Identifying Communication Barriers to Colorectal Cancer Screening Adherence Among Appalachian Kentuckians

Overview

Journal Health Commun

Specialty Health Services

Date 2017 Aug 19

PMID 28820641

Citations 6

Authors

Audrey Smith Bachman

Elisia L Cohen

Tom Collins

Jennifer Hatcher

Richard Crosby

Robin C Vanderpool

Affiliations

Soon will be listed here.

Abstract

Utilizing data from 40 in-depth interviews, this article identifies both barriers and facilitators to colorectal screening guideline adherence among Appalachian Kentucky adults recruited through a community-based research network. Key findings identify (a) varying levels of knowledge about screening guidelines, (b) reticence to engage in screening processes, and (c) nuanced communication with healthcare providers and family members regarding screening adherence. What participants knew about the screening process was often derived from personal stories or recalled stories from family members about their screening experiences. Reticence to engage in screening processes reflected reports of cumbersome preparation, privacy issues, embarrassment, medical mistrust, fear of receiving a cancer diagnosis, and lack of symptoms. Participants cited many ways to enhance patient-centered communication, and the findings from this study have implications for health communication message design and communication strategies for healthcare practices in Appalachian Kentucky clinics.

Citing Articles

Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science (ACCSIS) in Appalachia: protocol for a group randomized, delayed intervention trial.

Paskett E, Kruse-Diehr A, Oliveri J, Vanderpool R, Gray D, Pennell M Transl Behav Med. 2023; 13(10):748-756.

PMID: 37202831 PMC: 10538475. DOI: 10.1093/tbm/ibad017.

Adapting a Research and Community Capacity-Building Program to Address Rural Cancer Burden and Facilitate Partnership Development Between Rural Community Stakeholders and an Urban Comprehensive Cancer Center.

Lewis-Thames M, Leahy N, Kruse-Diehr A, Ackermann N, Maki J, Davis K J Cancer Educ. 2023; 38(4):1245-1255.

PMID: 36595213 PMC: 10315419. DOI: 10.1007/s13187-022-02256-7.

Development of a multilevel intervention to increase colorectal cancer screening in Appalachia.

Kruse-Diehr A, Oliveri J, Vanderpool R, Katz M, Reiter P, Gray 2nd D Implement Sci Commun. 2021; 2(1):51.

PMID: 34011410 PMC: 8136225. DOI: 10.1186/s43058-021-00151-8.

A Multilevel Approach to Understand the Context and Potential Solutions for Low Colorectal Cancer (CRC) Screening Rates in Rural Appalachia Clinics.

Zoellner J, Porter K, Thatcher E, Kennedy E, Werth Jr J, Grossman B J Rural Health. 2020; 37(3):585-601.

PMID: 33026682 PMC: 8238123. DOI: 10.1111/jrh.12522.

Ubiquitous Yet Unclear: A Systematic Review of Medical Mistrust.

Benkert R, Cuevas A, Thompson H, Dove-Meadows E, Knuckles D Behav Med. 2019; 45(2):86-101.

PMID: 31343961 PMC: 6855383. DOI: 10.1080/08964289.2019.1588220.

References

Gupta S, Brenner A, Ratanawongsa N, Inadomi J . Patient trust in physician influences colorectal cancer screening in low-income patients. Am J Prev Med. 2014; 47(4):417-23. PMC: 4171139. DOI: 10.1016/j.amepre.2014.04.020. View

Tan A, Moldovan-Johnson M, Parvanta S, Gray S, Armstrong K, Hornik R . Patient-clinician information engagement improves adherence to colorectal cancer surveillance after curative treatment: results from a longitudinal study. Oncologist. 2012; 17(9):1155-62. PMC: 3448408. DOI: 10.1634/theoncologist.2012-0173. View

Curry W, Lengerich E, Kluhsman B, Graybill M, Liao J, Schaefer E . Academic detailing to increase colorectal cancer screening by primary care practices in Appalachian Pennsylvania. BMC Health Serv Res. 2011; 11:112. PMC: 3128846. DOI: 10.1186/1472-6963-11-112. View

Heritage J, Robinson J, Elliott M, Beckett M, Wilkes M . Reducing patients' unmet concerns in primary care: the difference one word can make. J Gen Intern Med. 2007; 22(10):1429-33. PMC: 2305862. DOI: 10.1007/s11606-007-0279-0. View

Bardach S, Schoenberg N, Fleming S, Hatcher J . Relationship between colorectal cancer screening adherence and knowledge among vulnerable rural residents of Appalachian Kentucky. Cancer Nurs. 2011; 35(4):288-94. PMC: 3248994. DOI: 10.1097/NCC.0b013e31822e7859. View

Krieger J, Krok-Schoen J, Dailey P, Palmer-Wackerly A, Schoenberg N, Paskett E . Distributed Cognition in Cancer Treatment Decision Making: An Application of the DECIDE Decision-Making Styles Typology. Qual Health Res. 2016; 27(8):1146-1159. DOI: 10.1177/1049732316645321. View

Dignan M, Shelton B, Slone S, Tolle C, Mohammad S, Schoenberg N . Effectiveness of a primary care practice intervention for increasing colorectal cancer screening in Appalachian Kentucky. Prev Med. 2013; 58:70-4. PMC: 3925970. DOI: 10.1016/j.ypmed.2013.10.018. View

Epstein R, Franks P, Fiscella K, Shields C, Meldrum S, Kravitz R . Measuring patient-centered communication in patient-physician consultations: theoretical and practical issues. Soc Sci Med. 2005; 61(7):1516-28. DOI: 10.1016/j.socscimed.2005.02.001. View

Canary H, Bullis C, Cummings J, Kinney A . Structuring Health in Colorectal Cancer Screening Conversations: An Analysis of Intersecting Activity Systems. South Commun J. 2016; 80(5):416-432. PMC: 4865265. DOI: 10.1080/1041794X.2015.1081974. View

10.

Dearing J . Evolution of diffusion and dissemination theory. J Public Health Manag Pract. 2008; 14(2):99-108. DOI: 10.1097/01.PHH.0000311886.98627.b7. View

11.

Rosenwasser L, McCall-Hosenfeld J, Weisman C, Hillemeier M, Perry A, Chuang C . Barriers to colorectal cancer screening among women in rural central Pennsylvania: primary care physicians' perspective. Rural Remote Health. 2013; 13(4):2504. PMC: 4050077. View

12.

Sandelowski M . Whatever happened to qualitative description?. Res Nurs Health. 2000; 23(4):334-40. DOI: 10.1002/1098-240x(200008)23:4<334::aid-nur9>3.0.co;2-g. View

13.

Schoenberg N, Hatcher J, Dignan M . Appalachian women's perceptions of their community's health threats. J Rural Health. 2008; 24(1):75-83. PMC: 3025859. DOI: 10.1111/j.1748-0361.2008.00140.x. View

14.

Bibbins-Domingo K, C Grossman D, Curry S, Davidson K, Epling Jr J, Garcia F . Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016; 315(23):2564-2575. DOI: 10.1001/jama.2016.5989. View

15.

Krok-Schoen J, Katz M, Oliveri J, Young G, Pennell M, Reiter P . A Media and Clinic Intervention to Increase Colorectal Cancer Screening in Ohio Appalachia. Biomed Res Int. 2015; 2015:943152. PMC: 4609808. DOI: 10.1155/2015/943152. View