American Indians and Alaska Natives (AI/AN) have the highest smoking rates any ethnic group in the United States, at 41% versus 24% for African Americans and Whites. They also have the lowest quit rates of any group, at 8-10% at 6 months. Due to its long cultural significance as a sacred plant, the entirely negative portrayal of tobacco in most smoking cessation programs is inappropriate, leaving programs unsuccessful. In 2003, AI/AN patients from Haskell Health Center requested a culturally-appropriate smoking cessation program, causing the center director to contact the University of Kansas Medical Center Department of Preventive Medicine. Since that time, the larger AI/AN community in Kansas and Missouri has been working collaboratively with KUMC on the development of a culturally-tailored smoking cessation program, as well as several other projects. In 2006, KUMC and several community-based organizations formed the American Indian Health Research and Education Alliance, dedicated to improving the health of AI/AN using community-based participatory research methods. The culturally-tailored smoking cessation program that began the partnership, All Nations Breath of Life (ANBL), has now been developed and pilot tested and is ready for implementation in the urban AI/AN community of the Kansas City Metroplex. Our pilot data are promising;with a 25% quit rate and 80% participant retention at 6-months post-baseline. We will address the following specific aims: (1) To create appropriate infrastructure (personnel, space, supplies, leadership commitment) for the Heart of America Indian Center to serve as the primary site for implementation of ANBL;(2) To examine the acceptability and feasibility of implementing ANBL in an urban AI/AN community;(3) To estimate the effectiveness of ANBL in an urban AI/AN community;and (4) to identify factors that enhance dissemination of ANBL and contribute to program success or failure. We hypothesize that participants in ANBL will quit smoking at a higher rate than currently reported in the literature for the best available programs. In addition, we will conduct a cost-effectiveness analysis of the program to help determine its sustainability. If this project is successful, ANBL can be disseminated to other AI/AN communities to help them quit smoking. By reducing smoking rates in this community, we can ultimately reduce their leading cause of cancer death (lung cancer) and their leading cause of overall death, cardiovascular disease.

National Institute of Health (NIH)
National Institute on Minority Health and Health Disparities (NIMHD)
Resource-Related Research Projects (R24)
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Application #
Study Section
Special Emphasis Panel (ZMD1-RN (01))
Program Officer
Dankwa-Mullan, Irene
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University of Kansas
Public Health & Prev Medicine
Schools of Medicine
Kansas City
United States
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Filippi, Melissa K; Pacheco, Christina M; McCloskey, Charlotte et al. (2014) Internet Use for Health Information among American Indians: Facilitators and Inhibitors. J Health Dispar Res Pract 7:
Nazir, Niaman; Bevil, Bambi; Pacheco, Christina M et al. (2014) Characteristics of American Indian light smokers. Addict Behav 39:358-61
Pacheco, Christina M; Daley, Sean M; Brown, Travis et al. (2013) Moving forward: breaking the cycle of mistrust between American Indians and researchers. Am J Public Health 103:2152-9
Geana, Mugur V; Daley, Christine Makosky; Nazir, Niaman et al. (2012) Use of online health information resources by American Indians and Alaska Natives. J Health Commun 17:820-35
Berg, Carla J; Daley, Christine Makosky; Nazir, Niaman et al. (2012) Physical activity and fruit and vegetable intake among American Indians. J Community Health 37:65-71
Berg, Carla J; Daley, Christine M; Nazir, Niaman et al. (2012) Smoke-Free Policies in the Workplace and in the Home among American Indians. J Health Dispar Res Pract 5:7
Geana, Mugur V; Greiner, K Allen; Cully, Angelia et al. (2012) Improving health promotion to American Indians in the midwest United States: preferred sources of health information and its use for the medical encounter. J Community Health 37:1253-63
Berg, Carla J; Daley, Christine Makosky; Nazir, Niaman et al. (2012) Smoke-Free Policies in the Workplace and in the Home among American Indians. J Health Dispar Res Pract 5:81-91
Filippi, Melissa K; Young, Kristin L; Nazir, Niaman et al. (2012) American Indian/Alaska Native willingness to provide biological samples for research purposes. J Community Health 37:701-5
Daley, Christine M; Faseru, Babalola; Nazir, Niaman et al. (2011) Influence of traditional tobacco use on smoking cessation among American Indians. Addiction 106:1003-9

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