Distance and Transportation Barriers to Colorectal Cancer Screening in a Rural Community

Author:

Lee Katharine M. N.1ORCID,Hunleth Jean2,Rolf Liz2ORCID,Maki Julia2,Lewis-Thames Marquita3ORCID,Oestmann Kevin4,James Aimee S.2ORCID

Affiliation:

1. Tulane University, New Orleans, LA, USA

2. Washington University School of Medicine, St. Louis, MO, USA

3. Northwestern University, IL, USA

4. Southern Illinois Healthcare, IL, USA

Abstract

Rural residents in underserved areas face many barriers to health services, including colonoscopies for colorectal cancer (CRC) screening, but rural healthcare providers may assist patients navigating these challenges due to familiarity with local contexts. In 2017 to 2018, we interviewed clinical practitioners and staff (n = 40) at 13 primary care and gastroenterology locations across rural Southern Illinois. We used a semi-structured interview guide that addressed system, provider, and patient levels including domains related to barriers, facilitators, and needs for intervention. This article focuses on 3 main elements related to distance and transportation that emerged from inductive coding. First, providers described long distance travel for care as normalized but not necessarily preferable. Second, they identified and described distance-related challenges specific to CRC screening, and third, providers discussed strategies, mostly related to transportation, they use to navigate those challenges. Finally, they suggested a variety of broader solutions to reduce distance and transportation barriers to screening. Overall, distance to care remains a challenge to increasing CRC screening and contributes to disparities in rural communities. To increase early detection and reduce rural cancer disparities, efforts to increase screening and follow-up must address ways to help patients and providers navigate this distance within their local communities and contexts.

Funder

National Institutes of Health

Northwestern University Clinical and Translational Sciences Institute

Respiratory Health Association of Metropolitan Chicago

Publisher

SAGE Publications

Subject

Public Health, Environmental and Occupational Health,Community and Home Care

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