The Development of the Theory

Background Because of the heightened risk for stroke among indigenous people, we conducted this multiyear community case study from 2009 through 2012 to address stroke education needs among children aged 11 to 13 years residing in northern urban, rural, and remote First Nations in Ontario, Canada. The goal was to determine what young people understand about stroke and to develop an age-appropriate and culturally appropriate educational product. Community context This project responded to First Nations requests that we educate their young people about the signs and symptoms of stroke and the need for early response. Ten First Nations and 4 indigenous health organizations took part; 7 contributed to the educational product. Methods This study was developed under the guidance of the Northwestern Ontario Regional Stroke Network Aboriginal Advisory Committee. It employed indigenous researchers and facilitators to ensure that methods used (questions assessing children's knowledge of stroke and their ideas on how best to deliver messages) reflected the cultural values of participating study sites. Outcome Indigenous children had limited knowledge about stroke and its signs, symptoms, and consequences; children in remote communities were better informed than those in other locations. Educators agreed that a DVD was the most effective way to deliver stroke information to children in this age group. The principal outcome from this 3-year community engagement was an 11.5-minute DVD titled Act F-A-S-T 1-2-3!. Follow-up indicated that the educational tool continued to be used to educate indigenous children and adults about stroke signs and symptoms, the need for early response, and risk reduction. Interpretation Although indigenous communities are each unique in their culture and traditions, all have a strong commitment to improving health and are generous in their support for research that addresses their needs. Our study provides examples of the engagement and participatory research strategies that were effective, the practical supports required, limitations to the study, and how barriers to stroke education can be overcome.

https://stacks.cdc.gov/view/cdc/51485/cdc_51485_DS1.pdf

Teach Our Children: Stroke Education for Indigenous Children, First Nations, Ontario, Canada, 2009-2012.

Background:American Indian children and adolescents are at risk for obesity, type 2 diabetes, hypertension, elevated cholesterol, and smoking, all of which are risk factors for cardiovascular disease.Objective:To address these health issues, we developed, implemented, and evaluated a culturally appropriate cardiovascular disease curriculum called ‘In Our Voice’ for American Indian students in grades 7 through 12. The curriculum consisted of 16 modules lasting 50 minutes each, and it was implemented as a pilot test at five sites in two western states.Results:We faced many challenges to success, including competing demands for instructional time and classrooms, which prevented two schools from completing the curriculum. Two notable findings emerged: students preferred a multicultural focus over a culturally tailored focus, and they desired more interactive educational materials.Conclusion:Recommendations for successfully implementing an innovative curriculum include ensuring the ongoing presence of research...

‘In Our Voice’: Lessons learned from a cardiovascular disease curriculum for American Indian students:

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‘In Our Voice’: Lessons learned from a cardiovascular disease curriculum for American Indian students: