Adaptation of a brief smoke-free homes intervention for American Indian and Alaska Native families

Abstract

Background The goal of adaptation is to maintain the effectiveness of the original intervention by preserving the core elements that account for its success while delivering an intervention that is tailored to the new community and/or cultural context. The current study describes the process of adapting an evidence-based smoke-free homes (SFH) intervention for use in American Indian/Alaska Native (AI/AN) households. Methods We followed a systematic adaptation process. We first assessed the community through focus groups coordinated in collaboration with tribal partners. Because our team included the original developers of the intervention, the steps of understanding the intervention, selecting the intervention and consulting with experts were simplified. Additional steps included consulting with stakeholders through a national work group and collaboratively deciding what needed adaptation. Results A number of key themes pertinent to the adaptation of the SFH intervention were identified in the focus groups. These included the gravity of messaging about commercial tobacco use; respect, familialism, and intergenerationalism; imagery, including significant symbolism, colors, and representative role models; whether and how to address traditional tobacco; and, barriers to a SFH not adequately addressed in the original materials. Conclusions Adaptation of an intervention to create smoke-free homes in AI/AN families necessitated both surface structure changes such as appearance of role models and deep structure changes that addressed core values, and beliefs and traditions. Electronic supplementary material The online version of this article (10.1186/s12889-019-7301-4) contains supplementary material, which is available to authorized users.

On Target: Environmental Health Messaging That Hits the Mark

“…Henderson, who is the vice president of the Black Hills Center for American Indian Health in South Dakota, developed a smoking intervention that appealed to the values of respect, family, and intergenerationalism, which are important to Native peoples. 20 Accordingly, she found the most common reason cited for instituting smoke-free home rules was to protect the family’s children and grandchildren from the adverse health effects of secondhand smoke. 21 …”

Engaging Indigenous peoples in research on commercial tobacco control: a scoping review

“…Ratsch et al (2017) engage across seven steps and, in doing so, might be described as engaging more meaningfully. Five studies (8%) engage across six steps (Anderson et al, 2019; Bovill et al, 2018; Margalit et al, 2013; Montogomery et al 2012; Varcoe et al, 2010). In contrast, seven studies (11%) engage in one step (with Indigenous peoples involved in data collection as subjects or researchers) and, in doing so, might be described as engaging least meaningfully.…”

Smoking across adolescence and adulthood with cardiovascular risk among American Indian peoples.

“…This study advances our knowledge about developmental smoking patterns for AI peoples and how these patterns, and risk and resource factors, are linked to cardiovascular health. Prior qualitative research (Myhra & Wieling, 2014) and community-based participatory research (CBPR) methods with AI populations (Anderson et al, 2019) highlight that cultural and strengths-based approaches have the potential to advance efforts in reducing tobacco exposure among AI populations. Although there is a paucity of empirically based tobacco prevention and cessation programs among Indigenous populations (Carson, Brinn, Labiszewski, et al, 2012; Carson, Brinn, Peters, et al, 2012; Soto et al, 2018), a promising intervention is the All Nations Breath of Life Smoking Cessation Program, which is a culturally tailored cessation program that includes social support, motivational interviewing, culturally tailored psychoeducation, and nicotine replacement therapy (Choi et al, 2016).…”