Medicine and Health Sciences Commons^™

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 …

Propensity-Score Matching Beginning And Experienced Farmers On Stress And Coping Mechanisms To Predict Suicidal Ideation, Anne Montgomery, Stephanie M. Basey, Chris T. Scoggins, Lily Baucom

Georgia Public Health Association Annual Meeting and Conference

This presentation is an extension of a roundtable from last year; we added propensity-score matching thanks to suggestions from the roundtable:

The suicide rate among farmers is much higher than that of the overall working population. Literature on farmer mental health in Georgia has been scarce and mostly focused on farmer suicide. This study looks at the influence of being a beginning farmer (less than 10 years of experience) on farm-related stressors and coping mechanisms.

This cross-sectional study inventories mental well-being, stressors, and coping mechanisms for different types of farmers. Participants (N=1,328) were asked demographics, household composition, work descriptors, healthcare …

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 …

Telehealth Acceptance And Medical Mistrust Among The Elderly Of Rural Appalachia: A Correlational Study Using The Medical Mistrust Index And Technology Acceptance Model, Victoria Hood-Wells

Electronic Theses and Dissertations

Adults aged 65 years and above have grown substantially over with past decade. However, the chance of developing multiple comorbidities only increases with age. Because elderly residents of rural Appalachia often encounter barriers to healthcare, rural nurses, providers, and policy makers must overcome physical and structural barriers, but also gain a more in-depth understanding of the personal and cultural attitudes impacting the use of new and innovative forms of healthcare delivery. With a slow and variable uptake of telehealth adoption in rural Appalachia, and in the presence of well-documented medical mistrust, this study was designed to better understand the degree …

Integration Of Mental Health And Enabling Services In A Rural School-Based Setting: An Evidence-Based Initiative, Kim Ferguson, Teresa Carnevale

Epsilon Sigma at-Large Research Conference

The Rural Expansion Program for At-risk Communities to Promote Health Outcomes through the Integration of Mental health and Enabling services in an Existing Primary Care School-Based Setting (REACH ME) program was established to increase access to mental health services at two existing school-based health centers (SBHC) in rural Hancock County, TN. These SBHCs are among the most unique in the nation, holding designations as federally funded qualified health centers - proving primary care services in a geographically isolated, rural, and medically underserved area. The aim of the project is increasing the number of patients receiving mental health and enabling services …

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 …

Engaging The South Texas Latino Community: Utilizing Community Member Feedback To Inform Research On Community Engagement, Dolores Garcia, Rebecca Jones, Sonia Rincon-Sanchez, Paula Bravo

Research Symposium

Background: The UT Health San Antonio Mays Cancer Center Community Outreach and Engagement Core is identifying how South Texas Latino residents navigate cancer-related health needs. Our team explored these from a class and place perspective.

Methods: Listening sessions were conducted across South Texas. Sessions lasted 1.5 hours, were in English and Spanish, and recorded. Recordings were transcribed, and a thematic analysis was completed.

Results: Seventy-four South Texas residents participated in the sessions.

Insurance status and healthcare access were key factors impacting communities’ ability to navigate cancer-related health needs. Analyses were explored from an urban, rural, inland, and border perspective.

Urban …

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 …

The Perceived Benefits And Effectiveness Of Patient Feedback Systems In Strengthening Patient-Provider Relationships In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Introduction

Patient feedback system (PFS) forms an important entry point for the medical personnel and healthcare administrators to identify healthcare service delivery gaps and develop responsive interventions. This may foster patient trust consequently increasing healthcare-seeking, engagement in decision, continuity, and satisfaction. However, research on the PFS in rural primary healthcare settings appears limited.

Objective

The paper examines the perceived role and efectiveness of PFS in improving therapeutic relationships building on the recent research on patient-provider relationships in rural Tanzania.

Methods

The paper examines the fndings of qualitative descriptive research conducted in the Shinyanga Region which employed a human-centred design (HCD) …

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 Of Cutaneous Manifestations With Admission Duration Among Dengue Fever Patients In Rural, Underserved Philippines, Patricia Marie Guzman

Research Symposium

Background: Dengue fever (DF) is endemic to the Philippines, where it poses a major public health concern, especially in rural and medically underserved areas. Recent literature has underscored the clinical significance of rash in DF, reporting that cases with rash are associated with less severe complications than cases without. The aim of this study is to determine whether the presence of dermatological symptoms is associated with a shorter admission duration among DF patients in a rural, underserved area in the Philippines. This association may in turn aid in the management and triaging of DF cases, particularly in underserved areas …

Expressive Arts Therapy To Support Positive Experiences Of Embodiment Among Rural Lgbtq+ Adults: A Literature Review, Ann Stromgren

Expressive Therapies Capstone Theses

This paper investigates the use of expressive arts therapy to support LGBTQ+ adult clients in rural communities. Caring professionals in rural areas often lack training on how to work with LGBTQ+ clients, and best practices for clinical mental health counseling with rural LGBTQ+ clients have yet to be defined. Some evidence suggests that using “metronormative” best practices with rural clients may be irrelevant or cause harm (Giano et al., 2020). Although some recommendations exist for using expressive therapies with LGBTQ+ clients, they are rarely evidence-based, as very few empirical studies exist evaluating the effectiveness of expressive therapy interventions with LGBTQ+ …

Interventions Co-Designed By Healthcare Providers And Clients For Improving Therapeutic Relationships In Maternal And Child Healthcare: A Pilot Study Using Human Centered Design In Rural Tanzania, Kahabi Isangula, Eunice Pallangyo, Eunice Ndirangu

School of Nursing & Midwifery, East Africa

Background

Research shows that poor provider–client interactions in maternity and child health (MCH) continue to affect health outcomes, service uptake, continuity of care, and trust in formal healthcare systems.

Objective The study’s objective was to jointly create a prototype intervention package for enhancing nurse-client relationships using human centered design (HCD) approach.

Methods A five-step HCD methodology was used: (1) Community-driven discovery through qualitative descriptive research methods using 9 focus groups with nurses and clients and 12 key informant interviews with MCH administrators; (2) consultative ideation and co-creation meetings with 10 nurses, 10 clients, and 10 administrators to co-design a rough …

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:

Pocus Use For Emergency Airway Management In Rural Emergency Departments, Margaret Downing

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

- Preparation and accurate prediction of difficult airways in emergent situations is necessary for successful first pass intubation

- Current methods for airway assessments require patient cooperation and may vary by provider

• Mallampati score: open mouth, protrude tongue, see what structures are visible³
• LEMON criteria: look externally, evaluate 3-3-2 rule, Mallampati score, obstruction, neck mobility
• Thyromental distance: measure thyroid cartilage to tip of chin with neck extended³

- Difficult airways have successful first pass intubation only 82.2% of the time (vs 92.4% for non-difficult airways)⁶

- Adverse effects occurred in 14.2% of patients with successful first …

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 …

Prevalence, Knowledge, And Lifestyle-Associated Risk Factors Of Dyslipidemia Among Ghanaian Type-2 Diabetes Mellitus Patients In Rural And Urban Areas: A Multicenter Cross-Sectional Study, Wina I.O. Boadu, Enoch O. Anto, Joseph Frimpong, Felix Ntiful, Emmanuel E. Korsah, Ezekiel Ansah, Valentine C.K.T. Tamakloe, Afia Agyapomaa, Stephen Opoku, Ebenezer Senu, Michael Nyantakyi, Albright Etwi-Mensah, Emmanuel Acheampong, Kwame O. Boadu, Emmanuel Timmy Donkoh, Christian Obirikorang

Research outputs 2022 to 2026

Background and Aims: Dyslipidemia in diabetes mellitus has been linked to unhealthy lifestyle and bad eating habits. However, this association has not been well studied among rural and urban Ghanaian populations. In this study, we determined the prevalence, knowledge, and lifestyle-associated risk factors of dyslipidemia among Ghanaian type-2 diabetes mellitus (T2DM) patients in rural and urban areas. Methods: This comparative multicentre-cross-sectional study recruited 228 T2DM outpatients attending the St. Michael Hospital, Pramso (rural) and Kumasi South Regional Hospital (urban), Ghana for routine check-ups. Self-structured questionnaire was used to collect sociodemographic, knowledge, and lifestyle characteristics. Fasting blood samples were taken to …

Use Of Evidence-Based Telehealth To Reduce Complications In Adults With Type 2 Diabetes In A Rural Health Facility, Joni Kelley

Doctor of Nursing Practice Projects

Background: Formal education for type 2 diabetes mellitus (T2DM) patients is essential, especially in rural areas where diabetes is approximately 17% higher than in urban areas (Bolin & Ferdinand, 2018). In 2019, diabetes was listed as the direct cause of 1.5 million deaths, and 48% of all deaths due to diabetes occurred before 70 years (American Diabetes Association, 2021). According to the American Diabetes Association (2021), approximately 550,149 people in Alabama, or 14.1% of adults, have been diagnosed with diabetes. An additional 119,000 people in Alabama have diabetes but are unaware, significantly increasing their risk of complications (American Diabetes Association, …

Mental Health Wellness In The Latino Population: Improving Phq-9 Scores In Depressed Patients With Comorbid Type Ii Diabetes, Amanda Cuellar

Doctor of Nursing Practice Final Manuscripts

Major depressive disorder is one of the most common mental health conditions. In the United States, 8.1% of the population have symptoms of depression. Patients with diabetes are 2–3 times more likely to experience symptoms of depression compared to the general population. Having these chronic conditions simultaneously can cause complications in both. The purpose of this study was to improve depression scores for patients who have comorbid type II diabetes. This project took place in a rural community with the Latino population. The nurse practitioner led an evidence-based practice project implementing treatment of depression with medication management, individual psychotherapy, and …

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 …

A Rapid Review Of The Literature: Cardiovascular Disease Preventive Practices And Rural Black Women, Modjadji M. Choshi, Maria Devalpine

Virginia Journal of Public Health

Cardiovascular disease (CVD) is the leading cause of death among Black/African American women. Rural Black women have the highest CVD prevalence and are more likely to have modifiable risk factors such as high blood pressure, diabetes, and obesity than any other race. Accessible evidence-based culture-appropriate self-care programs for risk reduction and CVD prevention can address these disparities. This rapid review aims to provide a comprehensive collection of such programs. Methods. Searches were performed in PubMed, CINAHL, Web of Science, Psychinfo-Embase, and Scopus for studies reporting CVD prevention programs for rural Black women. Three articles met the inclusion criteria, with …

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 …

Exploring Barriers To Rural Mental Health Practice: A Pilot Study, Caitlin Vu

Educational Specialist, 2020-current

There is a shortage of mental health professionals in rural areas around the world. Current literature on barriers to healthcare professionals choosing to practice in rural areas mainly focuses on medical professionals, with few studies examining the barriers to rural practice for mental health professionals. Along with examining the perceived barriers and enablers to rural mental health practice, researchers wanted to further examine the reliability of the revised Barriers to Rural Mental Health Practice instrument. Researchers distributed the survey to mental health professionals across the United States. Preliminary findings support high internal reliability for the total scale and three of …

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 …

Rationale And Design Of Integrating A Parents First Obesity Intervention With A Pediatric Weight Management Intervention For Rural Families - Evaluating The Ripple Effect., Ann M. Davis, Christie A. Befort, Brittany D. Lancaster, Chris Tuck, Barbara J. Polivka, Jordan A. Carlson, Kandace Fleming, Rebecca Swinburne Romine, Kelsey Dean, Megan Murray

Manuscripts, Articles, Book Chapters and Other Papers

Rural families are disproportionately affected by obesity. Obesity often runs in families and is impacted by hereditary components, the shared home environment, and parent modeling/child observational learning. Moreover, parent changes in weight predict child changes in weight. Thus, targeting the family unit has the potential to enhance outcomes for adults and children simultaneously. Additionally, engaging rural nurses in medical clinics and schools may be important in determining whether rural telehealth programs are successfully implemented and sustained. This paper describes the rationale and design of a randomized control trial (RCT) evaluating the effectiveness of an integrated adult- and child-focused obesity treatment …