title: Patient and provider perspectives on the relationship between multiple morbidity management and disease prevention.
abstract: Despite competing demands of multiple morbidity (MM) management and disease prevention, our recent survey of 1,153 Appalachian residents aged 50 to 76 documented that individuals with MM were more likely to obtain colorectal cancer screening (CRCS) than those without MM. Nearly two thirds of respondents obtained CRCS, and the more MM, the greater the likelihood of screening. To gain insight into this relationship, we conducted nine focus groups, six with providers and three with patients. Three main explanations emerged: (a) patients' MM increases providers' vigilance for other health vulnerabilities; (b) having MM increases patients' own vigilance; and (c) patients' vigilance may stem from experiencing more symptoms, having a family history of cancer, and having successfully obtained health care. More frequent contact with health care providers appears to encourage preventive referral, especially in low-income populations that otherwise may not receive such counselling. We highlight participant recommendations to improve MM management and prevention.
authors.affiliation: University of Kentucky, Lexington, USA nesch@uky.edu.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.affiliation: Georgia Southern University, Statesboro, USA.
authors.forename: Yelena N
authors.initials: YN
authors.lastname: Tarasenko
authors.affiliation: University of Kentucky, Lexington, USA.
authors.forename: Shoshana H
authors.initials: SH
authors.lastname: Bardach
authors.affiliation: University of Kentucky, Lexington, USA.
authors.forename: Steven T
authors.initials: ST
authors.lastname: Fleming
mesh_terms: D000328:Adult; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis; D015897:Comorbidity; D055088:Early Detection of Cancer; D005260:Female; D017144:Focus Groups; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D010361:Patients / Q000523:psychology; D010820:Physicians / Q000523:psychology; D011315:Preventive Medicine; D055815:Young Adult
keywords: aging; chronic disease; health disparities; multiple morbidity; rural health