title: Appalachian women's perspectives on breast and cervical cancer screening.
abstract: BACKGROUND
  Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening.
  
  
  METHODS
  Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed.
  
  
  RESULTS
  Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers.
  
  
  CONCLUSIONS
  Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates.
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, Kentucky, USA. nesch@uky.edu
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.forename: Tina M
authors.initials: TM
authors.lastname: Kruger
authors.forename: Shoshana
authors.initials: S
authors.lastname: Bardach
authors.forename: Britteny M
authors.initials: BM
authors.lastname: Howell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001061:Appalachian Region; D001943:Breast Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D008875:Middle Aged; D010465:Perception; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
references.citation: Am J Prev Med. 2008 Jul;35(1 Suppl):S56-66
references.pmid: 18541188
references.citation: Med Anthropol Q. 2011 Jun;25(2):164-82
references.pmid: 21834356
references.citation: Prev Med. 2005 Nov-Dec;41(5-6):859-64
references.pmid: 16199083
references.citation: J Community Health. 2012 Apr;37(2):320-7
references.pmid: 21786205
references.citation: Prev Chronic Dis. 2007 Oct;4(4):A95
references.pmid: 17875270
references.citation: Lung Cancer. 2008 Oct;62(1):1-7
references.pmid: 18353487
references.citation: J Clin Oncol. 2005 Dec 1;23(34):8884-93
references.pmid: 16314649
references.citation: J Nutr Educ Behav. 2013 Mar;45(2):147-53
references.pmid: 22269474
references.citation: Prev Med. 2004 Mar;38(3):343-9
references.pmid: 14766118
references.citation: J Rural Health. 2004 Fall;20(4):368-73
references.pmid: 15551854
references.citation: Am J Public Health. 2003 Apr;93(4):618-23
references.pmid: 12660207
references.citation: Women Health. 2005;42(2):89-105
references.pmid: 16537302
references.citation: Am J Prev Med. 2012 Jul;43(1):97-118
references.pmid: 22704754
references.citation: Arch Intern Med. 2007 Mar 26;167(6):606-11
references.pmid: 17389293
references.citation: Nurs Outlook. 2012 Jul-Aug;60(4):172-181.e13
references.pmid: 22261002
references.citation: Qual Health Res. 2007 Jan;17(1):131-41
references.pmid: 17170251
references.citation: Genet Med. 2000 May-Jun;2(3):180-5
references.pmid: 11256663
references.citation: Fam Community Health. 2012 Jan-Mar;35(1):31-43
references.pmid: 22143486
references.citation: Cancer. 2008 Jan 1;112(1):181-92
references.pmid: 18000806
references.citation: Prev Med. 1999 Nov;29(5):355-64
references.pmid: 10564627
references.citation: Prev Med. 2010 Jan-Feb;50(1-2):74-80
references.pmid: 19744509
references.citation: Ann Fam Med. 2005 Mar-Apr;3(2):109-14
references.pmid: 15798035
references.citation: Am J Prev Med. 1999 Oct;17(3):207-10
references.pmid: 10987637
references.citation: Health Educ Res. 2003 Apr;18(2):156-70
references.pmid: 12729175
references.citation: J Community Health. 2012 Aug;37(4):804-13
references.pmid: 22101638
references.citation: Res Aging. 1995 Mar 1;17(1):89-113
references.pmid: 22058580