Understanding American Indian tribal college student knowledge, attitudes, beliefs, and behaviors surrounding alternative tobacco products.

Objectives: To examine knowledge, attitudes, beliefs, and behaviors about alternative tobacco products among American Indian tribal college students.

Participants: One hundred and five tribal college students.

Methods: Focus groups, one interview, and demographic surveys.

Using Bayesian hierarchical models for controlled post hoc subgroup analysis of clinical trials: application to smoking cessation treatment in American Indians and Alaska Natives.

Clinical trials powered to detect subgroup effects provide the most reliable data on heterogeneity of treatment effect among different subpopulations. However, pre-specified subgroup analysis is not always practical and post hoc analysis results should be examined cautiously. Bayesian hierarchical modelling provides grounds for defining a controlled post hoc analysis plan that is developed after seeing outcome data for the population but before unblinding the outcome by subgroup.

Pilot Testing All Nations Snuff Out Smokeless (ANSOS): A Culturally Tailored Smokeless Tobacco Cessation Program for American Indians.

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.

Baseline characteristics of American Indian smokeless tobacco users participating in two pilot cessation studies.

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.

One-Time Education Sessions to Help American Indian Smokeless Tobacco Users Quit.

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.

American Indian Knowledge, Attitudes, and Beliefs About Smokeless Tobacco: A Comparison of Two Focus Group Studies.

Though smokeless tobacco (SLT) use has decreased in many communities, concern for American Indian (AI) SLT use remains, as this population continues to be disproportionally affected by SLT-related diseases. Tobacco has cultural significance to many AI tribes, therefore tobacco cessation messages portraying tobacco as entirely negative may be ineffective. As a part of our formative research for an SLT cessation intervention, we sought to gain a better understanding of the knowledge, attitudes, and beliefs about SLT among AI community members.

Feasibility of Implementing the All Nations Breath of Life Culturally Tailored Smoking Cessation Program for American Indians in Multi-Tribal Urban Communities.

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.

Recruitment and Baseline Characteristics of American Indian Tribal College Students Participating in a Tribal College Tobacco and Behavioral Survey.

Introduction: American Indians (AIs) have the highest cigarette smoking rates of any racial/ethnic group in the United States. Although the overall smoking prevalence in the United States for nonminority populations has decreased over the past several decades, the same pattern is not observed among AIs. The purpose of this observational study was to collect cigarette smoking and related information from American Indian tribal college students to inform tailored interventions.

Teaching Confirmatory Factor Analysis to Non-Statisticians: A Case Study for Estimating Composite Reliability of Psychometric Instruments.

Texts and software that we are currently using for teaching multivariate analysis to non-statisticians lack in the delivery of factor analysis (CFA). The purpose of this paper is to provide educators with a complement to these resources that includes CFA its computation. We focus on how to use CFA to estimate a "composite reliability" of a psychometric instrument.

Geographic variation in colorectal cancer incidence and mortality, age of onset, and stage at diagnosis among American Indian and Alaska Native people, 1990-2009.

Objectives: We characterized estimates of colorectal cancer (CRC) in American Indians/Alaska Natives (AI/ANs) compared with Whites using a linkage methodology to improve AI/AN classification in incidence and mortality data.

Methods: We linked incidence and mortality data to Indian Health Service enrollment records. Our analyses were restricted to Contract Health Services Delivery Area counties.

Assessment of mammography experiences and satisfaction among American Indian/Alaska Native women.

Background: American Indian/Alaska Native (AI/AN) women have lower breast cancer (BCA) screening and 5-year survival rates than non-Hispanic Whites. Understanding reasons for low screening rates is important to combatting later stage diagnoses. The purpose of this study was to assess mammography experiences and satisfaction among AI/AN women.

Characteristics of American Indian light smokers.

Introduction: American Indians (AI) have the highest smoking rates of any racial/ethnic group in the U.S. and have more difficulty quitting smoking.

American Indian Community Leader and Provider Views of Needs and Barriers to Colorectal Cancer Screening.

Colorectal cancer is a great concern for the American Indian/Alaska Native (AI/AN) community, as incidence and mortality rates remain high and screening rates stay low. We conducted interviews with community leaders (n=13) and with providers from the Indian Health Service (IHS), tribal clinics, and urban safety-net clinics (n=17) in Northeast Kansas and the Kansas City Metro Area to determine their understanding of needs and barriers to colorectal cancer screening among American Indians. Using a community-based participatory research (CBPR) approach for this pilot study, community leaders and providers identified similar needs, including: culturally-appropriate education about colorectal cancer and screenings, the potential use of Native elders as patient navigators, and an emphasis on preventive care, particularly through the IHS.

Use of online health information resources by American Indians and Alaska Natives.

According to the Office of Minority Health, an estimated 4.9 million people living in the United States consider themselves American Indian or Alaska Native, either alone or in combination with one or more races/ethnicities. American Indians or Alaska Natives comprise a racial/ethnic group experiencing serious health disparities, with little if any improvement in health outcomes over the past several decades.

Improving health promotion to American Indians in the midwest United States: preferred sources of health information and its use for the medical encounter.

American Indians and Alaska Natives suffer significant health disparities for many infectious and chronic diseases as compared to the general population. Providing accurate and culturally tailored health information to underserved groups has been shown to influence health behaviors and health outcomes. Little prior research has explored American Indians health information use and preferences.

Breast cancer screening beliefs and behaviors among American Indian women in Kansas and Missouri: a qualitative inquiry.

American Indian women have rising incidence and disproportionate mortality rates due to breast cancer. Using a community-based participatory research approach, we conducted ten focus groups with American Indian women in Kansas and Missouri to understand their barriers to mammography and identify ways to intervene to improve screening rates. Focus groups were stratified by screening status, including women who were up to date with current screening mammography recommendations (mammogram within the last 2 years, N = 7 groups, 66 participants) and women who were not (N = 3 groups, 18 participants).

A computerized intervention to promote colorectal cancer screening for underserved populations: theoretical background and algorithm development.

Objective: The aim of this exploratory study was to assess factors deemed by patients as "important" as they planned and considered undergoing colorectal cancer (CRC) screening, and to use this data to design a computer-delivered intervention to promote screening.

Methods: Fifty participants 50 years or older, not up-to-date with current recommended CRC screening guidelines, were recruited from a primary care clinic. A semi-structured interview focused on aspects of preparing for colorectal cancer screening was administered; after transcription, researchers used triangulation and consensus to identify relevant themes and concepts.

Smoke-Free Policies in the Workplace and in the Home among American Indians.

Objectives: American Indians are more likely to smoke, less likely to have smoke-free homes, and potentially less likely to have worksite smoke-free policies. We examined correlates of smoke-free policies at home and work among a community-based sample of American Indians in the Midwest.

Methods: We examined correlates of smoke-free policies at home and work in a sample of American Indians in the Midwest using a community-based participatory research approach.

Physical activity and fruit and vegetable intake among American Indians.

The American Indian population has among the highest rates of obesity in the United States. Thus, it is critical to understand factors related to this epidemic (e.g.

Adapting pressure ulcer prevention for use in home health care.

Purpose: Clinical practice guidelines on pressure ulcer (PU)prevention have been written primarily for inpatient settings,but we currently lack data as to how these guidelines have been adapted for use in home health care. The purpose of this study was to delineate interventions and activities used to prevent PU in home health care.

Design: Focus group study using text analysis.

All Nations Breath of Life: using community-based participatory research to address health disparities in cigarette smoking among American Indians.

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.

Using focus groups in community-based participatory research: challenges and resolutions.

A community-based participatory approach requires that community members be involved in all phases of the research process. We describe three focus group studies with American Indians in Kansas and Missouri, using a newly developed method of conducting and analyzing focus groups with community input (72 focus groups, 519 participants). We conducted two needs assessment studies focused on barriers to breast and colorectal cancer screening and one study focused on Internet use for gathering health information.

Assessing the scientific accuracy, readability, and cultural appropriateness of a culturally targeted smoking cessation program for American Indians.

This study assesses educational materials developed for the All Nations Breath of Life smoking cessation program (targeted for American Indians and Alaska Natives) for scientific accuracy, readability and other literacy factors, and cultural appropriateness. The authors used a scientific review panel of experts in smoking cessation representing epidemiology, medicine, and psychology; the suitability assessment of materials (SAM) and the simplified measure of gobbledygook (SMOG) reading grade level formulas; and review by Native program facilitators and pilot participants. Materials were scientifically accurate and culturally appropriate.

College men's knowledge, attitudes, and beliefs about testicular cancer.

There is a paucity of information about what college-age men know about testicular cancer, making targeted educational programs difficult. The most common age group affected by testicular cancer is 15- to 40-year-olds. Therefore, educating young men, including the college population, becomes paramount.

College students' knowledge of risk and screening recommendations for breast, cervical, and testicular cancers.

Background: There is a gap in the literature regarding the knowledge of college students about breast, cervical, and testicular cancers.

Methods: I surveyed 3362 college students were surveyed about their knowledge of risk factors and screening recommendations for these 3 cancers during the 2002-2003 school year at a large public university in the Northeast.

Results: Students knew approximately 50% of the information about risk factors and screening recommendations for these 3 cancers.