Reducing Cancer Health Disparities in Navajo Nation

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 DESCRIPTION (provided by applicant): American Indians and Alaska Natives (AI/ANs) are disproportionately affected by many health disparities, including the lowest cancer survival rates of any racial group in the United States. Cancers that could have been prevented or detected through screening are often diagnosed in late stages, contributing to excess mortality. Therefore, in order to address cancer disparities in Indian Country, more focus must be placed raising awareness about cancer prevention and early detection. The COPE (Community Outreach and Patient Empowerment) Project provides training and evidence-based, culturally-informed educational materials to community health workers as a means to raise health literacy and reduce health disparities in Native communities. The COPE Project has partnered with the American Cancer Society (ACS) to provide cancer- specific training for community health workers in Navajo Nation and now seeks to adapt and disseminate the ACS's cancer curriculum using interactive information technology with the goal of improving prevention and early detection activities. Engaging, easy-to-use technology will be designed for hand-held devices to offer users tailored health education. We will evaluate characteristics and patterns of community users, when delivered passively (self-use by community member) or mediated by a community health worker. We will also evaluate the impact of the system on technology literacy and cancer awareness among community health workers and community members. In addition, we will develop a web-based training portal to disseminate the training and curriculum to other Native communities. We will evaluate competency among community health workers trained through in-person and virtual sessions to assess whether virtual training can provide an effective and efficient medium to disseminate curricula broadly across community health workers serving multiple communities. We will conduct this study in close collaboration with the Navajo Nation Division of Health, New Mexico Department of Health, and the Navajo Area Indian Health Service. This 3-year project will employ a community-based participatory feedback approach to develop, implement, and evaluate an online patient-centered cancer curriculum. This approach could have a meaningful public health impact and offer a new approach for the use of technological education tools in rural, underserved populations by leveraging existing curriculum and resources to deliver culturally sensitive and relevant education in a collaborative manner.