Exploring barriers to nutritional support for oncology patients in regional and rural settings: A scoping review through the lens of Levesque's accessibility framework.

[BACKGROUND] Integrating supportive cancer services into routine cancer care is challenging, especially in regional and rural settings where accessibility to healthcare is a known issue. This scoping review aimed to describe and map barriers to nutrition services from the perspectives of people living with cancer and health service providers. Exploring the applicability of Levesque's Accessibility Framework in identifying and prioritising service gaps was a secondary aim.

[METHODS] Electronic database searches were conducted in Allied and Contemporary Medicine, CINAHL, Informit, Medline and SPORTDiscus between May-July 2023. Studies reporting on perceived barriers to nutrition services from the perspectives of health service providers and people living with cancer in regional and rural settings were included. We categorised these into demand or supply determinants, which were mapped across the ten dimensions of Leveque's Accessibility Framework.

[RESULTS] Eight studies were included in this review. Thirty-seven barriers were identified and mapped across the ten dimensions described within Levesque's Accessibility Framework. The most frequently reported barriers related to: Availability and Accommodation of regional health services, Approachability of regional health services and Ability of patients to engage.

[CONCLUSION] This review identified the most commonly reported barriers to nutrition services for people living with cancer in regional and rural settings. Levesque's Accessibility Framework demonstrates value in categorising barriers to accessibility, which can be used to identify service gaps and inform future policy-setting agendas.