Cervical Cancer Worry and Screening Among Appalachian Women

Kimberly M. Kelly, Nancy Schoenberg, Tomorrow D. Wilson, Elvonna Atkins, Stephanie Dickinson, Electra Paskett

Research output: Contribution to journalArticlepeer-review

13 Scopus citations


Although many have sought to understand cervical cancer screening (CCS) behavior, little research has examined worry about cervical cancer and its relationship to CCS, particularly in the underserved, predominantly rural Appalachian region. Our mixed method investigation aimed to obtain a more complete and theoretically-informed understanding of the role of cancer worry in CCS among Appalachian women, using the Self-Regulation Model (SRM). Our quantitative analysis indicated that the perception of being at higher risk of cervical cancer and having greater distress about cancer were both associated with greater worry about cancer. In our qualitative analysis, we found that, consistent with the SRM, negative affect had a largely concrete-experiential component, with many women having first-hand experience of the physical consequences of cervical cancer. Based on the results of this manuscript, we describe a number of approaches to lessen the fear associated with CCS. Intervention in this elevated risk community is merited and may focus on decreasing feelings of worry about cervical cancer and increasing communication of objective risk and need for screening. From a policy perspective, increasing the quantity and quality of care may also improve CCS rates and decrease the burden of cancer in Appalachia.

Original languageEnglish
Pages (from-to)79-92
Number of pages14
JournalJournal of Primary Prevention
Issue number2
StatePublished - Apr 2015

Bibliographical note

Publisher Copyright:
© 2014, Springer Science+Business Media New York.


  • Appalachia
  • Cancer screening
  • Cervical cancer
  • Psychosocial impact

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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