Medicine and Health Sciences Commons^™

Finding A Good Fit: Tips On Hiring Rural Personal Assistants, Rayna A. Sage, Krys Standley

Health and Wellness

Living in rural areas means being part of close communities. For people with disabilities in these areas, Personal Assistance Services (PAS) help them live on their own. But finding good PAS workers in rural places can be hard. To help you pick the right PAS worker, we explored what traits make them a good fit.

Project Dig Summary Report, Tracy Boehm Barrett, University Of Montana Rural Institute

Health and Wellness

People with intellectual and developmental disabilities (IDD) are commonly overlooked in society because of a combination of social, economic, political, and cultural barriers. Due to such constraints, they also experience a wide range of health and community disparities that result in negative impact on their quality of life and well-being (Mpofu et al., 2020; Akyurek & Bumin, 2017). While many community-based organizations provide a variety of supports for people with disabilities, far less common are those providing therapeutic horticulture (TH) programs within the scope of their services. This report provides information about and recommendations for TH as an increased practice …

Creating Rural Community Outreach Materials Related To Covid-19 And Disability, University Of Montana Rural Institute

Health and Wellness

RTC:Rural researchers led by Andrew Myers present best practices in rural COVID-19 outreach based on feedback from regional rural disability leaders.

Research Report: Social Isolation And Loneliness Experiences Among People With Disabilities Before And During Covid-19, University Of Montana Rural Institute

Health and Wellness

Increased risk and fear of exposure to COVID-19 may impact social isolation and loneliness among vulnerable populations who are disproportionately at risk of COVID-19 complications, like people with disabilities. In a previous report, research findings showed people with disabilities experienced more than double the rates of social isolation and loneliness compared to those without disabilities before the COVID-19 pandemic. While recent data indicates rates of social isolation and loneliness have increased for the general population with the onset of the COVID-19 pandemic, less is known how rates of social isolation and loneliness have shifted for people with disabilities. Data in …

Social Isolation And Loneliness Among Rural And Urban People With Disabilities, University Of Montana Rural Institute

Health and Wellness

Social connection is the experience of interacting with and feeling connected to other people. A lack of social connections can lead to social isolation and loneliness. Social isolation is an objective measure based on a limited number of social connections. Loneliness is the perception of being isolated or feeling alone. Both social isolation and loneliness are associated with adverse physical and mental health outcomes. Researchers used data from two national surveys to understand the experiences of social isolation and loneliness among people with disabilities. Findings indicate people with disabilities report higher rates of social isolation and loneliness than people without …

People With Disabilities Still At Risk In Congregate Care Settings, University Of Montana Rural Institute

Health and Wellness

This report provides an analysis of data to better understand where cases and deaths are rising in nursing homes as of August 8 2021. We hope this analysis can help support local community planning and networking among rural partners to improve outcomes.

• COVID-19 cases among residents and staff are on the rise in nursing homes with the steepest increases in urban areas and in the South and Midwest.
• Disabled people are disproportionately overrepresented in the resident populations of unsafe congregate settings, such as nursing homes.
• Vaccination rates across both residents and staff in nursing homes have stagnated.
• Policy priorities should …

America At A Glance: Covid-19 Vaccination Among People With Disabilities, University Of Montana Rural Institute

Health and Wellness

There is a lack of foucs on how people with disabilities are experiencing COVID-19 vaccination efforts. Addressing this knowledge gap is critical to ensuring that people with disabilities are considered as vaccination efforts progress during the ongoing pandemic and future health crises. Overall, 19% of our sample of people with disabilities reported already being vaccinated, 56% wanted to get vaccinated, 10% were unsure, and 15% did not want to be vaccinated. Rural residents with disabilities reported higher rates of current vaccination, but higher rates of overall hesitancy, and more barriers to vaccination than urban residents with disabilities. Political party affiliation …

Creating Educational Opportunities For Independent Living Through Participatory Curriculum Development: A Toolkit For Centers For Independent Living, University Of Montana Rural Institute

Health and Wellness

This toolkit is an introduction for staff at centers for independent living (CILs) and their community partners who are interested in developing curriculums or trainings that meet the unique needs and goals of Independent Living. It provides instructions and guidance on how to use Participatory Curriculum Development (PCD) to create new ways of supporting Independent Living skills education and development.

This toolkit is for those who can commit to working collaboratively with consumers and other stakeholders to address an Independent Living service gap or training need.

Healthy Community Living: An Update On Outcomes, Craig Ravesloot Ph.D., Tracy Boehm Barrett, Tannis Mardece Hargrove, Justice Ender, Mary Willard, University Of Montana Rural Institute

Health and Wellness

The Healthy Community Living (HCL) program combines independent living skills training with health promotion to support self-determination and health status of adults with disabilities. It includes two workshop curricula, Community Living Skills and Living Well in the Community. Each of these provides a framework for workshop participants to increase peer support while building their individual capacity to live independently and maintain their health. The HCL Program weaves consumer choice and control throughout all of the workshop sessions by guiding consumers to identify their own goals, intentions, and process for reaching them. These workshops can be conducted in face-to-face groups or …

Engaging Stakeholders To Address Changing Service Delivery Conditions Due To Covid-19, University Of Montana Rural Institute

Health and Wellness

The COVID-19 pandemic forced organizations working in the field of disability research and program development to adapt when in-person services were suspended at Centers for Independent Living (CILs). One way this adaption occurred was by embracing collaborative problem-solving using a participatory curriculum development (PCD) approach. PCD requires consistent and continued stakeholder engagement. These practices align with Knowledge translation (KT) in that KT requires continued investment to adapt to the ever-changing contexts for which interventions are originally designed.

America At A Glance: Social Isolation And Loneliness During The First Wave Of Covid-19, University Of Montana Rural Institute

Health and Wellness

Social isolation and loneliness are a public health concern because they are associated with poor mental and physical health outcomes and mortality. To learn more about how COVID-19 and related responses (i.e. stay-at-home orders) may contribute to feelings of social isolation and loneliness among people with disabilities, we compared data from two cross-sectional samples collected before and after the first wave of “stay-at-home” orders. Post-COVID rural and urban samples reported significantly more interactions with family and close friends. Post-COVID urban respondents reported significantly lower rates of feeling left out, while the post-COVID rural respondents reported similar rates.

America At A Glance: Covid-19 And Disability In Rural Areas, Rtc: Rural, University Of Montana Rural Institute

Health and Wellness

To learn more about COVID-19 impacts on rural people with disabilities, we conducted a survey in late April/early May to explore rural and urban differences in COVID-19 health risks, adherence to public health recommendations, and trust in different information sources. We focused on people with disabilities because they often experience higher rates of secondary health conditions that place them at heightened risk of COVID-19 complications. Summary findings: Rural respondents reported higher rates of COVID-19 health risk factors, but less adherence to public health recommendations. Overall, individuals with health risk factors reported adopting fewer public health recommendations than individuals without health …

Aca And Medicaid Expansion Associated With Increased Insurance Coverage For Rural Americans With Disabilities, Rtc: Rural, University Of Montana Rural Institute

Health and Wellness

This fact sheet explores insurance rate changes associated with the Affordable Care Act (ACA) and Medicaid expansion on insurance coverage for rural and urban people with and without disabilities. Following the implementation of the ACA, rural people with disabilities had the greatest gains in insurance coverage. Rural people with disabilities in Medicaid expansion states saw a 10.7% increase in insurance coverage, compared to a 5.3% increase for those in non-expansion states. The loss of the ACA and Medicaid expansion could hurt rural people with disabilities more than their urban counterparts, or those without disabilities.

Cocreating With Stakeholders Through Participatory Curriculum Development, University Of Montana Rural Institute

Health and Wellness

Participatory curriculum development (PCD) is an approach to forming a working relationship between researchers and decisionmakers. The purpose of this relationship is to work together to create products that benefit the people who use them. During the PCD process, the researchers receive feedback from the decisionmakers, or stakeholders, about how the products work and any changes that could be made to improve them. This approach is called integrated knowledge translation.

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Verifying Discharge Orders During Rural Transitions, Tom Seekins

Health and Wellness

Patients typically leave a hospital with numerous tasks that need to be performed in order to complete their treatment successfully. The discharge process is designed, in part, to describe the services a patient needs to secure or the tasks they need to perform in order to complete treatment and promote recovery once he or she gets home. Many of the orders or services planned should be implemented immediately or soon after discharge to be useful. Some involve additional medical treatment. Others may involve starting long-term services that address chronic conditions.

In this delicate transition, hospital staff may not convey the …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Developing A Local Health And Human Services Resource Bank For Rural Communities, Tom Seekins

Health and Wellness

Patients may have a wide range of needs when they are discharged from a regional hospital back home to a small town or rural community. Discharge planners and other staff at the regional referral hospital are seldom aware of the range of services and resources that a patient could use to facilitate their recovery close to home. Indeed, in our research, regional providers acknowledged that they lacked information about the many small towns they served in their catchment area. Patients, regional referral hospital staff, and small town providers all reported that this frequently led regional providers to refer patients to …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Building A Rural Transitions Network Between Regional Referral And Critical Access Hospitals, Tom Seekins, University Of Montana Rural Institute

Health and Wellness

Residents of rural and frontier counties experience significant disparities in healthcare access and outcomes when compared to their urban counterparts. The organization of health care delivery contributes significantly to these disparities. Simply put, rural residents can face many challenges when they have to go to a hospital in a distant city for treatment and then return home to recover. The transition back home is also problematic because discharge planning generally does not adequately account for limited access to care in rural areas. The specific aim of this research project was to ascertain rural patients’ actual experience of the discharge planning …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Conducting A Rural Transition Needs Assessment, Tom Seekins

Health and Wellness

Researchers have suggested that readmissions following hospital discharge might be reduced by providing additional resources to patients most likely to be re-hospitalized. They have suggested three broad approaches to assessing the likelihood of readmission and prioritizing patients for extra support. These approaches include: (1) medical risk, (2) personal capacity, and (3) environmental. While work on assessing medical risk and personal capacity has been reported, few researchers have explored the role of environmental factors.

We used the third approach, an environmental perspective, to develop and test a Rural Transition Needs Assessment. This process involved patients in assessing their practical needs for …

Validation Of Evidence-Based Fall Prevention Programs For Adults With Intellectual And/Or Developmental Disorders: A Modified Otago Exercise Program, Mindy Oxman Renfro, Donna B. Bainbridge, Matthew Lee Smith

Health and Wellness

Introduction: Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer’s disease and related dementias, cerebral vascular accident, or traumatic brain injury.

Background: Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to …

Planning Your Transition From Pediatric To Adult Health Care: A Workbook To Help You Take Charge Of Your Health, Kim Brown, University Of Montana Rural Institute

Health and Wellness

Are you a child, teen or young adult with special health care needs and/or a disability? If so, this workbook is for you! The workbook is designed to help you take the lead in planning for your transition from pediatric (children’s) health care to adult care. It offers information about preparing for the transition, choosing medical providers, paying for services, taking responsibility for your own health, and much more.

Secondary Mental Health Conditions Of Rural Adults With Disabilities, Craig Ravesloot Ph.D., Bob Liston, Kevin Thorsen, Charles Asp, University Of Montana Rural Institute

Health and Wellness

No abstract provided.

Psychiatric Symptoms Reported By A Population-Based Sample Of Rural Adults With Physical And Sensory Impairments, Craig Ravesloot Ph.D., Charles Asp, Bob Liston, Kevin Thorsen, University Of Montana Rural Institute

Health and Wellness

No abstract provided.

Cost Containment Through Disability Prevention: Preliminary Results Of A Health Promotion Workshop For People With Physical Disabilities, Tom Seekins Ph.D., Craig Ravesloot Ph.D., Kay Norris Ph.D., Ann Szalda-Petree Ph.D., Quincy-Robyn Young, Glen White Ph.D., Ken Golden M.A., Juan Carlos Lopez M.A., Julie Steward, University Of Montana Rural Institute

Health and Wellness

The Disability Prevention Project at the University of Montana and the University of Kansas has developed and evaluated an eight week workshop and self-help manual that targets the prevention and management of secondary conditions among adults with spinal cord injuries. The preliminary results of this intervention are very encouraging.

Secondary Mental Health Conditions Reported By Rural Adults With Mobility And Sensory Impairments, Craig Ravesloot Ph. D., University Of Montana Rural Institute

Health and Wellness

People with disabilities who live in rural areas experience higher rates of disability than their urban counterparts. At the same time, they have less access to services and supports to address both medical and disability related needs. Based on their circumstances, they may be at greater risk for mental health conditions; however, little is known about their mental health status. The purpose of this study was threefold: 1) to examine the incidence of mental health symptoms reported by a population-based sample of adults with disabilities, 2) to develop a brief screening instrument to identify adults with disabilities who are experiencing …

Pain And Participation, Catherine Ipsen, Tannis Hargrove, Naomi Kimbell, University Of Montana Rural Institute

Health and Wellness

The objective of the Pain Interference Patterns research project is to understand how pain and environmental conditions, like access barriers, affect community participation of people who report physical, sensory and cognitive impairment. The information will be used to develop strategies for increasing participation in rural communities.

Peer Support In Managing Psychiatric Symptoms Of Rural Adults With Mobility And Sensory Impairments, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Little is known about the mental health of people with disabilities who live in rural America or the potential benefit of providing peer support services for these individuals. Stress diathesis models of psychiatric disorders suggest the challenges of living with a disability in rural areas may predispose individuals to higher rates of psychiatric disorders (Monroe & Simons, 1991). In addition, rural mental health service providers struggle to meet the needs of rural individuals with primary psychiatric diagnoses, and they may not be trained to assist people with disabilities who have secondary mental health conditions (New Freedom Commission on Mental Health, …

A Guide For Creating A Community Resource Map, Lillie Greiman, Tracy Boehm, University Of Montana Rural Institute

Health and Wellness

Using individualized community resource maps is an engaging way to introduce a consumer to the importance of place and the role the environment plays in health. Below you will find some suggestions for working with a consumer to create a personal community resource map.

Self-Advocacy For Rural American Health (Sarah) Program Overview And Implementation, Tannis Hargrove, Bob Liston, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Self-Advocacy for Rural American Health was a program developed for a research project that helped consumers locate community resources to support their health. Those who used community resources to manage health and pursue goals experienced long term positive outcomes.

Rural Self-Management Support, Craig Ravesloot Ph.D., Tracy Boehm, Tannis Hargrove, University Of Montana Rural Institute

Health and Wellness

The Rural Self-Management Support research project used an individually-focused health self-management support intervention to help people with disabilities locate resources for health support in rural America. This intervention led to better long term maintenance of health self-management behaviors compared to the control condition which did not include a focus on locating health resources. Future research will continue to look at how local communities impact long term health.

Personal Community Resource Mapping Road Maps To Better Health, Lillie Greiman, Tracy Boehm, University Of Montana Rural Institute

Health and Wellness

Personal Community Resource Mapping (PCRM) was used in a research project that led to positive health outcomes for people with disabilities living in rural America. Lack of health resources and long distances between them creates a barrier for consumers to manage complex health needs. Personal Community Resource Mapping (PCRM) is a way to identify resources in a community that can support health needs and a variety of independent living goals.