Project Leader: Linda Burhansstipanov, Dr. P.H.
Cancer prevention through screening is an important aspect of health care. However, screening procedures are underused and only a minority of eligible patients actually receive them. In particular, little is known about the use of most preventive measures among older individuals. In one study of patients ³ 70 years, Pap smears had been obtained in only 17%, fecal occult blood tests (FOBT) in 24% and MG in 56%. This may not be expected since 88% of primary care providers agree that guidelines improve care for the elderly, but these attitudes often did not translate into adherence to screening recommendations. Yet, preventative guidelines, typically implemented in the general medical setting, may have the greatest benefit among older persons. However, persons who are poor, less educated, non-white, and older are the least likely to receive them. These observations suggest that elderly (American Indians/Alaska Natives) AI/ANs may be an especially vulnerable population. Recently, we demonstrated inadequate screening for breast and colorectal cancer among elderly AI/AN seen in an urban, primary care practice.
- This study compares education alone to a unique, culturally relevant intervention that significantly improved rates of cancer screening and follow-up care among Native women in a community-based study. AI/ANs, trained as lay health advisors, or “Native Brothers/Sisters”, will contact AI/AN patients and provide education/encouragement to increase participation in cancer screening.
- This study addresses the following specific aims:
Adapt the community-based cancer screening intervention for implementation by AI/AN lay health advisors in a primary care setting;
- Modify the intervention to improve screening for colorectal cancer screening among both men and women;
Evaluate whether the Native Brother model is acceptable to AI/AN men;
- Assess the effectiveness of the lay health advisor model in increasing adherence to screening for breast and colorectal cancer compared with an observation-only group.