Perceptions of Cancer Causes, Prevention, and Treatment Among Navajo Cancer Survivors
Native Americans experience cancer-related health disparities. Yet, little is known about the current cancer experience in one of the largest Native American tribe, Navajo. A qualitative study of among Navajo cancer survivors, in which focus groups and individual interviews included questions related to perceptions of cancer causes, prevention, and treatment, allowed us to evaluate several aspects of the cancer experience from the Navajo perspective. An experienced, bilingual facilitator led the discussions using a standardized guide. Discussions were audio-recorded, documented by field notes, translated, as needed, and transcribed. NVivo software was used to summarize major themes according to the PEN-3 and health belief models. Navajo cancer survivors (N = 32) were both males (n = 13) and females (n = 19) that had been previously diagnosed with a variety of cancers: colorectal, breast, ovarian, cervical, esophageal, gall bladder, stomach, prostate, kidney, and hematologic. Many survivors had accurate knowledge of risk factors for cancer. Barriers to screening and clinical care included language, expense, geography, fear, lack of information, skepticism related to Western medicine, and treatment side effects. While some survivors experienced familial support, others were isolated from the family and community due to the perspective of cancer as a contagion. However, resilience, hope, trust in select community organizations, a desire to restore balance, and to support younger generations were positive attributes expressed regarding the treatment and recovery process. These evaluations need to be replicated across a larger cross-section of the Native cancer survivor community.
KeywordsNative American Health care Qualitative research Community-based participatory research Survivorship
We would like to thank the Navajo Nation Historic Preservation Department, Navajo Nation Human Research Review Board (NNIRB project # NNR-14.192), the Chapter House, Arizona Oncology Associates, and all the participants for their support of this project.
Financial support was provided by the following: National Institute of Health/National Cancer Institute U54CA143924 and P30CA023074; University of Arizona Faculty Seed Grant; Undergraduate Biology Research Program HHMI 52006942; and Northern Arizona University BRIDGES to Baccalaureate NIGMS1R25GM102788-01.
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Research Involving Human Participants
All procedures performed in the study involving human participants were in accordance with the ethical standards of the Navajo Nation Human Subjects Research Review Board (NNIRB project # NNR-14.192), Northern Arizona University Institutional Review Board, the University of Arizona Institutional Review Board, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study. This manuscript, including all aforementioned data and quotes, has been reviewed and approved by the Navajo Nation Human Subjects Research Review Board as a part of NNIRB project # NNR-14.192.
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