Download AI Cancer Support Circles - Native American Cancer Research

AI Cancer Support Circles
Supported and Developed by:
AI Cancer Support Circles
Supported by:
National Center for Minority Health and
Health Disparities
Native Navigators and the Cancer
Continuum (NNACC) [NCMHD
R24MD002811]
The original Native American Cancer Survivors’ Support
Circles were:
Supported by the California Community Foundation
Developed and pretested by Terrie Restivo (Cherokee
Nation of Oklahoma) … The Cedar Circle
Revisions and modifications were:
Supported by Mayo Clinic’s “Spirit of E.A.G.L.E.S. SOE)”
[NCI U01 CA86098]
Developed and modified by Lisa D. Harjo, (Choctaw) and
Linda Burhansstipanov (Cherokee Nation of Oklahoma)
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OBJECTIVES
By the end of this segment, the
community participant will be able to:
OBJECTIVES
By the end of this segment, the
community participant will be able to:
1. Describe unique features of the NACR Native
American cancer support circles.
2. Identify three things that make a cancer support
circle successful.
3. Describe how your Support Circle may be
organized to be acceptable to your local
community.
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4. Identify which resources are already in existence
and are likely to be included within your local Circle.
5. Describe recruitment strategies specific to your
local Circle.
6. Identify which topics are likely to be included as
“sessions” within your local Circle.
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What is an American Indian Cancer Survivor
Support Circle?
Overview of NACR Survivor
Support Circles
A place where American Indian
cancer survivors can share their
experiences with someone like them
who has been there.
A place where you can learn more
about your cancer, your treatment,
your recovery, and life after.
A place your culture is respected and
valued. AI Cancer Support Circles
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AI Cancer Support Circles
What is culture?
What are definitions of a “resource”?
A way of life that includes foods,
clothing, language, music, beliefs,
religion, lodging, customs and art.
An organization, literature, videos, media,
etc. that you can get information from to
use to learn about healthy life-skills,
quality of care & end of life care
information for physical, social, mental,
emotional and/or spiritual support
What is respect?
To honor others, to treat others as
you would like to treated.
An organization that you can refer a client
to
An individual you can refer clients to
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Examples of Available Native
Specific Resources
Native American Cancer Research (NACR)
and the Survivors’ Network 1-800-537-8295
Mayo Clinic’s “Spirit of E.A.G.L.E.S.”, the
Native C.I.R.C.L.E. and the Native WEB:
1-877-372-1617
Getting Started
Non-Native, Accurate Information
National Cancer Institute, Cancer Information
Service 1-800-4-CANCER
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How Does A Support Circle Work?
How Did NACR’s Circles Start?
A series of 8-12 meetings are set up with
dates, locations, and topics
Meeting dates are posted around the tribal
community, in newsletters, and flyers are
shared with American Indian community
members.
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We learned from Terrie Restivo,
consultant to NACR, who pretested the
Native American Support Circles
QUESTION: Where can you find
materials for your support circle?
Download them free off our webpage at
www.NatAmCancer.org
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AI Cancer Support Circles
How Does the NACR Support Circle Work?
NACR staff (Lisa Harjo) serves as the
coordinator / facilitator
Circle members tell NACR staff what they
want, how often to meet, when, etc. She
makes it happen
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NACR Staff Provides Meeting Handouts And
Materials
Provides a notebook (as funding allows)
with materials for the participants
Provides healthy foods
Many groups do this as a potluck, but
healthy food is the guideline
Provides speakers on topics requested by
the Circle members when feasible
Most local speakers volunteer their
time to talk with the Circle
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What are the benefits for members?
Benefits for Participants
Circle members receive support and
caring from other members and the
facilitator.
Circle members learn more about their
cancer, treatment, and recovery so they
can improve their quality of life during and
after cancer.
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What are the benefits for members?
What are the benefits for members?
Circle members learn how to handle the
side effects of treatments through diet,
herbal teas, and new behaviors.
Circle members learn about resources in
the community that can help them.
Circle members find out they are not
alone.
Circle members build new relationships
and friendships with other circle
members.
Circle members learn to have fun again
and make plans for the future.
Circle members learn more about
themselves and their strengths.
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AI Cancer Support Circles
How is an American Indian Support
Circle different from another support
circle?
How do NACR Native Circles
differ from non-Native support
groups?
American Indian support circles
respect the spiritual beliefs of the
members and allow them to bring
their spirituality in to the Circle.
AI Cancer Support Circles
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How is an American Indian Support
Circle different from another support
circle?
American Indian Cancer Support Circles
American Indian spiritual elders are
invited into the Circle to guide
members, council members, pray
with members, and to share their
understanding of the times.
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Improve the Quality of Life for
members
Promote healing and wellness
through the Medicine Wheel
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What Are Some of the Ways
That the Circles Are Unique?
Ranged from 4 to 12 (~2 hour) weekly
sessions
Basics (food, typical agenda)
Tailored for Native cultures
Spirituality incorporated throughout the
sessions
One of the few support programs that
have been evaluated for effectiveness
(both nationwide & multi-racial)
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AI Cancer Support Circles
Developing the Circles
Example of the Typical Agenda
Decide on Circle healthy snacks,
beverages, arts, crafts, keynote
speakers, etc.
Opening Prayer and Welcome
Pre-session learning
Questions: Why would you want to have
food & beverages? And why healthy
food/drink?
How might arts & crafts be used during
the Circle?
Why would keynote speakers be
beneficial?
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‰ Typically one (3-hour) session per week
‰ Topic Discussion (20-45 minutes)
‰ Artwork (throughout unless sad or angry
stories being shared)
‰ Sharing personal stories of grief, joy,
humor and information (1 to 1-1/2
hours)
‰ Evaluations, contract, journaling (1/2
hour)
Support for one another in the Circle
Personal Goals / Contracts
Journaling
Post-Session Learning
Closing Prayer
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Organizing the Circle Agenda
for Denver:
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Components (parts) of the
Circle
‰ Typically one (1½-2 hour) session per
week
‰ Ranged from 5 week sessions to 12-week
sessions
‰ Topic Discussion (15 minutes)
‰ Sharing personal stories of grief, joy,
humor and information (1 to 1-1/2 hours)
‰ What topics does the group want for the
next session (10 minutes)
‰ Evaluations (10 minutes)
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Sharing
Healthy snacks
Laughter
Tears
Affection and support
Organizing the Circle Agenda
for Southern California:
Example of the Typical Agenda
continued
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Topic or Guest Speaker
Personal stories/progress since last week
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1. Facilitators’ Checklist
2. Facilitators’ Outline
3. Ground Rules
4. Circle Prayer
5. Personal Inventory List
6. Topics Relevant to your Circle
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AI Cancer Support Circles
Components (parts) of the
Circle
7.
Keynote Speakers
8.
9.
Literature
Arts & Crafts
10.
Interactions through games or
tribal stories
Journaling with Natural Mediums
(e.g. stones, beads, etc)
11.
12.
Facilitator’s Checklists
Advertising / Recruitment
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Facilitators’ Checklist
Facilitator Qualifications
You cannot “make” someone serve as the
facilitator who does not want to do it
‰ Native American (survivor of family
member of survivor preferred
‰ Compassion
‰ Integrity / honesty / trusted
‰ Commitment
‰ Want to work with Cancer Survivors /
Thrivers and their Loved Ones
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Facilitators’ Checklist
___Matches
___Cedar, Sage and/or Corn Pollen
___Abalone Shell and a holder for the shell
___Healthy Foods and Drinks (e.g. fruits,
vegetables, juices)
___Water
___Cups
___Small Plates
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Facilitators’ Checklist
Materials to bring to each session continued:
___Napkins
___Eating Utensils (if applicable)
___Name Tents or Badges
___Tissue/Kleenex
___Arts & Crafts Supplies and Accessories
___Pens, Pencils, Notebook Paper
___Facilitator’s Notebook
___Medicine Wheel Forms
___Personal Contracts
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Materials to bring to each session:
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Materials to bring to each session continued:
‰ Journal Paper (My Circle Journey)
‰ Copies of 3-hole punched Handouts for each
participant for next session
‰ Referral Form for the National Native
American Cancer Survivors’ Network
‰ Business Cards with Business Card Holder
‰ Additional items requested by participants
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AI Cancer Support Circles
Personal Inventory List
for My Loved Ones
Personal Inventory List
___Birth Certificate
___Driver’s License
___Social Security Card
___Tribal Card/Roll #
___Military Papers/Military
___Doctor Name/Phone
___Medicine Person
___Herbalist
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Personal Inventory List for My Loved
Ones (continued)
___List of Prescriptions and dosage
___Hospital Name/Location
___Spiritual Advisor/Clergy
****Other Important Information****
___Vehicle Registration and Ownership Slip
___Medical Insurance/Card
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Personal Inventory List for My Loved
Ones (continued)
___Life and Accident Insurance/Card
___Durable Power of Attorney for Health
Care & Living Will
___Credit Cards
___Real Estate or Rental Papers
___Burial Papers
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Developing the Circle
Ground Rules
Set your Circle Ground Rules
Question: What is the definition of a
“ground rule?”
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AI Cancer Support Circles
Ground Rules
Ground Rules
A “Ground Rule” is: A set of directions for
conduct and processes throughout your
Circle.
“Ground Rules” refer to how participants
should behave with one another during
and after the support circle.
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Please form small groups of about 5
people each.
Discuss possible ground rules that you
would suggest for a support circle in your
community.
Groups will be asked to share their ideas
and possible ground rules.
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Examples of Cedar Circle’s Ground Rules
Ground Rules
1. Every session begins with the same Circle spiritual
blessing or prayer.
No one talks when someone else is
talking.
2. Show respect for others...allow them to tell their
story without interruptions.
Whatever is said in the circle stays in the
circle.
3. Family members and loved ones are welcomed to
the group
No cussing or bad words used during the
Circle.
4. Positive supportive comments should take place
while arts & crafts are being worked on (i.e., no
negativity toward others or ourselves; spiritual pain
could feed into our and others= artwork).
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Examples of Cedar Circle’s Ground Rules
5. No Smoking in the building or during the Circles.
6. Nutritious foods & beverages only (i.e., fruits,
vegetables, juices, occasionally sandwiches and
other healthy snacks to promote health, healing and
good tastes. Please do not bring sodas, burgers,
fast-foods, etc. (Remind diabetics to watch their
exchanges)
7. Circle participants, or their “designee,” determine
whether or not to invite a speaker to stay for the rest
of the Circle.
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Organizing the Circles for Southern
California:
The first (2) sessions are open for anyone
to attend.
Session #3 and beyond is closed to new
participants
Newly diagnosed people are referred to
one-on-one telephone counseling until the
next Circle begins to insure bonding
between the current Circle participants
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Benefits/Drawbacks to Including
New People Each Circle Session
Benefits/Drawbacks to Including
New People Each Circle Session
Some communities feel uneasy with not
allowing “new” people into the Circle after
Session #2.
Question: What do you think may happen
if new people joined the Circle each
Session?
Based on discussion with Native
survivors in your local Circles, you will
need to decide whether or not you should
allow new people to join in each week …
especially in smaller communities
Question: Why do you think this may
have been important to the Circle
participants to do this?
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Opinion: Do you think your local Circles should be
“closed” to allow for bonding and healing after the first
few session?
2. Yes
3. Don’t know / not sure
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0 / 75
Opinion: Do you think family (or loved ones) who are the
caregivers should take part in the Circles?
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Benefits/Drawbacks to Including
New People Each Circle Session
Question: If your Circle participants want
to keep the Circle “private” after the 2nd
session, how can your community provide
support to someone who is newly
diagnosed?
1. No, they should have their
own Circle (i.e., Caregivers’
Circle)
2. Yes, they should be with the
survivors EXCEPT when
caregiver issues are
discussed
3. Yes, they should be together
for ALL topics
4. Don’t know / not sure
0 / 75
Opinion: Do you think men and women should be in the
same Circle?
1. No, they should have their
own Circle (i.e., Men’s Circle,
Women’s Circle)
2. Yes, they should be together
EXCEPT when sexual or
intimate issues are discussed
3. Yes, they should be together
for ALL topics
4. Don’t know / not sure
1. No
0 / 75
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Question: Will your Circle participants be
willing to do this?
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AI Cancer Support Circles
Benefits/Drawbacks to Including
New People Each Circle Session
Benefits/Drawbacks to Including
New People Each Circle Session
“Those who do not have the
opportunity to evolve in their recovery
tend to not complete the healing
process”
Question: If new people continue to join
how will you help the group participants
bond and move forward in their own
recovery?
Terrie Restivo
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Ground Rules: Groups Report
1. List local AIAN community rules here
Prayer or Blessing to start
and end all sessions
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Excerpt from the Cedar Circle’s Prayer
Developing the Circles
Create a prayer or a spiritual opening
that is respectful to your local
community
Circle participants compose or write
thoughts, feelings and drawings, or
what they would want included in a
prayer
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Creator...thank you for bringing the women and men
of the Circle back once more. Special prayers for all
who were not able to make it here. Keep them safe
in their travels and strong in heart.
Special prayers that we remain in good heart and
good mind throughout the session.
Special prayers for the People of this land that they
may continue in their quest to bring back their
culture, their heritage, their traditions.
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AI Cancer Support Circles
Excerpt from the Cedar Circle’s Prayer
Excerpt from the Cedar Circle’s Prayer
Special prayers that we can clear our minds, calm
our hearts, strengthen our determination to work for
the health of ourselves, Mother Earth and all of Her
inhabitants.
Special prayers that we have the strength to accept
the stories of experiences shared by the women or
men here; strength to accept the reality of a
situation...both real or imagined; and ears to listen
to the stories and to hear the joy or sadness in
them.
And, Creator, special prayers for patience to stop
and listen to others; for the wisdom to understand
them both inside and outside of our situations; for
eyes to see around us the beauty and ugliness...and
to take from that experience information to pass
onto the next Circle.
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Thank you, Creator, for each breath we take; for the
air; the water; the rain; the sun; the win; all that are
on Mother Earth; all that is Above and all that is
Below. Thank you for another day of living.
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Facilitator Outline
~ Session #1
Facilitator’s Outline for
Each Session
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OBJECTIVES:
1. Participants can briefly share their
personal experience with cancer
2. Participants can identify unique
characteristics of cancer in Native
Americans
3. Participants can start the Circle opening
prayer
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Facilitator Outline ~ Continued
Facilitator Outline continued
B. MATERIALS FACILITATOR
needs to bring to this lesson, in
addition to normal
meeting supplies:
1. Notebook for each participant
2. Video tape machine and monitor
3. Video #1, #2, #6
4. Handouts:
a)
b)
c)
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Seascape Referral Form &
Consent Form
Introduction to Native
American Cancer
Survivors / Thrivers Support
Circles
Circle Ground Rules
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AI Cancer Support Circles
Facilitator Outline continued
d)
Personal Inventory List for
Family & Other Loved Ones
Personal Contract
Circle Journal Paper
Session Topics Ranking
Medicine Wheel Evaluation
Answer Sheet
Blank paper and a pen or
pencil for each participant
(for AInote
taking)
Cancer Support Circles
e)
f)
g)
h)
i)
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Facilitator Outline ~ continued
C. AGENDA:
1.
Blessing
2.
Self-Introductions, including
information such as
a) Tribal Affiliation
b) Are you a Survivor/Thriver, or
are you a Loved One of a cancer patient
c) Type of cancer & when
diagnosed
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What you want to get from the
Circles
3. The Native Survivors’ Support
Circles…[Distribute Notebooks with Intro
Section included]
a)
Introduction (see program
hand-out)
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Facilitator Outline ~ continued
Facilitator Outline ~ continued
d)
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b) Review Topics
1) Topic Survey is for participants to
rank theTopics of Interest
2) Participants may write
in additional Topics of Interest
3) The first two (2) sessions of the
Circle are open to anyone, but will be
closed from Session #3 on
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Facilitator Outline ~ continued
Facilitator Outline ~ continued
4. Ranking of Discussion Topics
c)
Review the format for each
session (see handout)
d)
Review the Circle “Ground
Rules.” Ask for revisions
and/or other changes. (see
handout)
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a. Ask the participants to complete the
ranking of Topics of Interest to them and
remind them they can add new items to
the list.
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b. Collect those forms at the end of the
session. New items added to the list will
be shared with all participants of the
group to determine if they are topics of
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high interest.
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Facilitator Outline ~ continued
Facilitator Outline ~ continued
5. *Sharing Stories (ask for volunteer/s
who is/are willing to share his/her
experiences) *Keep this time approx 1
hour*
6. “Personal Contract” for next session
~ Each participant identifies at least
one thing s/he will do between tonight
and the next session that is focused to
HER/HIS needs.
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7. Distribute Handouts for next session:
which will be “Dietary Concerns “[you will
finish Dietary Concerns ~ Traditional
Food Session 10]
8. Evaluation ~ Using the Medicine Wheel
Answer Sheet, ask participants to
respond to questions
9. Closing Prayer
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Sample Topic List
Dietary Concerns
Chemotherapy
Examples of Topics
and Handouts from
NACR Survivor
Support Circles
Radiation Therapy
Surgery
Pain Control
Intimacy and Sexuality
Outlook on Life
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AI Cancer Support Circles
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Dorcas Bloom
Siberian Yupik
Dx 1998 Breast
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76
Cancer had really changed
my life around for the
betterment
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IHS Age-adjusted Malignant Neoplasm Death Rates
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IHS Trends, 1999, Chart 4.33, p. 116
80
AI/AN cancer rates for all cancers, by
region, both sexes, compared to US all
race rates, 1999-2002
600
500
400
300
200
100
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es
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0
AI Cancer
Support
Special thanks to David Espey,
MD
andCircles
Roberta Paisano, MHSA, IHS 81
National
Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]
Epidemiology Program
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]
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AI Cancer Support Circles
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Espey, David K; Wo, Xiao-Chen; Swan Judith; Wiggins, Charles; Jim, Melissa A.; Ward, Elizabeth; Howe, Holly L.; Ries, Lynn A.G.; Miler, Barry A.; Jemal, Ahmedin; Ahmed, Faruque; Cobb, Nathaniel;
Kaur, Judith S.; and Edwards, Brenda K. Annual Report to the Nation on the Status of Cancer, 1975-2004, Featuring Cancer in American Indians and Alaska Natives. Cancer [American Cancer
Society]: 2007 [11-15-07]; Volume 110: No. 10. GRAPH MODIFIED BY Rick Clark, Native American Cancer Research
Haverkamp D, Espey D, Paisano R, Cobb N., Cancer Mortality among AIAN: Regional
Differences, 1999-2003, IHS, Rockville, MD 2008
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Haverkamp D, Espey D, Paisano R, Cobb N. Cancer Mortality Among American Indians and Alaska
Natives: Regional Differences, 1999-2003. Indian Health Service, Rockville, MD, February 2008.
GRAPHS MODIFIED BY: Rick Clark, Native American Cancer Research (note horizontal grid)
Haverkamp D, Espey D, Paisano R, Cobb N. Cancer Mortality Among American Indians and Alaska
Natives: Regional Differences, 1999-2003. Indian Health Service, Rockville, MD, February 2008.
GRAPHS MODIFIED BY: Rick Clark, Native American Cancer Research (note horizontal grid)
Haverkamp D, Espey D, Paisano R, Cobb N. Cancer Mortality Among American Indians and Alaska
Natives: Regional Differences, 1999-2003. Indian Health Service, Rockville, MD, February 2008.
GRAPHS MODIFIED BY: Rick Clark, Native American Cancer Research (note horizontal grid)
Haverkamp D, Espey D, Paisano R, Cobb N. Cancer Mortality Among American Indians and Alaska
Natives: Regional Differences, 1999-2003. Indian Health Service, Rockville, MD, February 2008.
GRAPHS MODIFIED BY: Rick Clark, Native American Cancer Research (note horizontal grid)
Excerpt from “Spiritual Healing”
George Hogan III
Crow
Diagnosed:
1992 lung cancer
Haverkamp D, Espey D, Paisano R, Cobb N. Cancer Mortality Among American Indians and Alaska
Natives: Regional Differences, 1999-2003. Indian Health Service, Rockville, MD, February 2008.
GRAPHS MODIFIED BY: Rick Clark, Native American Cancer Research (note horizontal grid)
Oh, my spiritual life. I do a lot of
spiritual work before my cancer and
even after I had the surgery, I kept
on with my spiritual work with the
church, and it takes me along and
helps me, and I look at it in a
positive way. Spiritually I didn't
have nothing to worry about,
because I still have my life in the
hands of God, go on living.
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Excerpt from “Healing / Spirituality / Recovery -- All Cancer Sites
Native American Cancer Survivors’ Stories about
Healing”
Katherine Big Hail
Crow
Dx 1993 Breast
[translated by daughter] ... a lot of people were praying
for her and she was in prayer and she even had a
dream, a vision that the Lord showed her that she was
already healed you know. While she, this happened
while she was still real sick and uh and then uh once
she seen this vision or dream and then she said well I
know I’m gonna be all-right.
She said to the other cancer patients, people that have
cancer, she said if you’re willing to get healed she said
you’re gonna get healed. Even from the help of your
doctor, pray for your doctor, you know, work with him,
like work with your doctor. (Native tongue) Ya, and then
she said just go ahead with the treatment they’re helping
you too so work with them, work with the doctor.
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Excerpt from “Personal Reaction to
Cancer”
Bonnie Heavy Runner
Craig
Blackfoot
Diagnosed: 1991 ovarian
cancer
It was just an amazing experience to
sit there and be totally alert, feel
good, and have a doctor tell you that
that you can't see because it came
over the phone. How can this be?
Why is this happening to me? What
do we do?
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Excerpt from “Personal Reaction to
Cancer”
When you first hear about it, to
me it was kind of a scary
situation, because I never did
ever believe that I would ever
come to the point where I would
have cancer.
Abe Conklin
Ponca-Osage
It kind of put fear into me. I
Diagnosed:
1987 prostate cancer
knew then that I should have
gone earlier.
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Excerpt from “Personal Reaction to
Cancer”
Sarah S. Allman
Oglala Sioux
Diagnosed:
1970 cervix cancer
I thought it was a killer, you
know. I was always so scared
of that word “cancer”.
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Excerpt from “Dietary Control during and
following Treatment”
I changed my diet, I didn't eat
red meat. I cut out all kinds of
fats, didn't use chocolate or eat
fruits that weren't grown in this
climate, a very strict regiment.
No coffee, so I tried to stick with
Angela Russell
Crow
that for the full year, half of that
Diagnosed:
1987 breast cancer
year of course I was on chemo,
I think that made a difference to
my body.
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Excerpt from “Chemotherapy”
Frank Mercer
Tlinqit-Raven Clan
Diagnosed:
1992 colon cancer
Well, I don't think I got really used to it, but it
didn't bother me that much. I think the only
discomfort I had from chemotherapy was when
they .. inserted a needle … but as time went
on, I got a little sensitive, but I got kind of used
to it …some cases like my colon cancer, since
it was caught in time, it is preventive measures
that I went through that therapy. It was just to
make sure there was no more cancer cells left
in my system so, that is why on early detection,
because the quicker they find the cancer in
your body and isolate it, the less time you will
spend in treatment. Like with me, I spent a
little over a year, about 14 months, of
chemotherapy.
didn't affect me that much.
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Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]
Inactive Activity: Which topics do
you feel are of most interest or need
for local Native survivors?
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Excerpt from “Chemotherapy -- All Cancer Sites
Native American Cancer Survivors’ Stories”
Jennie R. Joe
Navajo
Diagnosed:
1988 breast cancer
Chemotherapy consisted of probably three
different types of drugs. My treatment took
almost a year, because with chemotherapy, they
always give you time for your body to re build
your blood cells, so I think you know the
treatment isn't something that you can go in and
have it done within two or three days.
My particular cancer had spread through my
lymph nodes at least one of them was positive,
so I didn't have a choice, I had to have the
chemotherapy.
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Examples of Session Topics
Interactive Activity
Dietary Concerns
Benefits of Breast/Body Self-exams
1.In groups, please discuss which of the
following topics you think your local
community may want to have included
Chemotherapy
Radiation Therapy
2.What additional topics do you feel need to
be added to be of most relevance to your
survivors’ community?
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Hormonal Therapy
Surgery
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Examples of Session Topics
continued
Examples of Session Topics
continued
Pain Control
Emotional Purging
Economic Issues
Follow-up Care
Benefits of Physical Therapy
Managing Home & Family During Care
Intimacy and Sexuality
Incorporating Traditional Healing with
Modern Medicine
Outlook on Life
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Closing Ceremony & Celebration
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Advertising & Recruitment
Recruitment Strategies for
NACR Survivor Support
Circles
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How do patients learn about the support circle?
How would you let people know about
your upcoming Circles?
Question: What tribal or Health Board
approvals do you need to have in place
before you advertise or recruit to your
Circles?
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How do patients learn about the support circle?
Circle Members invite others who have
or have had cancer.
Organizations, both Indian and nonIndian, refer individuals to the Circle.
Doctors and clinics who provide care
for American Indian cancer patients
refer circle members.
Family members of cancer survivors
are also invited to join in the meeting.
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“Recruitment” of Survivors
Advertising the California
Circle: An example
NACR Website http://NatAmCancer.org
Fliers posted in the market
Exhibit booth during Pow Wows
and Health fairs
Information in community newsletter
Visit elder’s weekly “craft” gatherings
to share information
Native Wellness Conferences
Community News
Medical Center/Doctor/Clinic/I.H.S.
Word of Mouth (“Moccasin Telegraph”)
Telephone
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Inactive Activity: For your local
Native community, what strategies
do you are most likely to spread the
word about your Circles?
1. In small groups of about 5 people, please
brain storm an additional survivors’
recruitment strategy that would be
acceptable to your community.
Personal Contracts
2. Now, identify an additional way to
advertise the existence of these Circles.
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My Circle Journey
Interactive Activity
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Personal Health Contract (Weekly
Activity)
Focus on his / her needs at least 15
minutes per week
Write thoughts, feelings, poems…
Draw, cut or paste pictures
Compose a song
Group art using stones, shells, beads
American Indian people always take care
of their community / family before
themselves
Contract is between the participant and
his or her God / Creator
Contract is a weekly commitment
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AI Cancer Support Circles
Weaving a Healthy Life
Survivors’ Contract
I, __________________,
do hereby promise my God/Creator
that I will take 15 minutes
strictly for myself this next week; I will take
a few minutes to watch a butterfly dance or
listen to the beautiful songs of a bird, or
look up and see the stars looking down on
me.
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Tips for Successful Circles
Tips for Successful
Circles
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Tips for Successful Circles
Begin each session with a prayer or
silent time for members.
Hold sessions at times that are
convenient for members, for example
evenings, weekends.
Allow members to share their
experiences during the week.
Be flexible with the topics and modify
agenda as the needs of the members
demand.
Survey members to see which topics
they want to cover and in what order.
Have tissues handy for members.
Help to lighten the mood when
necessary.
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Tips for Successful Circles
124
Tips for Successful Circles
Have healthy and appropriate food
available for meetings.
Encourage circle members to establish
rules for interaction and to follow them.
Utilize the Medicine Wheel to address
the physical, mental, emotional and
spiritual aspects of life and survival.
Hold meetings in a private, safe place.
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Be patient. Successful Circles take
time to establish (Sometimes even a
year or more.)
Be persistent. Set meeting dates, hold
meetings, even if only one person
comes. And do it again and again.
People will come.
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AI Cancer Support Circles
Tips for Successful Circles
Local Artists Donate Artwork
Keep the size of Circles reasonable. 610 members is a good number for
interaction and trust.
A superb way you can acknowledge your
local talent is to seek artists from your
community that will donate their artwork to
your Circles
NACR has had groups as small as 2
people.
Remember to list your artists in your print
materials
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Medicine Wheel evaluations (pre and
post-session questions used during
development of the Circles)
Overall session evaluations (every 4
sessions) Recommend these still be
used …
129
The hardest work in holding Support
Circles is that they are hard to keep
“Continuing the Circle”
Question: If or when you have this
challenge, what are 3 things you can do
to increase the likelihood of the group
succeeding?
AI Cancer Support Circles
Native Navigators and the Cancer Continuum (NNACC) [NCMHD R24MD002811]
Thank you very much
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Conclusion
Evaluation
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