ArticleSurgery2023
A socioecological qualitative analysis of barriers to care in colorectal surgery.
Article in Surgery, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The invisible wall: experiences of social isolation in colorectal cancer patients with ostomy-a qualitative meta-synthesis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Pooled it
- The Role of Health Literacy in Gastrointestinal Cancer Patients' Surgical Journey: A Qualitative Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Patient-Reported Barriers to Foregut Cancer Care in the Deep South.Annals of surgical oncology · 2025Article
- Exploring factors contributing to patient decision-making in the care journey to elective hernia care in Kenya.PloS one · 2025Article
- Achieving Health Equity: Advancing Colorectal Surgery among Racial and Ethnic Minorities in America.Clinics in colon and rectal surgery · 2025Review
- Effect on Travel Distance of a Statewide Regionalization Policy for Initial Breast Cancer Surgery.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Providers' and survivors' perspectives on the availability and accessibility of surgery in gastrointestinal cancer care.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2024Article
- Exploring Disparities in Pancreatic Ductal Adenocarcinoma Outcomes among Asian and Pacific Islander Subgroups.Cancer research communications · 2024Article
- Review
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Authors and funding
11 authors.
Funding
Abstract
backgroundAlthough specific social determinants of health have been associated with disparities in surgical outcomes, there exists a gap in knowledge regarding the mechanisms of these associations. Gaining perspectives from multiple socioecological levels can help elucidate these mechanisms. Our study aims to identify social determinants of health that act as barriers or facilitators to surgical care among colorectal surgery stakeholders.
methodsWe recruited participants representing 5 socioecological levels: patients (individual); caregivers/surgeons (interpersonal); and leaders in hospitals (organizational), communities (community), and government (policy). Patients participated in focus groups, and the remaining participants underwent individual interviews. Semistructured interview guides were used to explore barriers and facilitators to surgical care at each socioecological level. Transcripts were analyzed by 3 coders in an inductive thematic approach with content analyses. The intercoder agreement was 93%.
resultsSix patient focus groups (total n = 18) and 12 key stakeholder interviews were conducted. The mean age of patients was 54.7 years, 66% were Black, and 61% were female. The most common diseases were colorectal cancer (28%), inflammatory bowel disease (28%), and diverticulitis (22%). Key social determinants of health impacting surgical care emerged at each level: individual (clear communication, mental stress), interpersonal (provider communication and trust, COVID-related visitation restrictions), organizational (multiple forms of contact, quality educational materials, scheduling systems, discrimination), community (community and family support and transportation), and policy (charity care, patient advocacy organizations, insurance coverage).
conclusionKey social determinants of health-impacting care among colorectal surgery patients emerged at each socioecological level and may provide targets for interventions to reduce surgical disparities.
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