Measures of American Indian Traditionality and its Relationship to Cervical Cancer Screening

Abstract

The goal of this study was to evaluate the relationship between culture and attitudes about cervical cancer screening among young American Indian women living and working in northeast Oklahoma. A cohort of 199 American Indian women, ages 18-40, were surveyed to determine their blood quantum, self-identification, and beliefs and practices regarding traditional behavior in order to develop a traditional behavior scale (the degree to which an individual maintained traditional tribal ways or behaviors). The use of this scale indicated that the degree of American Indian blood quantum, blood quantum for primary tribe, and self-identification are correlated to the traditional behavior scale. The scale, however, was unable to predict intention to get a Pap test. Results indicate that it is useful to understand the variation of traditional behavior within the specific population group to be served when planning and implementing culturally appropriate interventions for American Indian women. It is also useful to evaluate which segments of the population current programs are reaching.

A Comparison of Colorectal Cancer Screening Uptake Among Average-Risk Insured American Indian/Alaska Native and White Women

“…11 Others have found similar inverse relationships between measures of traditionalism and cancer screening. 45, 46 …”

Collaborative Measurement Development as a Tool in CBPR: Measurement Development and Adaptation within the Cultures of Communities

“…We found it culturally unacceptable to assess certain constructs such as trauma, just as Smith et al (2004) were not able to assess women’s personal sexual behavior as a risk factor for cervical cancer. We found that the issue of taboo topics of discussion arose with respect to suicide as in prior studies (Solomon & Gottlieb, 1999), and that the acculturation level of adolescents was a potential factor in the acceptability of certain ways of asking questions (Legaspi and Orr, 2007). Thus, the present measurement development process reflects many issues raised in prior reports of community intervention in American Indian/Alaska Native communities.…”

“…Several papers describe the host of cultural issues involved in adapting and creating measures in diverse cultural contexts. For example, the decision to use self-administered questionnaires rather than interviews was explored by Solomon and Gottlieb (1999). Their pilot test of the two formats resulted in no substantive differences in the information obtained.…”

“…For example, in some cultural contexts, the mere mention of a topic may invoke the belief that this increases the chance that the event may occur. With respect to Native Americans, several authors involved in cancer prevention interventions reported that one of the issues affecting how interventions were developed and assessed involved a local reluctance to talk about cancer for fear of bringing the disease on oneself (Smith et al, 2004; Solomon & Gottlieb, 1999). Similar cultural taboos were found among immigrants from the former Soviet Union (Dohan & Levintova, 2007) namely, that information about the diagnosis of cancer should be withheld from the person and indeed not be discussed in the community.…”

Effect of Tribal Language Use on Colorectal Cancer Screening Among American Indians

“…17 Several studies examining breast and cervical cancer screening among American Indian women foreground cultural characteristics, including Native language use, to explain screening disparities, but with mixed results. 18–20 One population-based study of women on the Hopi reservation found a positive relationship between “traditionalism”—assessed as Native language use, Native cultural participation, and length of resevation residency—and protective health behaviors. 19 A study of almost 1,000 Lumbees in North Carolina—a tribe that has not retained a Native language—nevertheless found better knowledge of cervical cancer screening among women who identified more strongly with other aspects of their Native American culture.…”