Search

Building upon the dynamic traditions of Alaska Native people, which include the arts as a viable way of knowing, the expressive arts were woven into a five-day cancer education course for Alaska village-based Community Health Workers (CHWs). Cancer is the leading cause of mortality for Alaska Native people. Course learning modalities included moving, drawing, sculpting and storytelling. A total of six cancer education courses were provided for 57 CHWs. During extended-interval post-course interviews, CHWs described the arts as a culturally traditional way of knowing and talked about how the arts expanded their perspectives, sparked creativity and imagination, freed/transformed emotions, made learning more memorable/more meaningful, infused learning with laughter, created community and broke the silence that often surrounds the topic of cancer in Alaska rural communities. The expressive arts empowered adult learners to explore new dimensions of knowledge, create deeper understandings and expand their perceptions of possibilities.

What does it mean to provide community-based health education that respects adults of diverse cultures and ways of being in the world? How does one nurture meaningful learning opportunities that awaken possibilities as a catalyst for understanding, conversation, and action? In this article, nurturing place, sharing power, heart listening, talking story, engendering humor, and the expressive arts are discussed as appreciative ways to add depth and dimension to community-based health education with diverse adult learners.

Dance, as a way to create meaning, was included in a week-long cancer education course for community health workers in Alaska. The eight course participants were Alaska Native women from throughout Alaska, including those of Yup'ik, Inupiaq, Aleut, Tlingit, and Athabascan heritage. As reported by participants on end-of-course written evaluations and post-course written email correspondence, the expressive movements of dance as part of cancer education supported laughter, relaxation, fun, healing, learning, and deeper understanding.

Community Health Aides and Community Health Practitioners (CHA/Ps), the primary providers of healthcare in rural Alaska, share the importance of story as a culturally respectful way for creating meaning and broadening understanding. Story is woven into the fabric of cancer education courses for CHA/Ps. Between May 2004 and April 2007, 13 week-long cancer education courses were provided for CHA/Ps. In response to the written, end-of-course, evaluation question, "Do stories help you to learn? If yes, how?" Ninety-six percent (96%) of respondents (99/103) described ways that story supported their learning. Additionally, in May 2005, 293 (65%) of the 454 CHA/Ps responded in writing to a mailed cancer education survey. Of the survey respondents, 240 (86%) were women and 239 (86%) were Alaska Native people. Nearly all, 98% (224/229) of Alaska Native people and 93% (37/40) of non-Native people identified story as helping them learn. CHA/Ps, on both the cancer education course evaluations and the CHA/P written survey, identified story as a pathway for connecting people, facilitating understanding, enhancing remembering, engendering creativity, expanding perspective, envisioning the future and inspiring possibility. Through stories we share our feelings, heal wounds, deepen understanding, strengthen community and discover hope.

Background: Culturally relevant education is an opportunity to reduce health disparities, and online learning is an emerging avenue for health promotion. In 2014–2019, a team based at the Alaska Native Tribal Health Consortium developed, implemented, and evaluated culturally relevant online cancer education modules with, and for, Alaska's tribal primary care providers. The project was guided by Indigenous Ways of Knowing and the principles of community-based participatory action research and was evaluated in alignment with empowerment theory. About 265 unique learners completed 1,898 end-of-module evaluation surveys between March 2015 and August 2019, and 13 people completed a follow-up survey up to 28 months post module completion. Key Findings: Learners described the modules as culturally respectful and informative and reported feeling more knowledgeable and comfortable talking about cancer as a result of the modules. About 98% of the learners planned to reduce their cancer risk because of the modules, and all follow-up survey respondents had reduced their risk, including by quitting smoking, getting screened for cancer, eating healthier, and exercising more. About 98% of the learners planned to share information with their patients, families, friends, and community members because of the modules, with all follow-up survey respondents indicating that they had shared information about cancer from the modules. Implications for Practice and Further Research: Culturally relevant online modules have the capacity for positive behavioral change and relatively high correlations between intent and behavior change. Future research could determine which aspects of the modules catalyzed reduced cancer risk and increased dissemination of cancer information. [ABSTRACT FROM AUTHOR]

Objective. The purpose of this project was to learn how Community Health Workers (CHWs) in Alaska perceived digital storytelling as a component of the "Path to Understanding Cancer" curriculum and as a culturally respectful tool for sharing cancer-related health messages. Design. A pre-course written application, end-of-course written evaluation, and internet survey informed this project. Methods. Digital storytelling was included in seven 5-day cancer education courses (May 2009-2012) in which 67 CHWs each created a personal 2-3 minute cancer-related digital story. Participant-chosen digital story topics included tobacco cessation, the importance of recommended cancer screening exams, cancer survivorship, loss, grief and end-of-life comfort care, and self-care as patient care providers. All participants completed an end-of-course written evaluation. In July 2012, contact information was available for 48 participants, of whom 24 completed an internet survey. Results. All 67 participants successfully completed a digital story which they shared and discussed with course members. On the written post-course evaluation, all participants reported that combining digital storytelling with cancer education supported their learning and was a culturally respectful way to provide health messages. Additionally, 62 of 67 CHWs reported that the course increased their confidence to share cancer information with their communities. Up to 3 years post-course, all 24 CHW survey respondents reported they had shown their digital story. Of note, 23 of 24 CHWs also reported change in their own behavior as a result of the experience. Conclusions. All CHWs, regardless of computer skills, successfully created a digital story as part of the cancer education course. CHWs reported that digital stories enhanced their learning and were a culturally respectful way to share cancer-related information. Digital storytelling gave the power of the media into the hands of CHWs to increase their cancer knowledge, facilitate patient and community cancer conversations, and promote cancer awareness and wellness. [ABSTRACT FROM AUTHOR]