Community Recommendations for Enhanced Regional Survivorship Outcomes: A Case for Social and Structural Determinants of Health from a US National Cancer Institute Designated Cancer Center

Background: The number of cancer survivors has increased drastically as a result of advances in early detection and treatment strategies. Nevertheless, many survivors in the cancer survivorship population face unique problems, risks, and needs. The study for this short report obtained qualitative data to assess barriers and facilitators to cancer care survivorship in urban and rural communities from a National Cancer Institute (NCI) Designated Cancer Center Catchment Area in the southeastern United States. Methods: Thirty (n = 30) community stakeholders participated in in-depth interviews. The interviews were audio-taped, transcribed, and coded by independent raters. Inter-rater reliabilities indicated adequate agreement [inter-rater reliability (r) = 0.79].Results: Themes related to community health concerns, cancer survivorship services, access to physical activity, and access to fresh fruits and vegetables were identified. In addition, participants provided strategies to improve the reach, utilization, and outcomes of postdiagnosis community-based care services.Conclusion: Integrated community-engaged approaches are needed to address local survivorship services impacted by the social and structural determinants associated with unhealthy lifestyles.