REDUCING CANCER RISK AMONG NATIVE-AMERICAN ADOLESCENTS

Background. This article discusses the development, implementation, an d preliminary testing of an intervention to reduce cancer risks throug h tobacco use prevention and dietary modification among Native America n youth in the Northeastern United States. Methods. The intervention o utcome study includes a research design and outcome measurement instru ments. In collaboration with Native American communities, reservations , and organizations in the Northeastern United States, implementation of the design quantifies the separate and combined effects of a tobacc o use prevention and a dietary modification intervention. Results. Nat ive American youths in the tobacco prevention intervention and in the combined tobacco and dietary intervention increased their knowledge of tobacco facts and their awareness of the motives of tobacco advertisi ng, and showed higher ratings for an ability to resist peer pressure a nd to refuse offers of tobacco use between pretest and posttest. Youth s in the combined intervention were significantly less apt to report s moking of any kind. Youths in the tobacco use prevention-only conditio n reported significantly less smoking than their counterparts in the d ietary modification-only condition and control condition on 4 of 8 mea surement items, As for dietary variables, pretest to posttest measurem ent scores showed that, after receiving the curriculum, youths in the dietary modification intervention and in the combined intervention imp roved their knowledge of the health implications of consuming dietary fat, fiber, fruits, and vegetables. Youths in the dietary modification and combined intervention also improved their scores of knowledge rel ated to cancer risk-reducing nutritional practices, cultural dietary h abits, and healthy food choices available for Native American cultures . Youths in the dietary modification-only condition report significant ly increasing their consumption of complex carbohydrates and significa ntly decreasing their fat intake between pretest and posttest occasion s. Conclusions. Data from this longitudinal study suggest the value of the FACETS curriculum for helping Native American youth reduce their risks for cancer associated with tobacco use and dietary preference an d consumption patterns. In particular, results indicate the enhanced e ffects of the combined tobacco use prevention and dietary modification intervention for preventing tobacco use and for improving youths' kno wledge and attitudes with regard to tobacco use and diet. Further, the study demonstrates the value of collaborating with Native American or ganizations to design a cancer risk-reducing curriculum and to impleme nt tests of that curriculum. (C) 1996 Academic Press, Inc.