The long-range goal of this project is to reduce or overcome barriers to cancer-related symptom management among American Indians (AIs). Little is known about the phenomena of cancer-related symptoms, their management, and barriers to care, or about the barriers faced by AI patients needing and/or seeking symptom management. Such cancer-related symptoms as fatigue, depression, and pain experienced by this population require clearer understandings-in terms of definitions, cultural constructs of symptoms, decision-making strategies, barriers to care, provider referrals, and treatment for symptom management care. This is an innovative, interdisciplinary study to (a) clarify/define the cultural constructs of cancer-related symptoms, and (b) to develop and test a reproducible clinic-based, innovative, and culturally appropriate program to overcome barriers to care for AI symptom management. 1. To ascertain, through qualitative means, barriers to treatment and management that derive from AI cultural perspective. More specifically, this aims seeks: To gain an understanding of culturally-embedded meaning of cancer-related symptoms (pain, fatigue, depression), their conceptualization, cultural construct(s), patterns and strategies of their disclosure by AIs. To identify the pathways and mechanisms of communication and treatment-seeking that AIs use for management of cancer-related pain and symptoms. To identify symptom management decision-making strategies/barriers among AI cancer patients/providers. 2. To design culturally sensitive materials to be used in the intervention phase of the study. These tools will include educational and resource materials and culturally appropriate instruments for measuring symptoms intended to improve AI knowledge of and access to cancer symptom management services. 3. To develop and test a reproducible, clinic-based, culturally appropriate intervention designed to overcome barriers to the delivery of symptom management for AIs. This intervention will be cast in a Talking Circles format, a culturally meaningful vehicle that has proven effective in past studies.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZCA1-SRRB-3 (M1))
Program Officer
O'Mara, Ann M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of California Los Angeles
Schools of Nursing
Los Angeles
United States
Zip Code
Hodge, Felicia; Nandy, Karabi; Cadogan, Mary et al. (2016) Predictors of Pain Management among American Indian Cancer Survivors. J Health Care Poor Underserved 27:636-43
Hodge, Felicia Schanche; Itty, Tracy Line; Cadogan, Mary P et al. (2016) The cultural constructs of cancer-related fatigue among American Indian cancer survivors. Support Care Cancer 24:1235-40
Palacios, Janelle F; Salem, Benissa; Hodge, Felicia Schanche et al. (2015) Storytelling: A Qualitative Tool to Promote Health Among Vulnerable Populations. J Transcult Nurs 26:346-53
Itty, Tracy Line; Hodge, Felicia Schanche; Martinez, Fernando (2014) Shared and unshared barriers to cancer symptom management among urban and rural American Indians. J Rural Health 30:206-13
Hodge, Felicia Schanche; Itty, Tracy Line; Cadogan, Mary P et al. (2012) ""Weaving balance into life"": Development and cultural adaptation of a cancer symptom management toolkit for Southwest American Indians. J Cancer Surviv 6:182-8
Hodge, Felicia Schanche; Maliski, Sally; Cadogan, Mary et al. (2010) Learning How to Ask: Reflections on Engaging American Indian Research Participants. Am Indian Cult Res J 34:77-90