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Table 1 Characteristics of included studies evaluating rural cancer screening promotion programs in the United States

From: Assessing the use of constructs from the consolidated framework for implementation research in U.S. rural cancer screening promotion programs: a systematic search and scoping review

First author

Year

Location

Target population

Program summary

Targeted cancer screening outcome

Viadro

1997

Five counties in eastern North Carolina

Women, age 50 + , African American

The program included assisting local health departments and community health centers in enhancing existing breast cancer screening services; reducing practical barriers to screening (e.g., high cost); and increasing awareness of breast cancer and screening among African American women

Breast: Mammography

Sharp

1998

North Carolina

Women, age 18 + , members of Eastern Band of Cherokee Indians and Lumbee Tribe

A lay health educator provided two in-home visits with an educational video, brochure, discussions, and tailored health information about cervical cancer detection and screening

Cervical: Pap smear

Cunningham

2000

Six counties in western North Carolina

Women, age 20 + , low income

The educational program at county health departments included media messages, direct education, telephone counseling, staff education, and small workshops

Skin: Clinical skin exam, skin self-exam

Cervical: Pap smear

Breast: Clinical breast exam, mammography, breast self-exam

Bencivenga

2008

One county in western Pennsylvania

Women, age 40 + , visiting a food pantry, eligible for breast cancer screening

Staff hung educational posters, developed a radio campaign, and stuffed promotional flyers in food bags for food pantry patrons. Women at the pantries were assessed for breast cancer screening eligibility, and staff provided navigation to schedule and identify financial support for mammography

Breast: Mammography

Teal

2012

Two counties in eastern North Carolina

Women, age 40 + , African American

The program relied on lay health advisors to conduct one-on-one and small group discussions with patients to schedule and identify financial support for mammography

Breast: Mammography

Norman

2013

Sixteen counties in eastern Colorado

Adults, age 40 + 

"Boot camp" process to translate evidence-based prevention guidelines into lay messages and campaigns (one exemplar topic was colon cancer prevention). The boot camp process for colon cancer prevention involved 1 full-day retreat, 4 half-day retreats, and 8 half-hour phone calls. The lay campaign included newspaper stories about community members, a farm auction flyer, pocket-sized cards with locally-tailored photographs, community education sessions, and a travel mug with a colon cancer prevention message

Colorectal: Colonoscopy and other screening

Lee-Lin

2014

Two communities in Oregon

Women, age 40 + , eligible for breast cancer screening

The multicomponent, community-specific intervention included appointment setting, financial assistance, one-on-one client education, reminder letters from a clinician, breast health education DVD, and breast cancer screening continuing medical education to clinicians

Breast: Mammography

Breslau

2015

Underserved counties in six states (Alabama, Georgia, Kentucky, Missouri, South Carolina, and Tennessee)

Women, low income, eligible for breast or cervical cancer screening

State and community organizations worked with a federal network to choose, adapt, and implement evidence-based interventions to increase breast and cervical cancer screening. Specific interventions differed across sites

Breast: Mammography

Cervical: Pap smear

Cardarelli

2017

Two communities in eastern Kentucky

Adults, age 55–77, eligible for lung cancer screening

The tailored community awareness campaign about lung cancer screening disseminated flyers, postcards, and radio and newspaper ads. In addition, the campaign included a website and provided education to clinicians

Lung: Low-dose CT

Gesthalter

2017

Three Veterans Administration clinics in three states

Not specified

Three VA clinics were classified as early adopters of lung cancer screening with low-dose CT. Specific interventions differed across sites

Lung: Low-dose CT

Katz

2017

Twelve counties in Appalachian Ohio

Adults, age 51–75

The media campaign disseminated information about colon cancer screening through billboards, posters, and newspaper articles

Colorectal: Any screening

Schlauderaff

2017

One rural health clinic in western Washington

Adult patients, age 50–75

The program included clinic-focused efforts: Additional staff education, standardizing protocols for clinicians to discuss and order screening, implementing a flag for screening in the electronic health record system, and improved systems for interprofessional communication. In addition, the program included patient-focused efforts: Mass mailing of stool tests, financial assistance, and outreach

Colorectal: Any screening

Woodall

2018

One city government workplace in Kentucky

Adult employees, age 18 + 

The program nurse delivered educational sessions about colorectal cancer screening to city employees. The nurse also distributed free stool tests and communicated test results to participants, providing referral to primary care clinicians if needed

Colorectal: Stool testing

Tolma

2019

One tribal community in Oklahoma

Women, age 52–74, American Indian, eligible for breast cancer screening, with a scheduled clinic visit in the next month

The program targeted systems change in the clinic and community. Clinic interventions included training to clinicians to support patient-doctor communication on mammography, including a tailored mammography brochure, sending follow-up recommendation letters, developing a screening flowchart, and hanging an educational bulletin board poster at the clinic. Community interventions included discussion groups for eligible women and a younger female relative, as well as a small gift after mammography

Breast: Mammography

Elliott

2021

Thirty-four primary care clinics in four states

Patients, age 11–75, eligible for cancer screening or prevention services, with a clinic visit during the study period

Primary care clinics instituted a web-based clinical decision support tool or shared decision making tools, integrated into the electronic health record, to prompt clinicians to prioritize delivery of primary and secondary cancer prevention services to eligible patients

Composite measure of breast, cervical, and colorectal cancer screening (any modality)

  1. CT Computed tomography