Lung Cancer Prevention Among Appalachian Kentucky Women: A Community-Engaged Mixed Method Study

Purpose: Appalachian Kentucky (KY) residents experience the highest lung cancer rates in the US with declines lagging among women; we sought to uncover barriers and facilitators to lung cancer prevention for Appalachian KY women and to identify community-specific interventions. Approach: We utilized concept mapping, a participatory mixed method, to generate consensus on perceived barriers and facilitators. Setting/Participants: We recruited 71 adult women from Appalachian KY counties. Method: After collecting online concept mapping data, we used multidimensional scaling to generate a point map of perceived similarities and hierarchical cluster analysis to create a thematic cluster map. We compared average cluster ratings across importance and feasibility. During focus group discussions, we shared concept maps to gather insights on intervention areas. Results: Participants listed 70 barriers and facilitators in 8 thematic clusters, including community-level, healthcare, and tobacco-related factors. Participants identified three intervention areas: 1) educational campaigns, including efforts directed toward youth, mothers, and those eligible for lung cancer screening; 2) policy, such as smoke-free laws, inclusion of vaping in existing policies, and advertisement bans; and 3) improving access to lung cancer screening. Conclusion: Our findings support multilevel interventions for lung cancer prevention, including improving awareness, local policy, and screening access for Appalachian KY women. This research contributes novel understanding of local and gender-specific barriers and informs future Appalachian lung cancer prevention studies.