Similarities and differences across the underlying dimensions of social functioning in rural and nonrural cancer survivors: A mixed-methods study

Jessica N. Rivera Rivera, Tia Borger, Yancey Sizemore, Jessica L. Burris

Research output: Contribution to journalArticlepeer-review


Purpose: For cancer survivors, social functioning greatly influences other quality of life dimensions. While there is potential for differences in social functioning to vary as a function of geographic residence, few studies examine the social functioning of rural cancer survivors specifically. This study aims to help fill this gap. Methods: This was an embedded mixed-methods study where all participants completed a questionnaire, and some were purposively selected to complete an interview to gather more information about social functioning (ie, social roles, activities, network, support, and constraint). Participants (n = 93; 63% rural) were recruited through a state cancer registry and cancer care facility. Participants were predominately White, non-Hispanic (92.47%), roughly half female (54.84%), and on average, diagnosed in the past two years (SD = 1.68), and 61.45 (SD = 10.87) years old. Findings: Few differences in the social functioning of rural and nonrural participants were found on questionnaires, though rural participants reported larger networks and more overall support. Across groups, common themes in the interview data were the experience of both social support (eg, instrumental support) and social constraint (eg, others minimizing participants’ problems or sharing their own negative experiences). Conclusions: This was the first cancer survivorship study to thoroughly examine social functioning by geographic residence. Rural cancer survivors described some unique strengths, but major group differences were not apparent. All participants highlighted situations when others, even with good intentions, were unhelpful to them. Future interventions to improve social functioning could work to dispel the belief that cancer survivors should handle their cancer on their own.

Original languageEnglish
Pages (from-to)434-443
Number of pages10
JournalJournal of Rural Health
Issue number2
StatePublished - Mar 1 2023

Bibliographical note

Funding Information:
The authors acknowledge the work of Gabriella Puleo, PhD, and William Bowling, BA, who assisted with recruitment and data entry. Also, the authors would like to thank all the health care technicians, staff, and providers who assisted in one way or another in carrying out this study. Data to support this study were provided by the Kentucky Cancer Registry. Data collection activities of the Kentucky Cancer Registry are supported by the National Cancer Institute's Surveillance Epidemiology and End Results (SEER) Program, the Centers for Disease Control and Prevention National Program of Cancer Registries (NPCR), and the Commonwealth of Kentucky.

Funding Information:
Research reported in this publication was also supported by the Center for Clinical and Translational Research of the National Institutes of Health under award number NIH UL1 TR000117 and UL1 TR001998, and the National Cancer Institute under award numbers K07 CA181351 (JLB) and T32 CA090314 (JRR). The content of this publication is solely the responsibility of the authors and does not necessarily represent the official views of the Kentucky Cancer Registry, National Institutes of Health, University of Kentucky, or Moffit Cancer Center.

Publisher Copyright:
© 2022 National Rural Health Association.


  • cancer survivors
  • quality of life
  • rural
  • social functioning

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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