Dignan M, Sharp P, Blinson K, Michielutte R, Konen J, Bell R, Lane C
Department of Family and Community Medicine, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27157-1084, USA.
J Cancer Educ. 1995 Winter;9(4):235-42.
The North Carolina Native American Cervical Cancer Prevention Project is a five-year, NCI-funded public health education program. The project was developed to address the problem of excess mortality from cervical cancer among Native American women by increasing screening and follow-up of abnormal cervical smears. This paper describes the process of developing and implementing the intervention, an individualized health education program. Development of the intervention was guided by the health belief model, social learning theory, self efficacy theory, and PRECEDE, a planning model. Community analysis revealed that the target populations had limited awareness of cervical cancer as a specific type of cancer, and had an experientially-based pessimistic outlook regarding survival with cancer. Steps in developing the cervical-cancer prevention program included 1) development of objectives, 2) selection of strategies and development of cervical cancer education materials, 3) pretesting and revision, and 4) implementation, monitoring, and further revision. Native American lay health educators were recruited and trained to deliver the program. The experience of developing and implementing the individualized health education program suggests that the design of health education programs for Native Americans should begin with examination of basic assumptions regarding the nature of health and illness in the target population. The unique cultures and the diversity of Native American populations are critical factors in the development of health education programs for them.
北卡罗来纳州美国原住民宫颈癌预防项目是一项由美国国立癌症研究所资助的为期五年的公共卫生教育项目。该项目旨在通过增加对异常宫颈涂片的筛查和随访，解决美国原住民女性宫颈癌死亡率过高的问题。本文描述了制定和实施一项个性化健康教育项目干预措施的过程。干预措施的制定以健康信念模型、社会学习理论、自我效能理论以及PRECEDE（一种规划模型）为指导。社区分析表明，目标人群对宫颈癌作为一种特定类型癌症的认识有限，并且对癌症生存持有基于经验的悲观看法。制定宫颈癌预防项目的步骤包括：1）制定目标；2）选择策略并开发宫颈癌教育材料；3）预测试和修订；4）实施、监测和进一步修订。招募并培训了美国原住民非专业健康教育工作者来实施该项目。制定和实施个性化健康教育项目的经验表明，为美国原住民设计健康教育项目应从审视关于目标人群健康和疾病本质的基本假设开始。美国原住民独特的文化和人口多样性是为他们制定健康教育项目的关键因素。
