Lung Cancer Prevention Among Appalachian Kentucky Women: A Community-Engaged Mixed Method Study

PurposeAppalachian Kentucky (KY) residents experience the highest lung cancer rates in the US with declines lagging among women; we sought to uncover barriers and facilitators to lung cancer prevention for Appalachian KY women and to identify community-specific interventions.ApproachWe utilized concept mapping, a participatory mixed method, to generate consensus on perceived barriers and facilitators.Setting/ParticipantsWe recruited 71 adult women from Appalachian KY counties.MethodAfter collecting online concept mapping data, we used multidimensional scaling to generate a point map of perceived similarities and hierarchical cluster analysis to create a thematic cluster map. We compared average cluster ratings across importance and feasibility. During focus group discussions, we shared concept maps to gather insights on intervention areas.ResultsParticipants listed 70 barriers and facilitators in 8 thematic clusters, including community-level, healthcare, and tobacco-related factors. Participants identified three intervention areas: 1) educational campaigns, including efforts directed toward youth, mothers, and those eligible for lung cancer screening; 2) policy, such as smoke-free laws, inclusion of vaping in existing policies, and advertisement bans; and 3) improving access to lung cancer screening.ConclusionOur findings support multilevel interventions for lung cancer prevention, including improving awareness, local policy, and screening access for Appalachian KY women. This research contributes novel understanding of local and gender-specific barriers and informs future Appalachian lung cancer prevention studies.