Mapping the Lay of the Land: Using Interactive Network Analytic Tools for Collaboration in Rural Cancer Prevention and Control

Bobbi J. Carothers, Peg Allen, Callie Walsh-Bailey, Dixie Duncan, Rebeca Vanderburg Pacheco, Karen R. White, Debra Jeckstadt, Edward Tsai, Ross C. Brownson

Cancer mortality rates in the U.S. are higher in rural than urban areas, especially for colorectal cancer. Modifiable cancer risks (e.g. tobacco use, obesity) are more prevalent among U.S. rural than urban residents. Social network analyses are common, yet rural informal collaborative networks for cancer prevention and control and practitioner uses of network findings are less well understood. In five service areas in rural Missouri and Illinois, we conducted a network survey of informal multisector networks among agencies that address cancer risk (N = 152 individuals). The survey asked about contact, collaborative activities, and referrals. We calculated descriptive network statistics and disseminated network visualizations with rural agencies through infographics and interactive Network Navigator platforms. We also collected feedback on uses of network findings from agency staff (N = 14). Service areas had more connections (average degree) for exchanging information than for more time-intensive collaborative activities of co-developing and sustaining ongoing services and programs, and co-developing and sharing resources. On average, collaborative activities were not dependent on just a few agencies to bridge gaps to hold networks together. Users found the network images and information useful for identifying gaps, planning which relationships to establish or enhance to strengthen certain collaborative activities and cross-referrals, and showing network strengths to current and potential funders. Rural informal cancer prevention and control networks in this study are highly connected and largely decentralized. Disseminating network findings help ensure usefulness to rural health and social service practitioners who address cancer risks.