The shared cultural knowledge and beliefs about cancer in the Yavapai-Apache community

Native American communities face an ongoing challenge of effectively addressing cancer health disparities, as well as environmental racism issues that may compound these inequities. This dissertation identified the shared cultural knowledge and beliefs about cancer in a southwest American Indian community utilizing a cultural consensus method, an approach that combines qualitative and quantitative data. A community-based participatory research (CBPR) approach was applied at all stages of the study. The three phases of research that were undertaken included: 1) ethnographic interviews - to identifying the themes or the content of the participants' cultural model, 2A) ranking of themes - to provide an understanding of the relative importance of the content of the cultural model, 2B) pile sorts - identify the organization of items within specific domains, and 3) a community survey - access whether the model is shared in the greater community. The cultural consensus method has not been utilized to date in identifying the collective cultural beliefs about cancer prevention, treatment or survivorship in a Native American community. Its use represents a methodological step forward in two areas: 1) the traditional ethnographic inferences used in identifying and defining cultural meaning as it relates to health can be tested more rigorously than in the past, and 2) it addresses the challenge of providing reliable results based on a small number of community informants. This is especially significant when working with smaller tribal/cultural groups where the small sample size has led to questions concerning the reliability and validity of health-related research. Results showed that the key consultants shared strong agreement or consensus on a cultural model regarding the importance of environmental and lifestyle causes of cancer. However, there was no consensus found among the key consultants on the prevention and treatment of cancer. The results of the community survey indicated agreement or consensus in the sub-domains of descriptions of cancer, risk/cause, prevention, treatment, remission/cure and living with cancer. Identifying cultural beliefs and models regarding cancer could contribute to the effective development of culturally responsive cancer prevention education and treatment programs.