Abstract
American Indians (AIs) experience continued disparities in incidence, mortality, and survival on cancers responsive to early screening in the USA. In New Mexico, AIs compared with other racial/ethnic populations are substantially less likely to adhere to recommended screening guidelines. Our study focuses on increasing cancer awareness using culturally, linguistically, and health literacy appropriate informational materials. We conducted 10 focus groups between June and December 2021 using non-probability purposive sampling methods in the Zuni Pueblo in rural New Mexico. We established a nine-member Tribal Advisory Panel (TAP) that included representation from tribal organizations, healthcare providers, and Zuni Pueblo leadership. We recruited TAP and other tribal members for the focus groups. The focus group questions inquired about cultural and traditional tailoring of the informational materials, specifically in terms of conveying traditional health beliefs, graphic layout, and native artwork. Focus group participants recommended designing Zuni-specific informational materials incorporating vignettes by Zuni Tribal leaders, using Zuni terms, photographs, artwork, and resources. Perspectives elicited during the focus groups informed the adaptation and development of the informational materials designed to raise awareness about cancers of the breast, colon-rectum, and cervix. These materials convey information about the cancers, their risk factors, screening options, and informational resources. The new informational materials form integral components of multi-level, multi-component interventions designed to enhance cancer screening uptake through heightened awareness about the benefits of guideline-concordant cancer screening. Designing informational materials with Zuni-specific cultural, linguistic, and tribal representation should enhance participation of Zuni Tribal members in cancer control educational interventions.