Participatory design of a health informatics system for rural health practitioners and disadvantaged women

While advances in highly targeted therapies and increased use of mammogram services have contributed to the overall decline of breast cancer deaths in the United States, these benefits have not been distributed equitably. Less educated, poor, rural, non-Hispanic African American women have poorer access to cancer services and are less likely to have had a mammogram than are urban women. Lack of physician recommendations and perceived barriers in accessing diagnostic services are major factors that hinder the uptake of regular mammograms in rural communities. This article reports results of formative research conducted as part of a larger study focused on the participatory development of an electronic reminder system for breast cancer screening. The article discusses insights gained from focus groups with rural patients and clinicians about their information needs, breast cancer screening behaviors, barriers to care, and mammography referral practices.