title: Colorectal cancer prevention: Perspectives of key players from social networks in a low-income rural US region.
abstract: Social networks influence health behavior and health status. Within social networks, "key players" often influence those around them, particularly in traditionally underserved areas like the Appalachian region in the USA. From a total sample of 787 Appalachian residents, we identified and interviewed 10 key players in complex networks, asking them what comprises a key player, their role in their network and community, and ideas to overcome and increase colorectal cancer (CRC) screening. Key players emphasized their communication skills, resourcefulness, and special occupational and educational status in the community. Barriers to CRC screening included negative perceptions of the colonoscopy screening procedure, discomfort with the medical system, and misinformed perspectives on screening. Ideas to improve screening focused on increasing awareness of women's susceptibility to CRC, providing information on different screening tests, improving access, and the key role of health-care providers and key players themselves. We provide recommendations to leverage these vital community resources.
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, KY, USA; nesch@uky.edu.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.affiliation: Department of Health Behavior, University of Kentucky, Lexington, KY, USA.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Eddens
authors.affiliation: Gatton School of Business and Economics, University of Kentucky, Lexington, KY, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Jonas
authors.affiliation: Department of Behavioral Science, University of Kentucky, Lexington, KY, USA.
authors.forename: Claire
authors.initials: C
authors.lastname: Snell-Rood
authors.affiliation: Department of Health Behavior, University of Kentucky, Lexington, KY, USA.
authors.forename: Christina R
authors.initials: CR
authors.lastname: Studts
authors.affiliation: College of Medicine, The Ohio State University, Columbus, OH, USA.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Broder-Oldach
authors.affiliation: College of Public Health, The Ohio State University, Columbus, OH, USA.
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
mesh_terms: D001061:Appalachian Region; D003113:Colonoscopy / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000517:prevention & control*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006801:Humans; D007407:Interviews as Topic; D007629:Kentucky; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009820:Ohio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011203:Poverty; D012424:Rural Population / Q000706:statistics & numerical data*; D012944:Social Support
keywords: Cancer screening; colorectal cancer; health inequities; qualitative; rural; social networks