Abstract B26: Are rural Ohio Appalachia cancer survivors needs different than urban cancer survivors?

Purpose: To plan appropriate services and educational programs for cancer survivors, we conducted an assessment of potential needs of cancer survivors living in rural Ohio Appalachia compared to urban Ohio.

Methods: Convenience samples of rural (n=99) and urban (n=107) cancer survivors completed a self-administered questionnaire that focused on demographic characteristics, potential needs, and their sources for cancer-related information at three time points (time of diagnosis, during treatment, and after treatment).

Results: Cancer survivors were female (62%),White (97%), married (73%), and had a mean age of 60 years. Rural survivors had significantly (p<0.05) less education (high school or less; 73% vs. 57%) and had lower annual household incomes (<$40,000; 63% vs. 39%). There were no significant differences between rural and urban survivors regarding employment and marital status, although 20% (40/199) reported that their employment status changed and 3% (6/199) reported that their marital status changed due to their cancer diagnosis. Both rural and urban survivors reported needs that were not currently being met in each of 10 categories (symptoms, emotional, health behaviors, relaxation & stress, relationships, money & legal issues, assistance, support, expressive arts, and spirituality) with urban survivors reporting more needs in 7 of 10 categories (p<0.05). Ranking of top needs by urban and rural survivors were fear of recurrence (51% and 28%) and fatigue (49% and 29%), with urban survivors reported these needs significantly more than rural survivors (p<0.01). Rural survivors reported needing help in paying medical bills (25% vs. 18%) and with health insurance (21% vs. 13%) more than urban survivors but these were not statistically different. Both rural and urban survivors reported searching for less cancer-related information (p<0.01) after treatment (52%) compared to at the time of diagnosis (92%) and during treatment (82%). In addition, rural survivors reported searching for more information during treatment compared to urban survivors (92% vs. 74%; p<0.05). Compared to urban survivors, rural survivors more frequently reported their family members as a source of information at the time of their cancer diagnosis (29% vs. 14%) and their healthcare provider (68% vs. 50%) as a source of information during treatment (p<0.05). Urban survivors reported using books (49% vs. 23%) and the library (16% vs. 4%) for their information more at time of diagnosis and during treatment compared to rural survivors (p<0.05).

Conclusion: Rural and urban cancer survivors in Ohio have many of the same needs, however some differences exist. Rural survivors used more “human” resources for information, while urban survivors were more likely to use written material. These findings will be helpful in planning future services and educational programs for cancer survivors living in rural and urban Ohio.