Article

Journal of Cancer Education

, Volume 28, Issue 3, pp 573-581

Identifying Health Literacy and Health System Navigation Needs among Rural Cancer Patients: Findings from the Rural Oncology Literacy Enhancement Study (ROLES)

  • Ana P. Martinez-DonateAffiliated withCarbone Cancer Center, University of WisconsinDepartment of Population Health Sciences, University of Wisconsin Email author 
  • , Julie HalversonAffiliated withCarbone Cancer Center, University of Wisconsin
  • , Norma-Jean SimonAffiliated withCarbone Cancer Center, University of WisconsinDepartment of Population Health Sciences, University of Wisconsin
  • , Jeanne Schaaf StricklandAffiliated withCarbone Cancer Center, University of Wisconsin
  • , Amy Trentham-DietzAffiliated withCarbone Cancer Center, University of WisconsinDepartment of Population Health Sciences, University of Wisconsin
  • , Paul D. SmithAffiliated withDepartment of Family Medicine, University of Wisconsin
  • , Rebecca LinskensAffiliated withCarbone Cancer Center, University of Wisconsin
  • , Xinyi WangAffiliated withDepartment of Population Health Sciences, University of Wisconsin

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Abstract

Rural residence is associated with disparities in cancer-related outcomes. Guided by the Chronic Care Model (CCM), the Rural Oncology Literacy Enhancement Study (ROLES) assessed health literacy and patient navigation needs among rural cancer patients. A mixed methods (qualitative and quantitative) approach was used, including: in-depth interviews, health literacy assessments, and phone surveys with cancer patients (N = 53) from 5 oncology clinics in rural Wisconsin; focus groups and self-administered surveys with staff (N = 41) in these clinics. Within four dimensions of the CCM (community resources, self-management support, delivery system design, and decision support), this study uncovered multiple unmet navigation needs, health literacy limitations, and barriers to quality cancer care. System-level implementation of patient navigation and health literacy best practices could contribute to improved cancer care and patient outcomes among rural populations. Further research identifying effective interventions that reduce cancer disparities among rural cancer patients is necessary.

Keywords

Chronic Care Model Health Literacy Quality cancer care Rural Patient navigation