General Article
August 7, 2003

CIS aims to trim tobacco use in Alaska

Public-health veteran Andrew Tooyak carries cancer-prevention message with sensitivity into remote communities, Alaskan cultures

Andrew Tooyak speaking, last June, to Community Health Aide Practitioners and health-aide representatives from six villages at the Kodiak Regional Tobacco Conference in Kodiak, Alaska. Photo by Katherine J. Briant

By AUTHOR

By BRAD BROBERG

Because cancer knows no boundaries, neither does the Cancer Information Service (CIS). Partnered with the Alaska Native Tribal Health Consortium and the Spirit of EAGLES American Indian/Alaska Native Leadership Initiative on Cancer, CIS extends its reach all the way to the Arctic Circle — and beyond.

The Pacific Region office of CIS and the health consortium hired Andrew Tooyak, a veteran public-health worker and Alaska Native, to help them better serve the residents of nearly 200 remote Alaska communities.

Tooyak was born and raised in one of those communities — Point Hope, a whaling village of about 800 people located 150 miles above the Arctic Circle. Reachable only by airplane, communities such as Point Hope rely on a statewide corps of Community Health Aides/Practitioners (CHA/Ps) as their first point of contact for health services.

Collaborative effort

Tooyak’s mission is to help CHA/Ps obtain whatever services and information they might need from CIS and the consortium, especially as it relates to tobacco use among Alaska Natives and cancer.

“Sixteen percent of the state’s population is Alaska Native, and a large percentage of that population uses tobacco and tobacco products,” said Nancy Zbaren, project director for the Pacific Region office of CIS. “Our main focus is on tobacco education.”

Tooyak spent a week training at the CIS Pacific Region office, the National Cancer Institute-funded program operated under contract by Fred Hutchinson.

Hiring Tooyak is the latest in a series of collaborations between the CIS-partnership program and the consortium. It’s also the latest in a series of steps that CIS — known mostly for its telephone-information service — has taken to reach with cultural sensitivity into underserved populations. A regional presence enables CIS to have knowledge of the community’s needs and resources.

Not long ago, Zbaren helped steer the Alaska Native Medical Center to resources it needed. The center wanted to formalize a program called “Navigating the System” to guide Alaska Natives when they come to Seattle for cancer treatment.

Zbaren directed the medical center’s representatives to Winona Hauge, Fred Hutchinson community-outreach manager, who arranged appointments for them with key Seattle Cancer Care Alliance staff as well Dr. Lee Hartwell, president and director of the center.

Patient/physician link

Tooyak is familiar with the needs of the community-health aides because he used to be one. The community-health aide system dates to the 1940s. Originally volunteers, CHA/Ps were recruited to help combat a tuberculosis epidemic. Their primary job was to help city-based doctors make sure TB patients in remote villages took their medicine.

Since then, their training and duties have grown dramatically. Working in local clinics under long-distance supervision from licensed physicians, they now handle IVs, injections and basic suturing. In more serious cases, they provide a diagnostic link between village-dwelling patients and city-based physicians.

Tooyak spent six years as a community-health aide before becoming a telemedicine instructor for the Alaska Federal Health Care Access Network through the health consortium. In that job, he trained aides to use computers to access and exchange medical information with the regional hospital — everything from sending digital EKGs to transmitting pictures of injuries.

Tooyak said the experience prepared him well for his present role.

“That job gave me an opportunity to build a rapport with community-health aides because I must have traveled 50,000 miles through the air visiting them,” he said. “I really do enjoy providing them with cutting-edge information.”

Going the distance

As with his previous job, Tooyak is based in Anchorage but travels regularly to meet with community-health aides in their villages.

“It’s difficult for us to serve Alaska from Seattle,” Zbaren said. “The whole idea is to go to the communities. We can’t get there, but Andrew can.”

Even so, distance isn’t the only challenge CIS and the health consortium face in their quest to educate Alaska Natives about the risks of tobacco use. They also must overcome a cultural acceptance of tobacco.

“Tobacco is part of their lifestyle,” Zbaren said. “It’s not viewed as a problem.” Cessation education is key

Tooyak’s task will be to help community-health aides deliver the message about tobacco’s dangers in a culturally relevant way. Since tobacco use also is prevalent among Pacific Northwest tribes, Tooyak’s CIS training included discussions with Beverly Price, tobacco-cessation counselor for the Seattle Indian Health Board, and Teresa Guthrie, CIS/Spirit of EAGLES project manager.

“Tailoring information to meet the needs of tribal communities shows respect for their traditions and is essential to successful outreach,” Guthrie said.

Tooyak expects to adapt existing educational tools to fit his Alaska Native audience. However, he also will work with CIS and the consortium to develop brand-new tools as necessary.

“That,” Zbaren said, “is what the exciting part will be.”

Save the date for the upcoming Reducing Cancer Disparities Conference to be held Oct. 18 at Seattle’s Bell Harbor Conference Center.

Join Fred Hutchinson, CIS, Spirit of EAGLES American Indian/Alaskan Native Leadership Initiative on Cancer and the Puget Sound Affiliate of the Susan G. Komen Foundation as they partner to promote awareness of cancer disparities faced by underserved populations.

The conference will include panel presentations with representatives from diverse ethnic and racial groups as well as perspectives from cancer-health professionals, researchers and patients. For more information, call Winona Hollins-Hauge at 206-667-1246 or Carrie Nass at 206-667-5477.

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