A community-based participatory approach requires that community members be involved in all phases of the research process. We describe three focus group studies with American Indians in Kansas and Missouri, using a newly developed method of conducting and analyzing focus groups with community input (72 focus groups, 519 participants). We conducted two needs assessment studies focused on barriers to breast and colorectal cancer screening and one study focused on Internet use for gathering health information. Community members and researchers collaborated to develop guides for the focus group moderators. Community organizations and our community advisory board conducted recruitment, and we trained and employed community members as moderators, assistant moderators, and analysts. Our community partners also helped with dissemination of research findings to their constituents. The methodologic approach and data from these three studies will allow us to more appropriately address health disparities in the American Indian community, with full community support for our research.

While there is an international trend toward lowering infant mortality, the United States ranks 19th among industrialized nations. In Arizona, as across the nation, a large and increasing number of low birth weight (LBW) infants are being delivered. This number is viewed with alarm as LBW is associated with infant mortality; however, LBW may be preventable in many cases if mothers receive adequate prenatal care. Despite recognition that absent or inadequate prenatal care is an important risk factor, a large number of women deliver without such care. In Arizona, the percentage of women delivering at a large metropolitan public hospital without prenatal care doubled in a 2-year period, reaching 14% (764 women). The majority of these women were of low socioeconomic status. The purpose of this study was to explore the reasons given by women delivering at this hospital for not seeking prenatal care. It was determined that a qualitative methodology was most appropriate; thus, an interview guide was developed with both demographic and open-ended probing questions. Fifteen respondents--5 Caucasian, 8 Latino (5 Spanish-speaking only), 1 Afro-American, and 1 Native American--participated in the interviews. The data were transcribed from taped interviews and studied using content analysis. Eleven barriers were identified and sorted into two categories: internal and external. Internal barriers identified by the women were attitudes associated with low motivation, knowledge deficits, fear, and fatigue. External barriers elicited were finances, transportation, system difficulties, lack of support, lack of child care, missed work, and insufficient time.(ABSTRACT TRUNCATED AT 250 WORDS)

Mexican American males have higher levels of total cholesterol and triglycerides, higher body mass indexes, and a higher prevalence of diabetes than do non-Hispanic White males. They are the least likely Hispanic subgroup to be insured, to have recently visited a physician, or to have preventive exams. To explore factors related to the use of preventive exams among mature men, and specifically among Mexican American men residing along the Arizona, United States/Sonora, Mexico border, information on barriers and motivating factors to male participation in preventive screening exams was collected. Interviews were conducted with mature men and women from a single border community and with clinical staff from three different border communities who deliver services to similar populations. Responses were triangulated. Common themes identified include health education/information/advertisement and female/family support as motivating factors and machismo/denial/fatalism as a barrier to male health-seeking behavior.

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