ASPO Abstracts
Access to Care and Screening Behaviors Among Rural Populations
Category: Behavioral Science & Health Communication, Cancer Health Disparities
Conference Year: 2018
Abstract Body:
Purpose: This study examined multiple dimensions of healthcare access in relation to cancer screening among rural populations. Methods: We surveyed 966 individuals in New Hampshire, Vermont, and Kentucky via MTurk and social media with a 120-item questionnaire across the domains of: demographics, access to care (insurance, travel time, other barriers), and screening knowledge and behaviors. We examined responses in relation to the participants’ urban-rural classification of their residential location. Results: Our convenience sample was predominantly women (30%), white, non-hispanic (84%), and had an educational level of some college or more (72%). A quarter of respondents lived in an urban area (25%), 26% in a large town, and 49% in a small town or isolated rural area. Healthcare coverage did not vary by urban-rural status, but more rural dwellers reported having no usual source of healthcare (23% v. 12%). Rural residents were willing to travel farther distances for both healthcare and other activities. To go to a healthcare provider for primary care, urban residents were willing to travel 25 min. compared to 30 for rural. However, to get a test for cancer screening, the willingness to travel was 30 min. for urban residents and 45 min. for rural. Rural residents were willing to travel 60 min. to get treatment for a serious condition such as cancer, while it was 30 min. for urban. Differences in knowledge and beliefs on when breast and colorectal cancer screening should begin were largely the same by rural-urban status. However, fewer rural residents reported being current with screening for those cancers. Conclusion: Differences in access to healthcare by rural-urban location of residence were more related to proximity than coverage/cost. However, rural residents reported a greater willingness to travel to receive health services, including screening. Knowledge of cancer screening initiation was the same for rural-urban categories, so is unlikely to account for lower screening rates among rural residents. . Understanding the role of rurality related to cancer control requires simultaneous examination of multiple domains, such as access, knowledge, and behaviors.
Keywords: rural access to care cancer screening