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Original Research

Appalachian women’s perspectives on breast and cervical cancer screening

Submitted: 6 December 2012
Revised: 18 April 2013
Accepted: 1 May 2013
Published: 10 September 2013

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Author(s) : Schoenberg NE, Kruger TM, Bardach S, Howell BM.

Nancy SchoenbergTina KrugerShoshana BardachBritteny Howell

Citation: Schoenberg NE, Kruger TM, Bardach S, Howell BM.  Appalachian women’s perspectives on breast and cervical cancer screening. Rural and Remote Health (Internet) 2013; 13: 2452. Available: (Accessed 17 October 2017)


Introduction:  Although breast and cervical cancer screening rates have been increasing over the three past decades, many Appalachian women in the USA do not receive screening, leading to disproportionate mortality rates. The aims of this study were to: (1) better understand barriers to and facilitators of breast and cervical cancer screening among Appalachian women; and (2) identify strategies to increase cancer screening.
Methods:  Eight focus groups and 19 key informant interviews were conducted with 79 participants. Tape-recorded session were transcribed and content analyzed.
Results:  Findings consistent with screening determinants research include: inadequate personal and community resources, attitudinal and knowledge barriers, and competing demands. Less commonly described factors include family cancer history, personal health habits, and the multiple influences of healthcare providers.
Conclusions:  Interpreting findings in terms of consumer information processing theory, healthcare providers and supports play a key role in educating and influencing the screening uptake among Appalachian Kentucky women. These findings have the potential to inform innovative and culturally consonant intervention approaches capable of increasing screening and decreasing mortality rates.

Key words: breast cancer, cancer screening, cervical cancer, rural health inequities, USA, women’s health.

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