Agency and fatalism in older Appalachian women’s information seeking about gynecological cancer

ABSTRACT

Researchers consider older women in rural Appalachia to have low levels of agency and high levels of fatalism regarding decision making about cancer treatment. Using the life course perspective, we examined older women’s agency with information seeking about gynecological cancer. Semistructured interviews with 20 White women living in central Appalachia revealed four trajectories: Surrendering Control, Accepting Death, Self-Care, and Advocacy, each with its own forms of agency. Some women experienced personal transformation, increased self-efficacy, and a passion for community empowerment. Fatalism was not understood apart from placing trust in medical expertise. We implore researchers to further explore rural expressions of agency.

KEYWORDS:

• Agency
• Appalachia
• gynecological cancer
• information seeking
• older women
• rural

Additional information

Funding

This work was supported by the Virginia Tech Institute for Society, Culture and Environment and the U.S. Department of Agriculture Cooperative State Research, Education, and Extension Service under Project No. VA-139732 of the Virginia Agricultural Experiment Station.