Subsistence use of natural resources, including the subsistence harvesting of shellfish, is central to Native cultures throughout Alaska. Shellfish harvesting appears as a motif in form line artwork and is a part of the traditional food ways taught by the tribes of Southeast Alaska to their youth. Saxitoxin, a toxin detected in Southeast Alaska that causes paralytic shellfish poisoning (PSP), was named after the butter clam (Saxidomus gigantea), which is a traditional food staple. The culturally central consumption of non-commercial shellfish puts Alaska Native communities at elevated risk for PSP. A population-based survey in two communities in coastal Alaska found that 20% of Alaska Natives in their sample reported a history of PSP.~The Theory of Planned Behavior is a behavioral science framework that has been applied in numerous public health settings to understand why people pursue specific actions. The Theory of Planned Behavior has been applied to children's health and to poisoning prevention/ environmental health, but as far as the investigators are aware this is the first pediatric poisoning prevention application of this framework. The project's K12 programming has been developed with this framework in mind. For the middle school research program (this clinical trial), the investigators aim to measure the relevant constructs for a theory-based investigation into children's poisoning-related risk behaviors in a context that affirms safe practice of cultural traditions.
The purpose of this tribally co-led community-based participatory research in partnership with Sitka Tribe of Alaska is to help prevent Paralytic Shellfish Poisoning (PSP) in children of Southeast Alaska. The investigators assess whether an education intervention leads to changes in participants' planned behaviors related to clam harvesting that may reduce risks of exposure to shellfish toxins. This project includes both a human subjects research component (this clinical trial) and a non-human environmental research component. In the non-human component, the tribe is monitoring for toxins in shellfish (including shellfish provided by people with data originally collected as a non-research service), and testing water for the presence of algae that make the toxin. The human subjects component involves age-appropriate K12 educational outreach in partnership with the Sitka School District, and a middle school after-school non-credit educational program coupled to a research program. Middle school students participating in the program will attend an after-school program with several units designed to teach cultural practices, strengthen competencies toward Alaska science state standards, and evaluate shellfish consumption-related risk behaviors, while affirming traditional culture.