Determinants of Infant Participation and Non-Participation in Primary Prevention Trials.

Lung cancer is the leading cause of cancer-related mortality in the United States. Lung cancer screening with annual low-dose computed tomography (LDCT) is an effective, evidence-based practice that can diagnose lung cancer at earlier stages and improve lung cancer mortality. Despite guideline support for lung cancer screening in high-risk populations, screening utilization remains low within and outside the Veterans Health Administration (VHA). Individuals residing in rural areas have higher smoking rates than those residing in non-rural areas. Further, individuals residing in rural areas face barriers to care, such as lower socioeconomic status, inadequate provider-patient communication, and limited geographic access to specialty care, that may contribute to higher lung cancer incidence, mortality, and advanced-stage disease. Rural norms and culture influence the way health care is delivered and received in rural settings. Understanding patient satisfaction with lung cancer screening care in rural settings is necessary for developing high-quality lung cancer screening practices. The primary aim of this study was to explore the association of rurality with Veteran satisfaction with lung cancer screening care at 10 Veterans Affairs Medical Centers (VAMCs). Our secondary aims were to explore the association of other Veteran factors, such as race/ethnicity, educational attainment, and smoking status, with satisfaction with lung cancer screening care and to identify specific areas where care gaps may exist by probing Veteran agreement with individual PSCC survey items that reflect more discrete steps in care.