Patient and provider perspectives on the relationship between multiple morbidity management and disease prevention

Nancy E. Schoenberg, Yelena N. Tarasenko, Shoshana H. Bardach, Steven T. Fleming

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Despite competing demands of multiple morbidity (MM) management and disease prevention, our recent survey of 1,153 Appalachian residents aged 50 to 76 documented that individuals with MM were more likely to obtain colorectal cancer screening (CRCS) than those without MM. Nearly two thirds of respondents obtained CRCS, and the more MM, the greater the likelihood of screening. To gain insight into this relationship, we conducted nine focus groups, six with providers and three with patients. Three main explanations emerged: (a) patients' MM increases providers' vigilance for other health vulnerabilities; (b) having MM increases patients' own vigilance; and (c) patients' vigilance may stem from experiencing more symptoms, having a family history of cancer, and having successfully obtained health care. More frequent contact with health care providers appears to encourage preventive referral, especially in low-income populations that otherwise may not receive such counselling. We highlight participant recommendations to improve MM management and prevention.

Original languageEnglish
Pages (from-to)359-376
Number of pages18
JournalJournal of Applied Gerontology
Issue number3
StatePublished - Apr 16 2015

Bibliographical note

Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Support for this research was provided by the National Cancer Institute through “Increasing Colorectal Cancer Screening for Patients With Multiple Morbidities.” (R21CA129881: Schoenberg & Fleming). Support for this research was also provided by Grant Number TL1 RR033172 from the National Center for Research Resources (NCRR), funded by the Office of the Director, National Institutes of Health (NIH) and supported by the NIH Roadmap for Medical Research.

Publisher Copyright:
© The Author(s) 2013.


  • aging
  • chronic disease
  • health disparities
  • multiple morbidity
  • rural health

ASJC Scopus subject areas

  • Gerontology
  • Geriatrics and Gerontology


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