The Urban Native American Women's Cancer Prevention Project is a study of cervical cancer prevention and treatment among Native American women living in eight metropolitan areas. The study will assess cancer prevention knowledge, attitudes, and behaviors; develop culturally-sensitive prevention intervention strategies; and evaluate the effectiveness and efficacy of those strategies. Both primary and secondary prevention intervention will be provided through four well-established urban Native American health programs, with four other matched clinic settings serving as comparison sites. The intervention will consist of 1) a review of patient records to determine the proportion of eligible women who are receiving annual Pap smear examinations and subsequent contact of eligible non-screened clients by field workers to induce their participation; 2) educational outreach into the community by trained Indian community health workers for primary prevention 3) cancer education programs provided by health professionals for women who come into the clinic for screening, 4) health provider training for Indian nurse educators on clinical cancer prevention, and for non-Indian community health organizations on providing culturally sensitive treatment to urban Indian women; and 5) case management services for women patients to assess their options for health care services and reduce financial barriers to follow-up care. Culturally sensitive cancer prevention and education materials will be developed for use in the intervention sites. Both clinic and comparison cities will receive data collection management staff and screening/provider training programs. All of the clinics will have a site coordinator to oversee the data collection process, as well as technical and material assistance from the research team to establish a standardized protocol for data gathering. Evaluation of the study will be accomplished by measuring the number of participants who are screened, as well as those who receive follow-up treatment.
