Table 2.

Summary of themes, subthemes, and examples from focus groups and key informant interviews

Barriers and facilitators of screening
Subthemes	Examples or explanation
Inadequate personal and community resources	Lack of insurance or transportation, healthcare professional shortages
Competing demands	Inadequate time or income
Attitudinal and knowledge barriers	Fear of the procedure or results, lack of perceived need for screening
Family health history	Parents’ death from cancer increases vigilance; sister’s cyst motivates screening
Personal health habits	Family sets preventive behaviors as norm
Healthcare providers.	Positive (strong recommendations for screening) or negative (office visit is day of reckoning and fear)
Recommendations
Provide and advertise free, low cost screenings
Leverage family cancer history to motivate people to get screened
Healthcare providers and their office staff should encourage the prevention habit. Reminders for screenings should be sent often, calls made the evening before a visit, and a screening recommendation with every visit, even if visit focuses on a different complaint.
Employ paraprofessionals or lay workers to compensation for rural provider shortages. Update rural providers’ medical knowledge.
Bundle screening and prevention during each office visit
Target younger women into prevention recommendations, as health habits start early.