Increasing Lung Cancer Screening for High-Risk Smokers in a Frontier Population.

Northern Plains American Indians (AIs) have some of the highest smoking and lung cancer mortality rates in the USA. They are a high-risk population in which many are eligible for low-dose computed tomography (LDCT) screening, but such screening is rarely used. This study investigated methods to increase LDCT utilization through both a provider and community intervention to lower lung cancer mortality rates. This study used the Precaution Adoption Model for provider and community interventions implemented in four study regions in western South Dakota. The goal was to increase LDCT screening for eligible participants. Intake surveys and LDCT screenings were compared at baseline and 6 months following the education programs for both interventions. A total of 131 providers participated in the provider intervention. At the 6-month follow-up survey, 31 (63%) referred at least one patient for LDCT (p < 0.05). Forty (32.3%) community participants reported their provider recommended an LDCT and of those, 30(75%) reported getting an LDCT (p < 0.05). A total of 2829 patient surveys were completed at the imaging sites and most (88%, n = 962) cited provider recommendation as their reason for obtaining an LDCT. Almost half (46%; n = 131) of the referring providers attended a provider education workshop, and 73% of the providers worked at a clinic that hosted at least one community education session. Over the study period, LDCT utilization increased from 640 to 1706, a 90.9% increase. The provider intervention had the strongest impact on LDCT utilization. This study demonstrated increased LDCT utilization through the provider intervention but increases also were documented for the other intervention combinations. The community-based education program increased both community and provider awareness on the value of LDCTs to lower lung cancer mortality rates.

Screening Native American children for asthma: findings from focus group discussions.

CONTEXT: Because of the past history among the Indian people related to research, it is incumbent upon those of us who wish to conduct research with these groups to protect them from exploitation, to conduct research that will be beneficial to the tribal community, and to work together to make the research as meaningful and as successful as possible. The process of conducting research among Native American tribes can appear to the novice as very time-consuming and full of barriers. These are necessary guards to protect their people. Additionally, many people of these tribes want to make sure that the research is going to benefit them. Focus groups provide a way for researchers to identify what the wishes of the tribal communities are in relation to the proposed research. PURPOSE: The overall purpose of this study was to understand some of the concerns the tribal communities had regarding asthma among their children, as well as their perceptions of how best to implement an asthma screening program in their community. METHODS: This was a qualitative study. An interpretative approach was selected for this research because such an approach emphasizes how a phenomenon is perceived and how meaning is constructed in situations. FINDINGS: Findings from the focus group are discussed according to themes that surfaced during the focus group discussion. CONCLUSIONS: Tribal community leaders and parents are interested in their children's health and do want to be involved in research to help children and others in their communities. Nurses working in tribal communities need to gain an understanding of the tribal communities' perspective prior to conducting research.