scholarly journals How do Rural Health Care Providers and Patients View Barriers to Colorectal Cancer Screening? Insights from Appalachian Kentucky

2011 ◽  
Vol 46 (2) ◽  
pp. 181-192 ◽  
Author(s):  
Jennifer Hatcher ◽  
Mark B. Dignan ◽  
Nancy Schoenberg
2018 ◽  
Vol 38 (5) ◽  
pp. 601-613 ◽  
Author(s):  
M. Gabriela Sava ◽  
James G. Dolan ◽  
Jerrold H. May ◽  
Luis G. Vargas

Background. Current colorectal cancer screening guidelines by the US Preventive Services Task Force endorse multiple options for average-risk patients and recommend that screening choices should be guided by individual patient preferences. Implementing these recommendations in practice is challenging because they depend on accurate and efficient elicitation and assessment of preferences from patients who are facing a novel task. Objective. To present a methodology for analyzing the sensitivity and stability of a patient’s preferences regarding colorectal cancer screening options and to provide a starting point for a personalized discussion between the patient and the health care provider about the selection of the appropriate screening option. Methods. This research is a secondary analysis of patient preference data collected as part of a previous study. We propose new measures of preference sensitivity and stability that can be used to determine if additional information provided would result in a change to the initially most preferred colorectal cancer screening option. Results. Illustrative results of applying the methodology to the preferences of 2 patients, of different ages, are provided. The results show that different combinations of screening options are viable for each patient and that the health care provider should emphasize different information during the medical decision-making process. Conclusion. Sensitivity and stability analysis can supply health care providers with key topics to focus on when communicating with a patient and the degree of emphasis to place on each of them to accomplish specific goals. The insights provided by the analysis can be used by health care providers to approach communication with patients in a more personalized way, by taking into consideration patients’ preferences before adding their own expertise to the discussion.


2013 ◽  
Vol 30 (2) ◽  
pp. 221-225 ◽  
Author(s):  
A. Clinton MacKinney ◽  
Keith J. Mueller ◽  
Thomas Vaughn ◽  
Xi Zhu

2013 ◽  
Vol 19 (11) ◽  
pp. 1443-1458 ◽  
Author(s):  
Amy McQueen ◽  
Paul R Swank ◽  
Sally W Vernon

To reduce negative psychological affect from information or behavior that is inconsistent with one’s positive self-concept, individuals use a variety of defensive strategies. It is unknown whether correlates differ across defenses. We examined correlates of four levels of defensive information processing about colorectal cancer screening. Cross-sectional surveys were completed by a convenience sample of 287 adults aged 50–75 years. Defenses measures were more consistently associated with individual differences (especially avoidant coping styles); however, situational variables involving health-care providers also were important. Future research should examine changes in defenses after risk communication and their relative impact on colorectal cancer screening.


2021 ◽  
Author(s):  
◽  
Maria Kuhns

Due to rural health disparities and an uneven distribution of health providers across the rural urban continuum, retaining the existing rural health care provider workforce may be an important strategy to maintain existing rural health care provision. While a large body of literature addresses how to recruit health care providers to rural areas, less is known about how to retain these providers. Even less literature has focused on the role of rural communities in health care provider retention. In this thesis, I examine the role of provider background and familial characteristics, workplace characteristics, and community characteristics that may impact a provider's likelihood to consider leaving a rural community. I use data from a survey of over 900 rural health care providers across nine states and a probit model to estimate the impact of these characteristics on a provider's propensity to consider leaving. I find that establishing social ties and integrating within the community through volunteering reduces providers' likelihood to consider leaving by 10 percent. Additionally, providers who engage in entrepreneurship by investing in part or all of their practice are 12 percent less likely to consider leaving, all else being equal. I also find that having unacceptable on-call responsibilities increases a provider's likelihood to consider leaving by 17 percent. This thesis contributes to the existing literature by estimating the effects of work-life balance, entrepreneurship, and the role of family and personal integration on provider retention. Furthermore, it emphasizes the role of communities in provider retention. These results offer insights to rural communities and decision-makers seeking to identify how to maintain their existing rural health care workforce.


PEDIATRICS ◽  
1990 ◽  
Vol 86 (2) ◽  
pp. 302-306
Author(s):  
Jeffrey E. Thompson ◽  
Bethann Bonner ◽  
Gerald M. Lower

We reviewed emergency department records that spanned a period of 5 years at seven rural hospitals to provide more specific data concerning pediatric resuscitation. The purpose was to plan better for preventive programs and to help rural health care providers prepare better for these difficult patients. Patients entered in the study had either cardiorespiratory arrest or respiratory arrest. Although the distribution by age was similar to studies from other areas, the outcome for cardiorespiratory arrests was as bad or worse (70 arrests with 3 survivors), and the outcome of respiratory arrests was as good or better (25 arrests with 21 survivors) as reported previously. Survival of arrest from trauma and accidents was markedly worse (16%) than survival from nontraumatic arrests (44%). The etiologies of the arrests were dominated by sudden infant death syndrome and pulmonary disease but with very few drownings or farmrelated fatalities. This study should encourage rural health care providers to increase efforts in specific areas of trauma and accident prevention. Also, respiratory illness needs to be monitored aggressively and respiratory arrests treated more effectively to avoid the much more consistently lethal cardiac arrests. In addition, more careful prospective study of these patients may be able to identify care patterns that can be improved to increase survival in these groups.


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