Compliance rates and predictors of cancer screening recommendations among Appalachian women

J Health Care Poor Underserved. 2002 Nov;13(4):443-60. doi: 10.1353/hpu.2010.0582.


High rates of morbidity and mortality in the Appalachian region of the country warrant examination of the preventive care behavior of its residents. This study determined compliance rates for breast and cervical cancer screening recommendations for women residing in Appalachian states and identified predictors of such compliance using the Behavioral Risk Factor Surveillance System data (1995-97). Healthy People 2000 goals were used as benchmarks for progress. Appalachian women have made good progress toward goals pertaining to breast and cervical cancer screening. Compliance with other preventive services, having insurance coverage, residing in urban areas, better self-reported health, and higher education were independently associated with increased odds of compliance with annual-screening recommendations. Risk factors of obesity and smoking were associated with decreased odds of compliance. Findings should be useful to health care providers, policy makers, and researchers in their efforts to educate, encourage, and promote preventive care behavior among residents of Appalachia.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Appalachian Region
  • Behavioral Risk Factor Surveillance System
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility
  • Humans
  • Insurance, Health / statistics & numerical data
  • Mass Screening / standards
  • Mass Screening / statistics & numerical data*
  • Medically Underserved Area
  • Middle Aged
  • Neoplasms / prevention & control*
  • Obesity / complications
  • Obesity / psychology
  • Patient Compliance / psychology
  • Patient Compliance / statistics & numerical data*
  • Practice Guidelines as Topic
  • Residence Characteristics / statistics & numerical data
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / psychology
  • Socioeconomic Factors
  • Women* / education
  • Women* / psychology