Thompson Jessica R, Burus Todd, McAfee Caree, Stroebel Christine, Brown Madeline, Francis Keeghan, Rogers Melinda, Knight Jennifer, Russell Elaine, Sorrell Connie, Westbrook Elizabeth, Hull Pamela C
Community Impact Office, Markey Cancer Center, University of Kentucky, Lexington.
Department of Health Policy and Administration, College of Health and Human Development, The Pennsylvania State University, University Park.
Prev Chronic Dis. 2024 Dec 26;21:E103. doi: 10.5888/pcd21.240183.
Kentucky has the highest all-site cancer incidence and death rate in the US. In 2021, the University of Kentucky Markey Cancer Center convened a steering committee to conduct a statewide community cancer needs assessment (CNA). The goal of the final CNA phase was to gather community input on prioritizing Kentucky's cancer-related needs and ways to address them.
In 2021, we recruited 162 people to participate in online concept mapping, a participatory mixed method, to explore connections and identify priority areas. Fifty-one community members and 111 organizational partners participated in survey-based activities to prioritize 80 items representing key CNA findings and discussion groups to explore key focus areas and strategies for Kentucky communities.
Concept maps display perceived similarity of the 80 items and a 6-cluster solution. High-priority focus areas included lung cancer screening, smoking, human papillomavirus (HPV) vaccination, and disparities driven by social determinants among rural, Appalachian, Black, and Hispanic residents. High-priority strategies to address needs included expanding health communication on risks, screening guidelines, and insurance benefits; patient navigation; accessible, culturally appropriate treatment information and self-efficacy in treatment decisions; access to care through financial assistance, mobile clinics, and at-home screening; and patient-provider trust and communication.
Our findings indicate the utility of the concept mapping process to facilitate the prioritization of wide-ranging catchment area needs and ways to address them. Moving forward, the prioritized focus areas and strategies can inform Kentucky's new state cancer plan and future research to reduce the state's cancer burden and disparities.
肯塔基州的全部位癌症发病率和死亡率在美国最高。2021年，肯塔基大学马基癌症中心召集了一个指导委员会，开展全州范围的社区癌症需求评估（CNA）。最终CNA阶段的目标是收集社区关于肯塔基州癌症相关需求的优先排序及应对方法的意见。
2021年，我们招募了162人参与在线概念图绘制，这是一种参与性混合方法，用于探索联系并确定优先领域。51名社区成员和111名组织合作伙伴参与了基于调查的活动，对代表CNA关键结果的80个项目进行优先排序，并参与了讨论小组，以探索肯塔基州社区的关键重点领域和策略。
概念图展示了80个项目的感知相似性以及一个六聚类解决方案。高优先级重点领域包括肺癌筛查、吸烟、人乳头瘤病毒（HPV）疫苗接种，以及农村、阿巴拉契亚、黑人和西班牙裔居民中由社会决定因素导致的差异。满足需求的高优先级策略包括扩大关于风险、筛查指南和保险福利的健康宣传；患者导航；提供可获取的、符合文化背景的治疗信息以及治疗决策中的自我效能感；通过经济援助、流动诊所和家庭筛查获得医疗服务；以及患者与提供者之间的信任和沟通。
我们的研究结果表明概念图绘制过程有助于对广泛的集水区需求及其应对方法进行优先排序。展望未来，这些优先排序的重点领域和策略可为肯塔基州新的州癌症计划及未来研究提供参考，以减轻该州的癌症负担和差异。
