TY - JOUR
T1 - Distance and Transportation Barriers to Colorectal Cancer Screening in a Rural Community
AU - Lee, Katharine M.N.
AU - Hunleth, Jean
AU - Rolf, Liz
AU - Maki, Julia
AU - Lewis-Thames, Marquita
AU - Oestmann, Kevin
AU - James, Aimee S.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by NIH grant U01CA209861(PI: James) and R01CA233848 (PI: James). KMNL’s and MWLT’s time was supported by T32CA190194 (MPI: James/Colditz), Siteman Cancer Center and the Foundation for Barnes Jewish Hospital provided additional support. MWL-T was also supported by a Northwestern University Clinical and Translational Sciences Institute award (UL1TR001422), the Respiratory Health Association of Metropolitan Chicago awards (RHA2020-01), a National Institutes of Health’s National Institute on Aging (P30AG059988), and funds from the Northwestern University Center for Community Health.
Publisher Copyright:
© The Author(s) 2023.
PY - 2023/1/1
Y1 - 2023/1/1
N2 - Rural residents in underserved areas face many barriers to health services, including colonoscopies for colorectal cancer (CRC) screening, but rural healthcare providers may assist patients navigating these challenges due to familiarity with local contexts. In 2017 to 2018, we interviewed clinical practitioners and staff (n = 40) at 13 primary care and gastroenterology locations across rural Southern Illinois. We used a semi-structured interview guide that addressed system, provider, and patient levels including domains related to barriers, facilitators, and needs for intervention. This article focuses on 3 main elements related to distance and transportation that emerged from inductive coding. First, providers described long distance travel for care as normalized but not necessarily preferable. Second, they identified and described distance-related challenges specific to CRC screening, and third, providers discussed strategies, mostly related to transportation, they use to navigate those challenges. Finally, they suggested a variety of broader solutions to reduce distance and transportation barriers to screening. Overall, distance to care remains a challenge to increasing CRC screening and contributes to disparities in rural communities. To increase early detection and reduce rural cancer disparities, efforts to increase screening and follow-up must address ways to help patients and providers navigate this distance within their local communities and contexts.
AB - Rural residents in underserved areas face many barriers to health services, including colonoscopies for colorectal cancer (CRC) screening, but rural healthcare providers may assist patients navigating these challenges due to familiarity with local contexts. In 2017 to 2018, we interviewed clinical practitioners and staff (n = 40) at 13 primary care and gastroenterology locations across rural Southern Illinois. We used a semi-structured interview guide that addressed system, provider, and patient levels including domains related to barriers, facilitators, and needs for intervention. This article focuses on 3 main elements related to distance and transportation that emerged from inductive coding. First, providers described long distance travel for care as normalized but not necessarily preferable. Second, they identified and described distance-related challenges specific to CRC screening, and third, providers discussed strategies, mostly related to transportation, they use to navigate those challenges. Finally, they suggested a variety of broader solutions to reduce distance and transportation barriers to screening. Overall, distance to care remains a challenge to increasing CRC screening and contributes to disparities in rural communities. To increase early detection and reduce rural cancer disparities, efforts to increase screening and follow-up must address ways to help patients and providers navigate this distance within their local communities and contexts.
KW - cancer screening
KW - colon cancer
KW - implementation
KW - rural healthcare
UR - http://www.scopus.com/inward/record.url?scp=85145492445&partnerID=8YFLogxK
U2 - 10.1177/21501319221147126
DO - 10.1177/21501319221147126
M3 - Article
C2 - 36594346
AN - SCOPUS:85145492445
SN - 2150-1319
VL - 14
JO - Journal of Primary Care and Community Health
JF - Journal of Primary Care and Community Health
ER -