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Transcript of Native American Tobacco Education Project (NATE) Funded by a grant from the CDPHE State Tobacco...
Native American Tobacco Education Project (NATE)
Funded by a grant from the CDPHE State Tobacco Education
and Prevention Partnership (STEPP)
Partners
Native American Cancer Research (NACR)
Ute Mountain Ute Tribe
NACR Staff
Dr. Burhansstipanov - Project Director
Lisa Harjo - Project Coordinator
Terri Rattler - Native Sister Rose Lee - Native Sister
(Navigators)
Native American Tobacco Education (NATE)
Multi-Agency project using Community-Based Participatory Research (CBPR) methodology to develop a sustainable infrastructure for the local tobacco control movement in the Indian community in Denver and at Ute Mountain Ute.
Two Advisory Coalitions
one in the Denver Metropolitan Area
one within Ute Mountain Ute Reservation.
Purpose
to develop an infrastructure that will allow both Native communities to assess local needs and potential strategies to prevent and reduce habitual tobacco use or exposure to secondhand smoke by Native American adolescents and adults, ages 12 to 85.
Expected Outcomes
(1)two functional Native Tobacco Coalitions (one in each site)
(2)baseline data from local focus and working groups to help the Coalitions prioritize issues; and
Expected Outcomes cont.
(3)a list of recommendations based on the focus and working group input by the respective Coalitions for tribal- and geographically-specific tobacco interventions they feel need to be developed in the near future to appropriately address the priorities in culturally respectful manners.
NATE Project Goal
To increase Native communities’ capacity for tobacco control by developing two well educated Native American Tobacco Education Coalitions in Denver and Ute Mountain Ute Reservation.
Strategy 1
Educate both of the Native tobacco control coalitions on the latest, most appropriate tobacco prevention and control information and interventions effective within Native and non-Native communities (includes evidence–based and native-specific strategies.)
Strategy 2
The NATE Coalitions will each recruit community members to take part in FG held in March and April in two different geographic locations in their respective communities (4 FG in Denver and 2 FG in Towaoc).
Strategy 3
The NATE Coalition from each site will review the expanded prioritized tobacco topics for their respective area (i.e., two different priority lists which are likely to have some overlap, yet issues specific to the rural or urban communities) and organize the priorities into a strategic plan.
Strategic Plan
This strategic plan will include (a) goals for next 3 years;
(b) measurable objectives to attain those goals;
(c) culturally acceptable and innovative strategies to attain the objectives;
Strategic Plan cont.
(d) participant interactive activities to reinforce the behaviors specified within each objective;
(e) evaluation strategies specific to each objective; and
(f) dissemination of recommendations plan (to local communities, State funders and others as needed).
Strategic Plan
This outline will be the beginning of a strategic plan for subsequent funding to develop interventions inclusive of these components that are culturally specific and designed to prevent, reduce, or control habitual tobacco use among Native Americans.
Advisory Coalition
Meets every other month for 2 hours
Training in beginning and during project.
Provides guidance and leadership during gathering of information from community, and development, implementation and dissemination of the plan to the community
Continues with Project during subsequent funding to provide leadership
Focus Groups
Conducted to gather more information directly from community members
Four groups in each site: 2 all ages, 1 youth, and 1 elders.
Questions from TAB and Coalition and 2-3 discussion questions
2 hours in duration, 8 participants, $20 each
Overview of Training
Ceremonial tobacco use vs. habitual tobacco use
Strategies for teambuilding
Tobacco Initiatives in Indian Country
Stages of Change in and out of Indian Country
Tobacco Facts and Fallacies in Indian country
Overview of Training cont.
Overview of AIAN Tobacco Surveys
Social Norm Strategies
ARS – Audience Response System
Second Phase
Goal: To continue the work established in the First Phase and add new levels of focus.
Second Phase
Strategy 1: Maintenance of a community advisory coalition and expanded partners to guide development, field testing, and implementation efforts for all age groups and sectors in the American Indian Community regarding Tobacco Control.
Second Phase
Strategy 2: Develop, refine, and implement age-specific culturally appropriate tobacco use interventions will reduce second hand smoke (SHS), reduce first time starts with tobacco, and increase cessation activities among American Indians.
Second Phase
Strategy 3: Develop Native-specific anti-habitual tobacco use messages that can be used in public awareness campaigns to help initiate community members' consideration of new ideas, behavior, and actions.
Second Phase
Strategy 4: QUITLINE and QUITNET (Native Adults) Determine cultural appropriateness and sensitivity of the proposed tobacco interventions, especially telephone counseling.
Second Phase
Strategy 5: Policy is an essential component of a comprehensive Tobacco Control Movement as it creates environments and opportunities for new behaviors and actions.
Successes
Sustainable Infrastructure for Tobacco Control Initiatives – Capacity-Building
Tribal and Native Tobacco Policy and Movement Training
Youth Intervention for Tobacco exposure reduction and cessation
Colorado Quitline
Established a relationship for future work
Participated in cultural competency training…….
Critiqued Cultural Training
Established plan to improve cultural sensitivity training for providing support to American Indian callers.
Challenges
Lack of knowledge and experience in the American Indian tobacco control movement.
remedied by training and networking at regional Indian tobacco control leadership workshops and seminars.
Challenges
Continued competition for the attention of Indian people who smoke.
remedied by interventions that are fun and based on some traditional beliefs and practices.
Challenges
Ute Mountain Ute Tribe – Working with a tribal nation yielded several challenges that continue to be addressed including:
Challenges
Lack of support for the program – Low priority in relationship to other efforts related to education, employment, health, tribal business, etc.
Lack of internal stability and coordination with tribal program leadership changes and facility limitations.
Challenges
Lack of participation in the advisory council by tribal program representatives and leaders.
Responses
The NATE staff at both locations worked to recruit and keep participants in the Ute Advisory Council to provide leadership and support to the program.
ResponsesActions taken:
The NATE Program worked to take the Advisory Council members including a Ute Mountain Ute Tribal council person to training with other Tribes and Indian people to uplift the issue and educate them on what other tribes are doing and how their efforts can help their community.
Responses
NATE staff raised the issue of changing and limited office space to the Tribe on many occasions.
Results
NATE staff in Denver provided on-going training to the Ute Mountain Ute staff on the ARS, tobacco control issues, and other topics to support the program in their efforts to get the community involved and participating in the program.
Results
The NATE staff in Ute Mountain Ute now has a permanent office and is housed in the Substance Abuse Program.
Future Activities…
Sustain Advisory CouncilPilot and implement Youth InterventionPromote SHS Reduction and Prevention Strategies including personal policy developmentWork with Quitline-established cessation programCreate culturally sensitive media
Preliminary NATE “Survey” findings
Survey Items Evolved from: o CO TAB instrument o Native American Tobacco Prevention
Network (survey tools) o National Health Interview Survey (2 items)o California Health Interview Survey o 4 National Cancer Institute Native tobacco
surveyso NATE Coalition Guidance
Includes NATE Coalition and focus group (FG) data from both Denver and Ute Mountain Ute Tribe (FG still in process)
Different numbers of responses on selected items as the items were refined to be culturally acceptable to the Native community members
Administered via ARS
Preliminary NATE “Survey” findings
Examples of Preliminary NATE “Survey” findings
“Preliminary Data” Comprise total of
o 52 Denver Natives
o 25 Ute Mountain Ute Tribal Members
Examples of demographics:
o ~41% males
o ~59% females
Typical tobacco survey breakout in Indian Country is ~75% respondents are female
Examples of Preliminary NATE “Survey” Demographics
Denver Ute Mt. Ute
N=52 answered the item
21 males (40.4%)
31 females (59%)
N=21 answered the item
8 males (30.3%)
13 females (60.7%)
Gender
Examples of Preliminary NATE “Survey” Demographics
Denver Ute Mt. Ute
52 (n=53; 98.1%) 15 (n=17;88%)
American Indians
The number of people who answered the item
Examples of Preliminary NATE “Survey” Demographics
Denver Ute Mt. Ute
27 (n=53; 50.9%) 15 (n=17;88%)
High school or less education
Examples of Preliminary NATE “Survey” Demographics
Denver Ute Mt. Ute
9 (n=29; 31%) 17 (n= ; 62.4%)
Primarily raised on reservation
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
24 (n=36; 52.2%) 8 (n=23; 35.4%)
Use tobacco for ceremonies
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
27 (n=44; 61.4%) 13 (n=23; 55%)
Not smoke at all
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
17 (n=45; 37.8%) 11 (n=24; 47.8%)
Yes, smoke when drink alcohol
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
41 (n=45; 91.10%) 26 (n=26; 100%)
Not use chew at all
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
30 (n=36; 83.3%) 18 (n=26; 67.5%)
Never allow smoking in home
Allow smoking in home only for special people
1 (n=36; 2.8%) 4 (n=26; 16.3%)
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
21 (n=45; 46.7%) 12 (n=27; 43.5%)
No habitual smoking in home at any age
Examples of Preliminary NATE “Survey” Tobacco Behaviors
Denver Ute Mt. Ute
22 (n=45; 48.9%) 11 (n=27; 40.6%)
No smoking or chewing in home <18 years
Examples of Preliminary NATE “Survey” NHIS
Denver Ute Mt. Ute
29 (n=45; 64.4%) 16 (n=25; 63.3%)
Yes, always wear seat belt
Strong correlation between consistent seat belt use and likelihood of adhering to tobacco cessation
Examples of Preliminary NATE “Survey” Tobacco Cessation
Denver Ute Mt. Ute
30 (n=37; 81.1%) 22 (n=22; 100%)
Culturally Appropriate Tobacco Quit Programs(“none”, “none that I know of”, “don’t know”)
Examples of Preliminary NATE “Survey” Tobacco Cessation
Denver Ute Mt. Ute
27 (n=45; 60%) 18 (n=30; 57.5%)
Yes, I’ve heard of CO Quitline / Quitnet
NATE Staff
Lisa Harjo, MA [Choctaw]Terri Rattler [Oglala Lakota]
Rose Lee [Navajo]Linda Burhansstipanov [Cherokee]
Native American Cancer Research1835 Franklin StreetDenver, CO 80218
phone: 303-837-8137fax: 303-837-7115
Native Cancer Survivors' Support Network: 1-800-537-8295
web page: http://www.NatAmCancer.org
email: [email protected]
What is NATE?
NATE is the Native American Tobacco Education Project. It is a community-based initiative to raise awareness in the Denver American Indian community about tobacco.
The NATE project is coordinated through Native American Cancer Research (NACR). It is funded through a grant from Colorado’s State Tobacco Education and Prevention Partnership (STEPP)
RespectTobacco
Denver, ColoradoSeptember 2006
Youth / Children
Based on the responses of the American Indians who participated in the Focus
Groups and surveys:
41% first tried tobacco between 14 and 16 years of age
68% were introduced to tobacco by their friends or peers
33% began using tobacco habitually before 20 years of age
57% believe that enforcement for minors is not adequate
87% believe that store owners should have a license to sell tobacco
62% of youth believe that enforcement for minors is not adequate
13% of youth currently smoke tobacco daily
What we Learned from our Community
12% of youth use tobacco with alcohol two times a week or less
25% of youth were exposed to second hand smoke in their home
What they said
“I thought it was cool … every movie you went to, someone was blowing smoke … it looked sophisticated.”
“My boyfriend got me to smoke. He was always smoking cigarettes and he said come on, smoke a cigarette… So, I smoked a cigarette. Now I’m hooked.”
“Our coach used to smoke … Wow, a coach is smoking and this guy is athletic and everything.”
Focus Groups and Surveys
NATE conducted a series of Focus Groups and surveys in the Denver Metro Area with American Indian people of all ages during the Spring and Summer of 2006 to learn more about attitudes, beliefs, and behaviors related to tobacco.
Who Participated?
59 American Indians who reside in Denver, CO
40% males
60% females
NATE Staff
Lisa Harjo, MA [Choctaw]Terri Rattler [Oglala Lakota]
Rose Lee [Navajo]Linda Burhansstipanov [Cherokee]
Native American Cancer Research1835 Franklin StreetDenver, CO 80218
phone: 303-837-8137fax: 303-837-7115
Native Cancer Survivors' Support Network: 1-800-537-8295
web page: http://www.NatAmCancer.org
email: [email protected]
What is NATE?
NATE is the Native American Tobacco Education Project. It is a community-based initiative to raise awareness in the Denver American Indian community about tobacco.
The NATE project is coordinated through Native American Cancer Research (NACR). It is funded through a grant from Colorado’s State Tobacco Education and Prevention Partnership (STEPP)
RespectTobacco
Denver, ColoradoSeptember 2006
Ceremonial Use
What we Learned from our Community
How is Traditional Tobacco Used?
Focus Groups and Surveys
NATE conducted a series of Focus Groups and surveys in the Denver Metro Area with American Indian people of all ages during the Spring and Summer of 2006 to learn more about attitudes, beliefs, and behaviors related to tobacco.
Who Participated?
59 American Indians who reside in Denver, CO
40% males
60% females
Based on the responses of the American Indians who participated in the Focus
Groups and surveys:
60% use tobacco for ceremonial purposes
45% use traditional, non-commercial tobacco for ceremonial purposes
Over 50% of American Indians use both traditional tobacco and commercially prepared tobacco for ceremonial purposes
47% use tobacco for non-ceremonial purposes
For healing with headaches, fevers, chills, earaches and other illnesses
For pain relief from childbirth pains, headaches, and toothaches
For relief from symptoms of asthma, stomach aches, and rheumatism
As a remedy for wounds
As a bug repellant
To honor and welcome guests
To communicate with the Creator
To bind agreements
To bless events, buildings, homes, and people
NATE Staff
Lisa Harjo, MA [Choctaw]Terri Rattler [Oglala Lakota]
Rose Lee [Navajo]Linda Burhansstipanov [Cherokee]
Native American Cancer Research1835 Franklin StreetDenver, CO 80218
phone: 303-837-8137fax: 303-837-7115
Native Cancer Survivors' Support Network: 1-800-537-8295
web page: http://www.NatAmCancer.org
email: [email protected]
What is NATE?
NATE is the Native American Tobacco Education Project. It is a community-based initiative to raise awareness in the Denver American Indian community about tobacco.
The NATE project is coordinated through Native American Cancer Research (NACR). It is funded through a grant from Colorado’s State Tobacco Education and Prevention Partnership (STEPP)
RespectTobacco
Denver, ColoradoSeptember 2006
General Information
What we Learned from our Community
Based on the responses of the American Indians who participated in the Focus
Groups and surveys:
41% currently smoke cigarettes
6% currently chew tobacco
38% smoke tobacco when they drink alcohol
58% have smoked more than 100 cigarettes in their life
41% first tried tobacco between 14 and 16 years of age
68% were introduced to tobacco by their friends or peers
% began using tobacco habitually before 20 years of age
60% use tobacco for ceremonial purposes
45% use traditional, non-commercial tobacco for ceremonies
18% allow smoking in their home
26% stated a desire to quit smoking
57% believe that enforcement for minors is not adequate
87% believe that store owners should have a license to sell tobacco
Focus Groups and Surveys
NATE conducted a series of Focus Groups and surveys in the Denver Metro Area with American Indian people of all ages during the Spring and Summer of 2006 to learn more about attitudes, beliefs, and behaviors related to tobacco.
Who Participated?
59 American Indians who reside in Denver, CO
40% males
60% females
What people said
“I don’t think Indians want to quit smoking”
“I think tobacco isn’t a risk for us (American Indians) because it was a gift to us from the Creator
NATE Staff
Lisa Harjo, MA [Choctaw]Terri Rattler [Oglala Lakota]
Rose Lee [Navajo]Linda Burhansstipanov [Cherokee]
Native American Cancer Research1835 Franklin StreetDenver, CO 80218
phone: 303-837-8137fax: 303-837-7115
Native Cancer Survivors' Support Network: 1-800-537-8295
web page: http://www.NatAmCancer.org
email: [email protected]
What is NATE?
NATE is the Native American Tobacco Education Project. It is a community-based initiative to raise awareness in the Denver American Indian community about tobacco.
The NATE project is coordinated through Native American Cancer Research (NACR). It is funded through a grant from Colorado’s State Tobacco Education and Prevention Partnership (STEPP)
RespectTobacco
Denver, ColoradoSeptember 2006
Quitting
What we Learned from our Community
Based on the responses of the American Indians who participated in the Focus
Groups and surveys:
41% currently smoke cigarettes
6% currently chew tobacco
38% smoke tobacco when they drink alcohol
58% have smoked more than 100 cigarettes in their life
26% stated a desire to quit smoking
18% would use the Cold Turkey method of quitting without help or counseling
33% began using tobacco habitually before 20 years of age
Focus Groups and Surveys
NATE conducted a series of Focus Groups and surveys in the Denver Metro Area with American Indian people of all ages during the Spring and Summer of 2006 to learn more about attitudes, beliefs, and behaviors related to tobacco.
Who Participated?
59 American Indians who reside in Denver, CO
40% males
60% females
64% were not aware of tobacco quitting programs in the Denver American Indian community
60% had heard of the Quitline or Quitnet (1-800-639-QUIT) or http://co.quitnet.com
91% have never contact the Quitline or Quitnet
26% stated that they would like to quit using tobacco in the next six months
97% were aware of the harm second hand smoke can cause to children and youth, homes, and people
Pregnant females who smoke increase their chances of having a low birth weight baby by up to 39%
CO Quitline “Tobacco Use in Colorado” fact sheet, October 2001
Smoking during pregnancy “Facts”
Low birth weight may cause stillbirths and newborn deaths.
CO Quitline “Tobacco Use in Colorado” fact sheet, October 2001
Within 20 minutes of quitting, blood pressure and pulse rate decrease.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Benefits of Quitting “Facts”
Within 8 hours of quitting, carbon monoxide and oxygen levels in the blood return to normal.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Within 1 day of quitting, the likelhood of heart attack decreases.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Within 2 days of quitting, nerve endings regenerate; sense of smell and taste improve.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Benefits of Quitting “Facts”
Within 2 weeks, circulation improves and lug function increases.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
After quitting for 1-9 months, coughing, sinus congestion, fatigue and shortness of breath decrease.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Within 1 year of quitting, the likelihood of heart attack is cut in half.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Benefits of Quitting “Facts”
Within 5 years of quitting stroke risk is reduced to the same levels as a non-smoker..
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Within 10 years of quitting, risk of dying from lung cancer is about half that of a current smoker.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com
Benefits of Quitting “Facts”
Within 15 years of quitting, risk of coronary heart disease and death become roughly equivalent to those who have never smoked.
Most Smokers regret the day they started smoking. CO Quitline 1-800-639-QUIT or http://co.quitnet.com