Purpose

The incidence and mortality rates of colorectal cancer (CRC) remain consistently high in rural populations. Telehealth can improve screening uptake by overcoming individual and environmental disadvantages in rural communities. The present study aimed to characterize varying barriers to CRC screening between rural individuals with and without experience in using telehealth.

Method

The cross-sectional study surveyed 250 adults aged 45–75 residing in rural U.S. states of Alaska, Idaho, Oregon, and Washington from June to September 2022. The associations between CRC screening and four sets of individual and environmental factors specific to rural populations (i.e., demographic characteristics, accessibility, patient–provider factors, and psychological factors) were assessed among respondents with and without past telehealth adoption.

Result

Respondents with past telehealth use were more likely to screen if they were married, had a better health status, had experienced discrimination in health care, and had perceived susceptibility, screening efficacy, and cancer fear, but less likely to screen when they worried about privacy or had feelings of embarrassment, pain, and discomfort. Among respondents without past telehealth use, the odds of CRC screening decreased with busy schedules, travel burden, discrimination in health care, and lower perceived needs.

Conclusion

Rural individuals with and without previous telehealth experience face different barriers to CRC screening. The finding suggests the potential efficacy of telehealth in mitigating critical barriers to CRC screening associated with social, health care, and built environments of rural communities.

中文翻译：

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评估美国太平洋西北地区农村地区与远程医疗使用相关的结直肠癌筛查障碍的变化

目的

农村人口结直肠癌（CRC）的发病率和死亡率始终居高不下。远程医疗可以通过克服农村社区的个人和环境劣势来提高筛查率。本研究旨在描述有或没有使用远程医疗经验的农村个体在结直肠癌筛查方面存在的不同障碍。

方法

这项横断面研究调查了 2022 年 6 月至 9 月居住在美国阿拉斯加州、爱达荷州、俄勒冈州和华盛顿州农村地区的 250 名 45-75 岁成年人。CRC 筛查与农村人口特有的四组个人和环境因素之间的关联（对过去采用和未采用远程医疗的受访者进行了评估，即人口特征、可及性、患者-提供者因素和心理因素。

结果

过去使用过远程医疗的受访者如果已婚、健康状况较好、在医疗保健方面经历过歧视、感知到易感性、筛查效果和癌症恐惧，则更有可能进行筛查，但当他们担心隐私时则不太可能进行筛查或感到尴尬、痛苦和不适。在过去没有使用过远程医疗的受访者中，由于日程繁忙、旅行负担、医疗保健方面的歧视以及感知需求较低，CRC 筛查的几率下降。

结论

有或没有远程医疗经验的农村个人在结直肠癌筛查方面面临着不同的障碍。该发现表明，远程医疗在减轻与农村社区的社会、医疗保健和建筑环境相关的结直肠癌筛查的关键障碍方面具有潜在功效。