Seeking connection: A qualitative study of psychosocial support needs of rural cancer survivors in Minnesota

Purpose: Individuals diagnosed with cancer have extensive and often unmet psychosocial support needs. We established a partnership between the University of Minnesota and Gilda's Club to identify survivorship issues, unmet psychosocial support needs, and barriers to receiving cancer support in rural Minnesota. Methods: We conducted six focus groups and 16 interviews (41 total participants) between November 2022 and January 2024 among cancer survivors living in rural Minnesota. Structured interview guides included questions about survivors’ definition of cancer support, what community support is desired and available, and barriers to obtaining support. Transcripts were analyzed using inductive thematic analysis. Findings: The mean participant age was 57.1 ± 13.4 years; the majority were female (68%), non-Hispanic White (95%), and college graduates (58%), and they represented many cancer diagnoses, with hematologic (20%) and breast cancers (17%) most frequently reported. Most (73%) were under surveillance (median 4 years from diagnosis). Many participants mentioned extensive travel burdens due to lack of local care, and virtually all participants agreed emotional support was critical. Over half (56%) of participants wished for peer support that they did not have, and 44% said their cancer information needs were insufficiently addressed. Some emphasized that having nurses facilitating care coordination and options for local care made care feel more personalized. Participants identified virtual options for cancer support as potentially beneficial, particularly when meeting in person was not possible. Conclusions: Lack of peer support, lack of local care, and travel burdens are significant concerns among rural cancer survivors. Participants expressed positive views about their rural residence and mentioned alternatives and rural strengths such as virtual support options, help from nurses, and caring relationships in their communities.