Messengers for Health is one of two recently awarded grants targeting the poor and underserved, a special category the American Cancer Society (ACS) has established.

Messengers for Health targets women of the Apsáalooke (commonly referred to as Crow) Reservation in Montana. The second grant was awarded to Gatherings of Wellness, which focuses on women of the Navajo, Pimo, Apache, Hopi, and Tohono O’Odham tribes in Arizona. Both programs aim to increase the survival rate of women in these communities by raising screening rates and increasing cancer prevention and screening knowledge.

"Women on the Apsáalooke reservation have a high incidence and death rate from cervical cancer," says Suzanne Christopher, PhD, an assistant professor at Montana State University who developed Messengers. "With appropriate screening and treatment cervical cancer is 100% treatable. Yet, rates of Pap smear screening are very low among Apsaalooke women compared to white women."

"We envision that Dr. Christopher’s findings ultimately will have a positive impact on the health of all women, not only in Butte and the state of Montana, but throughout the nation," says John Preston, vice president for the Eastern Region of the Northwest Division.

Many previous programs directed to minority communities have failed because they began without considering the communities’ unique cultural and behavioral attitudes, beliefs, lifestyle, diet, and other factors that can affect cancer risk.

With this in mind, Christopher, and Linda Larkey, PhD, who developed Gatherings, consulted extensively with each community to design the research projects.

Christopher says, "We had a huge community meeting, invited tribal elders, local organizations, and many others. We asked them what they wanted."

They said, "‘We want this to come from within us,’" Christopher explains. "‘We want to lead,’ So we invited them to come and write the grant for us," says Christopher.

Use of lay health advisors, individuals recognized as natural helpers in their communities, is another reason Christopher and Larkey believe their program will work.

This was echoed at a focus group where one of the American Indian women attending said, "There are many Indian women who are unaware and afraid to speak up or ask questions. I feel they would be more comfortable talking with another Indian woman."

In many communities lay advisors have proven to be much more effective in influencing individual and communal behavior change. This success is because they are part of the community and understand the language and beliefs. But more importantly, these lay advisors have credibility.

Most of the training of the advisors will be done orally, using stories, metaphors, life examples, and shared wisdom.

"When we held our focus groups the women told me, ‘if you say the word cancer aloud, you’re asking for it to come,’" says Christopher. "So we don’t use the word ‘cancer’. We say ‘health’ instead."

The programs draw on qualities intrinsic to the American Indian culture. This culture emphasizes spirituality, a holistic worldview, strong intergenerational bonds, and an oral tradition of handing down information.

Respecting family, community, and harmony with nature, the programs focus on women taking care of their health for the good of the whole community.