Transforming Cancer Health Messaging: Engaging Alaska Native People thru Digital Storytelling Cancer is the leading cause of death among Alaska Native people. This exploratory R21 uses primarily qualitative methods to increase understanding of digital storytelling as a culturally respectful and meaningful way for Alaska's village-based Community Health Workers (CHWs) to create and share a personalized cancer message that empowers action related to cancer prevention and cancer control for Alaska's community members. CHWs are primary medical providers of village-based health care in Alaska's 178 rural communities, ranging in size from 20 to 1200 people. Communities are only accessible year round by air transportation and are not on a road system. The tradition of storytelling is part of all Alaska Native cultures. Digital storytelling combines the tradition of ral storytelling with computer-based technology to provide a creative and engaging method for CHWs to share cancer health messages. Digital storytelling brings the power of the media into the voices and hands of community members to empower behavior change.
Aim 1. To identify engaging elements of digital storytelling among Alaska Native people. The principal investigator will conduct focus groups in three different rural Alaska communities with eight adult community members in each. Participants will view and discuss four cancer-related digital stories previously developed by CHWs. Viewers will comment verbally and in writing about cultural relevance, likability, engaging elements, information learned, understandability, and intent to change behavior. Comments will inform future CHW digital story creation.
Aim 2. To identify how creating a cancer-related digital story affects Alaska's Community Health Workers'own health behaviors and how they use their digital story as a communication tool to improve cancer control among their community members. As part of a 5-day cancer education course utilizing the 'Path to Understanding Cancer'curriculum, 40 CHWs will integrate medical information presented during the course with their personal experiences to create their own 2 to 3 minute cancer health message in the form of a digital story that they want to share with people in their own community. During this 2 year project, 4 courses with 10 participants will be provided. Data will be collected from CHWs over time including a pre-course needs assessment, an end-of-course written evaluation, a 2 week post-course group teleconference, a 1 month outreach log, and a 3 month individual in-depth telephone interview.
Aim 3. To identify how digital stories affect community members'cancer perceptions and health behaviors. After viewing CHW digital stories, community members will be asked by the CHW if a project team member can contact them to participate in an in-depth telephone interview. A semi-structured interview guide will assist the interviewer to conduct a minimum of 20 viewer interviews to learn their response to digital storytelling including likeability as a health messaging tool, information learned, and impact of the story on cancer conversations, attitudes, and intent to change behavior.

Public Health Relevance

Healthy people 2020 states innovative media and communication strategies to promote behavior change and shifts in social norms are critical for addressing issues of disparities. This research builds upon that guidance to explore how cancer-related digital stories created by Alaska's village-based Community Health Workers (CHWs) as a culturally respectful cancer communication tool affects cancer conversations, knowledge, attitudes, and behaviors among CHW digital story creators as well as Alaska's community member viewers.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Exploratory/Developmental Grants (R21)
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Health Disparities and Equity Promotion Study Section (HDEP)
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Chou, Wen-Ying
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Alaska Native Tribal Health Consortium
United States
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Cueva, Melany; Kuhnley, Regina; Revels, Laura et al. (2016) Engaging Elements of Cancer-Related Digital Stories in Alaska. J Cancer Educ 31:500-5
Cueva, Melany; Kuhnley, Regina; Lanier, Anne et al. (2016) Promoting Culturally Respectful Cancer Education Through Digital Storytelling. Int J Indig Health 11:34-49
Cueva, Melany; Kuhnley, Regina; Revels, Laura et al. (2015) Digital storytelling: a tool for health promotion and cancer awareness in rural Alaskan communities. Int J Circumpolar Health 74:28781