ArticleJournal of cancer survivorship : research and practice2026
The receipt of psychological services and acceptability of local follow-up care for childhood cancer survivors: are there rural vs. urban differences?
Article in Journal of cancer survivorship : research and practice, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study examined rural and urban parents' reports of their children's receipt of general follow-up care and psychological services, ratings of the acceptability of common sources of follow-up care, and ratings of local/nearby follow-up care access and effectiveness.
methodsA cross-sectional, quantitative survey was conducted among 238 (139 urban, 46 rural adjacent, and 53 rural non-adjacent) parents of childhood cancer survivors (ages 2-17 and at least 2 years since cancer diagnosis) recruited through the Kentucky Cancer Registry. Bivariate analyses and multivariable logistic regressions adjusting for predisposing, enabling, and need factors tested for differences across residence in urban counties, rural counties adjacent to an urban county, and rural counties non-adjacent to an urban county.
resultsChildren in rural adjacent counties had higher adjusted odds of receiving psychological services (OR 4.37; 95% CI 1.45, 13.22) than children in urban counties. Parents of children in non-adjacent counties had lower adjusted odds of agreeing that they could obtain local/nearby follow-up care for their child (OR 0.15; 95% CI 0.06, 0.36) and that local follow-up care was effective (OR 0.22; 95% CI 0.10, 0.48) than parents of children in urban counties.
conclusionsThe study findings provide a comprehensive yet complex picture of similarities and differences in children's follow-up care access according to their rurality of residence. Children residing in rural areas adjacent to an urban area have better access to psychological services than children residing in urban areas. However, parents of children residing in rural areas non-adjacent to an urban area have worse ratings of the accessibility and effectiveness of local follow-up care. IMPLICATIONS FOR CANCER SURVIVORS: Psychological services may need to be expanded for childhood cancer survivors in both rural and urban areas to ensure equitable access. The accessibility and quality of local services may need to be improved to encourage the use of local follow-up care among children residing in rural areas that are non-adjacent to an urban area.
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