Culturally-Relevant Online Education Improves Health Workers’ Capacity and Intent to Address Cancer

Abstract

To address a desire for timely, medically-accurate cancer education in rural Alaska, ten culturally-relevant online learning modules were developed, implemented, and evaluated with, and for, Alaska's Community Health Aides/Practitioners (CHA/Ps). The project was guided by the framework of Community-Based Participatory Action Research, honored Indigenous Ways of Knowing, and was informed by Empowerment Theory. Each learner was invited to complete an end-of-module evaluation survey. The survey asked about changes in intent to share cancer information with patients as a result of the module. In 1 year, August 1, 2016-July 31, 2017, 459 surveys were completed by 79 CHA/Ps. CHA/Ps reported that, because of the modules, they felt more knowledgeable about cancer, and more comfortable, confident, and prepared to talk about cancer with their patients, families, and communities. All learners shared that because of the modules, they intended to talk with their patients more often about cancer screenings, tobacco cessation, physical activity, or nutrition. These findings suggest that the application of this collaboratively developed, culturally-relevant, health promotion intervention has supported increased CHA/P capacity and intent to interact with patients about cancer. In the words of a learner: "Doing all these courses makes me a ton times more comfortable in talking about cancer with anyone. I didn't know too much about it at first but now I know a whole lot. Thank you".

Learning Together: Sharing Circles in Rural Alaska on Cancer Education Priorities for Youth

“…Health promotion efforts to reduce cancer risk factors have the potential to mitigate the disparities impacting Alaska Native people. Previous cancer education with, and for, Alaska Native people has led to self-reported decreases in cancer risk factors and improved self-efficacy to share cancer-related health information [10,11]. The disparities between Alaska Native and White Alaskan adults are not intractable; in part due to health promotion efforts, the percentage of Alaska Native adults who have reported receiving a breast, cervical, or colorectal cancer screening recently attained parity with rates for both Alaska White adults and U.S. White adults [12][13][14].…”

“…There is little cancer education that is designed to be culturally relevant and developed in partnership with Alaska Native people [10,11,15,16]. However, studies show that culturally relevant educational programs have greater success in supporting desired health outcomes such as reduced youth smoking [17].…”

Culturally Relevant Online Cancer Education Supports Tribal Primary Care Providers to Reduce Their Cancer Risk and Share Information About Cancer

“…The principles of CBPAR and Indigenous Ways of Knowing informed the design, delivery, and iterative evaluation of the online cancer education modules and are more fully described in previous publications (K. Cueva, Cueva, Revels, & Dignan, 2018; K.…”

Cancer Education for High School Students in the Northwest Arctic Increases Knowledge and Inspires Intent to Share Information and Reduce Cancer Risk

“…Culturally relevant health promotion efforts have the potential to reduce both cancer risk factors and alleviate disparities impacting Alaska Native people. Previous culturally relevant health promotion efforts developed with and for Alaska Native people have led to self-reported decreases in cancer risk factors and improved self-efficacy to share cancer-related health information [6,7]. In part due to health promotion efforts, the percentage of Alaska Native adults who reported receiving a breast, cervical, or colorectal cancer screening has attained parity with rates for both Alaska White adults and US White adults [5].…”