||Purpose: Previous research has demonstrated the potential for preventative health
services to help address the existing health disparities in Central Appalachia. The
Remote Area Medical Corps (RAM) Clinic in Wise County, Virginia provides a critical
opportunity to understand preventative screening rates and factors affecting use for
medically underserved patients in the region. This thesis contributes to existing
regional research by being the first to survey a large, regional sample of underserved
Methods: Over the course of three days, 205 patients were surveyed using questions
primarily taken from two national health surveys. Patient characteristics and screening
rates were compared to national data from the US Census and previous analysis of national
health surveys. In addition, multi-variable model selection was used to identify the
best predictors of screening use for RAM patients.
Results: RAM patients overwhelmingly have low rates of preventative screening use
according to the United States Preventative Screening Task Force Guidelines. On average,
patients were missing at least a third of the recommended screenings. Colon, breast
and cervical cancer screening rates fall well below the national averages. Blood pressure,
blood cholesterol and lung cancer screening use is low. Model selection results show
the importance of a healthcare visit within the past year, access to a personal provider
and a routine checkup.
Conclusions: Low screening rates combined with the existing mortality disparities
and established benefits of early screening demonstrate the need and potential of
health care reform to improve regional preventative services use.