Community programs for cancer control: the three tribes program.

In 1989, data collected for years 1950-1988 showed that the cancer related death rate for American Indians was much higher than the rate as compared to the white population. Specific data focused on lung, breast and cervical cancer. A model intervention program was implemented in the Three Affiliated Tribes (Mandan, Hidatsa, and Arikara) community in northwestern North Dakota. The model accomplishes community education through outreach strategies that include the media, community role models, care providers, and a volunteer network. Documentation and evaluation of the project show important changes in attitudes, knowledge, and awareness about cancer and wellness behaviors.