A Comparative Evaluation of Conceptual Frameworks for Examining Neighbourhood Socioeconomic Deprivation and Cancer Care Accessibility

ABSTRACT

Aim (s)

To identify and evaluate conceptual frameworks for studying neighbourhood deprivation and access to cancer services in nursing research.

Design

Discussion paper.

Methods

We searched the literature to identify conceptual models used in peer-reviewed articles that examined neighbourhood-level factors influencing access to cancer services. As a first step in the evaluation, the Theories, Models and Frameworks Comparison and Selection Tool (TCaST) was used to assess the rigour and applicability of eligible models. The two models with the highest TCaST scores were then further evaluated using Fawcett and DeSanto-Madeya's 2013 criteria.

Data Sources

A total of 546 articles were screened after searching PubMed, EBSCO Cumulated Index to Nursing and Allied Health Literature and Elsevier Co. Scopus from 2014 to 2025.

Results

Of eight eligible models, two met the criteria for further analysis. Revision 6 of Andersen's Behavioral Model (ABM) includes the full nursing metaparadigm and has been widely applied. It is logically and socially congruent, offers testable hypotheses and holds global significance. However, full utility requires familiarity with its unique vocabulary. The Concept of Access Model also demonstrates congruence, testable hypotheses and has greater parsimony than ABM, but its omission of the health metaparadigm limits its application in nursing research.

Conclusion

ABM most comprehensively provides clear and measurable concepts for neighbourhoods as well as realised, effective and equitable access for nursing research. It also supports the identification of highly mutable factors for clinical and policy intervention.

Implications for Nursing

Nurses can play a central role in applying frameworks to ensure research aligns with the holistic nature of profession values, captures contextual realities of patients and informs equitable care delivery.

Impact

Neighbourhood deprivation continues to drive disparities in cancer care, making it a pressing research priority. This evaluation equips nurses with a clear conceptual foundation to study access inequities and support actionable cancer care solutions.

Reporting Method

There are no relevant EQUATOR guidelines for this discursive paper.

Patient or Public Contribution

This study did not include patient or public involvement in its design, conduct or reporting.