Survivorship Care Plan use by cancer survivors living in rural versus urban settings: A qualitative analysis.

Purpose: With the growing number of cancer survivors, there is an increasing need for transitioning care from cancer centres to primary care providers (PCPs). Survivorship care plans (SCPs) were introduced to aid in this transition. Our study investigated how SCPs were used by survivors living in rural versus urban settings of Eastern Ontario and if there were any differences in needs related to the use of SCPs. Methods: Seventeen urban and 13 rural dwelling survivors who received their SCPs from The Ottawa Hospital Wellness Beyond Cancer Program (WBCP) were recruited. The participants were interviewed about their use of SCPs for 30-45 minutes using an interview guide. Content and thematic analyses were conducted using NVivo-12 to examine differences in how SCPs are used in urban and rural contexts. Results: Survivors from rural communities discuss trusting their PCPs with their transition and viewing SCPs more as a tool for their providers. Survivors living in urban locations report using their SCPs as an advocacy tool to communicate with their PCPs and discuss hesitancy about being discharged from specialist care. Survivors from rural settings report relying on social support networks while their urban counterparts did not report strong social supports. Interestingly, both groups reported the need for more support groups comprised of other survivors. Conclusions: Survivors from rural and urban locations face different challenges that can be addressed by individualizing SCPs. All survivors would benefit from support groups comprised of other survivors. We aim to highlight the specific needs that survivors from different geographical locations may have, to inform SCPs more effectively.