242214 Taboo Topics, Cultural Voices, Native Lessons

Tuesday, November 1, 2011

Felicia Schanche Hodge, DrPH , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Mary Cadogan, DrPH, APRN, BC , School of Nursing, University of California, Los Angeles, Los Angeles, CA
Sally L. Maliski, RN, PhD , Nursing, UCLA, Los Angeles, CA
Tracy Line Itty, MPH , School of Nursing, University of California, Los Angeles, Los Angeles, CA
In the course of research among American Indian/Alaska Native populations, taboo topics may be elicited. How communication about these taboo topics is handled by researchers may have significant consequences for the on-going sharing of information by research participants. Identifying taboo topics, learning how to respond to them, and learning from elder respondents who employ such techniques as Native language responses, counseling (we don't talk about it, or place and time to talk about it), and storytelling methods are important processes in research among Indigenous populations. As background, this presentation describes the results of the first phase of a large randomized clinical trial designed to reduce or overcome barriers to cancer-related symptom management among American Indians residing in the Southwest. Focus groups (N=126) among cancer patients, survivors, and family members were conducted in 2008-2009. The focus group discussions explored culturally-embedded communication styles, barriers, and preferences between cancer patients/survivors, researchers and healthcare providers. Grounded theory methods were used to identify taboo topics and to provide examples of recommended responses. We report on the categories of taboo topics that were identified in the focus groups and about culturally-competent methods for responding to these cancer-related questions and concerns. Illustrations of elder recommendation and elder modeling of responses are provided. An explanatory model was formed to analyze communication regarding taboo topics, such as sexuality, disease diagnosis, death, and pain. Identifying and understanding taboo topics and culturally-appropriate methods for cross-cultural health communication supported by Native elders may facilitate proper symptom management for cancer and other diseases.

Learning Areas:
Communication and informatics
Diversity and culture
Planning of health education strategies, interventions, and programs
Public health or related education
Public health or related research

Learning Objectives:
1. Identify taboo topics among American Indian cancer patients/survivors and their family members. 2. Identify the communication styles of American Indian patients/survivors and healthcare providers. 3. Discuss barriers to cross-cultural health communication 4. Differentiate culturally-appropriate mechanisms to respond to topics that are considered taboo among American Indians.

Keywords: Native and Indigenous Populations, Communication

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a professor and the director of the Center for American Indian/Indigenous Research and Education (CAIIRE) and have overseen numerous research grants serving American Indians on a variety of health topics, including cancer symptom management. I have a great deal of experience dealing with cultural taboos in my work with different tribes and communities throughtout the U.S.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.