Zahnd Whitney E, Jenkins Wiley D, Shackelford Judy, Lobb Rebecca, Sanders Jo, Bailey Angela
J Health Care Poor Underserved. 2018;29(1):71-80. doi: 10.1353/hpu.2018.0008.
Rural populations often face higher cancer rates and have lower cancer screening rates than urban populations. Screening disparities may be mediated by limited access to care, less knowledge of screening, and psychosocial factors. While the improved insurance rates and more comprehensive coverage under the Affordable Care Act may address some of these barriers, rural-urban disparities in cancer screening may not be fully attenuated. Faith-based interventions have been an effective approach to improving cancer screening among rural and underserved populations. Similarly, faith community nurses (FCNs) may be an effective agents for implementing evidence-based cancer screening strategies in rural communities. We provide a model for how FCNs standards of professional performance and practice can enable them to implement screening strategies. We also posit two recommendations of services that FCNs can provide to improve cancer screening in rural areas: educational messaging and patient navigation.
农村人口往往比城市人口面临更高的癌症发病率,且癌症筛查率更低。筛查差异可能是由获得医疗服务的机会有限、对筛查的了解较少以及社会心理因素所介导的。虽然《平价医疗法案》下保险费率的提高和更全面的覆盖范围可能解决其中一些障碍,但癌症筛查方面的城乡差异可能无法完全消除。基于信仰的干预措施一直是提高农村和服务不足人群癌症筛查率的有效方法。同样,基于信仰社区的护士(FCNs)可能是在农村社区实施循证癌症筛查策略的有效推动者。我们提供了一个模型,说明FCNs的专业表现和实践标准如何使他们能够实施筛查策略。我们还提出了FCNs可以提供的两项服务建议,以改善农村地区的癌症筛查:教育信息传递和患者导航。