ,1997). Follow-up studies with Native Navigators facilitating resilience skill modeling and adoption explore an effective solution to the current cancer disparities crises in AI/AN communities and may hold the keys to addressing cancer disparities in ethnic/racial or rural populations.
Reference: Jahn, A. L. et. al. (2012). Distress and resilience after cancer in veterans. Research in human development, 9(3), 229-247.
Funder Acknowledgement(s): Original research and conceptualization for this project was partially supported by the SAPAI program under AGEP. I gratefully acknowledge funding from the Center for American Indian Resilience (CAIR). I thank the University of Colorado Denver for their support.
Faculty Advisor: Alan Davis, Alan.Davis@ucdenver.edu
Role: I originally conceptualized and did the beginning research for this project with the AGEP sponsored program. I have now helped further extend this research. I administered the project and collected the data.