Community Health and Preventive Medicine Commons^™

Providing Patient-Centered Enhanced Discharge Planning And Rural Transition Support: Developing A Local Health And Human Services Resource Bank For Rural Communities, Tom Seekins

Health and Wellness

Patients may have a wide range of needs when they are discharged from a regional hospital back home to a small town or rural community. Discharge planners and other staff at the regional referral hospital are seldom aware of the range of services and resources that a patient could use to facilitate their recovery close to home. Indeed, in our research, regional providers acknowledged that they lacked information about the many small towns they served in their catchment area. Patients, regional referral hospital staff, and small town providers all reported that this frequently led regional providers to refer patients to …

University Of Montana Students And The Gardasil Vaccine, Markie C. Glidewell

Undergraduate Theses, Professional Papers, and Capstone Artifacts

Gardasil^® is a vaccine for human papilloma virus (HPV), a sexually transmitted virus that can cause genital warts, cervical cancer, and other diseases. Males and females ages 9-26 are recommended to receive the Gardasil^® vaccination. Most students attending the University of Montana (UM) are within the recommended age range for Gardasil^® vaccination and would benefit from receiving it if they have not yet done so. Gardasil^® is available at the Health Services Pharmacy on the UM campus and is often covered by insurance plans with no patient copay. In the fall semester of 2016, surveys were …

Lgbtq-Inclusive Sexuality Education In Montana Public High Schools: An Assessment Of The Needs Of Health Enhancement Teachers, Andrew G. Johnson

Graduate Student Theses, Dissertations, & Professional Papers

BACKGROUND

LGBTQ youth face many unique health challenges. Rates of depression and suicide are exponentially higher for LGBTQ youth than for their heterosexual, cisgender peers. Rates of HIV and STI infection are rising among this demographic. Comprehensive sexuality education has demonstrated the potential to address some of these health challenges. Specifically, it has been shown to delay the onset of sexual intercourse, and to reduce pregnancy and transmission rates of HIV and STIs among youth. Several studies have looked at LGBTQ-inclusive sexuality education from the perspective of LGBTQ students, but few have looked at this issue from the perspective of …

Validation Of Evidence-Based Fall Prevention Programs For Adults With Intellectual And/Or Developmental Disorders: A Modified Otago Exercise Program, Mindy Oxman Renfro, Donna B. Bainbridge, Matthew Lee Smith

Health and Wellness

Introduction: Evidence-based fall prevention (EBFP) programs significantly decrease fall risk, falls, and fall-related injuries in community-dwelling older adults. To date, EBFP programs are only validated for use among people with normal cognition and, therefore, are not evidence-based for adults with intellectual and/or developmental disorders (IDD) such as Alzheimer’s disease and related dementias, cerebral vascular accident, or traumatic brain injury.

Background: Adults with IDD experience not only a higher rate of falls than their community-dwelling, cognitively intact peers but also higher rates and earlier onset of chronic diseases, also known to increase fall risk. Adults with IDD experience many barriers to …

The Healthy Heart Program At The University Of Montana: A Program Review, Laura B. Porisch

Graduate Student Theses, Dissertations, & Professional Papers

Porisch, Laura, M.S., Spring 2016 Health and Human Performance

Abstract—The Healthy Heart Program at the University of Montana: A Program Review

Chairperson: Steven Gaskill

Purpose: The purpose of this paper is to identify whether the Healthy Heart Program at the University of Montana is successful at facilitating lifestyle behavior changes. Methods: Six participants from Spring of 2015 were interviewed 3-4 months post and again 9-10 months post participation in the program. Interview questions focused on whether participants were working toward goals as well as their opinion of the program and what could be done to improve it. Additionally, 18 participants …

Planning Your Transition From Pediatric To Adult Health Care: A Workbook To Help You Take Charge Of Your Health, Kim Brown, University Of Montana Rural Institute

Health and Wellness

Are you a child, teen or young adult with special health care needs and/or a disability? If so, this workbook is for you! The workbook is designed to help you take the lead in planning for your transition from pediatric (children’s) health care to adult care. It offers information about preparing for the transition, choosing medical providers, paying for services, taking responsibility for your own health, and much more.

Secondary Mental Health Conditions Of Rural Adults With Disabilities, Craig Ravesloot Ph.D., Bob Liston, Kevin Thorsen, Charles Asp, University Of Montana Rural Institute

Health and Wellness

No abstract provided.

Psychiatric Symptoms Reported By A Population-Based Sample Of Rural Adults With Physical And Sensory Impairments, Craig Ravesloot Ph.D., Charles Asp, Bob Liston, Kevin Thorsen, University Of Montana Rural Institute

Health and Wellness

No abstract provided.

Cost Containment Through Disability Prevention: Preliminary Results Of A Health Promotion Workshop For People With Physical Disabilities, Tom Seekins Ph.D., Craig Ravesloot Ph.D., Kay Norris Ph.D., Ann Szalda-Petree Ph.D., Quincy-Robyn Young, Glen White Ph.D., Ken Golden M.A., Juan Carlos Lopez M.A., Julie Steward, University Of Montana Rural Institute

Health and Wellness

The Disability Prevention Project at the University of Montana and the University of Kansas has developed and evaluated an eight week workshop and self-help manual that targets the prevention and management of secondary conditions among adults with spinal cord injuries. The preliminary results of this intervention are very encouraging.

Secondary Mental Health Conditions Reported By Rural Adults With Mobility And Sensory Impairments, Craig Ravesloot Ph. D., University Of Montana Rural Institute

Health and Wellness

People with disabilities who live in rural areas experience higher rates of disability than their urban counterparts. At the same time, they have less access to services and supports to address both medical and disability related needs. Based on their circumstances, they may be at greater risk for mental health conditions; however, little is known about their mental health status. The purpose of this study was threefold: 1) to examine the incidence of mental health symptoms reported by a population-based sample of adults with disabilities, 2) to develop a brief screening instrument to identify adults with disabilities who are experiencing …

Pain And Participation, Catherine Ipsen, Tannis Hargrove, Naomi Kimbell, University Of Montana Rural Institute

Health and Wellness

The objective of the Pain Interference Patterns research project is to understand how pain and environmental conditions, like access barriers, affect community participation of people who report physical, sensory and cognitive impairment. The information will be used to develop strategies for increasing participation in rural communities.

Peer Support In Managing Psychiatric Symptoms Of Rural Adults With Mobility And Sensory Impairments, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Little is known about the mental health of people with disabilities who live in rural America or the potential benefit of providing peer support services for these individuals. Stress diathesis models of psychiatric disorders suggest the challenges of living with a disability in rural areas may predispose individuals to higher rates of psychiatric disorders (Monroe & Simons, 1991). In addition, rural mental health service providers struggle to meet the needs of rural individuals with primary psychiatric diagnoses, and they may not be trained to assist people with disabilities who have secondary mental health conditions (New Freedom Commission on Mental Health, …

One-On-One Delivery Of Living Well With A Disability, Tracy Boehm, Craig Ravesloot Ph.D., University Of Montana Rural Institute Rural Institute

Health and Wellness

The RTC: Rural conducted a research project on health management support for rural Americans. The approach used individually-focused programs, one of which included selected content from the Living Well with a Disability (LWD) health promotion program. The project noted that transportation and limited access to group-based programs in rural areas may act as barriers for participation in health promotion programs. Findings suggest the traditional 10- week LWD group-based program is the recommended practice, but a shorter LWD program delivered one-on-one with a consumer may be an option in rural areas.

Rural Self-Management Support, Craig Ravesloot Ph.D., Tracy Boehm, Tannis Hargrove, University Of Montana Rural Institute

Health and Wellness

The Rural Self-Management Support research project used an individually-focused health self-management support intervention to help people with disabilities locate resources for health support in rural America. This intervention led to better long term maintenance of health self-management behaviors compared to the control condition which did not include a focus on locating health resources. Future research will continue to look at how local communities impact long term health.

Personal Community Resource Mapping Road Maps To Better Health, Lillie Greiman, Tracy Boehm, University Of Montana Rural Institute

Health and Wellness

Personal Community Resource Mapping (PCRM) was used in a research project that led to positive health outcomes for people with disabilities living in rural America. Lack of health resources and long distances between them creates a barrier for consumers to manage complex health needs. Personal Community Resource Mapping (PCRM) is a way to identify resources in a community that can support health needs and a variety of independent living goals.

Self-Advocacy For Rural American Health (Sarah) Program Overview And Implementation, Tannis Hargrove, Bob Liston, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Self-Advocacy for Rural American Health was a program developed for a research project that helped consumers locate community resources to support their health. Those who used community resources to manage health and pursue goals experienced long term positive outcomes.

A Guide For Creating A Community Resource Map, Lillie Greiman, Tracy Boehm, University Of Montana Rural Institute

Health and Wellness

Using individualized community resource maps is an engaging way to introduce a consumer to the importance of place and the role the environment plays in health. Below you will find some suggestions for working with a consumer to create a personal community resource map.

Pain Interference Patterns, Catherine Ipsen, Tannis Hargrove, University Of Montana Rural Institute

Health and Wellness

Advocates for community participation and quality of life issues may benefit from a better understanding of how pain intensity and environmental barriers influence participation outcomes. Unfortunately, little evidence exists on how the interaction between personal factors (e.g., pain) and environmental factors (e.g., physical accessibility) influence participation. To address this gap, we studied Pain Interference Patterns (PIP) by collecting both longitudinal and ecological momentary assessment (EMA or real-time) data to explore these factors and outcomes. Through better understanding of these interactions, we hope to inform interventions, policy, and services that can promote full participation in community life. This fact sheet reports …

Peer Support In Centers For Independent Living: What Do We Know?, Craig Ravesloot Ph.D., Bob Liston, University Of Montana Rural Institute

Health and Wellness

Peer support is ubiquitous.It is defined as a helping relationship between an individual who has experience living under certain conditions assisting another person to cope with and adapt to similar circumstances.It has been gaining in popularity and use since its early adoption in Alcoholics Anonymous (AA), and has been used widely, and with good effect, with people experiencing a variety of both physical and mental health conditions.

Nursing Home Emancipation: Barriers Reported By Centers For Independent Living, Tom Seekins Ph.D., Marsha Katz, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

In 1999, the U.S. Supreme Court affirmed the right of individuals with disabilities to receive services in "…the most integrated setting." Since then, centers for independent living (CILs) and other disability advocacy organizations have worked to transition adults with disabilities from inappropriate nursing home placements to community living.

Nursing Home Emancipation: Accomplishments Of Urban And Rural Centers For Independent Living, Tom Seekins Ph.D., Marsha Katz, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

In 1999, the U.S. Supreme Court established a legal precedent, based on the Americans with Disabilities Act, to help adults with disabilities leave institutional settings and return to community living (Olmstead v. L.C.). This established the right of individuals to receive services in "…the most integrated setting," which is generally the community. Since then, centers for independent living (CILs) and other disability advocacy organizations have initiated a wide range of efforts to emancipate (i.e. transition) adults with disabilities from inappropriate nursing home placements to community living. Nursing home emancipation is high on the priority lists of several national organizations and …

Tele-Health Promotion For Rural People With Disabilities: Toward A Technology Assisted Peer Support Model, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

There are relatively few health promotion programs for people with disabilities who live in rural areas. An exception is Living Well with a Disability, a health promotion program for people with disabilities developed by researchers at the RTC: Rural (Ravesloot & Seekins et al.,1994). The Living Well program was originally designed to be delivered in-person by peer-support staff of Centers for Independent Living (CILs) to groups of participants with disabilities. For many rural people with disabilities, however, the distances and travel difficulties inherent in their environment make onsite group programs impractical or inaccessible. Limited funding for programs such as Living …

Rural Women With Disabilities And Depression, Part One: Characteristics And Treatment Patterns, Rosemary Hughes, University Of Montana Rural Institute

Health and Wellness

Depression is a common mental health problem in which a person may experience persistent sadness, be unable to enjoy formerly pleasurable activities, and feel worthless or hopeless. Undetected and untreated depression causes substantial physical and social limitation and may lead to suicidal thoughts or actions. More than 80% of people with depression improve with appropriate treatment (National Institute of Mental Health [NIMH], 2005).

Physical Activity In A Cohort Of Medicaid Beneficiaries With Physical Impairments: Recruitment And Outcomes, Craig Ravesloot Ph.D., James Laskin Ph.D., Melody Huskey M.A., Sara Laney, Nancy Cherot, Huw Griffiths, Barbara Cowan, Lisa Brennan M.L.S., Catherine Ipsen, Sheri Martinez, Ann Szalda-Petree Ph.D., Rod Brod, University Of Montana Rural Institute

Health and Wellness

This document reports on research conducted by the University of Montana for the Office of Disability and Health at the Centers for Disease Control and Prevention. The research project, conducted between September 30, 2000 and September 29, 2004 was accomplished in three separate but related studies. The research was conducted at the New Directions programs, a community-based health promotion and wellness clinic operated through the rural Institute on Disabilities at the University of Montana. We collaborated with the State Department of Medicaid to recruit Medicaid beneficiaries with mobility impairments in Missoula County to participate in the research. We recruited 368 …

Living Well And Medicaid: Better Health For Consumers -- Lower Costs For States, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

The United States has the world’s most expensive healthcare system. In 2002, health spending rose to nearly 15 percent of U.S. Gross Domestic Product. Healthcare policymakers charged with balancing cost containment with quality healthcare for consumers are desperate for solutions (Levit, Smith, Cowan, Sensenig, and Catlin, 2004).

The Prevalence And Treatment Of Pain Among Rural Medicaid Beneficiaries With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Pain has an enormous impact on the lives of many people with disabilities. Recent research suggests that nearly 80% of people whose primary disability is not a pain disorder are still limited by pain as a secondary condition. As many as half of those people report that their pain is ongoing, intractable and limiting (Ehde, Jensen, Engel, Turner, Hoffman & Cardenas, 2003). Our research suggests strong associations between an individual’s pain and his or her quality of life, depression and the number of hours worked.

Pain As A Secondary Condition Experienced Byrural Medicaid Beneficiaries With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Secondary conditions are disability-related problems that further limit a person’s ability to engage in daily activities. People who live independently in the community and who have mobility impairments consistently report being limited by 14 secondary conditions annually.

Living Well With A Disability: An Update, Tom Seekins Ph.D., University Of Montana Rural Institute

Health and Wellness

As many as one of every five Americans has a disability or chronic health condition. In rural areas, that proportion (23%) is even higher. As the U.S. population ages, the numbers of people with disability and chronic conditions will predictably increase, which accounts for a growing national interest in the health and wellness of individuals with disabilities. While composing about 20% of the population, individuals with disabilities account for nearly half of all medical expenditures.

Marketing Health Promotion For People With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Healthy People 2010 is the blueprint for improving the health and well being of all Americans. Its overall focus is to decrease health risks and to increase the proportion of people engaging in healthy behaviors. For the first time, Healthy People includes a chapter on the health of people with disabilities. Chapter Six specifically addresses secondary conditions as a public health concern. Secondary conditions are medical and psycho-social conditions people often experience following the onset of disabilities or chronic illnesses. Our research suggests people with disabilities annually experience 14 secondary conditions that limit their health and independence.

Marketing Health Promotion For People With Disabilities, Craig Ravesloot Ph.D., University Of Montana Rural Institute

Health and Wellness

Healthy People 2010 is the blueprint for improving the health and well being of all Americans. Its overall focus is to decrease health risks and to increase the proportion of people engaging in healthy behaviors. For the first time, Healthy People includes a chapter on the health of people with disabilities. Chapter Six specifically addresses secondary conditions as a public health concern. Secondary conditions are medical and psycho-social conditions people often experience following the onset of disabilities or chronic illnesses. Our research suggests people with disabilities annually experience 14 secondary conditions that limit their health and independence.