Understanding the impact of distance and disadvantage on lung cancer care and outcomes: a qualitative interview study in urban and rural settings

<p>BACKGROUND-AIM: There are wide variations and stark inequalities in lung cancer care and survival across the UK. Most work to date has focussed on improving clinical services and much less on the factors affecting patients’ access to treatment. This place-based study aims to explore and characterise how personal circumstances and distance from the location of specialist services intersect and impact on access to optimal lung cancer care and therefore on outcomes for patients with lung cancer. METHODS: In-depth, semi-structured qualitative interviews will be carried out with patients with lung cancer diagnosed within the prior three months and their informal carers, who live in an urban (North East London) or rural (Lincolnshire) setting. The COM-B model for behaviour change will frame data collection and the interpretation of data. RESULTS: A framework approach to applied thematic analysis will be used to: (i) explore how patient and carer characteristics, and factors related to their location relative to specialist lung cancer services, interact to influence patients’ capability, opportunity, and motivation to engage with the optimal lung cancer care pathway (ii) compare and contrast these factors between rural and urban settings. CONCLUSIONS: The findings will be used to develop a patient?centred engagement intervention which ensures that lung cancer services and support are tailored to the needs of local people in both urban and rural areas. This intervention will be co-designed with health professionals and people living with and affected by lung cancer </p>