This proposal describes a multidisciplinary research project to prevent smoking and the use of smokeless tobacco among Southwestern Indian school children. An additional goal is to promote dietary intake of less fat and higher fiber. Using epidemiologic data from this discrete population and employing approaches specific to the culture and geographic characteristics the project will be carefully designed to: 1) produce positive changes in the health behaviors of the target population, and 2) provide a model of program development and implementation applicable to other discrete populations. We propose to develop, implement and evaluate a curriculum that focuses on avoiding tobacco use and promoting a healthful, diet using methods derived from social learning theory, developmental theory and good educational practices, and employing culturally relevant approaches to instruction. For example, a distinction will be made between traditional ceremonial tobacco use versus indiscriminate abuse. Indian contributions to American agriculture nad diet will be integrated into the curriculum as well. Indian educators, health educators nad nutritionists will be a part of the team that plans, implements and evaluates the curriculum. An emphasis will be placed on storytelling, a traditional and modern method for instructing children in lifeskills. The """"""""trickster"""""""" character of coyote will be used in original stories as a metaphor for the social and environmental influences that students encounter. Grandparents will be invited into the classroom to share oral histories and to tell about use of traditional foods which are naturally low in fat and high in fiber. The experimental design includes a comparison of the effectiveness of the curriculum as taught: 1) in both fifth and seventh grades and 2) supplemented by a health worker who will work with families to improve diet and avoid tobacco. Outcomes measures will include changes in knowledge, attitudes and changes in health-behaviors--dietary habits and tobacco use. The project will also collect demographic and normative data which will offer valuable information on these populations children.
| Koehler, K M; Cunningham-Sabo, L; Lambert, L C et al. (2000) Assessing food selection in a health promotion program: validation of a brief instrument for American Indian children in the southwest United States. J Am Diet Assoc 100:205-11 |
| Davis, S M; Lambert, L C; Cunningham-Sabo, L et al. (1995) Tobacco use: baseline results from pathways to health, a school-based project for southwestern American Indian youth. Prev Med 24:454-60 |
| Cunningham-Sabo, L; Davis, S M (1993) Pathways to health. A health promotion and cancer prevention project for American Indian youth. Alaska Med 35:275-8, 296 |
