Tobacco use among Appalachian adolescents: An urgent need for virtual scale out of effective interventions

"Just give it to us straight!": a qualitative analysis of midwestern rural lung cancer survivors and caregivers about survivorship care experiences

PURPOSE

We assessed the experiences of rural lung cancer survivors and caregivers to understand and identify barriers to posttreatment survivorship care management.

METHODS

From May 2021 to June 2022, we conducted semi-structured interviews with a purposively sampled cohort. Participants were either posttreatment lung cancer survivors (within 5 years of their last active treatment) or caregivers of a lung cancer survivor. Interviews probed participants regarding survivorship care knowledge, implementation, and navigation. Two analysts inductively coded verbatim transcripts and conducted a thematic analysis.

RESULTS

We interviewed N = 21 participants: lung cancer survivors (76%) and caregivers (24%). Participants self-identified as Non-Hispanic White (100%), were at least 65 years old (77%), identified as male (62%), and previously smoked ≥ 5 packs over the lifetime (71%). The perspectives of survivors and caregivers were similar; thus, we analyzed them together. Themes related to survivorship care included (1) frustrations and uncertainty regarding unexpected barriers, (2) strategies to improve the delivery of posttreatment information, (3) strategies to remain positive and respond to emotional concerns of survivorship care, and (4) the impact of engaging and patient-centered care teams.

CONCLUSION

Given the limited access to lung cancer care resources in rural communities, our findings reveal that following a survivorship care program or plan requires a high level of individual resilience and community/interpersonal networking.

IMPLICATIONS FOR SURVIVORS

This study's findings can be applied to improve practice-based care for rural posttreatment lung cancer survivors and provide an impetus for developing tools to assist patient navigation toward community-based supportive care and care management resources.

Engaging Appalachian Youth: Lessons Learned From a Virtual Tobacco Prevention and Advocacy Training

Engaging youth is recommended as a key component of comprehensive tobacco control to bring voice to youth perspective and to connect to community impact. Yet, limited research exists to showcase practical lessons learned in supporting skill development and engagement of youth. This practice note describes how a tailored prevention and advocacy virtual training can serve to engage and empower rural Appalachian high school students to participate in tobacco control efforts. Specifically, we describe the implementation and practical lessons learned from a two-session virtual tobacco prevention and advocacy training led by college facilitators. Participating high school students (N = 20) strongly agreed that tobacco use was a major problem facing their community and that addressing tobacco use should be prioritized. After participating in the training, students' interpersonal confidence improved and participation in self-reported advocacy increased. Students also liked the virtual platform, interaction with college students, and the opportunity to apply information learned. Youth-focused tailored training promotes skill-building and enhances self-efficacy to engage in tobacco control. Youth engagement should be integral to supporting community health initiatives, including tobacco prevention.