This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (29)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

D. Michael Elnicki, MD; Douglas K. Morris, MA; William T. Shockcor, MD

Arch Intern Med. 1995;155(4):421-424.

Abstract
Objective
To examine perceptions of a cohort of rural Appalachian patients regarding barriers to the use of preventive health measures.

Methods
Consecutive new patients (N=188) at a clinic for the indigent were confidentially surveyed about their use of six preventive health measures: blood pressure screening, cholesterol level, diphtheria-tetanus immunization, mammography, cervical Papanicolaou smear, and physical examination. When any of these measures was lacking, patients were asked why, and whether they would have the measure performed if the relevant barriers were removed.

Results
Applicable screening measures lacking were as follows: blood pressure screening, 16%; cholesterol level, 60%; diphtheria-tetanus immunization, 67%; mammography, 69%; Papanicolaou smear, 22%; and physical examination, 32%. Of the patients, 85% were lacking at least one measure. Patients most often identified the following reasons for having omitted these measures: lack of knowledge about prevention (51%) and cost (36%). Older and less educated patients more often identified cost (P<.01 and P=.06, respectively), and men were more likely to list lack of knowledge (P=.04). If the identified barriers could be removed, 72% of those lacking a screen indicated they would obtain the screening measures.

Discussion
This indigent population expressed a desire for preventive care. Our patients identified cost and lack of knowledge as the major reasons for omitting these health screening measures. Data obtained from health care providers, rather than patients, may fail to disclose the barriers these patients face. Adequate education about disease prevention may be as crucial as sufficient funding in improving compliance with preventive guidelines.

(Arch Intern Med. 1995;155:421-424)

Author Affiliations
From the Department of Medicine, West Virginia University, Morgantown.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Effectiveness of a Nurse-Managed, Lay-Led Tobacco Cessation Intervention Among Ohio Appalachian Women
Wewers et al.
Cancer Epidemiol. Biomarkers Prev. 2009;18:3451-3458.
ABSTRACT | FULL TEXT  

The Need for Increased Access to the U.S. Health-Care System
Bible et al.
JBJS 2009;91:476-484.
FULL TEXT  

Key Informants' Perspectives Prior to Beginning a Cervical Cancer Study in Ohio Appalachia
Katz et al.
Qual Health Res 2007;17:131-141.
ABSTRACT  

Using the PRECEDE Model to Plan Men's Health Programs in a Managed Care Setting
Meador and Linnan
Health Promot Pract 2006;7:186-196.
ABSTRACT  

Trust in Healthcare: An Information Perspective
Hoglund et al.
Health Informatics Journal 2004;10:37-48.
ABSTRACT  

Effectiveness of Interventions to Increase Papanicolaou Smear Use
Yabroff et al.
J Am Board Fam Med 2003;16:188-203.
ABSTRACT | FULL TEXT  

Breast and Cervical Cancer Screening among Appalachian Women
Hall et al.
Cancer Epidemiol. Biomarkers Prev. 2002;11:137-142.
ABSTRACT | FULL TEXT  

Preventive Services for Rural and Urban African American Adults
Hueston and Hubbard
Arch Fam Med 2000;9:263-266.
ABSTRACT | FULL TEXT