Medicine and Health Sciences Commons^™

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

Electronic Theses and Dissertations

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

Barriers To Musculoskeletal Injury Reporting In High School Athletes: A Qualitative Study, Mikayla Talak

Electronic Theses and Dissertations

INTRODUCTION: There are a substantial amount of sport related injuries recorded at the high school age and it has been recorded as a public health concern in a vast amount of health literature. Although participating in sports has a risk of injury associated with it, it is common for high school athletes to underreport injuries. But there is no known literature on injury reporting behaviors of musculoskeletal injuries in the high school athletic population. Therefore, the purpose of this study is to explore the barriers and facilitators to musculoskeletal injury reporting and towards playing injured in athletes that attend a …

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 …

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, …

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 …

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 …

An Exploratory Study Of Duty-Related Stress Among Conservation Officers, Logan Ledford

Electronic Theses and Dissertations

Research relating to police stress has typically focused on officers working in urban areas, neglecting their rural counterparts. This is especially true of conservation officers, who are tasked with enforcing laws in state parks and other recreational areas. To date, only a handful of studies have sought to better understand their experiences and perceptions. The current study seeks to further our understanding of conservation officer stress in three unique ways: (1) via applying McCreary and Thompson’s (2006) operational police stress scale (PSQ-Op) to the population, (2) determining whether officer characteristics (e.g., age, education, length of service) affect perceived stress, and …

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

Electronic Theses and Dissertations

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

Job Embeddedess Of Nurses Working In South Central Appalachia’S North Carolina Counties, Susan L. Adams Mrs.

Electronic Theses and Dissertations

Nurses working in the North Carolina counties of South Central Appalachia (NC-SCA) are a unique subset of nursing professionals. A continued nursing shortage is projected in this area while staffing has improved in other areas of SCA. The purpose of this research was to ascertain the level of job embeddedness of nurses working in NC-SCA in order to offer guidance regarding retention of nurses working in this area. Actively working licensed practical nurses, registered nurses, and advanced practice nurses (nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists) from 29 North Carolina counties included in South …

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

Electronic Theses and Dissertations

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

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

Electronic Theses and Dissertations

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

Practice Characteristics Of Graduates Of East Tennessee State University Quillen College Of Medicine: Factors Related To Career Choices In Primary Care, Ivy A. Click

Electronic Theses and Dissertations

The nation is facing a physician shortage, specifically in relation to primary care and in rural underserved areas. The most basic function of a medical school is to educate physicians to care for the national population. The purpose of this study was to examine the physician practicing characteristics of the graduates of East Tennessee State University Quillen College of Medicine including factors that influence graduates’ specialty choices and practice locations, especially those related to primary care. Secondary data for this study were collected from the college’s student database system and the American Medical Association Physician Masterfile. The study population included …

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

Electronic Theses and Dissertations

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

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