title: Cervical cancer worry and screening among appalachian women.
abstract: Although many have sought to understand cervical cancer screening (CCS) behavior, little research has examined worry about cervical cancer and its relationship to CCS, particularly in the underserved, predominantly rural Appalachian region. Our mixed method investigation aimed to obtain a more complete and theoretically-informed understanding of the role of cancer worry in CCS among Appalachian women, using the Self-Regulation Model (SRM). Our quantitative analysis indicated that the perception of being at higher risk of cervical cancer and having greater distress about cancer were both associated with greater worry about cancer. In our qualitative analysis, we found that, consistent with the SRM, negative affect had a largely concrete-experiential component, with many women having first-hand experience of the physical consequences of cervical cancer. Based on the results of this manuscript, we describe a number of approaches to lessen the fear associated with CCS. Intervention in this elevated risk community is merited and may focus on decreasing feelings of worry about cervical cancer and increasing communication of objective risk and need for screening. From a policy perspective, increasing the quantity and quality of care may also improve CCS rates and decrease the burden of cancer in Appalachia.
authors.affiliation: Department of Pharmaceutical Systems and Policy, School of Pharmacy, Mary Babb Randolph Cancer Center, Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9510, Morgantown, WV, 26506, USA, kmkelly@hsc.wvu.edu.
authors.forename: Kimberly M
authors.initials: KM
authors.lastname: Kelly
authors.forename: Nancy
authors.initials: N
authors.lastname: Schoenberg
authors.forename: Tomorrow D
authors.initials: TD
authors.lastname: Wilson
authors.forename: Elvonna
authors.initials: E
authors.lastname: Atkins
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dickinson
authors.forename: Electra
authors.initials: E
authors.lastname: Paskett
mesh_terms: D000328:Adult; D001061:Appalachian Region; D055088:Early Detection of Cancer / Q000523:psychology* / Q000706:statistics & numerical data; D005069:Evaluation Studies as Topic; D005260:Female; D006306:Health Surveys; D006801:Humans; D007348:Insurance, Health / Q000145:classification* / Q000191:economics / Q000706:statistics & numerical data; D017533:Marital Status; D008499:Medical Records / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D008875:Middle Aged; D036301:Qualitative Research; D012044:Regression Analysis; D012068:Religion and Medicine; D012423:Rural Health; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000517:prevention & control / Q000523:psychology*; D055815:Young Adult