Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
Department of Family and Community Medicine, University of New Mexico Health Sciences Center, Albuquerque, NM, USA.
J Cancer Educ. 2022 Dec;37(6):1752-1759. doi: 10.1007/s13187-021-02023-0. Epub 2021 May 7.
American Indians (AIs) in New Mexico have lower cancer screening rates compared to other populations and are more likely to be diagnosed with cancer at an advanced stage of the disease as reported by Li et al. (Archives of Internal Medicine 163(1):49-56, 2003). AIs also have the lowest 5-year cancer survival rates compared to any ethnic/racial group in the USA as reported by Clegg et al. (Arch Intern Med 162:1985-1993, 2002) and Edwards et al. (Cancer 97:1407-1427, 2005). Numerous barriers such as cultural beliefs, fear, fatalism, mistrust, stigma, and lack of culturally appropriate interventions could contribute to low cancer screening rates as reported by Daley et al. (J Health Dispar Res Pract 5(2), 2012); Filippi et al. (J Prim Care Community Health 4(3):160-166, 2013); James et al. (Prev Chronic Dis 10:E170, 2013); and Schumacher et al. (Cancer Causes Control 19(7):725-737, 2008). Trained Community Health Representatives (CHRs) from the Zuni Pueblo and native Zuni undergraduate students led six 1-h focus group sessions using a structured focus group guide with probes. The focus groups were conducted among 51 participants from different age groups (20-29 years, n = 19; 30-49 years, n = 17; and 50 years and older, n = 15) stratified by sex. Focus groups were conducted in both English and Shiwi (Zuni) languages. Sessions were audio recorded, and team members took notes. CHRs transcribed the notes and audio recordings, and created a codebook for qualitative data analysis. In the focus groups, participants provided Zuni-specific cultural context, opinion, and experience regarding (1) general knowledge about cancer, (2) cancer risk, (3) cancer risk reduction, (4) personal experiences with cancer, and (5) culturally competent delivery of cancer information and resources. Understanding the perceptions of cancer within the Zuni Pueblo is an essential component in the development of interventional/preventative measures and improvement of current care. Ultimately, this information will provide a basis for the next steps in culturally sensitive cancer care for the Zuni Pueblo.
美国新墨西哥州的美洲原住民 (AI) 的癌症筛查率低于其他人群，而且据 Li 等人报告，他们在疾病晚期被诊断出癌症的可能性更大。Archives of Internal Medicine 163(1):49-56, 2003)。Clegg 等人报告称，与美国任何其他族裔/种族群体相比，AI 的 5 年癌症生存率最低。(Arch Intern Med 162:1985-1993, 2002) 和 Edwards 等人。(Cancer 97:1407-1427, 2005)。据 Daley 等人报告，许多障碍，如文化信仰、恐惧、宿命论、不信任、耻辱感和缺乏文化上适当的干预措施，可能导致癌症筛查率低。(J Health Dispar Res Pract 5(2), 2012); Filippi 等人。(J Prim Care Community Health 4(3):160-166, 2013); James 等人。(Prev Chronic Dis 10:E170, 2013); 和 Schumacher 等人。(Cancer Causes Control 19(7):725-737, 2008)。来自祖尼普韦布洛的经过培训的社区卫生代表 (CHR) 和土生土长的祖尼本科生使用带有探针的结构化焦点小组指南领导了六次 1 小时的焦点小组会议。焦点小组由来自不同年龄组的 51 名参与者组成(20-29 岁，n=19;30-49 岁，n=17;50 岁及以上，n=15)，按性别分层。焦点小组以英语和 Shiwi (Zuni) 两种语言进行。会议进行了录音，团队成员做了笔记。CHR 将笔记和录音转录下来，并为定性数据分析创建了代码本。在焦点小组中，参与者提供了关于祖尼文化的特定背景知识、观点和经验，涉及：(1) 癌症的一般知识，(2) 癌症风险，(3) 癌症风险降低，(4) 个人癌症经历，以及(5) 以文化能力提供癌症信息和资源。了解祖尼普韦布洛的癌症观念是制定干预/预防措施和改善当前护理的重要组成部分。最终，这些信息将为祖尼普韦布洛的癌症护理提供一个基础，以便进行下一个步骤。
