Digital Commons Network^™

Exploring The Lived Experiences Of Rural Texas School Counselors Working With Students’ Mental Health After The Covid-19 Pandemic, Lanessa K. Allman

Doctoral Dissertations and Projects

The purpose of this qualitative descriptive phenomenological study was to describe the lived experiences of rural Texas counselors when working with students’ mental health in the aftermath of the COVID-19 pandemic. The study aims to answer questions of what school counselors describe as the mental health environment for students in rural Texas schools prior, during, and after the COVID-19 pandemic and the changes in the mental health environment of rural students. Most existing research has been focused on how COVID-19 changed school counselors’ roles and responsibilities and how the pandemic affected students’ mental health. The current study concentrated on the …

Gender-Based Differences In Stress And Coping Among Farmers: A Cross-Sectional Study With Propensity Score Matching, Anne Montgomery, James B. Dunaway, Stephanie M. Basey, Chris T. Scoggins, Lily R. Baucom

Georgia Public Health Association Annual Meeting and Conference

This cross-sectional study compares the mental health experiences of male and female farmers, with a particular focus on stress levels, stressors, and coping mechanisms. The research aims to shed light on gender-based differences in stress experiences and coping strategies among agricultural workers. The study involved 1,394 farmers (67.7% male, 32.3% female) from Georgia, USA, who completed an online survey on aspects of mental well-being.

Findings indicate that female farmers were more likely to hold farm manager roles and less likely to be farm owners. Notably, a higher proportion of female farmers were first-generation farmers, indicating potential unique challenges for this …

Non-Urgent Use Of Emergency Departments By Rural And Urban Adults, Erika Ziller Phd, Carly Milkowski, Zachariah Croll, Yvonne Jonk Phd

Access / Insurance

This study, conducted by researchers at the Maine Rural Health Research Center, provides updated information and addresses gaps in knowledge about rural non-urgent ED use. Understanding the rates of non-urgent ED use among rural adults and the factors associated with this use can inform policy and practice efforts to reduce unnecessary and inappropriate use of EDs in rural communities.

Hospital emergency departments (EDs) serve a vital role in the US health care system, providing lifesaving, around-the-clock care to patients in acute health situations. However, use of the ED for non-urgent care is costly and reflects a suboptimal care setting, with …

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 …

Self-Efficacy, Grit, And Rural Career Aspirations Among Early Career Nurses: A Repeated Cross-Sectional Study, Daniel Terry, Blake Peck, Ed Baker, David Schmitz

Public Health and Population Science Faculty Publications and Presentations

Background Global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite collective efforts, a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, which is exacerbated in rural communities. The aim of the study was to compare self-efficacy, grit, and rural career aspirations among nursing graduates between their second and fourth year of their nursing profession.

Methods As part of a longitudinal investigation, a repeated cross-sectional design was utilised. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18–24 months after graduating, and 32 participants (response …

Quality Of Life Among Cancer Survivors: Comparison Of Multiple Cancers Using Icare2, Shinobu Watanabe-Galloway, Rachael L. Schmidt, Kendra Ratnapradipa, Kristin Dickinson, Abbey Fingeret, Whitney Goldner

Manuscripts: Epidemiology

Background: The number of cancer survivors continues to increase due to dramatic improvements in cancer treatment, accounting for approximately 5% of the entire population. As cancer survivors continue to live longer, it is important to understand their quality of life (QoL) in order to maximize supportive care efforts.

Objectives: In this study, the quality of life (QoL) among patients with different types of cancer was examined. The objectives were to: 1) compare patient-reported outcome measures of QoL using the Short-Form (SF-36) Health Survey scores among patients of different cancer types and 2) identify demographic, oncologic, and clinical factors that are …

Improving Black Maternal Outcomes In Christian County, Ky: A Social Marketing Approach To Perinatal Provider Change, Ariel A. Arthur

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Compared to other states in the country, Kentucky has historically poor population health outcomes. While the statewide maternal mortality rate is 16.1 per 100,000 live births, this statistic belies the stark racial disparities that exist. In 2018, the pregnancy-related death rate for Black women was 40.2 per 100,000 live births compared to 13.1 for White women. This pattern is persistent even after controlling for socioeconomic status, prenatal care, and other protective factors. Research shows that institutional and interpersonal racism when receiving obstetric care contributes to poor childbirth and postpartum outcomes for Black women. Additionally, geography and rural status may compound …

Impact Of An Opioid Harm Reduction Consortium: Emergency And Justice Engagement, Maren Wright Wright Voss, Gabriele Ciciurkaite, Matthew Huntington, Melissa Flint, Emily Hamilton, Jennifer Peatross

Outcomes and Impact Quarterly

Utah State University Extension engaged first responders and law enforcement officials in a consortium to identify local needs related to opioid use disorder (OUD). To this end, the Tooele Opioid Response Network (TORN) conducted three first-responder harm reduction summits to meet local overdose prevention needs. The initiative trained over 200 personnel, which resulted in an 87.5% increase in knowledge related to harm reduction. TORN also facilitated the acquisition of $90,000 in funding for jail-based opioid medication and the disbursement of 400 naloxone kits and training to incarcerated persons at discharge.

Association Between Chronic Disease And Substance Use Among Older Adults In Tennessee, Manik Ahuja, Jessica Stamey, Johanna Cimilluca, Kawther Al Skir, Mary K. Herndon, Kathleen Baggett, Thiveya Sathiyasaleen, Praveen Fernandopulle

ETSU Faculty Works

Background:

Design and methods:

A Consensus Panel Approach To Estimating The Start-Up And Annual Service Costs For Rural Ambulance Agencies, Yvonne Jonk Phd, Gary Wingrove Facpe, Cp-C, Nikiah Nudell Ms, Mphil, Nrp, Facpe, Kevin Mcginnis Mps

Emergency Medical Services (EMS)

This brief serves to fill the information void on the costs of running ambulance services for three population-based service tiers and establishes a minimum access standard for ambulances servicing a 25-minute travel time radius from the ambulance station. The model enables policymakers and community stakeholders to develop strategic plans for the financing and provision of ambulance services. Key Highlights: An expert panel established that ambulances could reasonably serve a maximum 25-minute travel time from the ambulance station that accounts for road conditions. A minimum access standard was defined as a single resource consisting of one full-time staffed ambulance, with a …

The Role Of Rural And Urban Geography And Gender In Community Stigma Around Mental Illness, Shawnda Schroeder, Chih Ming Tan, Brian Urlacher, Thomasine Heitkamp

Indigenous Health Faculty Publications

Empirical evidence describes the negative outcomes people with mental health disorders experience due to societal stigma. The aim of this study was to examine the role of gender and rural/urban living in perceptions about mental illness. Participants completed the Day’s Mental Illness Stigma Scale, a nationally validated instrument for measuring stigma. Directors of Chambers of Commerce in North Dakota distributed the electronic survey to their members. Additionally, distribution occurred through use of social media and other snowball sampling approaches. Analysis of data gathered from 749 participants occurred through examination of the difference in perceptions based on geography and gender. The …

Opioid Overdose: Rural Georgia Vs. Urban Georgia - Who's Winning The Battle?, Zizah-Wosseni Blair, Justice Dove, Didem Aydin, Stacie Fairley

Research Day

INTRODUCTION: The opioid crisis is a major public health issue affecting communities across the United States, including Georgia. The widespread misuse of prescription and illicit opioids has led to a significant increase in opioid-related overdoses and deaths. The impact on Georgia communities has been devastating, affecting individuals from all walks of life and causing significant harm to families and communities. The Georgia Department of Public Health reported that the number of drug overdose deaths in the state rose by 61.9% from 2019 to 2021. Rural and Urban communities in Georgia face unique challenges in addressing this epidemic. Rural communities often …

Association Of Prenatal Depression With New Cardiovascular Disease Within 24 Months Postpartum., Christina M Ackerman-Banks, Heather S Lipkind, Kristin Palmsten, Mariah Pfeiffer Rn, Mph, Catherine Gelsinger Rn, Katherine Ahrens Mph, Phd

Population Health

No abstract provided.

Ambulance Deserts: Geographic Disparities In The Provision Of Ambulance Services [Chartbook], Yvonne Jonk Phd, Carly Milkowski Mph, Zachariah Croll Mph, Karen Pearson Mlis, Ma

Emergency Medical Services (EMS)

This chartbook begins with a broad overview of ambulance services including common types of organizational structure(s) and workforce and reimbursement issues. The methods section provides our definition of ambulance deserts and describes how ambulance deserts are illustrated in the national and state maps. The results section begins with an overall description of the prevalence of ambulance deserts in rural and urban counties across the 41 states for which data were available at the time, and the variation in the percent of people living in ambulance deserts across the four census regions. States are ranked in terms of the percent of …

Factors Associated With Physical Activity Increases And Decreases Among A Sample Of Appalachian Residents During The Covid-19 Pandemic: A Cross-Sectional Study, Christiaan G. Abildso, Angela M. Dyer, Shay M. Daily, Christa Lilly, Emily A. Sarkees, Samantha I. Moyers, Thomas K. Bias

Journal of Appalachian Health

Introduction: Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic.

Purpose: This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia.

Methods: Surveys were collected from a convenience sample of adults from eight …

Rural Working-Age Adults Report More Cost Barriers To Health Care, Erika C. Ziller Phd, Carly Milkowski Mph, Amanda Burgess Mppm, Mph

Access / Insurance

Using the 2019-2020 National Health Insurance Survey, researchers at the Maine Rural Health Research Center examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults. Rural adults (18-64) were more likely than their urban counterparts to report problems paying, or being unable to pay, their medical bills. They were also more likely to delay or go without needed care because of the cost. Compared with urban adults, those in rural areas were more likely to engage in prescription drug cost-saving measures such as skipping doses, delaying refills, or taking less medication than prescribed. For all affordability measures, …

Family Caregivers Of Older Adults With Physical Disabilities In Rural Thailand, Denis Tuttle, Jiranan Griffiths, Anuchart Kaunnil

The Qualitative Report

Thailand is one of many countries experiencing changes in the demographics of its population. People are living longer and having fewer children resulting in an increasing percentage of older adults in the general population. This presents a challenge in providing care for older adults, especially in countries where there is a culture of family caregiving. This study aims to investigate the experience of family caregivers, exploring the problems of caring for older people with physical disabilities and the needs of family caregivers. This is done to better understand ways to support caregivers. Using a descriptive qualitative approach, 15 family caregivers …

Identifying Barriers To Dental Care Among Hispanics In Southwest Minnesota, Lissette Garza

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this study was to assess the different barriers for dental health care among the Hispanic population in a rural, southwestern community in Minnesota. To collect data, an adaptation of the survey written by Vazquez and Swan (2003) was distributed to Hispanic individuals at an agricultural facility, religious organization, and an early childhood organization. The findings for the research question are presented in the cross-sectional study utilizing descriptive statistics in the form of frequencies and percentages. The results of this study indicate that not having a dental provider of the same cultural background, having a language barrier, and …

The Impact Of Healthcare Disparities In Rural Ohio, Bailey Stammen, Sara Curtis

Scholarship in Medicine - All Papers

Rural communities in the state of Ohio face barriers to care that affect the health of the population. This paper investigates the extent to which the general state of health, life expectancy, uninsured rates, and access to primary care providers can be affected by living in a rural community and how these variables have changed over time. Data from urban and rural counties in Ohio, taken from 2016 to 2022 via the 2022 County Health Rankings, will be used to explore health-related concerns. There were significant findings of decreased general health and access to primary care providers for rural communities …

Knowledge Of Pregnancy And Postpartum Complications Up To One Year Postpartum Compared By Rurality, Evelyn Frances Fagan, Alisha Riggins, Ariel A. Alston, Mario Keko, Ana M. Palacios, Helen Bland, Joanne Chopak-Foss

Georgia Public Health Association Annual Meeting and Conference

Introduction: Georgia has one of the highest maternal mortality rate in the U.S. at 46.2 maternal deaths per 100,000 live births, disproportionately affecting Black and rural populations. This study sought to 1) assess knowledge of Georgian adults about complications and urgent warning signs both during pregnancy and up to 1-year postpartum, and 2) characterize knowledge within rural and urban population.

Methods: As part of a larger study, an online survey with previously validated questions was distributed to Georgia residents through social media and email. Data was grouped into 2 different categories: 1) pregnancy warning signs and 2) post-partum warning signs. …

Comparing The Impact Of Food Insecurity, Access To Exercise Opportunities, And County Classification On Obesity Rates In Ohio, Ankur Parekh, Deborah Lee

Scholarship in Medicine - All Papers

Objective: We completed a study to determine how food insecurity, access to exercise opportunities, and county classification (rural or urban) impacted obesity rates in Ohio. We hypothesized that the county classification impacted obesity the most followed by food insecurity and access to exercise opportunities.

Methods: We obtained data on food insecurity, access to exercise opportunities, and obesity from County Health Rankings and county classification data from the United States Department of Agriculture Census. We analyzed correlations between obesity and food insecurity and obesity and access to exercise opportunities in both county types. We also analyzed changes in obesity rates in …

A Descriptive And Visual Analysis Of The North Coast Fall Prevention Survey Data, Mishell Lopez

Cal Poly Humboldt theses and projects

Older adults over 65 will double from 52.4 million in 2018 to 94.7 million in 2060. Among this aging group, falls affect one out of four older adults and are a critical economic concern for our American society, with yearly costs of $50 billion. In older adults, falling can result in negative consequences such as fear of falling, injuries, mobility restrictions, and loss of independence. California has one of the highest costs per fall ($4 billion annually) and a high percentage of adults who have fallen (30.6%) compared to the nation. Moreover, two of California’s northwest rural counties, Del Norte, …

Development Of A Scoring Tool For Australian Rural Food Retail Environments, Tracy L. Schumacher, Carissa A. Alderton, Leanne J. Brown, Susan Heaney, Laura Alston, Katherine Kent, Stephanie L. Godrich

Research outputs 2022 to 2026

Current tools scoring the healthiness of food retail outlets do not reflect outlets found in rural locations. This study aimed to adapt pre-existing Australian scoring tools to represent non-metropolitan areas. Rural nutrition experts were identified, and a modified Delphi technique was used to adapt two pre-existing, food-scoring tools in five iterative stages. Stages included identifying all relevant outlets, providing a description and score for each, ensuring consistency between outlet scores and pre-existing, metro-centric tools, and providing instructions for correct use. Six rural nutrition experts were identified and engaged in the modified Delphi technique. The final tool consisted of 12 categories …

Implementation Of A School-Based Adolescent Pregnancy Prevention Program In Harlan County, Kentucky, Jaycea Frederick

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Kentucky has the 6^th highest rate of adolescent pregnancy in the United States and Harlan County ranks among the highest rates in the state. Adolescent pregnancy is a public health problem and costs taxpayers in the United States around $9.4 billion each year. Overall, there have been declines in adolescent pregnancy but the national average soars above those in other Western industrialized nations such as the United Kingdom. Implementing a comprehensive sexual health education program in a public school setting is an efficient strategy to reach numerous adolescents and influence sexual health knowledge and help to delay the initiation …

Telehealth Acceptance Among Appalachian Respondents During Covid 19: A Secondary Data Analysis, Victoria Hood-Wells, Florence M. Weierbach, Amy Wahlquist, Janet M. Keener, Manik Ahuja, Hadii M. Mamudu

ETSU Faculty Works

Purpose: The purpose of this study is to examine the relationship between telehealth use, telehealth satisfaction, and chronic medical conditions among residents living in Appalachian and non-Appalachian communities.

Sample: A COVID-19 public health survey was distributed via social media and healthcare clinics in the tri-state region of central Appalachia. Survey responses were limited to adults aged ≥18 years who consented to participate in the survey that self-identified as an individual with one or more chronic medical conditions (n=195).

Method: Simple descriptive statistics including frequencies, percentages, means, and standard deviations (SDs) were calculated for variables of interest both overall and by …

Evaluating How Physical Activity Affects The Perception Of Resilience In Box Butte County, Nebraska, Eric Pulver

Capstone Experience

Physical activity is one of the modern hallmarks for good health in individuals and the public, in general. Resiliency is a growing concentration in all levels of disaster preparedness where the focus is on how to deal with the growing number of disasters stemming from global climate change. This research project’s aim is to look at the possible relationships between physical activity and resiliency in a rural Nebraska population. This was done with the use of a cross-sectional study utilizing a fifteen-question survey to gather demographics, assess the amount of physical activity, and then apply a perception of resilience tool …

Identifying Community-Engaged Translational Research Collaboration Experience And Health Interests Of Community-Based Organizations Outside Of Metropolitan Atlanta, Breanna B. Greteman, Latrice Rollins, Ph.D., Msw, Allisen Penn, Alison C. Berg, Eric J. Nehl, Nicole Llewellyn, Amber Weber, Melissa George, Darrell Sabbs, Mohamed Mubasher, Tabia H. Akintobi

Journal of the Georgia Public Health Association

Background: While rural health research has increased over the last two decades, there is limited understanding of the self-reported health priorities and research interests of rural and suburban community-based representatives and residents. These insights can be used to inform more successful intervention strategies that are responsive to the lived experiences of local residents and leaders who are the gatekeepers to buy-in and sustainability of community engaged research. The Georgia Clinical and Translational Science Alliance, a collaboration between four academic institutions includes a Community Engagement Program (CE) designed to facilitate community-academic research partnerships. This study aimed to assess the health priorities, …

Patterns Of Health Care Use Among Rural-Urban Medicare Beneficiaries Age 85 And Older, 2010-2017, Yvonne Jonk Phd, Heidi O'Connor Ms, Amanda Burgess Mppm, Carly Milkowski Mph

Access / Insurance

The purpose of this study was to examine rural-urban differences in health care use among Medicare beneficiaries age 85+. Understanding these differences, and the socioeconomic characteristics that contribute to them, can have important implications for Medicare policies aimed at serving the age 85+ population. Using the Medicare Current Beneficiary Survey 2010-13 Cost and Use and 2015-17 Cost Supplement Files, we examined whether and how rural and urban Medicare beneficiaries age 85+ differ in terms of their:

1. socioeconomic and health characteristics that may inform health care use;
2. trends in health care use, including use of inpatient and emergency department (ED) care; …

“We Live On An Island:” Perspectives On Rural Family Caregiving For Adults With Alzheimer’S Disease And Related Dementias In The United States, Heather J. Williamson, Andria B. Begay, Dorothy J. Dunn, Rachel Bacon, Mark Remiker, Yolanda E. Garcia, Michael J. Mccarthy, Julie A. Baldwin

The Qualitative Report

As the United States’ aging population grows, there will be increased prevalence of individuals living with Alzheimer’s Disease and related dementias (ADRD), who largely rely on the support of their family caregivers. Family caregivers residing in rural areas face additional challenges with managing caregiving responsibilities and navigating support services. The purpose of this multilevel phenomenological qualitative study was to explore the assets, unique needs, and resources of rural-residing ADRD caregivers from the caregiver, provider, and policy influencers’ perspectives. The study took place between 2019 through 2021 in northern Arizona, a largely rural and geographically vast area home to caregivers from …