Medicine and Health Sciences Commons^™

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 …

The Effect Of Asynchronous Versus Synchronous Online Course Delivery On Hesi Scores And Student Engagement For Rural Pre-Licensure Nursing Students, Susan Luke Belliston

UNLV Theses, Dissertations, Professional Papers, and Capstones

Since nurses are the primary providers of direct patient care in the United States, a shortage in any community can impact the quality of health care available. Rural areas were among the first to be affected by the current nursing shortage. Further challenges to the rural nurse supply include a lack of access to nursing education, particularly baccalaureate education.Both distance and online education options allow for the increased reach of higher education to rural areas. Existing nursing education literature focuses on graduate nurse education and baccalaureate completion education. The pre-licensure nursing student is mostly absent from the existing literature concerning …

A Program Evaluation Of A Rural Nursing Academic Partnership, Meagan A. Spencer

Electronic Theses and Dissertations

As the American Association of Colleges of Nursing and Commission on Collegiate Nursing Education continue to promote the implementation and creation of literature on academic partnerships, a Christian university, sought to evaluate its academic partnership with a for-profit hospital for the first time in regard to student perspectives. The purpose of this mixed-methods program evaluation was to describe the student perceptions of the academic partnership in trusting, collaborating, and engaging nursing students and recruiting and retaining nursing graduates to rural hospitals and health care facilities. Measurable impacts included both qualitative and quantitative coding of the levels of trust, collaboration, and …

Identifying, Adapting, And Implementing A Weight Management Program In Rural Primary Care, Gwenndolyn Porter

Theses & Dissertations

Rural adults are at heightened risk for obesity, yet evidence‐based interventions lack consistent translation into clinical practice. This multi-phase study addresses this gap. First, a systematic review and meta-analysis of rural adult weight loss interventions were conducted to assess overall impact. Though few studies reported participant representativeness, meta‐analyses revealed a significant weight reduction among interventions. Second, 10 focus groups were conducted with primary care (PC) staff to determine the feasibility of implementing a weight-management program through PC. Differences in responses among rural, micropolitan, and metropolitan was also assessed. Thematic analyses revealed rural PC currently lacks the capacity to manage patient …

A Qualitative Inquiry Exploring Help-Seeking Behaviors And Resilience Strategies Women With Disabilities Utilize When Experiencing Gender-Based Violence In Rural Communities, Kimberly Ann Aguillard

Dissertations & Theses (Open Access)

Women with disabilities (WWD) are at pronounced risk of experiencing multiple forms of severe and prolonged violence, and they face barriers to accessing help. A multitude of factors associated with disability and rurality may compound the experience of violence, including geographic and social isolation, forcing WWD in rural settings to navigate extremely dangerous situations with limited avenues for accessing help and securing safety. This research explored how women with disabilities experiencing violence while living in rural communities navigate programs and policies, make decisions about seeking and securing help, and build resilience despite experiencing violence. The current study methodology empowers this …

Serious Mental Illness And Rural Primary Care: Provider Training, Attitudes, And Opinions, Lydia Eisenbrandt

Electronic Theses and Dissertations

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, …

Barriers And Facilitators To Voting For People With Disabilities In Michigan Rural Communities, Christian Aguilar-Quiroz, Kaylyn Brzys, Chris Paclibar, Kyle Witte

Community Based

Objective: In this study, we sought to investigate and obtain data on the perceived barriers and facilitators that rural Michigan residents with disabilities face throughout the voting process.

Method: We conducted two separate focus groups in two different rural areas of Michigan asking a series of semi-structured questions about the participants’ voting experiences. We obtained recorded interviews, qualitative data, of their answers to these prepared questions.

Results: Physical accessibility was limited by poor lighting for people with low vision problems and a lack of accommodations for those who are not able to stand for a prolonged time while waiting in …

A Study Of Job Satisfaction And Turnover Intention Among Acute Care Nurses Working In Rural And Urban Settings, Yasin Yasin

Electronic Thesis and Dissertation Repository

In Canada, a close look at the nursing workforce shows a decline due to limited supply and increasing demand resulting in a looming shortage in the near future. Retaining nurses’ is a key strategy to overcome the shortage by limiting nurses’ turnover. Nurses’ job dissatisfaction is the most significant predictor of turnover intention and is associated with undesired outcomes such as nurses’ absenteeism, burnout, low service quality, and patient dissatisfaction. The differences in factors affecting job satisfaction between rural and urban nurses have not been fully studied. This study aimed to identify the differences and similarities in the extrinsic 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 …

Assessing The Health Literacy Levels Of Diabetic Patients Located In Rural Southeast Kansas, Meghan Murray

Doctor of Nursing Practice Scholarly Project

Data shows that limited health literacy is prevalent throughout the United States. This data has also found a correlative relationship between limited health literacy and poor health outcomes. An individual’s health literacy level affects many areas of their health, including their ability to effectively manage chronic diseases, such as diabetes mellitus. Awareness of an individual’s health literacy level allows for targeted interventions and a potential improvement for a patient’s health outcomes. The Newest Vital Sign (NVS) is a validated screening tool that allows for the identification of a patient’s likely health literacy level. The purpose of this Doctor of Nursing …

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 …

Improving End-Of-Life Care On Navajo Through Education, Johanna G. Bahe

Doctor of Nursing Practice Scholarly Projects

End-of-life care (EOLC) is an essential component of comprehensive healthcare and has been shown to improve the quality of life of patients and their families by preventing and relieving pain caused by physical, psychosocial, and spiritual complications. Many rural communities lack access to EOLC, specifically certified palliative and hospice services. The lack of this specialty in rural areas directly affects the experience of healthcare staff. The absence of education for rural healthcare staff and the importance of culturally sensitive care among indigenous people are key concepts in this study.

The purpose of this study was to measure the knowledge, confidence, …

Report: Creating And Piloting A Survey To Determine Readiness In Rural Populations In Ohio, Annie Bowen, Kay Ball

Doctor of Nursing Practice Scholarly Projects

In 2015, the Affordable Care Act and Medicaid expansion allowed over 700,000 Ohioans to gain access to healthcare insurance, but having health insurance did not improve access to healthcare providers. In rural populations in Ohio, there are several counties in which less than five healthcare providers are available for the entire county with little or no specialists available for patients. People in rural areas of Ohio may have significant travel time and distance to see a provider which decreases preventative health visits. Telehealth is the next big wave of technology and advancement for healthcare, but most rural populations in Ohio …

Poster: Creating And Piloting A Survey To Determine Readiness In Rural Populations In Ohio, Annie Bowen, Kay Ball

Doctor of Nursing Practice Scholarly Projects

In 2015, the Affordable Care Act and Medicaid expansion allowed over 700,000 Ohioans to gain access to healthcare insurance, but having health insurance did not improve access to healthcare providers. In rural populations in Ohio, there are several counties in which less than five healthcare providers are available for the entire county with little or no specialists available for patients. People in rural areas of Ohio may have significant travel time and distance to see a provider which decreases preventative health visits. Telehealth is the next big wave of technology and advancement for healthcare, but most rural populations in Ohio …

Analysis Of Tech-Based And Telemental Health Approaches Within The Adolescent And Young Adult Populations Of Rural America, Audrey Smeenk

Physician Assistant Scholarly Project Papers

Background: The incidences of depression and anxiety among adolescent and young adult populations are intensifying, and resources remain limited for the management of these diseases within rural America. Objective: The purpose of this literature review is to evaluate evidence-based practices regarding telemedicine and tech-based mental health interventions. Evaluation of different interventions will demonstrate the ability of access, efficacy, and patient adherence with the hope of decreasing the incidence of disease and increase the availability of resources to rural areas. Methods: A comprehensive literature review was completed by assessing journal articles and scientific databases from the last fifteen years using a …

Comparing Hpv Vaccination Rates Between Rural And Urban Female Undergraduate Students At The University Of Tennessee, Knoxville, Brynn J. Seaton

Chancellor’s Honors Program Projects

No abstract provided.

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 …

"Urban" Dengue? An Examination Of Perceived Dengue Risk And Notions Of The Urban In Esmeraldas Province, Ecuador, Charlotte Robbins

Senior Theses and Projects

Is dengue fever an urban disease as public health literature suggests? And what does this literature mean by urban? To answer these questions, I compare perceptions of the urban and dengue risk from residents who I interviewed across different sites in Esmeraldas Province, Ecuador. I ground my analysis in four urban frameworks: the bounded city theory, postcolonial theory, assemblage urbanism, and urban political ecology. I find that residents in Esmeraldas Province think about urban spaces very differently from how the Ecuadorian government defines what is urban. In particular, residents discuss government investment in infrastructure and services as an important dimension …

Associations Between County-Level Socioeconomic Status And Opioid Overdose Rates In Northern New England, Samuel Godfrey

Theses and Dissertations

Background – The opioid epidemic persists as a significant concern to public health as the proliferation of fentanyl presents additional risks for illicit opioid users. States such as Maine and New Hampshire experience far greater opioid overdose rates compared to the overall US opioid overdose rate. Many studies on the opioid epidemic use socioeconomic and macroeconomic factors individually but few use a composite index of multiple of these measures. Limited attention has been paid to the need for a composite index of socioeconomic status at the small area (county) level designed to quantify the impact of socioeconomic status on the …

Leading Rural Nurse Academic Progression, Cynthia Jean Larsen

Dissertations (1934 -)

Higher levels of nurse education have been associated with improved patient outcomes and lower healthcare costs. Members of rural populations are vulnerable, having poorer outcomes than urban inhabitants on a number of health indicators. Rural nurses are more likely than urban nurses to enter practice with associates degrees. Hence, academic progression is important for rural nurses and for the health of rural patients and communities. Rural nurse leaders work to promote the academic progression of rural nurses. Grounded theory methodology was used in this study to describe the concerns of and the actions taken by nurse leaders in the promotion …

Multidisciplinary Team Approach To Prevent Hf Readmissions In Rural Areas, Naydu Lucas, Rn, Msn, Mba

Doctor of Nursing Practice Projects

Background: Despite the national efforts to decrease 30-days hospital readmissions, readmission remains a challenge for healthcare organizations across the continuum of care. The aim of this quality improve project was to develop and implement a multidisciplinary team approach to provide education to patients hospitalized with congestive heart failure (CHF) to improve 30-day hospital readmissions.

Method: This project was conducted in a critical access hospital in Northeast Washington. Using a pre-post design, we evaluated the 30-day readmission before and after implementing the multidisciplinary education program for patients hospitalized with CHF. The education focused on disease management, discharge education, pharmacy consult and …

Assessing The Effect Of Cold Weather On Rural Cardiovascular Disease Deaths In Vermont, Alex V. Sherbrook, Madison M. Freeman, Cody A. Aspril, Jennifer A. Tomczak, Emily C. Pareles, Timothy B. Plante

Master of Public Health Culminating Projects

Objective: To study Vermont mortality and temperature data to determine if there is an increased incidence of cardiovascular disease related death on categorically cold streak days among rural residents.

Methods: A retrospective study was conducted using a cohort of Vermont CVD deaths between 2009-2017 subset with corresponding daily temperature data. CVD deaths that occurred on a categorical cold streak day were then identified and analyzed using a Poisson Regression to assess the relationship between ambient temperature changes, CVD mortality, and rurality.

Results: As compared to non-cold streak days, risk of CVD mortality was 4% higher on cold …

Utilization Of Telepsychiatry To Combat The Opioid Crisis In The United States, Haley Tallarico

Theses, Dissertations and Capstones

Introduction: In the past five years, the United States (U.S.) has experienced an unprecedented epidemic of opioid misuse, abuse and overdose related death, leading to a national public health crisis. Telepsychiatry along with medication-assisted treatment has been proposed as a viable solution. The purpose of this research was to examine the field of telepsychiatry as a practical means to combat the rapidly increasing opioid epidemic facing America and to determine the effect of telepsychiatry utilization on access to treatment received in an outpatient medical setting.

Methodology: The methodology for this study was a literature review including the use of …

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 …

A Rural Mother's Guide To Breastfeeding, Haley Tillett

Undergraduate Honors Theses

Breastfeeding is considered as the gold standard of infant health (CDC, n.d.). The benefits provided to both the baby and mother by breastfeeding are unmatched when compared to formula feeding. Recent studies have shown a disparity in rates of breastfeeding, primarily in rural areas. This may be due, in part, to the fact that mothers in rural areas may not have equal access to resources and support they need to successfully breastfeed due to geographic isolation. This guide will provide an overview of breastfeeding resources in rural communities with a focus on Kittitas Valley, Washington. Resources include but are not …

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 …

Growing Green Minds: Implementation Of A School Garden & Nutrition Program For The Freedom Area School District In Rural Wisconsin, Marissa Schuh

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

Most children in the U.S. consume too few fruits and vegetables which is putting them at risk to develop obesity and other lifestyle diseases. The 2015-2020 Dietary Guidelines for Americans recommends that individuals should increase the amount and variety of fruits and vegetables consumed in order to prevent weight gain and other chronic diseases. Research shows that garden-based educational programs can increase children’s fruit and vegetable intake as well as change their preferences and attitudes towards eating and trying new fruits and vegetables. Incorporating a garden and nutrition curriculum into a school setting is an ideal opportunity to improve children’s …

Impact Of Coaching By Extension Professionals On Rural Wellness Coalition Success, Taylor Willhite

Electronic Theses and Dissertations

Objective: To quantitatively assess coaches perceived confidence in coaching rural wellness coalitions and to qualitatively determine barriers and facilitators to success in coaching rural wellness coalitions.
Design: A mixed methods design was utilized with quantitative (scorecard) and qualitative (key informant interviews) methodologies.
Setting: Six rural South Dakota wellness coalitions.
Participants: Extension wellness coalition coaches (n=7), one previous and six current.
Intervention: A component of the broader SDSU Extension 1416 Centers for Disease Control (CDC) and Supplemental Nutrition Assistance Program Education (SNAP-Ed) intervention.
Analysis: STATA was utilized for the quantitative scorecard data by running paired ttests. NVivo was utilized in the …