Culturally Relevant Online Cancer Education Supports Tribal Primary Care Providers to Reduce Their Cancer Risk and Share Information About Cancer

Katie Cueva, Melany Cueva, Laura Revels, Michelle Hensel, Mark Dignan

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


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.

Original languageEnglish
Pages (from-to)631-639
Number of pages9
JournalHealth Promotion Practice
Issue number4
StatePublished - Jul 2022

Bibliographical note

Funding Information:
This work is part of “Distance Education to Engage Alaskan Community Health Aides in Cancer Control,” supported by the National Cancer Institute of the National Institutes of Health (NIH), award R25CA186882. Data analysis, theoretical understandings, and manuscript preparation and submission were supported by NIH grant 3R25CA057711. The content of this article is solely the responsibility of the authors and does not necessarily represent the views of the NIH. This research protocol was reviewed and approved by the Alaska Area Institutional Review Board, the Alaska Native Tribal Health Consortium Health Research Review Committee, and the Southcentral Foundation Executive Committee and Board of Directors.

Publisher Copyright:
© 2021 Society for Public Health Education.


  • Alaska Native
  • Indigenous
  • community-based participatory research
  • distance education, cancer
  • evaluation
  • online learning
  • survey

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Nursing (miscellaneous)


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