Cancer is a scary word in any language. But in Native American cultures, there are as many negative associations with the word as there are different tribes. In some Indian languages, there is no word at all for the disease, while in others, cancer means the "sore that never heals," implying that death is inevitable. In other groups, cancer is considered contagious, or believed to be brought on simply by speaking about it.
So it's no surprise that Native Americans have the poorest cancer screening rates of any ethic group. Radiologists and minority health specialists who serve these communities have devised a creative patient outreach plan involving another word that is often associated with American Indian tribes: gaming.
"Games and stories have been particularly popular historically among many tribes, and we believe that ... games may therefore be a potentially effective way to deliver health information to Native Americans," wrote Dr. Marilyn Roubidoux and colleagues in the Journal of Women's Imaging (June 2005, Vol. 7:2, pp. 77-86).
Roubidoux, who is from the department of radiology at the University of Michigan Health Care Systems in Ann Arbor, and her colleagues devised three games -- one based on bingo, two based on the TV show "Jeopardy," and one narrative tale -- to deliver accurate and meaningful messages about breast cancer to Native Americans and their healthcare providers.
All the games can be accessed for free at the Web site of the American Indian/Alaska Native Cancer Information Resource Center and Learning Exchange (Native CIRCLE).
Co-authors on this project are from the Native American Cancer Initiatives in Pine, CO, and the Native Women Enjoy the Benefit program at the Mayo Clinic in Rochester, MN.
"Breast Care Bingo" is similar to the conventional game. Questions appear on one side of the screen, and the player chooses the answer from one of the text boxes. The winner must achieve "bingo," or five correct, consecutive answers.
"Breast Cancer Detective" was modeled after "Jeopardy," with players having to answer questions about case scenarios. Versions of the game were created for healthcare professionals, medical students, and patients. Finally, the "Breast Health Advisor" offers four vignettes in which the player acts as a healthcare advisor.
Some of the topics covered by the games included:
- Methods of detection (breast self-exam, mammography)
- How breast lesions are identified and diagnosed
- Risk factors specific to Native American women
Since the beginning of 2005, the games have been released through Native American health organizations, such as the Phoenix Indian Medical Center in Arizona and the Huntsman Cancer Learning Center in Salt Lake City, as part of staff training and educational programs. Roubidoux told AuntMinnie.com that the games have been well received by the target audience. In addition, the games were praised at the 2005 Association of American Indian Physicians annual meeting in Washington, DC, she said.
"Recently I took them to Alaska and demonstrated (them) to the cancer coordinators for the Alaska Native Tribal Health Consortium in Anchorage," Roubidoux said. The coordinators expressed interest in using the games to train physicians and nurses about breast care health problems in remote areas of the state, she added.
The authors acknowledged that access to computers is an obstacle to the dissemination of these games. A "digital divide" does exist between Native people and the general population in terms of computer ownership and access, although that gap is closing, they stated. Roubidoux said that the ideal scenario would have women playing the games under the supervision of a healthcare educator, making the whole process more interactive.
By Shalmali Pal
AuntMinnie.com staff writer
August 30, 2005
Related Reading
Mammography use in U.S. meets national goals, study shows, June 3, 2005
Women fail to return for annual mammograms, June 23, 2004
Bollywood-style song inspires U.K. women to get mammograms, February 10, 2004
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