Namitunatya: A Pilot Study to Assess Appropriateness of Male-Focused Native Patient Navigator and Mobile Phone Technology to Increase Preventive Care and Cancer Screenings for Hopi Men

Co-Leaders

Priscilla R. Sanderson, Ph.D., CRC (NAU), Ken Batai, Ph.D. (UA)

Biostatistician         

Chiu-Hsieh Hsue, (UA)

Community Partner

Dana Russel, BBA (Hopi Cancer Support Services)

Scientific Advisor    

Linda Burhanstipanov, MSPH, DrPH (Native American Cancer Research Corporation)

Research Assistant  

Kellen Polingyumptewa, (NAU Undergraduate Student)

Studies have shown that Native American (NA) men experience higher death rates and lower participation in health and cancer screening, and annual wellness check-ups than the general population. The Western medical care that promotes preventive screening and periodic check-ups is viewed as a new phenomenon among many NA tribal groups including Hopi. Hopi men living on the Hopi Reservation reported low rates of participation in cancer screening and annual check-ups. Reasons for this may include lack of knowledge on screening, stigma with testing, fear of cancer diagnosis, and distrust of medical professionals.

Use of mobile health (mHealth) technology, such as text messaging, has been successfully used for health promotion. Previous intervention studies demonstrated that text messaging helps increase cancer screening participations. However, there is limited data available on NA men’s mHealth technology use, and use of text messaging for preventive care and cancer screening promotion has not been well-explored. The use of Native Patient Navigators (NPNs) and community education, on the other hand, have been demonstrated to increase cancer care utilization including screening and shorten the time between an abnormal finding and diagnosis among NAs. The combined approach using mHealth and community education by NPN will likely improve preventive care utilization, cancer screening participation and increase knowledge, attitudes, and beliefs (KAB) on cancer, and cancer screening in Hopi men.

This Community Based Participatory Research Project (CBPR) is a two-year NACP pilot formative assessment with Hopi men age between 50 and 75 years living on the Hopi Reservation. The goal is to assess the feasibility of a future intervention study by the application of Namitunatya NPN and mHealth technology approach to increase cancer screenings among Hopi men on the Hopi Reservation. “Namitunatya,” a Hopi word translated as “taking care of you” is used as a cultural vehicle to influence health behaviors of Hopi men.

In this project, we

  1. conduct formative assessments to evaluate Hopi men’s mobile technology and text messaging use through interviews with ten key informants and to identify barriers and facilitators for Hopi men’s preventive care utilization and cancer screening through three focus groups from the three Mesas and one focus group with Hopi male cancer survivors on their cancer diagnosis, treatment, and experience,
  2. design and conduct a formative community survey that addresses preventive care utilization, KAB on cancer screening, the percentage of mobile phone use, and mobile technology literacy among selected 200 (50-75-year-old) Hopi men using an Audience Response System,
  3. in consultation with expert Native Patient Navigators and Community Advisory Committee develop a pilot mHealth NPN program a) to perform a formative assessment of Namitunatya NPN’s roles and responsibilities, b) to evaluate mHealth education contents and text messaging contents and frequency, and c) to evaluate NPN service and mHealth program to increase cancer screening.

The study’s overall impact is a development of a men’s culturally tailored health promotion program to increase preventive care utilization and cancer screening combining NPN, mHealth, and community education.