Community Health and Preventive Medicine Commons^™

Local Systems Change: Applied Research Methods For Sustainable Communities, Taylor Barrett Hill

Graduate Student Portfolios, Professional Papers, and Capstone Projects

No abstract provided.

The Impact Of State-Mandated Certification Of Surgical Technologists On Surgical Site Infection Rates: Evaluating Policy, Practice, And Patient Outcomes, Katherine E. Geiger

Graduate Student Theses, Dissertations, & Professional Papers

Abstract

Chairperson: Matthew Schertz, Ph.D.

Committee Member: Morgen J Alwell, Ph.D.

Committee Member: Jill Davis, M.Ed.

As a surgical technology instructor, I have witnessed firsthand the impact that certified surgical technologists (CSTs) have on patient safety, particularly in the prevention of surgical site infections (SSIs). This professional paper investigates the relationship between state-mandated certification of surgical technologists and SSI rates, with a focus on how standardized education and credentialing influence clinical outcomes. SSIs remain a significant concern in surgical environments, contributing to increased morbidity, longer hospital stays, and greater healthcare costs. The research presented here examines certification requirements across various …

Seeding Belonging: Project Dig Short Report, Jeff Gutierrez, Connie Lewis, University Of Montana Rural Institute

Health and Wellness

This short report provides a snapshot of Project DIG, a therapeutic horticulture (TH) pilot project of the Rural Institute for Inclusive Communities. It contains information about and recommendations for TH as an increased practice for supporting and promoting the quality of life and well-being of people with intellectual and developmental disabilities.

Veterans In Focus: Disability And Veterans In Rural America, Hannah W. Pepprock, Lillie Greiman, University Of Montana Rural Institute

Health and Wellness

There are an estimated 17 million Veterans living throughout the United States. Relative to the general population, Veterans are more likely to experience disability. Veterans are also disproportionately represented in rural areas across the U.S. As people with disabilities are also disproportionately represented in rural areas, it is valuable to explore the intersection between veteran status, disability, and rurality. This analysis uses publicly available date from the American Community Survey to examine service-connected disability rating status and the ACS-6 questions on functional ability as they related to U.S. regions and rurality.

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.

"I Live My Best Life In The Garden": 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 …

Traditional Chinese Medicine And The Argument For Future Application In The United States, Kylie Nicole Frohlich

Graduate Student Theses, Dissertations, & Professional Papers

No abstract provided.

An Endemic Issue: Malawi's Struggle To Prevent Childhood Malaria, Hailey A. Smalley

Graduate Student Theses, Dissertations, & Professional Papers

Malaria is one of the most prolific diseases in the world, generating hundreds of millions of cases and hundreds of thousands of deaths a year. In 2021, the World Health Organization initiated preliminary trials for the first malaria vaccine in three countries, including Malawi. This project explores the impact of the malaria vaccine on community perspectives and health outcomes related to malaria , describes ongoing challenges that health workers face when disseminating the vaccine, and explains how Malawi’s experience implementing the malaria vaccine reflects larger trends in international aid.

Barriers To Outdoor Recreation For Marginalized Groups At The University Of Montana, Sabine R. Englert, Beatrix Frissell, Adrienne Liebert, Sophia Rodriquez, Margaret Jensen, Rachana Harris, Abby Doss

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Exclusion from outdoor recreation reflects legacies of oppression of marginalized communities and makes access to the outdoors not equally available. In the United States, approximately 38% of Black Americans and 48% of Hispanic Americans participated in outdoor recreation in 2020. This is compared to 55% participation among Caucasian Americans. Many other intersecting identities are actively excluded, including people with disabilities, fat populations, and members of the LGBTQIA2S+ community; furthermore, class-based hierarchies are shown through the restricted outdoor access of low-income populations.

While numerous studies show a lack of diversity in outdoor recreation, little to no research has been conducted on …

Creating Rural Community Outreach Materials Related To Covid-19 And Disability, University Of Montana Rural Institute

Health and Wellness

RTC:Rural researchers led by Andrew Myers present best practices in rural COVID-19 outreach based on feedback from regional rural disability leaders.

Research Report: Social Isolation And Loneliness Experiences Among People With Disabilities Before And During Covid-19, University Of Montana Rural Institute

Health and Wellness

Increased risk and fear of exposure to COVID-19 may impact social isolation and loneliness among vulnerable populations who are disproportionately at risk of COVID-19 complications, like people with disabilities. In a previous report, research findings showed people with disabilities experienced more than double the rates of social isolation and loneliness compared to those without disabilities before the COVID-19 pandemic. While recent data indicates rates of social isolation and loneliness have increased for the general population with the onset of the COVID-19 pandemic, less is known how rates of social isolation and loneliness have shifted for people with disabilities. Data in …

Social Isolation And Loneliness Among Rural And Urban People With Disabilities, University Of Montana Rural Institute

Health and Wellness

Social connection is the experience of interacting with and feeling connected to other people. A lack of social connections can lead to social isolation and loneliness. Social isolation is an objective measure based on a limited number of social connections. Loneliness is the perception of being isolated or feeling alone. Both social isolation and loneliness are associated with adverse physical and mental health outcomes. Researchers used data from two national surveys to understand the experiences of social isolation and loneliness among people with disabilities. Findings indicate people with disabilities report higher rates of social isolation and loneliness than people without …

People With Disabilities Still At Risk In Congregate Care Settings, University Of Montana Rural Institute

Health and Wellness

This report provides an analysis of data to better understand where cases and deaths are rising in nursing homes as of August 8 2021. We hope this analysis can help support local community planning and networking among rural partners to improve outcomes.

• COVID-19 cases among residents and staff are on the rise in nursing homes with the steepest increases in urban areas and in the South and Midwest.
• Disabled people are disproportionately overrepresented in the resident populations of unsafe congregate settings, such as nursing homes.
• Vaccination rates across both residents and staff in nursing homes have stagnated.
• Policy priorities should …

America At A Glance: Covid-19 Vaccination Among People With Disabilities, University Of Montana Rural Institute

Health and Wellness

There is a lack of foucs on how people with disabilities are experiencing COVID-19 vaccination efforts. Addressing this knowledge gap is critical to ensuring that people with disabilities are considered as vaccination efforts progress during the ongoing pandemic and future health crises. Overall, 19% of our sample of people with disabilities reported already being vaccinated, 56% wanted to get vaccinated, 10% were unsure, and 15% did not want to be vaccinated. Rural residents with disabilities reported higher rates of current vaccination, but higher rates of overall hesitancy, and more barriers to vaccination than urban residents with disabilities. Political party affiliation …

Creating Educational Opportunities For Independent Living Through Participatory Curriculum Development: A Toolkit For Centers For Independent Living, University Of Montana Rural Institute

Health and Wellness

This toolkit is an introduction for staff at centers for independent living (CILs) and their community partners who are interested in developing curriculums or trainings that meet the unique needs and goals of Independent Living. It provides instructions and guidance on how to use Participatory Curriculum Development (PCD) to create new ways of supporting Independent Living skills education and development.

This toolkit is for those who can commit to working collaboratively with consumers and other stakeholders to address an Independent Living service gap or training need.

Healthy Community Living: An Update On Outcomes, Craig Ravesloot Ph.D., Tracy Boehm Barrett, Tannis Mardece Hargrove, Justice Ender, Mary Willard, University Of Montana Rural Institute

Health and Wellness

The Healthy Community Living (HCL) program combines independent living skills training with health promotion to support self-determination and health status of adults with disabilities. It includes two workshop curricula, Community Living Skills and Living Well in the Community. Each of these provides a framework for workshop participants to increase peer support while building their individual capacity to live independently and maintain their health. The HCL Program weaves consumer choice and control throughout all of the workshop sessions by guiding consumers to identify their own goals, intentions, and process for reaching them. These workshops can be conducted in face-to-face groups or …

Engaging Stakeholders To Address Changing Service Delivery Conditions Due To Covid-19, University Of Montana Rural Institute

Health and Wellness

The COVID-19 pandemic forced organizations working in the field of disability research and program development to adapt when in-person services were suspended at Centers for Independent Living (CILs). One way this adaption occurred was by embracing collaborative problem-solving using a participatory curriculum development (PCD) approach. PCD requires consistent and continued stakeholder engagement. These practices align with Knowledge translation (KT) in that KT requires continued investment to adapt to the ever-changing contexts for which interventions are originally designed.

America At A Glance: Social Isolation And Loneliness During The First Wave Of Covid-19, University Of Montana Rural Institute

Health and Wellness

Social isolation and loneliness are a public health concern because they are associated with poor mental and physical health outcomes and mortality. To learn more about how COVID-19 and related responses (i.e. stay-at-home orders) may contribute to feelings of social isolation and loneliness among people with disabilities, we compared data from two cross-sectional samples collected before and after the first wave of “stay-at-home” orders. Post-COVID rural and urban samples reported significantly more interactions with family and close friends. Post-COVID urban respondents reported significantly lower rates of feeling left out, while the post-COVID rural respondents reported similar rates.

America At A Glance: Covid-19 And Disability In Rural Areas, Rtc: Rural, University Of Montana Rural Institute

Health and Wellness

To learn more about COVID-19 impacts on rural people with disabilities, we conducted a survey in late April/early May to explore rural and urban differences in COVID-19 health risks, adherence to public health recommendations, and trust in different information sources. We focused on people with disabilities because they often experience higher rates of secondary health conditions that place them at heightened risk of COVID-19 complications. Summary findings: Rural respondents reported higher rates of COVID-19 health risk factors, but less adherence to public health recommendations. Overall, individuals with health risk factors reported adopting fewer public health recommendations than individuals without health …

Linking Health Behavior Theory And Interventions To Increase Human Papillomavirus Vaccine Uptake, Gretchen Elizabeth Neal

Graduate Student Theses, Dissertations, & Professional Papers

Human papillomavirus (HPV) is the most common sexually transmitted disease in adults in the United States (US). Persistent HPV infection can cause several cancers, including cervical, oropharyngeal, and anal cancer. To prevent these cancers, the U.S. Advisory Committee on Immunization Practices recommends that all adolescents start the HPV vaccine series at ages 11-12 years. Despite the safety and efficacy of available HPV vaccines, vaccine uptake rates remain lower than public health goals. In the US, only 51.1% of eligible adolescents have completed the vaccine series, a rate lower than the Healthy People 2020 goal of 80% coverage for series completion. …

Aca And Medicaid Expansion Associated With Increased Insurance Coverage For Rural Americans With Disabilities, Rtc: Rural, University Of Montana Rural Institute

Health and Wellness

This fact sheet explores insurance rate changes associated with the Affordable Care Act (ACA) and Medicaid expansion on insurance coverage for rural and urban people with and without disabilities. Following the implementation of the ACA, rural people with disabilities had the greatest gains in insurance coverage. Rural people with disabilities in Medicaid expansion states saw a 10.7% increase in insurance coverage, compared to a 5.3% increase for those in non-expansion states. The loss of the ACA and Medicaid expansion could hurt rural people with disabilities more than their urban counterparts, or those without disabilities.

Cocreating With Stakeholders Through Participatory Curriculum Development, University Of Montana Rural Institute

Health and Wellness

Participatory curriculum development (PCD) is an approach to forming a working relationship between researchers and decisionmakers. The purpose of this relationship is to work together to create products that benefit the people who use them. During the PCD process, the researchers receive feedback from the decisionmakers, or stakeholders, about how the products work and any changes that could be made to improve them. This approach is called integrated knowledge translation.

Missoula Prescription Produce Program: Lessons Learned 2015-2017, Harley Fredriksen

Graduate Student Theses, Dissertations, & Professional Papers

The Missoula Fruit and Vegetable Prescription Produce program (MFVPP) started in 2015 as a partnership between Garden City Harvest (a Missoula, MT food-security non-profit) and the Providence Endocrinology Center (a local health clinic focused on diabetes care). MVFPP allows physicians, physician assistants, and dieticians to prescribe fresh produce to their patients. Patients must be of low income and suffer from chronic disease. The purpose of this paper is to evaluate the effectiveness of the MFVPP to lead to improved biometric measurements for patients. This paper also discusses the program’s limitations and complications and aims to chart a path forward for …

Meaning And Hope In Health Behavior Change: An Examination Of Health Coaching For Individuals With Disabilities, Krys Standley

Graduate Student Theses, Dissertations, & Professional Papers

Introduction:In an effort to expand the reach of health-promotion efforts for people with disabilities, a one-on-one health promotion intervention titled Health My Way was piloted. This intervention incorporated health coaching and health-promotion curriculum designed specifically for people with disabilities.

Purpose:The intervention was evaluated for its effects on health behavior change. Additionally, personal sense of meaning and hope were examined as potential mechanisms of influence in the hypothesized behavior change process.

Methodology:A convergent-parallel mixed-methods research design was used to examine the research questions. Pre- and post-intervention surveys were used to evaluate changes in levels of meaning, hope, and …

Extreme Smoke Events: Climate Change And Human Health In Western Montana, Sarah Luth

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Abstract not available.

Examining Injury Data Reporting Practices Among Wildland Firefighters, Erin M. Boggs

Graduate Student Theses, Dissertations, & Professional Papers

Wildland Firefighter (WLFF) Crews lack an injury surveillance program to collect information on non-traumatic and traumatic injuries. Tactical athletes including: police, military and structural firefighters all have a variety of collection systems in place for injury data collection. The lack of injury data prevents WLFF crews from identifying high-risk environments, implementing injury prevention programs, and improving the overall quality of care on the job. Over the last several decades the recent rise in wildfire occurrences and wildfire suppression costs creates a need for healthy and strong individuals in the field. The cost of firefighter salaries and medical care can be …

Evaluation Of A Web-Based Performance Program For Wildland Firefighters, José M. Peña Cueto

Graduate Student Theses, Dissertations, & Professional Papers

Introduction: In an effort to increase work capacity and reduce occupational injury rates and mortality rates among wildland firefighters, a web-based performance program named The Black was developed. The training program was designed to provide evidence-based training specific to wildland firefighters’ needs.

Purpose: A formative and process evaluation of the program was conducted to study the user rates, and user’s attitudes and preferences regarding the program during the pilot of its first phase.

Methodology: A sequential mixed-methods design was utilized for this evaluation. Qualitative interviews were conducted with firefighters who attended an introductory seminar. Interview data was utilized by program …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Verifying Discharge Orders During Rural Transitions, Tom Seekins

Health and Wellness

Patients typically leave a hospital with numerous tasks that need to be performed in order to complete their treatment successfully. The discharge process is designed, in part, to describe the services a patient needs to secure or the tasks they need to perform in order to complete treatment and promote recovery once he or she gets home. Many of the orders or services planned should be implemented immediately or soon after discharge to be useful. Some involve additional medical treatment. Others may involve starting long-term services that address chronic conditions.

In this delicate transition, hospital staff may not convey the …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Building A Rural Transitions Network Between Regional Referral And Critical Access Hospitals, Tom Seekins, University Of Montana Rural Institute

Health and Wellness

Residents of rural and frontier counties experience significant disparities in healthcare access and outcomes when compared to their urban counterparts. The organization of health care delivery contributes significantly to these disparities. Simply put, rural residents can face many challenges when they have to go to a hospital in a distant city for treatment and then return home to recover. The transition back home is also problematic because discharge planning generally does not adequately account for limited access to care in rural areas. The specific aim of this research project was to ascertain rural patients’ actual experience of the discharge planning …

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Conducting A Rural Transition Needs Assessment, Tom Seekins

Health and Wellness

Researchers have suggested that readmissions following hospital discharge might be reduced by providing additional resources to patients most likely to be re-hospitalized. They have suggested three broad approaches to assessing the likelihood of readmission and prioritizing patients for extra support. These approaches include: (1) medical risk, (2) personal capacity, and (3) environmental. While work on assessing medical risk and personal capacity has been reported, few researchers have explored the role of environmental factors.

We used the third approach, an environmental perspective, to develop and test a Rural Transition Needs Assessment. This process involved patients in assessing their practical needs for …