title: Community strategies to address cancer disparities in Appalachian Kentucky.
abstract: Central Appalachian residents suffer disproportionate health disparities, including an all-cancer mortality rate 17% higher than the general population. During 10 focus groups and 19 key informant interviews, 91 Appalachian residents identified cancer screening challenges and strategies. Challenges included (1) inadequate awareness of screening need, (2) insufficient access to screening, and (3) lack of privacy. Strategies included (1) witnessing/storytelling, (2) capitalizing on family history, (3) improving publicity about screening resources, (4) relying on lay health advisors, and (5) bundling preventive services. These insights shaped our community-based participatory research intervention and offered strategies to others working in Appalachia, rural locales, and other traditionally underserved communities.
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, Kentucky 40536, USA. nesch@uky.edu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.forename: Britteny M
authors.initials: BM
authors.lastname: Howell
authors.forename: Nell
authors.initials: N
authors.lastname: Fields
mesh_terms: D000328:Adult; D001061:Appalachian Region / Q000453:epidemiology; D019058:Community Networks; D055812:Community-Based Participatory Research; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control*; D011314:Preventive Health Services / Q000458:organization & administration; D036301:Qualitative Research; D019035:Rural Health Services / Q000458:organization & administration; D012424:Rural Population; D012959:Socioeconomic Factors