Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107473

Christine Makosky Daley, PhD, MA, SM¹, Aimee S. James, PhD, MPH¹, Charlotte McCloskey, MA², Marcia Segraves, BS, CADCI³, David Wilkett, MD³, and Won S. Choi, PhD, MPH¹. (1) Department of Preventive Medicine and Public Health, University of Kansas Medical Center, Mail-Stop 1008, 3901 Rainbow Boulevard, Kansas City, KS 66160, 913-588-2747, ajames@kumc.edu, (2) Department of Educational, School and Counseling Psychology, University of Missouri, Columbia, 16 Hill Hall, Columbia, MO 65211, (3) Haskell Health Center, 2415 Massachusetts Avenue, Lawrence, KS 66046

Smoking rates among American Indians (AI, 41%) are nearly twice as high as those of other ethnic groups (15-24%). While there have been some tribe-specific efforts to develop smoking cessation programs, they are unvalidated and should not be used in clinics with more heterogeneous AI populations, such as the Haskell Indian Health Service Health Center. This heterogeneity presents dramatic challenges for cultural-tailoring and evidence-based practice. Haskell and the University of Kansas Medical Center have collaborated to modify a currently untested culturally-tailored smoking cessation program with plans to test it for efficacy. During the development, we have encountered several challenges to evidence-based practice for this population. First, data are extremely limited. There is information on general trends of smoking and cessation in AI, but there is no empirical evidence about what works for ending tobacco usage. Second, a common problem in the literature is that the AI population is often grouped into an “other” category or treated as one homogenous group. This makes it difficult to determine whether smoking cessation programs were effective for AI in general or for individual tribes (or whether they were even represented). Third, the significant role of tobacco in many AI nations needs to be addressed in a sensitive and positive light within a smoking cessation program. Finally, inter-tribal politics can come into play when preparing culturally-appropriate materials. We present these challenges and ways that we have addressed them to produce a smoking cessation program for a heterogeneous population that can be rigorously evaluated for effectiveness.

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