Adapting and implementing evidence-based cancer education interventions in rural Appalachia: real world experiences and challenges

Vanderpool, Robin C.; Gainor, Sara Jane; Conn, Mary Ellen; Spencer, Cherie; Allen, Amy; Kennedy, Stephenie

doi:10.22605/rrh1807

Cited by 18 publications

(21 citation statements)

References 36 publications

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“…10,[13][14][15] More challenging for rural health systems in their promotion of CRC screening is the research-practice gap of adopting and implementing evidencebased interventions (EBIs) that are supported by published scientific research. 16 The Community Guide introduced various CRC screening EBIs, including one-on-one client education, small media (eg, brochures or posters), client reminders, and/or provider assessment and feedback, at multiple levels. [17][18][19][20] The NCI also introduced 22 researchtested intervention programs for promoting CRC screening, and among those, 8 targeted rural and low-income populations.…”

Section: Introductionmentioning

confidence: 99%

“…However, rural health systems face chronic challenges, such as lack of provider time to recommend screenings due to a shortage of health professionals, lack of specialists or facilities for endoscopic procedures, inadequate financial resources, and limited information technology infrastructure and capacities to remind rural residents about CRC screening needs and track CRC screening rates 10,13–15 . More challenging for rural health systems in their promotion of CRC screening is the research‐practice gap of adopting and implementing evidence‐based interventions (EBIs) that are supported by published scientific research 16 . The Community Guide introduced various CRC screening EBIs, including one‐on‐one client education, small media (eg, brochures or posters), client reminders, and/or provider assessment and feedback, at multiple levels 17–20 .…”

Section: Introductionmentioning

confidence: 99%

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Cross‐sectional survey study of primary care clinics on evidence‐based colorectal cancer screening intervention use

Watanabe‐Galloway

Kim²,

LaCrete

et al. 2021

The Journal of Rural Health

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Purpose:The purpose of this study was to examine differences between urban and rural primary care clinics in the use of colorectal cancer (CRC) screening methods and evidence-based interventions to promote CRC screening.Methods: This was a cross-sectional survey of primary care clinics in Nebraska. Surveys in paper form were sent out and followed up with telephone interviews to nonrespondents. Of the 375 facilities, 263 (70.1%) responded to the survey.Findings: Over 30% of urban clinics indicated that 80% or more of their patients were meeting the CRC guidelines compared to 18.3% of rural clinics (P = .03). Rural clinics were more likely than urban clinics to prefer the use of colonoscopy alone or in combination with stool tests (P = .02). The most common interventions for CRC screening included one-on-one patient education and use of computer-based pop-ups to remind providers. Conclusions:In conclusion, we found some important differences between rural and urban primary care clinics in the implementation of CRC screening. Given that there is evidence for differences in preference for CRC screening methods (colonoscopy vs stool-based tests) between rural and urban community members, it is important to assess the effectiveness of different types of CRC screening interventions by comparing rural and urban primary care clinic patient populations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cross‐sectional survey study of primary care clinics on evidence‐based colorectal cancer screening intervention use

Watanabe‐Galloway

Kim²,

LaCrete

et al. 2021

The Journal of Rural Health

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“… 18 However, adapting and implementing cancer education interventions can be challenging in this region, and need to include key stakeholders and community participation for success. 19 Given the results of this study, researchers and health practitioners have an opportunity to further examine other sun-protection behaviors in this underserved group, and can work at the community level to improve rates of sun-protective behaviors.…”

Section: Discussionmentioning

confidence: 99%

Skin Cancer and UV Exposure-Related Behaviors Among Appalachian and Non-Appalachian Adults

Patel¹,

Serrano²,

Rice³

et al. 2020

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Introduction Appalachian communities experience elevated rates of cancer incidence and mortality relative to other regions in the U.S. Specifically, melanoma mortality rates are higher in Appalachia compared to the national average, despite comparable incidence rates. Purpose To examine differences in self-reported history of skin cancer and prevalence of two UV exposure behaviors between Appalachian and non-Appalachian adults in a nationally representative sample. Methods Data are from four cross-sectional cycles of the Health Information National Trends Survey (2011–2014) (N=14,451). We examined sunscreen use and tanning bed use, and self-reported history of melanoma and non-melanoma skin cancer. Descriptive and weighted multivariable analyses were conducted to examine sunscreen and tanning bed use, controlling for sociodemographic characteristics. Results Approximately 8% of the study sample resided in Appalachia (n=1,015). Self-reported melanoma (0.6%) and non-melanoma (3.2%) skin cancer histories were low among Appalachians and did not differ statistically from non-Appalachians ( p >0.05). Only 21.2% of Appalachians reported using sunscreen often or always when going outside for more than one hour on a warm, sunny day compared to 27.4% of non-Appalachians ( p p=0.04), but there were no regional differences in tanning bed use (OR=1.48, p=0.23) when controlling for sociodemographics and general health status. Implications Appalachians had comparable histories of self-reported melanoma and non-melanoma skin cancer but were less likely to report sunscreen use than non-Appalachians. Enhanced communication efforts to promote sunscreen use and other UV protection behaviors in Appalachia may be valuable.

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“…We believe this work expands upon what others have implemented (Levit et al, 2020) to address another important barrier to developing sustained opportunities for research participation to rural residents. We also include the addition of cultural context to the barrier and facilitator assessment step, invite input to the research by rural communities as well as offer to local/non-clinical adopters, implementers, in uencers and champions authentic, tangible opportunities to partner with incoming researchers (Dorgan et al, 2009;Ko et al, 2022;Vanderpool et al, 2011) In the current project, we used an adapted Implementation Mapping approach to develop a systematic strategy intended to increase the number and success of clinical trials in a rural community. Our goal was both to acknowledge regional limitations to clinical trial participation, and to work collaboratively with our rural community partners to develop a structured process for reviewing and introducing studies that integrates known community and clinic system limitations into capacity and feasibility assessments of incoming research.…”

Section: Introductionmentioning

confidence: 99%

Rural Research Capacity – a Co-Created Model for Research Success

Farris

Crist

Miller

et al. 2022

Preprint

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Purpose. The National Institutes of Health have long challenged academia to improve clinical trial enrollment, especially in underrepresented populations; inclusive of geography, age, disability status, racial and ethnic minorities. It has been shown that rural and urban residents enrolled in clinical trials have similar outcomes, yet, rural healthcare systems struggle to provide opportunities to participate in clinical trials when infrastructure is limited or unsupportive of research programs and/or research staffing levels are insufficient. To fully address the barriers to clinical trial access in rural areas, it is not adequate to simply open more trials. Community receptivity of research as well as organizational and community capacity must be considered. Methods. Herein we present the co-creation and implementation of a community-oriented approach to the receipt, review, and acceptance of clinical research in a rural community setting. We used an adapted 5 step Implementation Mapping approach to develop a systematic strategy intended to increase the success, and therefore, the number of clinical trials in a rural community. Results. The review strategy, inclusive of a Regional Cultural Landscape and 3 co-created project submission and feasibility review forms, was pilot tested using a cancer early detection clinical trial that requires engagement from primary care and oncology and was shown to support strong researcher-community stakeholder communication, resulting in early identification and resolution of potential barriers and timely trial opening. Conclusion. We propose that this approach may be replicated broadly as a key component of increasing clinical trial opportunities in rural and frontier settings.

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Adapting and implementing evidence-based cancer education interventions in rural Appalachia: real world experiences and challenges

Cited by 18 publications

References 36 publications

Cross‐sectional survey study of primary care clinics on evidence‐based colorectal cancer screening intervention use

Cross‐sectional survey study of primary care clinics on evidence‐based colorectal cancer screening intervention use

Skin Cancer and UV Exposure-Related Behaviors Among Appalachian and Non-Appalachian Adults

Rural Research Capacity – a Co-Created Model for Research Success

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