| Race and ethnicity |
“Sun exposure, we don’t really hear too much about that, especially for African Americans, you think ‘oh, we don’t really need [to know about the risks of] the sun exposure,’ but we need to [watch sun exposure] just as much as everybody else does.” [Black woman from an urban county; aged 29 y] “The Latino community, generally speaking, when parents bring their daughters to their appointments and the doctor starts talking about the HPV [human papillomavirus] vaccination, the doctors also start talking about if the teen’s been sexually active and that doesn’t click so well...perhaps there is a deep cultural and religious background, but many moms are like ‘I don’t see the need for that vaccination, because my daughter is not sexually active.’” [Latina woman from an urban county; aged 50 y] “Some people really don't go to the doctor unless they know for a fact, something is wrong with them. And, sometimes I think in the Black community, there is a lack of trust with health care providers, and I think that sometimes there’s a lot of fear. It’s more out of sight, out of mind. If I don't have anybody telling me that there’s nothing wrong with me, then I don't have anything to worry about. So, kind of that type of thing is a cultural thing as well, and people just don’t go to the doctor. It’s just not something that’s done unless you know, something is wrong.” [Black woman from an urban county; aged 30 y]
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| Rural and urban residency |
“Transportation and the fact we only have two clinics. If those clinics don’t offer screenings, then they have to go outside the county...And [it’s] not only transportation, it’s...the gas money, eating if you’re gone very long, and all that goes along with that.” [White woman from a rural county; aged 49 y] “I think that there is a lot available now, more now than there used to be. I still feel that a lot of people still travel. They still travel to larger hospitals in the larger cities because they feel like they can get better treatment, better care. I think a lot of it has to do with trust and outcomes and seeing that there’s success in this area, with treating it. People don’t want to risk their lives going through treatment in a small town where they’re just starting this treatment.” [White woman from a rural county; aged 58 y] “We need to have the doctor that will stay for years. I mean when I was young, the doctor that I saw until I was 18 was the doctor that birthed me, and I know that that is so rare. But, there’s just no relational aspects to health care. You’re just a number, and you’re lucky if you can get a doctor that’ll stay for a few years in a small town. So that’s, you know, I think that’s the big thing is just access, and access doesn’t mean 30 minutes away, it means I can walk there.” [White woman from a rural county; aged 55 y]
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| Gender norms and LGBTQ+a identity |
“It was after the surgery, my follow-up, and I was going to get the pathology report from the breast surgeon. My partner came with me, and I don't think they even offered to have her sit down. They didn't ask her if she had any questions. There was just no, you know, they just kind of ignored her, and it was, you know, not a fun time at all. So, I don’t know how prejudiced they were, but we felt it anyway.” [White woman from an urban county; aged 73 y; LGBTQ+ identity] “I mean, my father was very anti-doctor. No matter what I would say to him...he wouldn't go to a doctor. But at the chiropractor, they said ‘hey, I’m not qualified to say this, but it looks like you have cancer, you’re a very sick man and you need to go to the hospital.’ He died six weeks later. I’d hear him say it many times, he felt like it [health care] was only for the rich...if you can figure out how to change that mentality. [White man from an urban county; aged 41 y; LGBTQ+ identity]
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| Generational differences |
“My mom is in her 60s...this morning, she asked me if her camera was capable of videos...I think not knowing how to do it is a barrier, but maybe you can walk them through how you set it up.” [Black woman from an urban county; aged 29 y] “I think within my family the 30 and under group, we're much more open to [genetic] information and talking to each other about it. Whereas my mom...she’s much more, ‘Why are you sending off your DNA, I don’t want to know,’ and I feel there’s a generational difference in sharing information and understanding why it’s important.” [Black woman from an urban county; aged 30 y]
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