Medicine and Health Sciences Commons^™

Positive And Negative Deviant Counties: Identification Of Factors Associated With Health Outcomes, Olivia Egen

Electronic Theses and Dissertations

Rural counties in the United States vary drastically on metrics related to socioeconomic status and dominant economic industry as well as health behaviors and outcomes. This study sought to understand the underlying structural reasons why some rural counties have better or worse than expected health outcomes using a positive deviance (PD) approach. The study aimed to: 1) create an area deprivation index and divide counties into quartiles using the index; 2) identify positive, negative, and non-deviant counties using health outcome metrics; 3) analyze differences between deviance on a variety of local public health system metrics; and 4) analyze differences between …

Rural-Urban Variations In Meals On Wheels Programs, Lea C. Florence

Electronic Theses and Dissertations

Older adults are living longer than ever before. By 2060, the U.S. population aged 65 or older is projected to reach 98 million. As adults age, the prevalence of chronic diseases and disabilities increases. The need for Meals on Wheels (MOW) services is growing alongside the aging population. Yet, little is known about the geographic variation of services. Little is documented about the organizational capacity of MOW organizations in terms of geography. The current policies supporting home-and community-based services, including MOW, may be insufficient to support all older adults in all types of communities. An analysis of the More Than …

Physical Activity Environments In Rural Communities: Exploring The Relationship Between Community Perceptions And The Environment, Elizabeth M. Bye

Electronic Theses and Dissertations

Purpose: To assess the physical activity environment, community perceptions of the physical activity environment, and the relationship between these variables in rural and/or underserved communities with high obesity prevalence.
Methods: The Rural Active Living Assessment (RALA) was used to assess the programs and policies (PPA), town-wide amenities (TWA), and street segments (SSA) of the physical activity environment and the Rural Active Living Perceived Environmental Support Scale (RALPESS) was used to assess community perception of the physical activity environment within eleven rural and/or underserved communities. Each section of the RALA and RALPESS are further broken down into additional subsections in order …

Examining Preference Of Home-Based Telemental Health Among Rural Veterans, Paige Dixon

Electronic Theses and Dissertations

Rural veterans face significant disparities to health care that have resulted in lower physical and mental health related quality of life when compared to their urban counterparts (Weeks et al., 2006). Such disparities are further complicated by the six-fold increase in prevalence of mental health diagnoses among Operation Enduring Freedom and Operation Iraqi Freedom veterans (Seal et al., 2009). These rising rates are particularly relevant to rural veterans as they represent 41% of the overall Veteran Health Administration enrollees, but only 19% of the general population (U.S., Department of Veterans Affairs, 2012; U.S. Census Bureau, 2014). Rural veterans face three …

Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver

Electronic Theses and Dissertations

The purpose of this study was to evaluate the prevalence of child psychosocial concerns in rural primary care, hypothesized to be greater than national averages due to lacking mental health services in rural areas. This study was an examination of the role of SES, various definitions of “rural,” and the interaction of SES and rurality, in predicting parent-reported child psychosocial concerns in Appalachian primary care clinics. Caregivers presenting with their child at one of 8 pediatric primary care sites (n=2,672) were recruited to complete a measure assessing demographics and the Pediatric Symptom Checklist (PSC). Results showed that while rural status …

A Measurement Of Readiness For Tennessee Hospitals To Implement “Meaningful Use” Criteria Resulting From The American Recovery And Reinvestment Act, 2009, Kathryn Wallin Wilhoit

Electronic Theses and Dissertations

In 2009, the American Recovery and Reinvestment Act was signed into law. This legislation provided for monetary rewards for those acute-care hospitals that meet "meaningful use" computerization and reporting criteria.

The study used a descriptive, nonexperimental design to answer three research questions (1) What is the level of readiness to meet "meaningful use" criteria in the Tennessee Hospital Association (THA) member hospitals; (2) What is the level of readiness to meet "meaningful use" criteria in the rural THA member hospitals; and (3) Is there a difference in the readiness to meet "meaningful use" criteria between rural and urban THA member …