Abstract
Problem Identification
Lung cancer is the deadliest cancer type, causing more deaths in the U.S. than breast and prostate cancer combined (U.S. Cancer Statistics Working Group [U.S CSWG], 2022b). American Indian/Alaska Native (AI/AN) populations experience a higher incidence of lung cancer and have the lowest 5-year relative survival among all races (NCI SEER 2020; U.S. Cancer Statistics Working Group [U.S. CSWG], 2022a; U.S CSWG, 2022b). The lung cancer incidence among AI/AN in Oglala Lakota County, South Dakota (66.4 per 100,000) is nearly double the national rate (36.1 per 100,000). Analysis
Historical trauma, a multigenerational compound trauma, and the community’s use of commercial tobacco in traditional and cultural practices increase the risk of smoking, the highest risk factor for lung cancer (Burgess et al., 2007; Duran et al., 1998; Soto et al., 2015). There are currently no public health efforts in the community targeting these specific determinants of smoking to decrease the incidence of lung cancer.
Intervention Proposal
The proposed “Connecting through Ċanśaśa” program is a community-based six-week intervention led by Community Health Workers (CHWs). The six one-hour sessions will employ theory informed strategies such as consciousness raising and facilitation methods while incorporating tribal specific traditional practices to reduce historical trauma and the ceremonial use of commercial tobacco among program participants. Implementation and Evaluation
A program team comprised of representatives from the tribal nation and organizations focused on American Indian health will lead the program’s development, implementation, and evaluation. To ensure fidelity to the program design, the CHWs will complete a checklist after each session to ensure consistency among all program groups. A non-experimental pre/posttest design will be used to conduct the summative evaluation.