Reducing Cancer Health Disparities in Navajo Nation

 描述(由申请人提供)： 美国印第安人和阿拉斯加原住民(AI/ANS)受到许多健康差距的不成比例的影响，包括美国所有种族中最低的癌症存活率。本可以通过筛查预防或发现的癌症往往在晚期被诊断出来，导致过高的死亡率。因此，为了解决癌症方面的差异 在印度，必须更加重视提高对癌症预防和早期发现的认识。COPE(社区外联和患者赋权)项目向社区卫生工作者提供培训和基于证据的文化知识教育材料，以此作为提高土著社区的健康素养和减少健康差距的一种手段。COPE项目与美国癌症协会(ACS)合作，为纳瓦霍民族的社区卫生工作者提供针对癌症的培训，现在寻求利用互动信息技术调整和传播ACS的癌症课程，目的是改善预防和早期发现活动。吸引人的、易于使用的技术将被设计用于手持设备，为用户提供量身定制的健康教育。我们将评估社区用户的特征和模式，当被动提供(社区成员自用)或由社区卫生工作者调解时。我们还将评估该系统对社区卫生工作者和社区成员的技术素养和癌症意识的影响。此外，我们将开发一个基于网络的培训门户网站，向其他原住民社区传播培训和课程。我们将评估通过面对面和虚拟会议培训的社区卫生工作者的能力，以评估虚拟培训是否可以提供一种有效和高效的媒介，在服务于多个社区的社区卫生工作者中广泛传播课程。我们将与纳瓦霍国家卫生局、新墨西哥州卫生局和纳瓦霍地区印第安人卫生局密切合作进行这项研究。这个为期3年的项目将采用基于社区的参与式反馈方法来开发、实施和评估以患者为中心的在线癌症课程。这一方法可对公共卫生产生重大影响，并通过利用现有课程和资源以协作方式提供对文化敏感和相关的教育，从而为在农村、服务不足的人口中使用技术教育工具提供一种新的方法。

 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.