The Black Hills Center for American Indian Health Collaboration (BHCAIH)
The Center for Health Equity Research (CHER) works with the Black Hills Center for American Indian Health (BHCAIH) to develop systems level public health interventions to reduce commercial tobacco related health disparities among American Indians of the US Southwest and the Great Plains regions through collaborative research, practice and policy.
CHER and BHCAIH have collaborated on three vital partner projects that include the Lakota Advocacy Leadership Program for Smoke-free Policies, the Cigarette Smoking Among American Indian Women Experiencing Intimate Partner Violence, and Secondhand Smoke Exposures for Nonsmokers in Cheyenne River Sioux Tribal Households.
BHCAIH is a long-standing National Institute of Health (NIH) funded Native American Research Centers for Health (NARCH). The NARCH program supports opportunities for conducting research and career enrichment to meet health needs prioritized by American Indian/Alaska Native (AI/AN) tribes or tribally based organizations. It aims:
- To work toward reducing health disparities in AI/AN populations by allowing the AI/AN communities to control and prioritize the health research and career enhancement opportunities
- To support health research projects selected and prioritized by the AI/AN communities
- To encourage research capacity and infrastructure building within AI/AN communities to provide the framework for sustainability of research within the tribal communities
- To enhance health research partnerships while promoting a cadre of scientists and health research professionals interested in AI/AN health research from within and outside the AI/AN communities
CHER is a research partner of the Lakota Center for Health Research NARCH program funded by the Black Hills Center for American Indian Health, and collaborates on two NARCH projects:
Lakota Advocacy Leadership Program for Smoke-free Policies
Conducted with the Oglala Sioux Tribe, the Lakota Advocacy Leadership Program for Smoke-Free Policies is a community-based, participatory pilot intervention study that targets community leaders to effectively advocate for smoke-free policies.
Cigarette Smoking Among American Indian Women Experiencing Intimate Partner Violence
American Indian women are 30 % more likely to experience intimate partner violence than any other racial group. The rate of smoking among women experiencing intimate partner violence is as high as 70 percent––three times the national average.
The primary study objective is to engage American Indian women experiencing IPV and public health and social service providers and systems serving them to adapt an evidenced based smoking cessation intervention.
Guided by a Community Advisory Board, researchers from the BHCAIH, NAU, and University of Kansas, will engage American Indian women experiencing IPV and service providers in the development of the first ever smoking cessation intervention.
Secondhand smoke exposures for nonsmokers in Cheyenne River Sioux Tribal households
Secondhand smoke (SHS) is a class A carcinogen and has no safe levels of exposure. Through a recent study, BHCAIH researchers Dr. Patricia Nez Henderson, a Navajo Nation tribal member, and Dr. Jeffery A. Henderson, a tribal member of the Cheyenne Sioux Tribe, discovered that 19% of Lakota non-smoking adults have cotinine (a metabolite of nicotine) levels comparable to active smokers. With a smoking rate at approximately 50 %, the researchers are developing and testing a culturally tailored intervention to encourage adoption of home smoking restrictions in Cheyenne River Sioux Tribal households where nonsmokers are present. The study is being conducted in close collaboration with the Missouri Breaks Industries Research Inc., an American Indian-owned health research organization located on the Cheyenne River Sioux Reservation in South Dakota and is the first to use biomarker feedback with adult nonsmokers for advocacy efforts.
The goals of the research project were:
- Assess the knowledge, attitudes, and beliefs about secondhand smoke exposure and perceived barriers to develop adoption of smoking restrictions in tribal member households on the Cheyenne River Sioux Tribe Reservation
- Augment, implement, and evaluate nonsmokers’ urinary cotinine and carcinogen biomarker feedback intervention for the adoption of household smoking restrictions
- Determine the effect of the intervention on health-related quality of live six months after implementation of the advocacy and biomarker feedback intervention
For more information, visit the Black Hills Center for American Indian Health website at bhcaih.org.
Video resources
Navajo Traditional Healer Perspectives on Commercial Tobacco: A Digital Story Project Accordion Closed
The Navajo Traditional Healer Perspectives on Commercial Tobacco Digital Story Project is an educational video series developed in 2016 by the NCI-funded “Networks among Tribal Organizations for Clean Air Policies” (NATO CAP) project in partnership with two prominent Navajo traditional healer associations on the Navajo Nation. NATO CAP researchers interviewed 15 Navajo healers during the winter of 2014–15 to document their perspectives on the use of commercial tobacco in tobacco-based Navajo healing ceremonies.
About this video series
This educational video series depicts Navajo healers’ views on the history, role, and impact of commercial tobacco in ceremonial settings as well as solutions and policies for controlling the use of commercial tobacco within these settings. These videos can be shared and used in various educational and public health settings.
About the video discussion guides
Each video in this series is accompanied with a video discussion guide to help facilitate group discussions on key topics presented in the video. Discussion guide questions were developed using the Diné worldview, and are designed to guide critical thinking and discussion within the Diné learning framework of Są’áh Naagháí Bik’eh Hózhóó (SNBH). These discussion guides can serve as useful supplemental instructional tools for health educators, community health representatives (CHRs), school teachers, and community program leaders.
Access the entire discussion guide for the Traditional Healer Perspectives collection
Download the entire discussion guide for the Commercial Tobacco Public Service Announcement
Video 1: A Historical Overview of Commercial Tobacco in American Indian Life Accordion Closed
Video 1 provides an overview of key federal Indian policies and events in United States history that contributed to the introduction of commercial tobacco among various American Indian tribes, and closes with a description of the two types of Navajo healers featured in this video series.
Video 2: Differences Between Commercial Tobacco and Dził Nát’oh Accordion Closed
Video 2 provides an overview of healer perspectives on the differences between commercial tobacco and Dził Nát’oh, or traditional mountain smoke. Healers make strong distinctions about the purpose and meaning of commercial tobacco versus Dził Nát’oh. Commercial tobacco is believed to be harmful to health and Dził Nát’oh as restorative to health and spiritual well being.
Video 3: The History and Impact of Commercial Tobacco in Ceremonial Settings Accordion Closed
Video 3 provides a historical overview of when and why healers began using commercial tobacco in ceremonies. Commercial tobacco is used more often in certain ceremonies compared to others. Commercial tobacco is often mixed with Dził Nát’oh for various reasons. Healers are aware of the health risks of secondhand smoke from commercial tobacco and expressed concern for its use in ceremonies, especially among youth and others with existing health conditions.
Video 4: Creating Smoke-free Ceremonial Environments: Thoughts on Solutions and Policies Accordion Closed
In video 4, healers share their thoughts on how a commercial tobacco free policy might affect ceremonial practices on the Navajo Nation. Healers also highlight solutions to create healthy ceremonial environments free from commercial tobacco secondhand smoke. Healers recognize there are challenges to consider in this movement, such as sustainable harvesting of dził nát’oh and the need to create a supply of untreated tobacco for ceremonial use.
Commercial Tobacco Digital Stories Accordion Closed
This compilation of short educational videos was developed by the NIH/NCI funded “Networks among Tribal Organizations for Smoke-free Policy (NATO CAP)” project in collaboration with the Center for American Indian Resilience (CAIR). Videos can be used to stimulate conversation about second hand smoke and smoke-free policy. Videos 1 & 2 communicate research findings gathered through survey, interview and focus groups with Navajo elected officials and community members. Video 1 aims to raise awareness about Navajo elected official’s perspectives on (1) second-hand smoke, (2) smoke-free environmental policy, (3) the evidence base in support for smoke free environmental policy, and (4) the recently passed Navajo Nation Executive Order on smoke-free environments. Video 2 shares results of community focus groups regarding how Navajo citizens characterize the effects of secondhand smoke as negative and harmful and how these focus group participants were favorable to the creation of policy measures aimed at protecting the health of all Navajo people, especially vulnerable members of the population. Video 3 is a personal story about the harmful effects of smoking in the home and ways to encourage friends and loved ones to keep indoor air smoke-free. We hope you enjoy and use these videos in creative educational ways!
For more information please contact:
Carmenlita Chief, MPH