MAY 04, 2023 3:00 AM PDT

Increased Outreach to Rural Communities Encourages Cancer Screening

WRITTEN BY: Katie Kokolus

The Healthy People initiative emerged from the US Department of Health and Human Services (HHS) in 1980.  Each decade since, experts have set forth measurable objectives to improve the health and well-being of people throughout the county.  Healthy People 2030 (the fifth iteration laid out in 2020) encompasses several goals focused on reducing the incidence and mortality associated with cancer.

Regarding cancer prevention, Healthy People 2030 set goals to increase the percentage of women getting screened for breast (target 80.3%) and cervical (target 79.2%) cancers and the percentage of adults getting screened for colorectal cancer (target 68.3%).  Currently, these measures still need to meet 2030 goals, and while we still have several years to achieve these milestones, experts can evaluate timely statistics to stay on track. 

Cancer disparities exist in many groups of individuals including those living in rural areas.  Many factors, including socioeconomics, access to care, and lifestyle, could affect the disparities between rural and urban settings.  Understanding these factors can identify groups that will most benefit from interventions on the way to reaching Healthy People 2023 goals.

A study recently published in JAMA Network Open evaluated how to reach rural women best to educate and encourage them to follow screening guidelines for breast, cancer, and colorectal cancers.  The study enrolled 963 women (average age 58.6 years) living in rural areas in Indiana and Ohio. 

The researchers employed three interventions:

  1. Mailing a tailored digital video disc (DVD)
  2. Mailing a tailored digital video disc plus telephone patient navigation (DVD/PN)
  3. No intervention/usual care (UC)

The interactive digital video (provided to the DVD and DVD/PN groups) provided basic health information, including risk factors associated with breast, cervical, and colorectal cancers.  Further, the video discussed the barriers and benefits of following screening recommendations.  The women randomly assigned to the DVD/PN group had access to patient navigators by telephone. Patient navigators provided counsel to women experiencing barriers to receiving cancer screening. 

At baseline, participants were not current on recommended cancer screenings, and at 12 months, the researchers evaluated associations between interventions and screening.  The analysis revealed that women in the DVD group had about twice the odds of those in the UC group getting all recommended screenings.  The DVD/PC intervention appeared even more beneficial as women were six times more likely to get all recommended screenings than those in the UC group.

The study demonstrates how the intervention consisting of a video and access to a patient navigator is more effective than the usual care received by women living in rural areas.  Similar interventions can be provided at low cost and from a remote setting. 

Healthcare providers can implement minor adaptations to the suggested intervention to suit other cohorts of patients.  For example, this type of intervention can be tailored to different groups of people at high risk for a particular kind of cancer.  Further, the video could be adapted to an online format to avoid needing a DVD player.  The information could also be narrated in multiple languages to cater to the specific needs of all patients. 

Sources: Womens Health Rep, JAMA Network Open

About the Author
Doctorate (PhD)
I received a PhD in Tumor Immunology from SUNY Buffalo and BS and MS degrees from Duquesne University. I also completed a postdoc fellowship at the Penn State College of Medicine. I am interested in developing novel strategies to improve the efficacy of immunotherapies used to extend cancer survivorship.
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