1
Q
STAGES OF PREVENTION: PRIMORDIAL
A
- In this section, you will focus on primordial prevention. Recall the disease progression pathway from the last section. Targets for prevention strategies at the primordial level occur before disease and even risk factors are present. This section will focus on relevant theories and strategies for effective primordial prevention, and more broadly health promotion. Section 03 will focus on the remaining types of prevention.
- Primordial Prevention aims to prevent the development of risk factors of diseases by targeting the underlying environmental and social conditions that might promote them
2
Q
HEALTH PROMOTION
A
Primordial prevention is often considered synonymous with health promotion; however, by strict definitions, that is not entirely accurate. Primordial prevention consists of risk factor prevention/reduction through social and environmental changes for the entire population. These changes tend to be accomplished through policy and law changes. In addition to the aforementioned, health promotion helps individuals increase their control over their health, by promoting skill development and healthy habits. Thus, health promotion is a comprehensive approach to helping people obtain their maximum achievable health status.
3
Q
Learn the two main approaches to effective health promotion.
A
- IDENTIFICATION RISK
- Identification of individuals susceptible to a risk factor and intervening to reduce the development of that risk is one effective approach to health promotion. For example, you can prevent the likelihood of children developing smoking habits by advising parents to quit smoking and providing the parents with smoking cessation programs. - REDUCED AVERAGE RISK
- Reducing the average risk level for the whole population is another effective approach to health promotion, which can be accomplished through legislative and/or public policy changes. For example, consider a policy that mandates companies to display nutritional facts on all food products. This would allow individuals to see nutritional value of products and may make them less likely to purchase unhealthy products.
4
Q
THE OTTAWA CHARTER OF HEALTH PROMOTION
A
- The First International Conference on Health Promotion was held in Ottawa, Canada in 1986. During this conference, The Ottawa Charter of Health Promotion was developed. The charter called for several important actions to facilitate health promotion, which included to:
- Build healthy public policy,
- Create supportive environments,
- Strengthen community actions,
- Develop personal skills, and
- Reorient health services.
The charter highlights the importance of advocacy through all stages of health promotion. The action framework outlined in the charter continues to guide the discipline of health promotion today
5
Q
Read an excerpt from the Ottawa Charter of Health Promotion.
A
“Health promotion is the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental, and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being.”
6
Q
HEALTH PROMOTION AND THE SOCIAL DETERMINANTS OF HEALTH
A
Health promotion at the individual and population levels targets the behaviours, environmental conditions, social conditions, and any other factors that could lead to the development of risk factors. These factors are often grouped into three categories: environmental factors, social factors, and other factors. In each of these categories you will see numerous examples listed. Notice that the majority of these examples are, in effect, the Social Determinants of Health (S D H).
7
Q
Read various examples from each of the three categories of factors.
A
EXAMPLES OF ENVIRONMENTAL FACTORS
* Occupation
* Housing/living conditions
* School or work environment
EXAMPLES OF SOCIAL FACTORS
* Education
* Family
* Social Economic Status (S E S)
* War/conflict
* Culture
* Race/racism
EXAMPLES OF OTHER FACTORS
* Internal/external factors that affect health
* Healthy/unhealthy behaviours
* Availability of quality health services
8
Q
THE NEED FOR BEHAVIOUR CHANGE
A
- The S D Hs collectively have an impact on one’s health. However, the healthy behaviours one chooses to engage in are arguably the most significant factors in determining an individual’s health. The behaviours we choose to engage in also happen to be the most easily modifiable S D H, as the remaining ones we are either born into, or they are beyond our immediate control.
- Given that personal health behaviours are a critical aspect of one’s health, modifying such behaviours (tobacco use, diet, physical activity, risky sexual practices) is a large and effective component of health promotion. Yet, behaviour change tends to be a difficult aspect of health promotion as there is often be disconnect between knowledge and behaviour.
9
Q
BARRIERS TO CHANGING HEALTH BEHAVIOURS
A
- There are numerous barriers to health behaviour change, and every individual may encounter different barriers. These barriers may be grouped into the levels of the Social Ecological Model (SEM).
- The barriers that are associated with each of the four socio-ecological levels.
10
Q
INTRAPERSONAL
A
Intrapersonal barriers are mostly situated within the control of an individual. Some of the factors related to this level include knowledge, attitudes, skills, self-efficacy, motivation, age, and socioeconomic status.
11
Q
Examples of Barriers - intrapersonal
A
- Lack of knowledge about safe sexual practices, dental hygiene, etc.
- Flawed risk perception of unhealthy eating, drinking habits, bad sleeping habits, etc.
- Perception of lack of control over certain aspects of their health (e.g. depressive thoughts, etc).
- Cost (time or money) of switching to healthy foods, joining a gym, getting proper medical advice, etc.
12
Q
INTERPERSONAL
A
Barriers at the interpersonal level involve social relationships, including those with friends, family, peers, partners, and coworkers. Any one of these relationships may influence an individual’s behaviour positively or negatively.
13
Q
Examples of Barriers - interpersonal
A
- Lack of connection and social integration with peers at school.
- Unsupportive family or peer environment.
- Lack of agreeableness within the physician-patient relationship.
- Social norms within peer group that promote negative behaviours such as smoking.
14
Q
COMMUNITY/INSTITUTION
A
Thecommunity/institution level includes the social and physical environments and settings individuals engage with daily, including schools, workplaces, neighbourhoods, and healthcare facilities. This level encompasses social and gender norms, a sense of empowerment within the community, and the policies that influence the social environment of schools and workplaces.
15
Q
Examples of Barriers - community/institiution
A
- Lack of economic and housing opportunities.
- Inflexible work environment.
- Lack of healthy food options at school.
- Inaccessible parks and other recreational areas.
16
Q
PUBLIC POLICY
A
The public policy level involves the broad, structural factors such as local, state, and federal policies, that may either enable or hinder an individual’s ability to take control over their health.
17
Q
exmaples of barriers - public policy
A
- Unfair trade and labour laws that increase prices and access to care products and services.
- Lack of funding to the healthcare system and other social services.
- Punitive drug policies.
- Lack of a comprehensive health curriculum at school.
18
Q
Social Ecological Model (S E M)
A
A theory-based framework for understanding the multifaceted and interactive effects of personal and environmental factors that determine behaviours
19
Q
MODELS OF BEHAVIOURAL CHANGE
A
Models of behavioural change provide guidance about how to overcome barriers to health behaviour change. You just learned about the Social Ecological Model, which provides a comprehensive approach to addressing the different levels of barriers.
20
Q
Two additional models that explain the process of effective health behaviour change.
A
- Health Belief Model (H B M)
- the Transtheoretical Model (T T M) of health behaviour change
21
Q
THE HEALTH BELIEF MODEL
A
The Health Belief Model (H B M) is one of the best known and most widely used theories of health behaviour change. It was first developed by a group of social psychologists in the 1950s, who were trying to understand the widespread failure of tuberculosis screening programs
22
Q
Health Belief Model (H B M)
A
The Health Belief Model is a social psychological model developed to both predict and explain health behaviours. The model suggests that an individual’s beliefs about various facets of a potential health problem or disease can impact and explain their health related behaviours
23
Q
THE HEALTH BELIEF MODEL BREAK DOWN
A
24
Q
Perceived Seriousness
A
A person’s subjective perception of a disease or illness, including the medical and social consequences. This includes considerations such as if the condition is life threatening, the social stigma associated with the condition, and if it restricts daily activities or drastically impacts quality of life. For example, how does a person perceive diseases associated with a lack of exercise?
25
Perceived Susceptibility
A person’s subjective perception of their risk of acquiring a disease or illness.
This might depend on factors such as their family history, genetics, and cultural views.
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Perceived Benefits
A person’s perception of the effectiveness of a behaviour in reducing the risk of disease. A possible benefit for increasing exercise would be better energy levels and reduced disease risk
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Perceived Barriers
A person’s perception of the obstacles to adopting a healthy behaviour, which are weighed against the benefits. For exercises, barriers could be that it is time-consuming and the financial cost of a gym membership.
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Self-Efficacy
The level of a person’s confidence in their ability to successfully carry out a health behaviour change.
This may look like a person’s confidence in their ability to sustain consistent exercise, maintain weight loss, or their ability to stay in a smoking cessation program.
29
Cues to Action
- The specific triggers, both external and internal, needed to prompt the decision-making process to engage in a specific health behaviour change.
- Some cues to action could be the pre-existence of a health condition, physician recommendations, or the illness of a family member
30
THE TRANSTHEORETICAL MODEL OF HEALTH BEHAVIOUR CHANG
- Another very common theory of behavioural change is the Transtheoretical Model (T T M), or the “Stages of Change” Model. This model outlines the process of intentional behaviour change.
- Understanding this process can facilitate the development of successful interventions. The T T M posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and relapse.
31
Transtheoretical Model (T T M)
The Transtheoretical Model is a biopsychosocial model to conceptualize the process of intentional behaviour change, allowing for the to development of successful interventions
32
THE TRANSTHEORETICAL MODEL
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PRECONTEMPLATION
- Individuals in this stage are unaware of the need to change. They are often uninformed about the consequences of their behaviour.
Example: A smoker who has never thought of quitting and never thought about the harmful
effects of smoking.
34
CONTEMPLATION
This is the ‘getting ready’ stage. Individuals in this stage are often ambivalent or ‘behavioural procrastinators’.
Example: A smoker is thinking about the health hazards of smoking and is considering quitting,
but has not yet made any plans and is in no hurry to do so
35
PREPARATION
Individuals in the preparation stage have motivation and a plan of action. Some steps have been taken to change their behaviour.
Example: A smoker may set a quit date and ask family and friends to help hold them accountable.
36
ACTION
In this stage, individuals are actively trying to modify their lifestyle and want to succeed.
Example: A person is actively participating in a smoking cessation program, and constantly
modifying their behaviour based on the program’s best practices.
37
MAINTENANCE
In this stage, individuals have sustained their behaviour change for at least six months and work towards preventing relapses to previous stages.
Example: A person is no longer smoking and is actively engaging in behaviours to prevent relapse, such as replacing smoking with exercise, which gives them similar feelings of satisfaction.
38
RELAPSE
Individuals in this stage have abandoned the idea of changing due to difficulty in maintaining their new behaviour. Health care workers may encourage the individual to try again and re-enter the contemplation stage.
Example: A person begins smoking again.
39
Ambivalent
Having mixed feelings or contradictory ideas about something or someone
40
STAGES OF CHANGE
The first individual is in the precontemplation stage as they have not identified a problem with their sleeping habits. The second individual is in the preparation stage as they are motivated and have started making steps towards their weight loss goal. The third individual is in the contemplation stage. The fourth individual has relapsed as they have stopped their healthy behaviour. The fifth individual is in the contemplation and preparation stage as they have looked into making a change to their diet, but have not made any concrete changes. The final individual is in the maintenance stage as they have effectively changed their behaviour
41
HEALTH PROMOTION
Now that you understand that health behaviour change is an important part of effective health promotion, you will learn about the three different levels at which health promotion efforts are carried out. These include the individual level, the peer or group level, and the population level
42
HEALTH PROMOTION: INDIVIDUAL LEVEL
Individual level health promotion happens through one-on-one interactions, and is suitable when there is a lot of individualized information and knowledge to be transferred. One-on-one interactions provide an opportunity for personal clarification and adaptation, however, individual level health promotion can be labour intensive and costly.
43
INDIVIDUAL LEVEL HEALTH PROMOTION EFFORTS
Teaching individuals about the proper use of condoms; both how to use them and why it is important.
Discussing strategies for smoking cessation.
Optimizing the patient-provider relationship to allow for supportive and productive interaction
44
HEALTH PROMOTION: PEER OR GROUP LEVEL
Health promotion at the peer or group level can include small groups, institutions, or entire communities, and can occur in many spaces, such as classrooms, theatre groups, or even on field trips. This level of health promotion is suitable when social interaction is helpful and may be a more efficient method to transfer information because one individual can teach or lead a large group of people.
45
PEER OR GROUP LEVEL HEALTH PROMOTION EFFORTS
- Prenatal classes which educate and prepare new parents.
- Sports activities and recreational programs which motivate you to exercise with others.
- Strategies to enhance sense of belonging, like community walking groups, community garden program, etc.
- Creating safer and more inclusive workplaces. For example, creating breastfeeding friendly workplaces
46
HEALTH PROMOTION: POPULATION LEVEL
There are two main types of health promotion at the population level, which include legislation and policy, and social marketing.
47
Legislation, Regulation, and Policy
Legislative, regulatory, and policy based promotion is effective but often an overlooked approach as it requires political will and public support. This type of promotion helps change environments and sets the community standard for behaviour. Since individuals are forced to change, this can cause a massive shift in attitude and behaviour.
48
Legislative, Regulatory and Policy Health Promotion Efforts:
- Public policy changes that promote healthy behaviours and deter negative behaviours, like a policy that bans junk food and mandates regular daily physical activity in school.
- Fiscal measures that reward healthy behaviours and punish negative behaviours, such as a gym tax credit or taxation on cigarettes and other tobacco products.
- Changes to legislation, like smoking by-laws that diminish negative health behaviours
49
Social Marketing
Social marketing health promotion relies on ‘selling’ health like businesses that sell products. This approach to health promotion leverages a target niche market. Often this approach can influence acceptability of social norms and attitudes.
50
Social Marketing Health Promotion Efforts:
- Mass communication in the form of ads on any form of media or social media, such as television ads marketing the benefits of influenza vaccinations.
- A catchy ad, slogan, logo, or picture which can change perceptions of a behaviour, like the Body Break commercials.
- Using “product placement” in shows and movies to enhance health promotion, for example showing the use of condoms.
51
NEED FOR INDIGENOUS VOICES IN HEALTH PROMOTION STRATEGIES
- As you have learned in previous modules, many Indigenous communities are disproportionately affected by health related issues compared to non-Indigenous populations. As Canada moves forward with answering the Calls to Action from the Truth & Reconciliation Commission of Canada (T R C), a space needs to be created for Indigenous voices to be heard when developing Indigenous health promotion strategies.
- When Indigenous voices are not heard, colonial health promotion strategies are left unchecked and can result in the continuous and damaging perpetuation of neocolonialism. There is a clear need to view Indigenous health promotion through an Indigenous lens, in the effort to create a more equitable society.
52
Researcher Perspectives
Many Indigenous health researchers and practitioners do not come from an Indigenous background, or do not identify as Indigenous. This can be problematic and oftentimes results in a contradiction between the Indigenous community’s priorities and common goals and researcher’s perspectives in how they identify and address these issues.
53
Intervention Evaluation
There is an evident lack of research on evaluating the effectiveness of health promotion interventions for Indigenous Peoples. Even when research is conducted, program effectiveness is regularly measured based on westernized individualistic evaluation methods that do not align with Indigenous holistic community measures. Thus, these evaluations are misaligned with Indigenous health indicators and lack validity
54
Neocolonialism
The process of using economic influences, cultural imperialism, and aids to influence another country, territory, or foreign land
55
COMBINING TRADITIONAL AND WESTERN MEDICINE
Another effective health promotion strategy is to blend Traditional and Western medicine perspectives in clinical care. One example of a medical centre that does this is the B C Cancer - Prince George Centre for the North. The centre provides comprehensive cancer care and support programs for B C residents in partnership with the regional health authorities
56
BC CANCER PRINCE GEORGE CENTRE FOR THE NORTH
The BC Cancer - Prince George Centre for the North has taken on various initiatives that are aimed at improving the healthcare and health experiences of Indigenous Peoples. At the forefront, they have enabled all people living in the North to receive treatment closer to home and also provide telehealth services. Receiving treatment at or close to home is important to the many Indigenous communities in Northern B C. In addition to this, they have implemented several other significant strategies in order to combine Western and Traditional medicines.
Learn the strategies utilized to promote and support Indigenous culture in healthcare.
57
ABORIGINAL CARE COORDINATOR
As part of their healthcare team, they have an Aboriginal Care Coordinator that aids in fostering a trusting dynamic and helps facilitate treatment from an Indigenous perspective.
58
HEALING GARDEN
In consultation with Indigenous stakeholders from the area, they have created a healing garden with Indigenous plants of the north, known for their healing properties. In the healing garden they have also constructed a smudging pavilion to promote and support Indigenous ceremonial healing practices.
59
Smudging
A ceremonial practice usually involving prayer and the burning of sacred plants (e.g.,sweetgrass, cedar, sage, tobacco) that are known for their healing and/or purification properties
60
AMPLIFYING INDIGENOUS VOICES IN HEALTH PROMOTION
- Indigenous health promotion should take a more holistic and community-based approach. To be able to align with the needs and goals of Indigenous communities, researchers must genuinely collaborate with, and work alongside chiefs, elders, and leaders.
- By creating a safe space for Indigenous voices to be heard, health promotion strategies can be developed that reflect Indigenous cultures, values, and traditional knowledge.
61
PROTECTIVE FACTORS
* Self-government
* Land control
* Control over cultural activities
62
PREVENTION
* Community based approaches
* Gatekeeper training
* Peer support groups
63
SPIRITUALITY
* Using Indigenous concepts of well-being and spiritual practices: pow-wows, sweetgrass ceremonies, and sweat lodges.
64
Gatekeeper Training
The training of individuals within a community to be able to recognize persons at risk of suicide and provide appropriate assistance
65
Pow-wow
A celebration to showcase Indigenous dances, regalia, crafts, food, and culture as a whole. Pow-wows are often a time to visit friends and family, welcome newcomers, celebrate Indigenous cultural heritage, and provide an opportunity for cross-cultural sharing.
66
Sweetgrass ceremonies
Sweetgrass is commonly burned as an incense for daily prayers and during many community events. To many Indigenous communities sweetgrass is a sacred plant that has purification and healing powers and thus, is used in many religious ceremonies.
67
Sweat lodges
A sweat lodge is a dome shaped inclosed structure where inside water is poured over hot stones to create intense heat. They are used in many purification ceremonies as well as for healthy living
68
INDIGENOUS HEALTH PROMOTION: SUICIDE PREVENTION
- The suicide rate among the Indigenous populations is higher than the non-Indigenous population. In some instances, health promotion strategies have unfortunately fallen short due to their lack of an Indigenous perspective.
- Although these issues can be difficult to navigate and digest, solutions include empowering Indigenous Peoples and allowing for their voices to be heard
69
SUCCESSFUL PROGRAMS
Successful programs focus on community and family connectedness, community empowerment, and Indigenous cultural affinity. Programs developed with these components in mind have proven to be effective in lowering rates of suicide. An example of a community-based approach to treat substance-abuse issues would involve community healers utilizing spiritual practices, dances, and ceremonies. In many Indigenous communities culture is viewed as treatment and it is understood that all healing is spiritual
70
UNSUCCESSFUL PROGRAMS
There have been cases where westernized suicide prevention programs and strategies have failed in Indigenous communities. As the programs lacked Indigenous perspective, they created incongruences in culture and resulted in the further disruption of Indigenous communities. In some situations, the implementation of these suicide prevention programs has actually resulted in higher rates of suicide
71
HEALTH PROMOTION IN PRACTICE
As a whole, health promotion focuses on encouraging people to improve their health in one of two ways; by either increasing their frequency of healthy behaviours, or by reducing or eliminating their unhealthy behaviours
72
INCREASING FREQUENCY OF HEALTHY BEHAVIOURS
- One practice focuses on increasing the frequency of healthy behaviours by identifying healthy behaviours and implementing programs to make these behaviours easier to achieve.
- OMama is an example of an intervention that increases the frequency of healthy behaviours during pregnancy. It is a smartphone application that aids mothers in tracking important pregnancy information and following evidence-based health recommendations. Evidence suggests that health events occurring in utero and in early life can have a major impact on the future long-term health of an individual.
73
OMama
An application created by the The MotHERS ProgramTM dedicated to improving maternal health through education, research, and screening
74
OMAMA: SUPPORTING PREGNANCY, BIRTH, & EARLY PARENTING
View the health information OMama provides that encourages healthy behaviours before, during, and after pregnancy.
75
OMama: pregnancy, labour & birth, post-partum, newborn
- Pregnancy: Throughout pregnancy, OMama provides supporting information on healthy living, healthy environments, folic acid supplements, immunizations, complementary therapies, prenatal care and classes, and Group B Streptococcus (GBS) screening.
- Labour & Birth: OMama provides information on newborn complications, signs of labour, variations of labour and birth, skin to skin contact, and breastfeeding.
- Post-Partum: OMama provides information on postpartum complications, postpartum recovery, and breastfeeding.
- Newborn: OMama provides information on birth registration, newborn immunizations, mental health supports, and caring for a newborn
76
REDUCING/ELIMINATING UNHEALTHY BEHAVIOURS
In addition to encouraging healthy behaviours, health promotion focuses on empowering the population to identify and reduce behaviours that are detrimental to a healthy lifestyle, and designing interventions which will effectively alter those behaviours. However, it is often not enough to simply suggest replacing an unhealthy behaviour with a healthy behaviour - effective health promotion relies on interventions which help individuals replace these unhealthy behaviours in a sustainable way. The best health promotion is accessible to all, and leads to long-term changes for the target population
77
SMOKING CESSATION INTERVENTIONS
- Smoking cessation programs are an example of promoting health through the elimination and replacement of an unhealthy behaviour. One such program, Unsmoke, is an initiative set by the Canadian government that aims to reduce tobacco use in Canada to only 5% of the population by 2035. The initiative provides important information on the benefits of quitting, tips for quitting, and how to support a loved one trying to quit.
- Learn several smoking cessation interventions provided by the program to aid in the elimination of unhealthy behaviours. Combining cessation interventions usually increases a smokers chance of successfully quitting
78
smoking cessation interventions
COLD TURKEY
Quitting cold turkey means choosing a specific date to quit and stopping with no formal assistance or supports.
WEANING
Weaning involves gradually reducing the amount of tobacco consumed per day or week until eventually quitting completely.
THERAPY & SUPPORT GROUPS
Therapy and support groups involve seeking support from a professional therapist or support group that will help a person quit.
MEDICAL TREATMENT
Medical treatment involves nicotine replacement products or prescription medications that work by decreasing the pleasure, craving, and withdrawal symptoms associated with smoking.
79
HEALTH PROMOTION: INDIGENOUS CONSIDERATIONS
In 2016, a report released by the Chiefs of Ontario and Cancer Care Ontario found a significantly higher prevalence of smoking in the First Nations population in comparison to the non-Indigneous population in Ontario. As smoking is one of the most significant modifiable risk factors for cancer, this behaviour has become a large focus for health promotion in Ontario. However, this health promotion focus is at odds with the traditional or spiritual use of tobacco for medicinal and ceremonial practices that are common in many Indigenous communities.
80
traditional roles tobacco has in First Nations, Métis, and Inuit
FIRST NATIONS
First Nations have traditionally used tobacco for prayer, purifying the body and mind, providing spiritual strength, guidance, and as a symbol of respect in First Nations gatherings. However, most practices do not involve directly inhaling tobacco smoke (e.g. holding burning tobacco in left hand as an offering to the Creator).
MÉTIS
Métis use of tobacco has historically been influenced by First Nations as a medicinal plant and for social uses. Early Métis were known for being voyageurs, and during long canoe journeys they would stop frequently for rest and to pipe. Eventually, this way of life became so important they would measure their distance travelled by the number of pipes smoked.
INUIT
From a traditional perspective, Inuit typically do not use tobacco for ceremonial or other practices because tobacco could not grow in the colder climate of their traditional land.
81
BECOMING TOBACCO-WISE
- In 2009, the Chiefs of Ontario passed a resolution for First Nations to become tobacco-free. It is important to differentiate that this resolution was only related to non-traditional commercial use of tobacco.
- The role tobacco has an important traditional and ceremonial role in many Indigenous cultures, which must be considered when developing health promotional strategies for limiting tobacco use. Such strategies must be modified to be mindful of and culturally responsive to Indigenous ways of knowing and living.
- Currently, there is an initiative promoting and encouraging Indigenous communities to become Tobacco-Wise by continuing traditional tobacco practices and eliminating commercial tobacco use.
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Culturally Responsive
Culturally responsiveness is the ability to learn from and relate respectfully with individuals from different cultures
83
tobacco-wise
Understanding the difference between commercial and traditional tobacco use and developing skills and strategies to make healthy choices for yourself and others in your community
84
THE SACRED SMOKE PROGRAM
The Sacred Smoke Program was an initiative that was developed to support and promote being Tobacco-Wise in two communities: Batchewana First Nation and Garden River First Nation. The program was based on traditional Anishinaabe practices and shares smoking cessation information in a culturally responsive manner. This cessation program involved both western medicine nicotine replacement therapies and support groups in conjunction with traditional Anishinaabe medicines and cultural resources.
85
culturally responsive smoking cessation strategies used in the Sacred Smoke Program
ELDERS
Led by elders, participants were shown how to make kinikinik (traditional tobacco) and taught traditional methods of smoking cessation such as tobacco offerings, quitting on a new moon, and selecting traditional medicines.
COPING STRATEGIES
Participants were shown how to incorporate adaptive coping strategies into their daily routines to help distract from cravings and avoid relapse. Some of the strategies included exercise, drumming, crafts, and cultural ceremonies
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Batchewana First Nation
The Batchewana First Nation is composed of four reserve communities and has a population of 2,400 people. This community is located near Sault Ste. Marie, Ontario.
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Garden River First Nation
The Garden River First Nation lies between Sault Ste. Marie and Echo Bay, just north of the Canadain US border. The name of this Nation comes from the time of the fur trade as people in this area were known for their vegetable growing along the route voyagers followed
GLPH 271
flashcards
Decks in class (25)
# Cards
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Module 1 Section 128
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Module 1 Section 221
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Module 1 Section 317
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Module 2 Section 111
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Module 2 Section 214
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Module 2 Section 313
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Module 2 Section 46
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Module 2 Section 56
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Module 2 Section 69
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Module 3 Section 122
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Module 3 Section 251
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Module 3 Section 334
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Module 3 Section 428
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Module 3 Section 515
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Module 4 Section 110
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Module 4 Section 29
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Module 4 Section 350
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Module 4 Section 437
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Module 5 Section 113
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Module 5 Section 287
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Module 5 Section 311
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Module 5 Section 416
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Module 6 Section 134
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Module 6 Section 251
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Module 6 Section 331
