Feasibility Testing of a Culturally Adapted Smoking Prevention Website for Young Rapid City Urban American Indians Patricia Nez Henderson, MD, MPH, Deb Bowen, PhD, Dedra Buchwald, MD

To test the feasibility of implementing a culturally adapted smoking prevention website for Rapid City AI/AN youth. Compare the effects of the program and associated tobacco-related information in diverse youth AIAN setting. SPECIFIC AIM

1 year pilot project Collaboration between the Black Hills Center for American Indian Health and the University of Washington IRB approval through the AATCHB Grant funded by NCI BACKGROUND

BACKGROUND Smoking is responsible for more premature morbidity and mortality than any other known behavioral risk factor. Public school-based surveys in South Dakota showed that, in 2003, approximately 26% of AI/AN youth in middle school and 53% in high school had smoked 1 or more days in the past 30 days.

METHODS Goal for the study is to recruit 60 American Indian youth from the Rapid City site. After exploring several locations and organizations including the Rapid City schools, we decided to work with a GEAR- UP. It is summer enrichment program for AI youth living in South Dakota. Students are between years old and grades 6 through 12 grade.

METHODS During first day of program 164 students and parents were approached about the program. 113 students were consented, given baseline, and then randomized to one of two arms: delayed-control and intervention. Monetary incentive was given to GEAR-UP to be used for student activities (e.g.. movies, theme park).

METHODS All students were given pre-tobacco survey. Intervention Arm: Students were given a card that had the website for SmokingZine, username and password. Students were encouraged to go to the website at least two times during the next six weeks.

METHODS METHODS GEAR-UP had weekly computer classes so the students were encouraged to go SmokingZine website during this time. Progress was intermittently monitored by the number of visits to website. At week 8, we delivered post-tobacco survey to all students. 94 (83%) responded to survey

METHODS At the end of week 8 cards with website, username and password were given to Control participants. At 2-months after the GEAR-UP ended, follow-up postcards were sent to all 113 students.

Intervention site  Based on successful program developed and tested in RCT in Toronto  Went through formative research to modify at SIHB with Native and nonNative colleagues

An existing web-based youth smoking prevention and cessation resource developed at University of Toronto SmokingZine Also adapted for Chinese- Canadian and middle-east Arabic youth

Percent of intervention kids who smoke once per week

Percent of intervention youth who say that they will smoke in future

Percent of intervention youth who helped another person quit

Other findings  No differences in ever smoked and in helping to prevent smoking  Youth used between 0-6 times  Now—must link use with survey data

IMPLICATIONS Smoking among American Indian youth is a public health concern. Web-based intervention is a tool that may be effective in reducing initiation. Need to get kids to use website! Must increase attention to cessation for this target population.