Due to the advances in cancer screening, diagnosis and treatment and an aging population, cancer survivorship has become a focal cancer control and health communications research area. Both adult and childhood cancer patients are treated with modalities that are accompanied with immediate and late- appearing complications. Moreover, there are multiple psychosocial and economic consequences associated with a cancer diagnosis. Consequently, information and communication are essential for patients and providers to manage these complications and long-term health issues. All of the abovementioned challenges may be magnified in Appalachia, where cultural barriers, lower SES, co-morbidities and high-risk health behaviors, and limited access to health services and insurance are often present. Reliance on primary care providers for survivorship care and information may be especially high in the Appalachian region since many cancer survivors may have received their primary treatment in a distant, urban setting or from one of a limited number of oncologists practicing in the area. The extent to which the information needs of Appalachian cancer survivors are being met by their primary care providers is currently unknown. In addition, we are unaware of the strategies used and challenges faced by Appalachian primary care providers in providing survivorship-oriented care and information. In collaboration with community-based partners and primary care providers in Appalachian Kentucky and Virginia, we will conduct formative research using focus groups and in-depth interviews. The broad, long-term goal of the project is to improve understanding of the dynamics of communication and information sharing between Appalachian cancer survivors and their primary care providers. Reaching this goal will help improve patient-provider communication, reduce cancer morbidity and mortality, and improve quality of life, and ultimately impact cancer disparities in Appalachia. The study's 3 specific aims are to: 1) Identify the cancer information and communication needs of Appalachian cancer survivors and their primary care providers; 2) Determine Appalachian cancer survivors' experiences with and perceptions of their primary care provider in providing cancer survivorship care and information; and 3) Identify the strategies used and challenges faced by Appalachian primary care providers in managing the care and information needs of cancer survivors in their practices. ? ? ?
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