Applying Community-Based Participatory Research in Identifying a Cultural Consensus Model About Cancer in an American Indian Community

Native American communities face an ongoing challenge of effectively addressing cancer health disparities, as well as environmental racism issues that may compound these inequities. This study identified the shared cultural knowledge and beliefs about cancer in an American Indian community utilizing a cultural consensus method, an approach that combines qualitative and quantitative data. A community-based participatory research (CBPR) approach was applied at all stages of the study. The three phases of research that were undertaken included: 1) ethnographic interviews, 2) ranking of themes, 3) pile sorts, and 4) a community survey. The cultural consensus method has not been utilized to date in identifying the collective cultural beliefs about cancer prevention, treatment or survivorship in a Native American community. Its use represents a methodological step forward in two areas: 1) the traditional ethnographic inferences used in identifying and defining cultural meaning as it relates to health can be tested more rigorously than in the past, and 2) it addresses the challenge of providing reliable results based on a small number of community consultants. This is especially significant when working with smaller tribal/cultural groups where the small sample size has led to questions concerning the reliability and validity of health-related research. Results showed that the key consultants shared strong agreement or consensus on a cultural model regarding the importance of environmental and lifestyle causes of cancer. Identifying cultural beliefs and models regarding cancer could contribute to the effective development of culturally responsive cancer prevention education and treatment programs.