Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA.
Faculty of Medicine, Medical Humanities (HEALS) program, Medical Division of Medical Education, Dalhousie University, B3H4R2, Halifax, NS, Canada.
J Cancer Educ. 2021 Oct;36(5):996-1004. doi: 10.1007/s13187-020-01727-z.
American Indians residing in the Northern Plains region of the Indian Health Service experience some of the most severe cancer-related health disparities. We investigated ways in which the community climate among an American Indian population in an urban community in the Northern Plains region influences community readiness to address cancer. A Community Readiness Assessment, following the Community Readiness Model, conducted semi-structured interviews with eight educators, eight students, and eight community leaders from the American Indian community in Omaha's urban American Indian population and established the Northern Plains region community at a low level of readiness to address cancer. This study reports on a subsequent qualitative study that analyzed all 24 interview transcriptions for emergent themes to help understand the prevailing attitude of the community toward cancer. A synthesis of six emergent themes revealed that the community's perceptions of high levels of severity and barriers, paired with perceptions of low levels of susceptibility and benefits, lead to low levels of self-efficacy, all of which are reflected in minimal cues to action and little effort to address cancer. These findings, interpreted through the lens of the Health Belief Model, can inform the development of more community-based, comprehensive, and culturally appropriate approaches to address the multilevel determinants of health behaviors in relation to cancer among American Indians in the Northern Plains region.
居住在印第安人健康服务北部平原地区的美洲印第安人经历了一些最严重的与癌症相关的健康差距。我们研究了城市社区中美洲印第安人群体的社区氛围如何影响社区准备情况，以解决癌症问题。根据社区准备模型，对奥马哈市城市美洲印第安人口中的 8 名教育工作者、8 名学生和 8 名社区领导人进行了社区准备评估，确定了北方平原地区社区在解决癌症问题方面的准备程度较低。本研究报告了随后的一项定性研究，该研究分析了所有 24 次访谈的转录本，以发现新出现的主题，以帮助了解社区对癌症的普遍态度。六个新出现的主题的综合表明，社区对高严重程度和障碍的看法，加上对低易感性和低收益的看法，导致自我效能感低，这反映在行动提示很少，很少努力解决癌症问题。这些发现通过健康信念模型进行解释，可以为开发更多基于社区、全面和文化上适当的方法提供信息，以解决北方平原地区美洲印第安人在与癌症相关的健康行为的多层次决定因素。
