Abstract 5289: Implementing cancer intervention programs in rural settings: A review
Authors: Percy-Laurry Antoinette , Chambers David A. 
Published: August 2018

Abstract
INTRODUCTION While a decrease in overall cancer rates is found during the period, 1999-2013, geographic disparities still persist. Understanding the relationship between rurality and access to evidence-based interventions remain significant. This review investigates cancer control interventions developed to deploy in a rural environment and their common implementation strategies and approaches. METHOD We searched the National Cancer Institute's (NCI) Research-Tested Intervention Programs (RTIPs) database to identify interventions in rural settings. The interventions were reviewed for program focus, population, cultural relevance, physician influence, coordination of services, and implementation strategies. We compared the review in RTIPs to systematic reviews on breast cancer programs and obesity-related programs found in PubMed using keyword searches. RESULTS Of the 185 intervention programs provided by the RTIPs database, 36 were recommended for rural settings. Of the 36 programs, 12 were conducted in rural populations only. Cancer topics and related areas varied with most of the 12 interventions on nutrition/obesity-related (4) and breast cancer screening (3). In PubMed, we searched for systematic reviews on diet/nutrition and breast cancer screening in the US rural settings and found two systematic reviews specific to breast cancer screening interventions and one systematic review on lifestyle interventions focused on diet/nutrition and physical activity. Of the two breast cancer systematic reviews, one was focused on supportive care and the other review included only 5 interventions of a larger review of breast cancer studies. The lifestyle systematic review summarized 18 interventions, most of which were tailored to target a specific racial/ethnic group. Implementation strategies used were mainly education and building capacity in meal preparation and physical activity. The breast cancer review provided no detail on the implementation strategies and approaches of the 5 interventions since they were reviewed for differences in mammography uptake in rural vs urban. Only 5 RTIPs rural only interventions were found to target the underserved and an additional 2 interventions focused on minority women population. DISCUSSION More studies and interventions are needed on rural populations to contribute to the understanding and reduction of the high rates of cancer. Early detection is vital in advancing cancer efforts and NCI's RTIPs would benefit from having new interventions focused on messaging and physician guidance and knowledge to allow for effective comprehensive cancer control programs. The reviews also show there is a need for research on strategies and approaches used in rural settings. Furthermore, there needs to be a comprehensive evaluation on the effectiveness of breast cancer intervention programs and diet/nutrition-related programs in rural communities.
Citation Format: Antoinette Percy-Laurry, David A. Chambers. Implementing cancer intervention programs in rural settings: A review [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5289.