A tribal-university partnership to reduce lead exposure among Native American children

Tribal Efforts Against Lead, or the TEAL Project, is a ten-year partnership between several universities and tribes to address childhood lead poisoning in the Tar Creek Superfund site. This rural area in northeastern Oklahoma, home to 9 tribes, is heavily contaminated with waste from lead mining. Tribal partners include the: Wyandotte, Quapaw, Miami, Seneca-Cayuga, Eastern Shawnee, Ottawa, Peoria and Modoc and Shawnee Nations. We used community-based participatory research to recruit and train members of local Native American social networks to serve as lay health advisors in educating the community about lead poisoning prevention and advocating for community change. Outcomes were assessed at multiple levels, including: individual, network, organizational and community. The evaluation design involved three cross-sectional population-based blood lead screenings and extensive caregiver interviews conducted in 1997, 2000 and 2004. We also conducted a process evaluation of lay health advisor activity, and organizational network interviews to assess collaboration. Among Native Americans living in the Superfund communities, annual blood lead testing and hand washing behavior increased from 1997 to 2004, as did use of a damp cloth when dusting. Self-efficacy to engage in preventive behaviors also increased significantly over time. This presentation will highlight the partnership, intervention design, and selected policy, behavioral and psychosocial outcomes.