Extending Success II
Abstract
This Developmental CARA proposal represents a continuation of the Developmental CARA entitled “Extending CD Success in Indian Country to Tobacco”. The research project described here addresses ClearWay Minnesota’s Primary Funding Priority Area II.a: Research to determine effective strategies for mobilizing priority populations to address the harms caused by exposure to tobacco use and secondhand smoke. Findings from this project will provide preliminary information about a promising strategy to help mobilize the American Indian community to develop a healthier relationship to tobacco.
Compared to other American ethnic/racial groups, American Indians in the Upper Midwest are reported to smoke cigarettes earlier, at higher rates, and with more severe health consequences. Yet very little has been published regarding recreational smoking prevention or cessation in any American Indian populations.
The original “Extending Success” project revealed that changes in social norms around community alcohol use were based on appeal to traditional AI values and practices. Building on these results, this proposal is to develop and pilot-test a mobilization strategy with elders designed to increase awareness of the harm of and to de-normalize cigarette smoking. Elders have important status as mentors, role models, and teachers. Through storytelling, ceremonies and cultural events elders are a resource for adults and youth alike about continuing traditional ways of life: how to treat humans, animals, and the earth; how to be self-sustaining as a people; how their actions affect future generations; and how to maintain health and well-being.
Using a community health worker model, the Specific Aims of this proposal are the following:
1. Expand our current collaboration with the AI community in the Twin Cities to include organizations that serve AI elders, such as Inter Tribal Elder Services. This organization is affiliated with Wisdom Steps, an initiative of the Minnesota Board on Aging that is dedicated to helping elders improve their own health and that of their communities.
2. Determine the level of support among AI elders in the Twin Cities for reducing recreational tobacco use in the AI community, and willingness to serve as leaders and cultural role models in this effort.
3. Develop and pilot-test a program based on a community health worker model with American Indian elders in the Twin Cities. The goal of the program is to provide elders with the knowledge, opportunities and support so that they may lend leadership to a tobacco control movement that is grounded in the ceremonial traditions of tobacco use.
Findings from this project will provide valuable insight into the feasibility of working with elders as key advisors on tobacco issues. We will know whether elders can be recruited to work on reducing cigarette smoking in their community; are willing to use their cultural roles to increase knowledge of the harms of commercial tobacco in the American Indian community; are willing to try to increase knowledge of, demand for, and use of various cessation methods; and are willing to encourage reductions in environmental tobacco smoke exposure in homes.