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Articles 91 - 120 of 138
Full-Text Articles in Community Health and Preventive Medicine
Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Out-Of-Pocket Spending Among Rural Medicare Beneficiaries, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Access / Insurance
The majority of Medicare beneficiaries experience gaps between the care they need and costs covered by Medicare and seek supplemental coverage to meet this gap, including private plans offered by former employers or purchased individually, or public coverage through Medicaid. Since rural beneficiaries are more likely to purchase supplemental indemnity coverage individually, to participate in Medicaid, or to go without supplemental coverage altogether, it is likely that their out-of-pocket spending differs from that of urban residents, although the magnitude and direction of these differences may vary for individual beneficiaries. This study used data from the 2006-2010 Medical Expenditure Panel Survey …
Rural Adults Delay, Forego, And Strategize To Afford Their Pre-Aca Health Care, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Rural Adults Delay, Forego, And Strategize To Afford Their Pre-Aca Health Care, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Andrew F. Coburn Phd
Access / Insurance
About 40% of non-elderly adults reported problems paying medical bills or cost-related barriers to obtaining needed medical care in 2012, difficulties that are especially pronounced for the uninsured and underinsured, the chronically-ill, and those with low incomes. Given their lower incomes and higher uninsured rates compared to urban residents, rural residents may face particular cost barriers in accessing health care. Past research has shown that, compared to urban residents, rural residents are more likely to experience higher out-of-pocket costs and delayed or foregone care as a result of cost, even when covered by private health insurance. This study provides detailed …
Promoting Active Living In Rural Communities, Anush Yousefian Hansen Ms, Ma, David Hartley Phd, Mha
Promoting Active Living In Rural Communities, Anush Yousefian Hansen Ms, Ma, David Hartley Phd, Mha
Population Health
This brief summarizes current research on elements of the rural built environment that may be related to obesity or physical activity. Much of this research is qualitative in nature, including evidence and conclusions drawn from rural focus groups, PhotoVoice studies, policy statements, observations from the field, and lessons learned from rural active living interventions.
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
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.
Domestic Violence In The North Dakota Oil Patch: Barriers To Identifying And Serving Female Victims, Kristi Rendahl
Domestic Violence In The North Dakota Oil Patch: Barriers To Identifying And Serving Female Victims, Kristi Rendahl
School of Business Student Theses and Dissertations
This study explored domestic violence in energy boomtowns to answer the questions: What issues are confronting social service professionals who are in a position to identify and respond to female victims of domestic violence in rural North Dakota? What opportunities do professionals cite in identifying and responding to female victims of domestic violence in rural areas and boomtowns? Further, how has the professionals’ experience of the oil boom changed their methods of identifying and responding to female victims of domestic violence? The study used a qualitative approach through a focus group and interviews with the program directors of rural domestic …
Secondary Mental Health Conditions Of Rural Adults With Disabilities, Craig Ravesloot Ph.D., Bob Liston, Kevin Thorsen, Charles Asp, University Of Montana Rural Institute
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
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
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
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
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
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
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
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
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
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
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.
Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd
Integrated Care For Older Adults In Rural Communities, Eileen Griffin Jd, Andrew F. Coburn Phd
Mental Health / Substance Use Disorders
Recognizing that traditional models of health care delivery and payment often produce fragmented and costly care and poor outcomes for those with the highest needs, many reforms under the Affordable Care Act (ACA) focus on realigning payment incentives and integrating care. These reforms presuppose the existence of supporting infrastructure and capacity, including dedicated care management staffing and health information technology and exchange. With a focus on community-dwelling older adults in need of integrated physical, behavioral health services, and long term services and supports (LTSS), this brief reviews the opportunities and challenges these reform initiatives present for rural communities: How easily …
Pain Interference Patterns, Catherine Ipsen, Tannis Hargrove, University Of Montana Rural Institute
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 …
Who Done It? Rurality Vs. Ses As Critical Factors In Evaluating The Prevalence Of Child Psychosocial Concerns In Primary Care, Robert M. Tolliver
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 …
Rural Vets: Their Barriers, Problems, Needs, John A. Gale Ms, Hilda R. Heady
Rural Vets: Their Barriers, Problems, Needs, John A. Gale Ms, Hilda R. Heady
Access / Insurance
Evolving population trends--the aging of rural veterans, the growing number of female veterans and rates of homelessness among veterans--place significant demands on VA and rural delivery systems. Coordination among health care providers is essential to increasing the availability of services and expanding veteran outreach programs.
Appalachian Regional Model For Organizing And Sustaining County-Level Diabetes Coalitions, Richard Crespo, Molly Shrewsberry, Darrlyn Cornelius-Averhart, Henry B. King Jr.
Appalachian Regional Model For Organizing And Sustaining County-Level Diabetes Coalitions, Richard Crespo, Molly Shrewsberry, Darrlyn Cornelius-Averhart, Henry B. King Jr.
Family and Community Health
This article describes a model for developing diabetes coalitions in rural Appalachian counties and presents evidence of their sustainability. The rural Appalachian coalition model was developed through a partnership between two federal agencies and a regional university. Coalitions go through a competitive application process to apply for one-time $10,000 grants. The project has funded 7 to 9 coalitions annually since 2001, reaching 66 total coalitions in 2008. Sustainability of the coalitions is defined by the number of coalitions that voluntarily report on their programs and services. In 2008, 58 of 66 (87%) coalitions in the Appalachian region continue to function …
Peer Support In Centers For Independent Living: What Do We Know?, Craig Ravesloot Ph.D., Bob Liston, University Of Montana Rural Institute
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
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
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
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
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
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
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
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
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.