American Indian (AI) adults have the highest rate of cigarette smoking in the United States. Little research has examined the cultural aspects or unveiled promising behavioral change interventions related to cigarette smoking among this population, specifically Northern tribes such as the Ojibwe. Dr. Roxanne Struthers's career goal is to gain advanced skills and enhance her understanding of cancer research through advanced study and by designing, implementing and evaluating a cigarette smoking education intervention for adult Ojibwe AIs. Activities to achieve this goal include taking courses, attending conferences/workshops, conducting a secondary data analysis-on existing data and initiating a cigarette smoking educational intervention pilot project using the Talking Circle approach among adult Ojibwe Indians who smoke. The Transtheoretical Model of stages of change provides the behavioral change theoretical framework. A multifaceted research approach will be used to test the central hypothesis: AIl Ojibwe adults who participate in the Talking Circle intervention will increase their knowledge, attitude and awareness related to harmful effects of cigarette smoking and will be more likely to move from one stage of behavioral change to another. Primary specific aims of the study include: 1) Construct a curriculum and research design based on the results of key informant interviews and focus groups. 2) Implement and evaluate the smoking cessation intervention, employing a pre-post questionnaire to gather information on several aspects of smoking including traditional use of tobacco among adult Ojibwe Indians (N=100). A base line survey will examine selected factors on cigarette smoking and health literacy level. To understand the cultural underpinnings of smoking behavior among Ojibwe adults, cultural terms describe the primary factors that influence health and wellness, learning methods/styles, literacy, historical tobacco use, and smoking patterns will be collected using key informant interviews and Glaser & Strauss's constant comparison analysis technique and through focus groups using Krueger's focus group methodology; photographs taken by participants will be analyzed to determine personal meanings of cigarette smoking. This research pilot intervention study will set the stage for a fullscale intervention to be proposed in a future R01 application. This grant will prepare Dr. Struthers, an American Indian nurse, to acquire skills needed in cancer research to address a major health concern, cigarette smoking, for American Indian people. The study reflects Healthy People 2010 priorities on tobacco and NCI goals to reduce cancer-related health disparities and address the devastating effects of tobacco.
