title: Assessing awareness and knowledge of breast and cervical cancer among Appalachian women.
abstract: BACKGROUND
  West Virginia is the only state that lies entirely within Appalachia. West Virginians tend to be poorer and more likely to lack health insurance than the general U.S. population. The purpose of this qualitative study was to 1) obtain an understanding of attitudes about breast and cervical cancer screening among women aged 25 to 64 years; 2) determine factors that motivate women to be screened for breast and cervical cancer; and 3) evaluate educational materials about breast and cervical cancer screening for use in this population.
  
  
  METHODS
  The West Virginia Breast and Cervical Cancer Screening Program (WVBCCSP) is a comprehensive public health program, funded by the Centers for Disease Control and Prevention, dedicated to removing barriers to breast and cervical cancer screening and providing screenings to underserved women aged 25 to 64 years. The program partnered with RMS Strategies, Inc, to conduct six focus groups in three communities in West Virginia. Women were recruited by telephone based on program eligibility guidelines.
  
  
  RESULTS
  Results indicated that women were concerned about health care costs and lack of health insurance. Cost, fear, and embarrassment were identified as the top barriers to breast and cervical cancer screening. Participants believed that community-based educational campaigns would increase screening and promote use of the WVBCCSP.
  
  
  CONCLUSIONS
  Understanding why low-income Appalachian women do not get screened for breast and cervical cancer and determining motivational factors that encourage screening are important to increase screening rates among this population. Breast and cervical cancer efforts that use the words, knowledge, and suggestions of the women they serve are more likely to be effective and have a larger impact.
authors.affiliation: West Virginia Department of Health and Human Resources, West Virginia Breast and Cervical Cancer Screening Program, 350 Capitol St, Room 427, Charleston, WV 25301, USA. nikkilyttle@wvdhhr.org
authors.forename: Nikki L
authors.initials: NL
authors.lastname: Lyttle
authors.forename: Kelly
authors.initials: K
authors.lastname: Stadelman
mesh_terms: D000328:Adult; D001061:Appalachian Region; D001943:Breast Neoplasms / Q000517:prevention & control / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000191:economics / Q000523:psychology; D008403:Mass Screening / Q000191:economics / Q000523:psychology; D017057:Medically Uninsured; D008875:Middle Aged; D011203:Poverty / Q000523:psychology; D012424:Rural Population; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control / Q000523:psychology*; D014626:Vaginal Smears / Q000191:economics / Q000523:psychology; D014903:West Virginia