TY - JOUR
T1 - Multilevel Associations with Cancer Screening Among Women in Rural, Segregated Communities Within the Northeastern USA
T2 - a Mixed-Methods Study
AU - Moss, Jennifer L.
AU - Leach, Kelsey
AU - Stoltzfus, Kelsey C.
AU - Granzow, Marni
AU - Reiter, Paul L.
AU - Onega, Tracy
AU - Klesges, Lisa M.
AU - Ruffin, Mack T.
N1 - Publisher Copyright:
© 2021, American Association for Cancer Education.
PY - 2022/12
Y1 - 2022/12
N2 - We recruited women (primarily non-Hispanic White) from 14 rural, segregated counties in a Northeastern US state for an explanatory sequential study: 100 women (ages 50–65 years) completed a survey, and 16 women participated in focus groups. We sought to identify personal (e.g., healthcare mistrust) and environmental (e.g., travel time to healthcare providers) factors related to colorectal and cervical cancer screening. Quantitatively, 89% of participants were up-to-date for cervical screening, and 65% for colorectal screening. Factors interacted such that compounding barriers were associated with lower odds of screening (e.g., insurance status and healthcare mistrust: interaction p =.02 for cervical; interaction p =.05 for colorectal). Qualitatively, three themes emerged regarding barriers to screening: privacy concerns, logistical barriers, and lack of trust in adequacy of healthcare services. While cancer screening was common in rural, segregated counties, women who reported both environmental and personal barriers to screening had lower uptake. Future interventions to promote screening can target these barriers.
AB - We recruited women (primarily non-Hispanic White) from 14 rural, segregated counties in a Northeastern US state for an explanatory sequential study: 100 women (ages 50–65 years) completed a survey, and 16 women participated in focus groups. We sought to identify personal (e.g., healthcare mistrust) and environmental (e.g., travel time to healthcare providers) factors related to colorectal and cervical cancer screening. Quantitatively, 89% of participants were up-to-date for cervical screening, and 65% for colorectal screening. Factors interacted such that compounding barriers were associated with lower odds of screening (e.g., insurance status and healthcare mistrust: interaction p =.02 for cervical; interaction p =.05 for colorectal). Qualitatively, three themes emerged regarding barriers to screening: privacy concerns, logistical barriers, and lack of trust in adequacy of healthcare services. While cancer screening was common in rural, segregated counties, women who reported both environmental and personal barriers to screening had lower uptake. Future interventions to promote screening can target these barriers.
KW - Cancer screening
KW - Cervical cancer
KW - Colorectal cancer
KW - Racial residential segregation
KW - Rural
KW - Women’s health
UR - http://www.scopus.com/inward/record.url?scp=85121794535&partnerID=8YFLogxK
U2 - 10.1007/s13187-021-02069-0
DO - 10.1007/s13187-021-02069-0
M3 - Article
C2 - 34263433
AN - SCOPUS:85121794535
SN - 0885-8195
VL - 37
SP - 1982
EP - 1992
JO - Journal of Cancer Education
JF - Journal of Cancer Education
IS - 6
ER -