Urban American Indian Community Health Beliefs Associated with Addressing Cancer in the Northern Plains Region.

American Indians residing in the Northern Plains region of the Indian Health Service experience some of the most severe cancer-related health disparities. We investigated ways in which the community climate among an American Indian population in an urban community in the Northern Plains region influences community readiness to address cancer. A Community Readiness Assessment, following the Community Readiness Model, conducted semi-structured interviews with eight educators, eight students, and eight community leaders from the American Indian community in Omaha's urban American Indian population and established the Northern Plains region community at a low level of readiness to address cancer. This study reports on a subsequent qualitative study that analyzed all 24 interview transcriptions for emergent themes to help understand the prevailing attitude of the community toward cancer. A synthesis of six emergent themes revealed that the community's perceptions of high levels of severity and barriers, paired with perceptions of low levels of susceptibility and benefits, lead to low levels of self-efficacy, all of which are reflected in minimal cues to action and little effort to address cancer. These findings, interpreted through the lens of the Health Belief Model, can inform the development of more community-based, comprehensive, and culturally appropriate approaches to address the multilevel determinants of health behaviors in relation to cancer among American Indians in the Northern Plains region.

A day of immersive physiology experiments increases knowledge and excitement towards physiology and scientific careers in Native American students.

Underserved minority groups are disproportionately absent from the pursuit of careers in science, technology, engineering, and mathematics (STEM) fields. One such underserved population, Native Americans, are particularly underrepresented in STEM fields. Although recent advocacy and outreach designed toward increasing minority involvement in health care-related occupations have been mostly successful, little is known about the efficacy of outreach programs in increasing minority enthusiasm toward careers in traditional scientific professions. Furthermore, very little is known about outreach among Native American schools toward increasing involvement in STEM. We collaborated with tribal middle and high schools in South Dakota and Nebraska through a National Institutes of Health Science Education Partnership Award to hold a day-long physiology, activity-based event to increase both understanding of physiology and enthusiasm to scientific careers. We recruited volunteer biomedical scientists and trainees from the University of Nebraska Medical Center, Nebraska Wesleyan University, and University of South Dakota. To evaluate the effectiveness of the day of activities, 224 of the ~275-300 participating students completed both a pre- and postevent evaluation assessment. We observed increases in both students self-perceived knowledge of physiology and enthusiasm toward scientific career opportunities after the day of outreach activities. We conclude that activity-based learning opportunities in underserved populations are effective in increasing both knowledge of science and interest in scientific careers.

Using Ethnobotany and Aquaponics to Engage Native Youth in STEM.

Increasing the diversity of the science, technology, engineering, and mathematics (STEM) workforce is more than a noble goal. The richness of ideas and experiences from many cultural perspectives can help to move science forward. To help pave pathways to higher education and STEM careers, we have been working with schools and communities that serve Native American students. Part of this engagement has been to educate students about plants used by Native people of the Great Plains with the help of an ethnobotany booklet. A second approach has been using aquaponics, the coproduction of fish and plants in an ecosystem, to teach aspects of basic agriculture, fish anatomy, and water systems that may, at scale, help ease the food deserts in many Native American and underserved communities. Here, we describe our efforts to engage Native American students in STEM education by using ethnobotany and aquaponics to generate excitement for these fields.

Improving Student Understanding of Academic Assessment Vocabulary Words Using Visual Cues: A Collaborative Effort.

Many students have difficulty understanding terms from the academic register such as "analyze," "discuss," and "compare." This issue may be exacerbated for some Native American students, especially those who live on reservations with limited exposure to mainstream cultures. In this community-based participatory research project, academic investigators partnered with educators and community members from Native communities in Nebraska and South Dakota to expand students' academic vocabulary and improve student achievement. Together, we formed a team in which community members collaborated with academic investigators to develop word-wall cards incorporating dual-coding theory-that is, combining visual and verbal cues-to help students understand academic vocabulary words. Paivio's dual-coding theory postulates that verbal and visual information are encoded in separate but interconnected pathways and that concepts encoded via both pathways are more easily remembered. Accordingly, presenting information using multiple mediums, such as graphs, photographs, or demonstrations, may enhance learning. These cards were shared with community educators who used them in their classrooms. We present evidence that incorporating these multimodal tools into classrooms may improve students' understanding of academic vocabulary. Through this partnership, educators in Native American communities were able to represent their lived experiences. Teachers and administrators in Native American and non-Native classrooms could easily partner with other experts to incorporate similar innovations in their own schools and classrooms.

Tailoring Our Approach in Response to the SARS-CoV-2 Pandemic and Transcending Science Outreach Modalities for Native American Students in a Cancer Research Education Program.

In response to the SARS-CoV-2 pandemic, a cancer research education program at the University of Nebraska Medical Center designed for Native American middle school, high school and undergraduate students adapted activities to be delivered online. There are considerable challenges to adapting in-person science programming to online delivery that can impact overall effectiveness. These challenges are further exacerbated when the cognate student population also faces significant disparities in health, wealth, and educational outcomes. We encountered both disadvantages and advantages in transitioning programming to online virtual formats. Challenges faced in delivering our programming during the pandemic included varied online accessibility, peripheral stressors, and disconnection to places and people. Despite these challenges, we found several benefits in remote delivery, some of which have alleviated barriers to program participation for Native American students. Some successes achieved by transitioning to fully remote programming included increased program reach, sustainability, and cultural relevancy. In this overview of the implementation of four online programs at the middle school, high school, and undergraduate levels, we highlight the challenges and successes experienced. Through this program description, we aim to provide insight into potential strategies to improve program delivery designed for Native American students during the SARS-CoV-2 pandemic and beyond.

Cancer Biology and You: An Interactive Learning Event for Native American High School Students to Increase Their Understanding of Cancer Causes, Prevention, and Treatment, and to Foster an Interest in Cancer-Related Careers.

The National Institutes of Health and the National Science Foundation have made a compelling call to action not only to strengthen the pipeline of available STEM-trained talent, but in addition to foster students who are members of populations currently under-represented in science. Furthermore, the scientific community must not only increase the accessibility of STEM-related education, but also implement and test evidence-based practices. Presented here, we detail the proceedings of a hands-on, science-focused informal learning opportunity aimed at educating an underrepresented population in cancer biology. Fifteen undergraduate and graduate student volunteer instructors from the University of Nebraska at Omaha and the University of Nebraska Medical Center engaged with 89 high school students, mostly Native American, in an informal learning event called "Cancer Biology and You Day." Throughout the event, students completed two independent lessons focusing on breast cancer and skin cancer and demonstrated strong learning gains associated with the lessons as assessed by KWL charts. Exit surveys of the students indicated high levels of satisfaction with the event, and positive attitudes associated with considering a career in science/research were evident in survey responses. Overall, we report the event as a success and outline how similar experiences may be achieved.