Facilitators of Multisector Collaboration for Delivering Cancer Control Interventions in Rural Communities: A Descriptive Qualitative Study

Abstract

Purpose and Objectives Multisector collaboration is a widely promoted strategy to increase equitable availability, access, and use of healthy foods, safe places for physical activity, social supports, and preventive health care services. Yet fewer studies and resources exist for collaboration among governmental and nongovernmental agencies to address public problems in rural areas, despite an excess burden of risk factors for cancer morbidity and mortality. We aimed to learn about cancer prevention activities and collaboration facilitators among rural informal interagency networks. Evaluation Methods In 2020, researchers conducted semistructured interviews with staff from rural public health and social services agencies, community health centers, and extension offices. Agency staff were from 5 service areas across 27 rural counties in Missouri and Illinois with high poverty rates and excess cancer risks and mortality. We conducted a thematic analysis to code interview transcripts and identify key themes. Results Exchanging information, cohosting annual or one-time events, and promoting other agencies’ services and programs were the most commonly described collaborative activities among the 32 participants interviewed. Participants indicated a desire to improve collaborations by writing more grants together to codevelop ongoing prevention programs and further share resources. Participants expressed needs to increase community outreach, improve referral systems, and expand screenings. We identified 5 facilitator themes: commitment to address community needs, mutual willingness to collaborate, long-standing relationships, smaller community structures, and necessity of leveraging limited resources. Challenges included lack of funding and time, long travel distances, competing priorities, difficulty replacing staff in remote communities, and jurisdictional boundaries. Although the COVID-19 pandemic further limited staff availability for collaboration, participants noted benefits of remote collaborative meetings. Implications for Public Health Rural areas need consistent funding and other resources to support health-improving multisector initiatives. Existing strengths found in the rural underresourced areas can facilitate multisector collaborations for cancer prevention, including long-standing relationships, small community structures, and the need to leverage limited resources.

Prioritizing rural populations in state comprehensive cancer control plans: a qualitative assessment

“…Recognizing that CCC plan leadership is often located in urban areas, the importance of creating and leveraging existing relationships with organizations in rural communities was highlighted. This corroborates a conclusion drawn by Allen et al that increased bi-directional collaboration may help improve cancer control activities in rural communities [ 26 ]. Partnering organizations in rural areas may include direct healthcare service providers (e.g., hospitals, clinics), as well as coalitions, associations, and community-based organizations.…”

Assessing the use of constructs from the consolidated framework for implementation research in U.S. rural cancer screening promotion programs: a systematic search and scoping review

“…Engagement of community stakeholders is a critical component of effective implementation [ 27 , 39 , 40 , 42 , 43 ], although community-engaged research approaches are underutilized [ 44 , 45 ]. Collaboration with community members and community organizations may be particularly important for rural cancer control given the tight relationships and small networks in rural communities [ 46 ]. Although half of the studies described internal implementation leaders and champions (i.e., roles internal to the study team), only two studies described external change agents, and none described opinion leaders (see engaging construct under Process domain).…”

Associations between county-level public health expenditures and community health planning activities with COVID-19 incidence and mortality

“…( Carlton and Singh, 2018 ) Long-standing relationships between local health departments, federally qualified health centers, and other agencies can be strengthened to increase access to services, such as vaccinations. ( Allen et al, 2022 ) In addition to hospitals and clinics, there are calls within academic medicine for building cross-agency collaborations, integrating medical and public health schools, and expanding the pipeline of physicians considering public health careers. ( Blazer et al, 2022 ).…”