Medicine and Health Sciences Commons^™

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.

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 …

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. …

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, …

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 …

Increased Rates Of Death From Unintentional Injury Among Non-Hispanic White, American Indian/Alaska Native, And Non-Metropolitan Communities, Lindsey R. Hammerslag, Jeffery Talbert, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Overview of Key Findings

• Living in a nonmetropolitan area is associated with an increase in the age-adjusted death rate from unintentional injuries, from 46.2 in metropolitan areas to 59.2 in nonmetropolitan areas in 2018, with all races/ethnicity groups affected except for non-Hispanic Black.
• The ratio of unintentional injury deaths in nonmetropolitan areas, compared to metropolitan areas, was 1.28 overall, ranging from 1.05 to 1.56 depending on race and ethnicity.
• American Indians and Alaska Natives have the highest rate of living in nonmetropolitan areas (39.5%), and this group has the greatest increase in death from unintentional injury associated with living in …

The Quality Of Life Of Regional And Remote Cancer Caregivers In Australia, Belinda C. Goodwin, Fiona Crawford-Williams, Michael Ireland, Sonja March, Suzanne K. Chambers, Joanne F. Aitken, Jeff Dunn

Research outputs 2022 to 2026

Objective: This study compares the well-being of rural caregivers with that of the general population and explores the potential drivers of poorer outcomes. Method: Patient–caregiver dyads (n = 241) residing in regional or remote Queensland, Australia, reported on QoL, chronic illness, caregiver burden, depression, anxiety and stress. Caregiver outcomes were compared with population norms and patient outcomes. Multiple regressions were conducted to identify factors associated with poorer caregiver outcomes. Results: Caregivers reported lower mental health-related QoL (M = 0.436, 95% CI = 0.410–0.462) in comparison with age-matched population norms (M = 0.556, 95% CI = 0.532–0.580). No differences existed between …

Providers’ Perspectives On Barriers Associated With Repeat Teen Pregnancies In Rural Southeastern United States, Vanessa Iheoma Iheanachor

Walden Dissertations and Doctoral Studies

Teen (or adolescent) pregnancy remains a significant public health problem in the United States. Rapid repeat pregnancy, defined as any pregnancy that occurs within 24 months of a previous birth, has been linked to adverse maternal and neonatal outcomes. The purpose of this quantitative, cross-sectional study was to understand the perceptions of health care providers (HCPs) regarding barriers that influence repeat pregnancies among adolescents in rural southeastern United States. The theoretical framework that guided this study was Urie Bronfenbrenner’s social ecological model. A survey instrument was developed and disseminated to HCPs using Qualtrics, an online survey platform. Data (n=32) were …

Factors Associated With Nonmedical Prescription Opioid Use And Prescription Opioid Misuse Among Rural Americans, Brittany Cox

Walden Dissertations and Doctoral Studies

Opioid misuse is a rapidly evolving health epidemic in the United States, leading to opioid use disorders, overdose deaths, and disparities in treatment. The rural population may be more susceptible given socioeconomic status, less educational attainment, and lower income. The impact on specific populations is not well understood. The purpose of this study was to identify the association of nonmedical prescription opioid use (NPOU), prescription opioid misuse (POM), and treatment-seeking with race, age, sex, education, and insurance status among rural Americans. The social-ecological model (SEM) served as the theoretical framework. The SEM described the interplay between individual, relationship, community, and …

Parental Status As A Modifying Factor In Covid-19 Vaccination Status: A Mixed Methods Approach, Mackenzie Carter

All Master's Theses

Introduction: Vaccines are the best protection against COVID-19 and have been proven to be safe and effective. Parental efforts to protect their children by complying with or refusing pediatric vaccinations have previously been studied. However, the author found little research on how parental status affects the vaccination decisions for the parents. Using an explanatory sequential mixed-methods approach and the Health Belief Model, this study examines how parental status influences parental COVID-19 vaccination status. Methods: A local health department conducted a quantitative survey on COVID-19 vaccination attitudes and beliefs from September to October 2021. The COVID-19 vaccination status of parents of …

Through The Lens: Youth Experiences With Cancer In Rural Appalachian Kentucky Using Photovoice, Katie Gaines, Courtney Martin, Chris Prichard, Nathan L. Vanderford

Markey Cancer Center Faculty Publications

Rural Appalachian Kentucky experiences disproportionately high cancer incidence and mortality rates. This cancer burden is due to social determinants of health and cultural factors prominent in the region. The firsthand experiences of community members—especially young people—can highlight these factors and identify areas for improvement. The purpose of this study was to encourage Appalachian Kentucky youth to consider determinants of cancer and visualize the effects that cancer has on their families or communities by asking them to take photographs of cancer-related objects around them. Content analysis was performed on 238 photographs submitted by 25 students, and photographs were organized into themes, …

Policy Implications Of The Covid-19 Pandemic On Food Security In Rural America: Evidence From Appalachia, Kathryn M. Cardarelli, Emily M. Dewitt, Rachel Gillespie, Rachel Hogg-Graham, Heather Norman-Burgdolf, Janet T. Mullins

Dietetics and Human Nutrition Faculty Publications

Rural communities are disproportionally affected by food insecurity, making them vulnerable to the consequences of supply disruptions caused by the COVID-19 pandemic. While access to food was initially diminished due to food supply disruptions, little is known about the mechanisms through which federal emergency assistance programs impacted food access in rural populations. Through a series of five focus groups in spring 2021, we examined the impact of the COVID-19 pandemic on food access in a rural Appalachian community in Kentucky. Data were analyzed using a Grounded Theory Approach. Findings revealed the following four primary themes: food scarcity in grocery stores; …

Process Evaluation Of The Early Implementation Stages Of The National Diabetes Prevention Program Through Kentucky Cooperative Extension: Perceptions Of Adopters And Potential Adopters, Nicole Breazeale, Heather Norman-Burgdolf, Katherine Counts, Lovoria B. Williams

Dietetics and Human Nutrition Faculty Publications

With the growing demand for lifestyle change programs that prevent or delay Type 2 diabetes onset, community organizations with broad reach should be explored for national dissemination of the National Diabetes Prevention Program (NDPP). This study evaluates the early implementation of the NDPP through Cooperative Extension in four Kentucky counties and explores the feasibility of scaling up the program to additional counties. Using a qualitative approach, semi-structured telephone interviews were conducted with 12 Family and Consumer Sciences (FCS) Agents – four who were participating in the pilot (adopters) and eight who had no experience with the NDPP (potential adopters). Five …

Physical Activity Barriers And Assets In Rural Appalachian Kentucky: A Mixed-Methods Study, Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily M. Dewitt, Joann Lianekhammy, Stacey A. Slone, Kathryn M. Cardarelli

Sports Medicine Research Institute Faculty Publications

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five …

Comparison Of Mortality Data From Nebraska’S Rural & Metropolitan Health Districts, Claire Figi

Theses/Capstones/Creative Projects

As there has been minimal research done on the correlation between communities identified as rural or metropolitan and their mortality rates, this research aims to provide baseline evidence that mortality rates associated with non-infectious and infectious diseases are connected to an area’s rural or metropolitan classification. This study analyzed public data from the Nebraska Department of Health and Human Services and the Center for Disease Control to compare mortality rates related to the top two causes of death in both rural and metropolitan health districts of the state of Nebraska, United States. This data was then compared to mortality rates …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan M. Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

The Intersection Of Rural Residence And Minority Race/Ethnicity In Cancer Disparities In The United States, Whitney Zahnd, Cathryn Murphy, Marie Knoll, Gabriel A. Benavidez, Kelsey R. Day, Radhika Ranganathan, Parthenia Luke, Anja Zgodic, Kewei Shi, Melinda A. Merrell, Elizabeth L. Crouch, Heather M. Brandt, Jan Eberth

Faculty Publications

One in every twenty-five persons in America is a racial/ethnic minority who lives in a rural area. Our objective was to summarize how racism and, subsequently, the social determinants of health disproportionately affect rural racial/ethnic minority populations, provide a review of the cancer disparities experienced by rural racial/ethnic minority groups, and recommend policy, research, and intervention approaches to reduce these disparities. We found that rural Black and American Indian/Alaska Native populations experience greater poverty and lack of access to care, which expose them to greater risk of developing cancer and experiencing poorer cancer outcomes in treatment and ultimately survival. There …

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

Emergency Encounters: A Cross Sectional Study Of A Rural Emergency Room, Selynto Rodrecca Anderson

Walden Dissertations and Doctoral Studies

It is very difficult for certain populations to obtain access to healthcare within the United States, particularly in rural areas. Typically, individuals who live in rural areas are far less healthy than those who live in more urbanized areas. Although there have been some improvements made to ensure there is adequate health care for all, barriers still exist. A few examples of these barriers are socioeconomic status, education, and job status. In this study, adult patients from a rural Southeastern hospital were surveyed via those who came to the emergency room seeking care, and via those who came to the …

Association Between Learning Methods And Analgesic Opioid Abuse, Nicole Marie Blanchard

Walden Dissertations and Doctoral Studies

Opioids are an extremely addictive class of medication used to treat pain; overprescribing practices and chronic misuse has led to an epidemic that continues to grow. The opioid epidemic not only has the potential to cause injury or even death but also has a large impact on the U.S. economy. Research regarding determinants of abuse are needed to improve safeguards for opioid abuse prevention. The purpose of this quantitative study was to determine if learning capabilities and/or learning medium preference are correlated with analgesic opioid abuse. The social-ecological model was used to evaluate the social levels of influence for abuse …

Prevalence And Correlates Of Secondary Syringe Exchange (Sse) Among People Who Inject Drugs (Pwid) In Rural Kentucky, Jordan R. Wilson

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

Aim: To describe the prevalence of secondary syringe exchange (SSE) in a sample of syringe service program (SSP) clients in rural Appalachian Kentucky and to identify the correlates of SSE.

Methods: Participants (n=338) completed interviewer-administered questionnaires. Only those who reported having ever exchanged syringes at a SSP (n=140) were included in analysis. SSE was measured through self-report of obtaining syringes for someone else at a SSP in the past 6 months. Prevalence and correlates of SSE were examined using bivariate analysis and multiple logistic regression.

Results: Overall, 30% of participants reported SSE. Participants in the second [aOR= 3.83; 95% CI: …

Development Of A Web-Based Agriculture Health Risk Assessment Tool For Military Veteran Farmers And Ranchers, Alyssa Damke

Capstone Experience

In the U.S., significant health disparities exist among rural populations compared to their urban counterparts. These disparities can be compounded in agricultural workers due to the dangerous and unpredictable nature of their work. Agricultural producers who are also military Veterans may experience additional health pressures that are often overlooked in the healthcare setting. Over 2.5 million Veteran Health Administration (VHA) patients reside in rural areas and the healthcare infrastructure to care for these Veterans may not include an agricultural occupational approach. To address healthcare disparities in Veteran farmers and ranchers, this study, in collaboration with AgriSafe Network, will be used …

Qualitative Analysis Of Maternal Barriers And Perceptions To Participation In A Federal Supplemental Nutrition Program In Rural Appalachian North Carolina, Sydeena E. Isaacs, Lenka H. Shriver, Lauren Haldeman

Journal of Appalachian Health

Background: Little is known about barriers to and perceptions of participation in the in Women, Infants, and Children (WIC) program in rural Appalachia.

Purpose: To gain a deeper understanding of maternal barriers and perceptions related to WIC participation in rural Appalachia

Methods: Pregnant women and mothers were recruited in-person and via flyers from WIC offices in three counties in Appalachian North Carolina. Four semi-structured focus groups were conducted between May to July 2018. Each focus group was approximately 60 minutes long and included open-ended questions about the overall WIC experience in rural Appalachia. Focus groups were audio-recorded, transcribed verbatim, and …

Baseline Health Assessment Of A Rural Delta Community, Sydney Mitchell

Honors Theses

The Lower Mississippi Delta is characterized by poverty, chronic health issues, health disparities, and food insecurity. The rural Delta communities are primarily African American, experiencing disproportionately higher rates of poverty, job loss, and chronic health problems. Historically, chronic health issues have persisted in these areas over time, including obesity, hypertension, and diabetes, which have only seemed to increase in this region. The food environment in this rural region tends to assist in the creation of the largely obesogenic population which, in turn, contributes to the increased prevalence of diabetes and hypertension and a lower quality of life. Many residents in …

An Evaluation Of Community Based Food Intervention: Cooking Matters In Charleston, Ms, Lindsay Fournier

Honors Theses

The purpose of this study is to evaluate the effectiveness of Cooking Matters classes in producing improvement in individuals’ cooking skills and confidence, as well as their eating behaviors, shopping skills, and perceptions of cooking in rural Charleston, MS. These classes have reported great success in more urban areas such as Atlanta, GA; Philadelphia, PA; and Washington, DC; however, different challenges may be faced in rural Mississippi. To study the effectiveness of the interventions in a new context, pre- and post-intervention self-report surveys were performed and evaluated using Wilcoxon statistical analysis as well as paired sample t tests, and bootstrap …

The Impact Of Location On Healthcare Access For Individuals With Disabilities, Addison Kimber

Honors Scholar Theses

This paper analyzes healthcare access for individuals with disabilities living in rural areas. In current political discussion, we typically think of insurance coverage as the metric to analyze healthcare access. However, as demonstrated by studies of healthcare in the United Kingdom, people with disabilities continue to face barriers to health care even with universal healthcare systems. In particular, individuals in rural areas have less healthcare access than urban residents. This is due to factors including socioeconomic status, insurance coverage, access to competent care, and transportation. This study aims to understand if disability status exacerbates the issue of access in rural …

Education To Improve Health For Rural Africa American Women With Diabetes, Monique Deidre Pendleton

Walden Dissertations and Doctoral Studies

Diabetes (DM) is the 7th leading cause of death in the United States. Minorities like Hispanics and African Americans (AA) are at greater risk of developing DM. The prevalence and outcomes affecting diabetes are attributed to socioeconomic status, sex differences, ethnic, cultural, and religious status. Diabetes-related mortality is a major health problem in AA in rural America. The focus for this project was to identify the best evidence regarding educational counseling on lifestyle modifications that positively impact adult AA women with diabetes living in Rural America. The social-ecological theory and health belief model informed this project because these models incorporate …

Exploring Health Literacy In The Acute Care Setting In A Rural Border Region, Shiloh Williams

Walden Dissertations and Doctoral Studies

Health literacy is important to ensuring patients have the necessary knowledge and skills needed to actively participate as a member of their own healthcare team. Patients with low health literacy are at increased risk for poor outcomes and limited participation in decisions affecting their health or treatment plan. Using the Social Ecological Model (SEM) as a framework, the purpose of this study was to determine the relationship between medical-surgical registered nurses, medical-surgical patients and the registered nurse’s (RN) assessment of their patient’s health literacy of those who live in a rural-border region. The study’s sample consisted of 84 pairs of …

Fitnessgram Assessment Results In Five Rural Counties Of Georgia, Tara L. Underwood, Jimmie H. Smith Jr, Dawood H. Sultan

Journal of the Georgia Public Health Association

Background: Childhood obesity continues to be more prevalent in the United States (US) than ever before. Youth who reside in rural areas tend to experience higher risks of obesity and overweight status, mainly due to barriers to physical activity. Even though the US federal government has mandated a daily requirement of physical activity for all school-age children, the majority of youth from rural communities tend to not achieve the recommended Health Fitness Zone (HFZ) goals.

Methods: The FITNESSGRAM is the instrument that has been used to measure and report students’ physical activity and body mass index (BMI) based …

Healthcare Access Barriers In Rural America, Lakyn E. Jolly

Kentucky Journal of Undergraduate Scholarship

• In rural America, the path to accessing healthcare is met with many challenges. These challenges can present geographically and structurally within rural healthcare systems, as well as larger healthcare delivery entities. Due to these access barriers, rural Americans are at higher risk for developing poor health outcomes, as compared to their urban counterparts. Among these are higher mortality and morbidity rates, higher instances of chronic conditions, and higher rates of childhood obesity. Because rural communities are at risk for adverse health outcomes, it is vital that research and policy be geared toward reducing barriers to accessing healthcare within this population. …