ASPO Abstracts
Barriers and Facilitators of Lung Cancer Screening Uptake and Tobacco Cessation in Rural New England
Category: Behavioral Science & Health Communication
Conference Year: 2019
Abstract Body:
Purpose This study sought to identify barriers and facilitators to lung cancer screening for eligible rural New Hampshire and Vermont residents. Methods Five focus groups (N=23) were conducted in October 2018 in isolated rural counties using community-based recruitment methods and eligibility criteria consistent with those for lung cancer screening by the USPSTF. Surveys ascertained demographics and beliefs related to screening and smoking just prior to the 1-hour focus groups, which were audio recorded and transcribed. Qualitative coding and analysis of transcripts was conducted using Dedoose software. Results All 23 participants completed the survey and focus group activities, with a female majority (78%), median age of 66 years, 40% current smokers, 74% retired/disabled, all with some form of insurance, and 70% non-college graduates. Qualitative analysis resulted in 9 parent codes and 36 child codes, which yielded four overall themes: 1. Knowledge, attitudes and beliefs related to lung cancer screening and tobacco cessation; 2. Barriers and facilitators related to lung cancer screening; 3. Barriers and facilitators related to tobacco cessation; 4. Acceptability of community-level interventions to increase access to lung cancer screening and tobacco cessation services. Most participants (57%) had never heard of lung cancer screening, and many felt that their doctor would tell them about it if they could benefit from it. All current smokers discussed cessation with their doctor, but <50% discussed treatment options in detail. The greatest barrier to lung cancer screening was lack of knowledge; specifically about: effective tests, eligibility criteria, where to get tested; cost. The greatest facilitators included: insurance coverage; having transportation, and motivation to know results. The main interventions to increase access to lung cancer screening proposed/endorsed by the participants were: primary care providers discussing with them, local advertising, and community events. Conclusion Rural residents of NH and VT who are eligible, but have not received lung cancer screening are receptive to it, but need more knowledge and some practical factors for uptake. They would like to be educated by their providers, local media, and at community events.
Keywords: Lung cancer screening, rural, screening knowledge, barriers