Bridging Science to Practice: Using a Qualitative Study to Guide Culturally Adapted Interventions to Improve Cancer Screening Behaviors in an American Indian Tribal Nation

Background and Purpose: American Indian individuals are disproportionately affected by cancer when compared to the general population. Reports for 2014-2018 show that female breast cancer is the leading cause of cancer deaths among an Indigenous Tribal Nation in Arizona. Significant changes are needed in preventative care approaches for screening-eligible cancers. The purpose of this pilot study was to seek guidance and recommendations from patients and caregivers about their experiences with breast cancer, and whether culturally adapted approaches would improve prevention services through increased cancer screening behaviors and coping.

Methods: The interdisciplinary research team was diverse, comprising of Indigenous, Hispanic, and non-Hispanic White team members, and used a community-engaged research approach following CBPR tenets. The team traveled to two communities and, using a narrative inquiry approach, interviewed 21 AI female breast cancer survivors and 20 AI caregivers to individuals with breast cancer. Interview questions asked about participants’ experiences with breast cancer, coping mechanisms, barriers to care, and traditional ways they lean on for support. Qualitative analysis using the consensus method was applied.

Results: Data analysis was completed in early 2025 and results revealed 9 core themes among breast cancer survivors and 6 core themes among caregivers, each with multiple sub-themes. Major themes noted by both survivors and caregivers was the inclusion of spirituality and family. Detailed results will be shared at the SSWR conference if abstract is accepted but specific results cannot be shared in this abstract format. This is to preserve Tribal sovereignty and Tribal data governance. Tribal IRB approval is in the process of gaining approval for results to be shared if abstract is accepted. This is standard procedure and there are no indications from the Tribe that approval will not be granted, but out of respect for the Tribal Nation, the name of the Tribe and results cannot be shared until the Tribal IRB meets for their May or June meeting.

Conclusions and Implications: Themes and subthemes are guiding a hypothesis-testing NIH RO1 application through a partnership between Northern Arizona University, Mayo Clinic of Scottsdale, Arizona, and a Tribal College. Due to recognizing the need for a culturally adapted preventative care approach to increasing screening behaviors, some of the pilot participants provided Letters of Support for the RO1 application. The application is seeking to offer culturally guided interventions to increase cancer screening among AI women who are of screening-eligible age, using science to guide interventions. This is an innovative approach that, to our knowledge, has not been conducted anywhere else. Findings would be used to implement change in how cancer screening is provided on the Tribal Nation, moving from a Western-colonial approach to a Traditional way of knowing, and could be scaffolded to other Tribal Nations. By increasing screening rates, health disparities can decrease, moving towards a more equitable future for the Tribal Nation. Lastly, dissemination materials are being created for the Tribal Nation and will be presented at Tribal Council meetings in the summer of 2025.