Abstract
Background: Appalachians experience increased rates of cancer incidence and mortality compared to non-Appalachians. Many factors may contribute to the elevated cancer burden, including lack of knowledge and negative beliefs about the disease. Methods: Three National Cancer Institute (NCI)-designated cancer centers with Appalachian counties in their respective population-based geographic service areas—Kentucky, Ohio, and Pennsylvania—surveyed their communities to better understand their health profiles, including 5 items assessing cancer beliefs. Weighted univariate and bivariate statistics were calculated for each of the 3 state's Appalachian population and for a combined Appalachian sample. Weighted multiple linear regression was used to identify factors associated with a cancer beliefs composite score. Data from the combined Appalachian sample were compared to NCI's Health Information National Trends Survey (HINTS). Results: Data from 1,891 Appalachian respondents were included in the analysis (Kentucky = 798, Ohio = 112, Pennsylvania = 981). Significant differences were observed across the 3 Appalachian populations related to income, education, marital status, rurality, perceptions of present income, and body mass index (BMI). Four of 5 cancer beliefs were significantly different across the 3 states. Education, BMI, perceptions of financial security, and Kentucky residence were significantly associated with a lower composite score of cancer beliefs. When comparing the combined Appalachian population to HINTS, 3 of 5 cancer belief measures were significantly different. Conclusions: Variations in cancer beliefs were observed across the 3 states’ Appalachian populations. Interventions should be tailored to specific communities to improve cancer knowledge and beliefs and, ultimately, prevention and screening behaviors.
| Original language | English |
|---|---|
| Pages (from-to) | 176-188 |
| Number of pages | 13 |
| Journal | Journal of Rural Health |
| Volume | 35 |
| Issue number | 2 |
| DOIs | |
| State | Published - Mar 1 2019 |
Bibliographical note
Funding Information:Special thanks goes to Kelly Blake, ScD, Health Scientist and Program Director at the National Cancer Institute, for facilitating this collaborative work. All 3 cancer centers would like to thank their respective project teams for assistance with data collection and other study-related activities. University of Kentucky: This project was funded through an administrative supplement from the National Cancer Institute to the University of Kentucky Markey Cancer Center (3P30 CA177558-04S5). This project was supported by services from the University of Kentucky Markey Cancer Center Behavioral and Community-Based Research, Cancer Research Informatics, and Biostatistics and Bioinformatics Shared Resource Facilities (P30 CA177558). Support was also provided by University of Kentucky Clinical and Translational Science Award (UL1TR001998). ICF Macro, Inc.: Work produced for this manuscript was funded by the National Cancer Institute, Division of Cancer Control and Population Sciences through 2 contract mechanisms (Contract # HHSN276201400002B and Contract # HHSN261201400002B). University of Pittsburgh: This project was funded through an administrative supplement from the National Cancer Institute to the University of Pittsburgh Medical Center Hillman Cancer Center (3P30 CA047904). The Ohio State University: This project was funded through an administrative supplement from the National Cancer Institute to The Ohio State University Comprehensive Cancer Center (P30 CA016058). The Behavioral Measurement Shared Resource at The Ohio State University Comprehensive Cancer Center, which also funded this study, is also supported by a grant from the National Cancer Institute Grant (P30 CA016058). Support was also provided by The Ohio State University Clinical and Translational Science Award (UL1TR002733).
Funding Information:
Funding:University of Kentucky: This project was funded through an administrative supplement from the National Cancer Institute to the University of Kentucky Markey Cancer Center (3P30 CA177558-04S5). This project was supported by services from the University of Kentucky Markey Cancer Center Behavioral and Community-Based Research, Cancer Research Informatics, and Biostatistics and Bioinformatics Shared Resource Facilities (P30 CA177558). Support was also provided by University of Kentucky Clinical and Translational Science Award (UL1TR001998). ICF Macro, Inc.: Work produced for this manuscript was funded by the National Cancer Institute, Division of Cancer Control and Population Sciences through 2 contract mechanisms (Contract # HHSN276201400002B and Contract # HHSN261201400002B). University of Pittsburgh: This project was funded through an administrative supplement from the National Cancer Institute to the University of Pittsburgh Medical Center Hillman Cancer Center (3P30 CA047904). The Ohio State University: This project was funded through an administrative supplement from the National Cancer Institute to The Ohio State University Comprehensive Cancer Center (P30 CA016058). The Behavioral Measurement Shared Resource at The Ohio State University Comprehensive Cancer Center, which also funded this study, is also supported by a grant from the National Cancer Institute Grant (P30 CA016058). Support was also provided by The Ohio State University Clinical and Translational Science Award (UL1TR002733).
Publisher Copyright:
© 2019 National Rural Health Association
Keywords
- Appalachia
- cancer beliefs
- fatalism
- rural
- survey research
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
