Providing Cancer Prevention and Care Services for Tribal Members During the Pandemic

Debra Williams from Bishop, California displays the basket she won at a health fair organized by the Toiyabe Indian Health Project.

Debra Williams from Bishop, California displays the basket she won at a health fair organized by the Toiyabe Indian Health Project.

When doctors’ offices closed during the COVID-19 pandemic, the Toiyabe Indian Health Project, with its main clinic site in Bishop, California, went into the community to help. Toiyabe, a consortium of seven federally recognized tribes and one Native American community, hosted three drive-through health events that reached almost 200 people. During these events, clinic staff provided COVID-19 vaccinations. They also recommended services to help tribal members who smoke commercial tobacco quit and urged members to reschedule any cancer screening tests they missed.

Helping Tribal Members Quit Commercial Tobacco

It’s important to Toiyabe staff to help tribal members quit using commercial tobacco products since lung cancer is the leading cause of cancer death among American Indian and Alaska Native people. Cigarette smoking causes most lung cancers. In addition, tobacco use can cause cancer almost anywhere in the body.

In 2020, Toiyabe hired a trained tobacco cessation counselor. Toiyabe staff encouraged doctors to ask new patients if they use tobacco and to offer help quitting as needed. As a result, 38 patients were referred to tobacco cessation services in 2021—up from only 3 in 2019.

Supporting Cancer Survivors in Culturally Appropriate Ways

Patient navigators are health care workers who help people overcome problems getting health care. Toiyabe created a program to train patient navigators to help tribal members with cancer. Six staff members were trained in this 2-month program. They provide support to cancer patients, survivors, and their families by phone and in person.

Toiyabe developed a cancer resource guide for the navigators. The guide includes educational materials and tools to help cancer patients during treatment. The team working on the guide used local images, art, and resources and even used the communities’ language to define words throughout the document. They also worked with community members to complete a thorough review of the resource to make sure it was culturally appropriate. Toiyabe’s patient navigators have given out 400 copies of the guide.

In June 2021, Toiyabe partnered with seven community organizations to host its first event for cancer survivors. People who attended received a free blood pressure screening and health information. Specialists from local hospitals talked about physical activity and nutrition for cancer survivors. More than 50 people attended the 2-hour event.

Putting Training Into Action

The Toiyabe Indian Health Project is one of eight tribal health programs supported by the California Rural Indian Health Board, Inc. (CRIHB).external icon With funding from CDC’s National Comprehensive Cancer Control Program, CRIHB collaborates with partners through the California Tribal Comprehensive Cancer Control Program.external icon They work together to lower the number of American Indian people in California who get cancer.

“Our CDC funding helps us offer a variety of culturally appropriate trainings and other assistance to coalition members, which include the tribal health programs,” said Kathleen Jack, CRIHB’s Research and Public Health Department Deputy Director. “These activities are designed to enhance their ability to increase commercial tobacco cessation, ensure timely cancer screenings, and support cancer survivors.”

Toiyabe leaders spoke at CRIHB’s Journey of Wellness conference in June 2021 about how they planned and implemented their cancer survivor support and tobacco cessation efforts.

“These efforts by the Toiyabe Indian Health Project have made it easier for communities served to access tobacco cessation and cancer prevention and care services,” said Melissa Meza, a health education specialist in the California Tribal Comprehensive Cancer Control Program. She noted that CDC’s National Comprehensive Cancer Control Program recommends assessing tobacco use, referring tobacco users to cessation services, and going into communities to make it easier for people to access health care as effective ways to prevent and control cancer.