Iowa Governor's Conference on Public Health

This presentation will outline the creation, implementation, and evaluation of a health literacy/ self-advocacy training curriculum for laypersons in American Indian (AI) communities utilizing
a Community Based Participatory Research (CBPR) approach; specifically, the presentation will address the collaborations that were necessary and lessons learned from this process. Health literacy is critical to enable individuals the capacity to obtain, process, and understand information to make informed health decisions, advocate for themselves and family members, and to activate patients to collaborate in sharing responsibility for health decisions. This is a particular challenge in disadvantaged groups such as the AI population. The purpose of this pilot study was to develop a health literacy/self-advocacy training curriculum for laypersons in an AI community, deliver training curriculum via classroom integration in adult education programs, and deploy an evaluation model to assess the impact on patient activation. Our study population was adult learners in an AI tribal community. A committee consisting of representatives from the community and health science content experts developed a four- module curriculum. The curriculum was modified following feedback from the local adult educators who, following training, then implemented it into their programs. Data was collected at three points in time to study our primary research question that laypersons who participated in the program would demonstrate increased patient activation. Patient activation was measured using the validated Patient Activation Measure (PAM). AI PAM scores varied significantly at baseline, and on average, AI patient activation changed over time. Findings signal our heuristic health education approach to promote positive health behaviors among American Indians may be viable.