Community Health and Preventive Medicine Commons^™

Rural/Urban Disparities In Utilization Of Diabetes Self-Management Training (Dsmt) To The Fee-For-Service Medicare Population, 2017–2024, Wanying Zhu, Aleksandr Taraskin, Jeffrerey Talbert

Rural & Underserved Health Research Center Publications

Key Report Highlights

• A significant rural DSMT access gap exists. Rural beneficiaries accounted for 20.1% of Medicare beneficiaries with diabetes but only 7.8% of DSMT participants.

• Geographic availability remains limited. Only 16.8% of counties with DSMT utilization were rural.

• Access, not demand, appears to be the primary challenge. Rural counties offering DSMT achieved utilization rates more than twice those observed in urban counties (6.0% vs. 2.5%).

• Expanding rural DSMT capacity may represent a high-impact opportunity to improve diabetes self-management support among underserved Medicare beneficiaries.

Non-Metropolitan Vs. Metropolitan Variations In Alcohol, Illicit Drug, And Prescription Therapeutic Drug Misuse, Tyrone F. Borders

Rural & Underserved Health Research Center Publications

Key Findings

Alcohol Use. The prevalence of past year and past 30-day drinking was lower among non-metropolitan (non-metro) than metropolitan (metro) residents. However, non-metro drinkers engaged in more frequent binge drinking than metro drinkers. Drinking 3-5, 6-19, and 20-30 days over the past 30 days were higher among non-metro than metro residents.

Illicit Drug Use. Hallucinogens were the mostly commonly used illicit drugs among non-metro as well as metro residents. Methamphetamine use was significantly higher among non-metro than metro residents.

Prescription Pain Reliever Use. The misuse of prescription pain killers, primarily prescription opioids, was higher among non-metro than …

Cost-Effectiveness Evaluation Of Artificial Intelligence-Assisted Chest Radiograph Interpretation For Tuberculosis Screening In Rural Health Units In The Philippines, Harold Henrison C. Chiu, Bryan Christopher C. Lao, Gloanne C. Adolor

Graduate School of Business Publications

Background: Tuberculosis remains a major public health burden in the Philippines, where diagnostic delays are amplified by limited radiology capacity in rural health units (RHUs) and geographically isolated and disadvantaged areas (GIDAs). Computer-aided diagnosis (CAD) using artificial intelligence (AI)-assisted chest radiograph interpretation may shorten the screening pathway and reduce reliance on scarce specialist readers. However, its economic value for RHUbased tuberculosis screening has not been fully evaluated.
Methods: We developed a decision-tree cost-effectiveness model in Microsoft Excel 365 to compare AI-assisted chest radiograph interpretation with conventional manual radiologist or teleradiology interpretation among a theoretical annual cohort of 1,000 presumptive tuberculosis …

Baseline Nutrition Knowledge And Feasibility Of A Whatsapp-Delivered Nutrition Education Intervention Among California Wildland-Urban Interface Firefighters, Lauren E. Anderson

Master's Theses

Wildland firefighters perform physically demanding work under challenging environmental conditions that place substantial demands on nutritional health and occupational performance. Despite the importance of nutrition in supporting physical performance, recovery, and long-term health, limited research has examined nutrition knowledge and dietary behaviors among California wildland firefighters or evaluated the feasibility of remotely delivered nutrition education interventions within this occupational population. Therefore, the purpose of this pilot study was to assess baseline nutrition knowledge, nutrition self-efficacy, and dietary behaviors while evaluating the feasibility of a 12-week WhatsApp-delivered nutrition education intervention among California wildland firefighters.

Twenty-four firefighters completed the baseline assessment and …

“It’S Not Just Cost”: Barriers To Mammography Screening Access Among Low-Income Women In The United States—A Scoping Review, Julia Messerman, Callia Nickels, Nigel C. James

Health Studies Faculty Publications

Despite the recognized importance of early detection, disparities in mammography access persist among low-income women in the United States. While financial barriers are often emphasized, less is known about how multiple barriers interact to shape access to screening. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines to synthesize evidence on barriers to mammography access among low-income women in the United States. A systematic search of PubMed, CINAHL, and Google Scholar identified peer-reviewed studies published between 2010 and 2025, of which 47 met inclusion criteria. Extracted barriers were categorized into …

Montana Kinship Navigator Program: A Statewide Frontier Initiative Promoting Kinship Family Health And Wellness, Daniel J. Koltz Dr., Peyton Vining, Yu Jiang

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This practice brief report describes the development, implementation, and new updates of the Montana Kinship Navigator Program (MTKNP), a statewide initiative designed to support kinship caregivers in a large, rural frontier context. Montana’s geographic isolation, limited infrastructure, and sparse population create significant barriers for kinship families, including restricted access to healthcare, transportation, childcare, and social services. These challenges are compounded when caregivers unexpectedly assume responsibility for children, often with limited resources and support. MTKNP addresses these gaps through a comprehensive, evidence-informed model that integrates information and referral services with individualized case management. The program serves both formal and informal kinship …

Association Between Occupational Stress, Sleep Quality, And Premature Ejaculation Among Indonesian Information Technology Workers, Muhammad Faisal Ratman, Suryo Wibowo, Muhammad Ilyas, Retno Asti Werdhani, Dewi Yunia Fitriani

Occupational and Environmental Medicine Journal of Indonesia

Introduction Premature ejaculation (PE) is a common sexual dysfunction that significantly impacts quality of life. Occupational stress and poor sleep quality are hypothesized as risk factors, particularly among Information and Technology (IT) workers who experience unique occupational stressors. This study aimed to evaluate the proportion of PE, examine the influence of occupational stress and sleep quality on PE, and determine whether sleep quality mediates the relationship between occupational stress and PE among Indonesian IT workers.

Methods This cross-sectional study involved 89 married male IT workers who completed online questionnaires, including the Premature Ejaculation Diagnostic Tool (PEDT), Perceived Occupational Stress (POS) …

Depressive Symptoms And Functional Disability Among Older Adults In Nakhon Ratchasima Province, Thailand: A Cross-Sectional Population-Based Study, Jiranya Bureemas, Atthawit Singsalasang

Journal of Health Research

Background: Depressive symptoms have been associated with activities of daily living (ADL) disability; however, evidence among Thai older adults remains limited and inconsistent. This study investigates the association between depressive symptoms and ADL disability in older Thai adults.

Methods: A cross-sectional analytic study was conducted among 312 older adults in Nakhon Ratchasima, Thailand, who were selected using a multistage sampling method. Data were collected between April and July 2023 using structured questionnaires covering demographic and environmental variables. Depressive symptoms were assessed using the 15-item Geriatric Depression Scale. ADL disability was measured using the Barthel and Chula ADL Indices. Multiple logistic …

Global Trends In School Disaster Preparedness Research: Bibliometric Analysis Impacts On Public Health And Safety, Muhammad Farid, Muhammad Agita Hutomo, Oktomi Wijaya, Dian Ika Puspitasari

Chulalongkorn Medical Journal

Background: Disasters disrupt daily human activities, arising from natural or artificial triggers, with varying impacts based on community vulnerability and resource capacity. Effective disaster management involves a cycle of mitigation, preparedness, response, and recovery. One of the mitigation measures is to establish school disaster preparedness that integrate education and capacity building.

Objective: The aim of this research is to conduct a bibliometric analysis based on Scopus publications regarding school disaster preparedness.

Methods: A bibliometric analysis was performed on publications indexed in Scopus from 1965 to 2024. Data were processed and visualized using VOSviewer to explore trends in annual outputs, contributing …

Applying The Ottawa Charter To Evaluate Health Literacy Outcomes Of The Little Aussie Bugs Course For Australian Early Childhood Educators, Amelia Ruscoe, Elizabeth J. Cook, Eleanor K. O'Brien, Leesa N. Costello, Gillian Kirk, Ros Sambell, Theresa Rayfield, Amanda Devine, Ruth M. Wallace

Research outputs 2022 to 2026

Early childhood offers an important opportunity to lay the foundations for lifelong health literacy. The Little Aussie Bugs (LAB) dialogic book series and online professional development (PD) course were designed to support Early Childhood Education and Care (ECEC) educators to embed health literacy concepts, including hygiene, healthy eating, and oral health, into everyday learning routines. This mixed methods study evaluated the course pilot and examined its contribution through the lens of the Ottawa Charter for Health Promotion—a framework comprising five interrelated action areas: building healthy public policy; creating supportive environments; strengthening community action; developing personal skills; and reorienting health services. …

Assessing Hpv And Hpv Vaccine Awareness And Perception Amongst Undergraduate Students, Maura Hawkins

Honors Theses

Human Papillomavirus (HPV) is one of the most common sexually transmitted infections in the United States. Vaccination rates remain low among college-aged students despite an effective vaccine being available. This study investigates HPV and HPV vaccination-related knowledge, beliefs, and perceptions among undergraduate students to inform targeted intervention strategies. Participants included undergraduate students (n = 19) who attended one of three focus groups conducted in April 2025 at the University of South Alabama. Structured interview guides explored HPV knowledge, perceived risk and severity, attitudes towards vaccination, autonomy in health decision-making, trust in health information sources, and preferred educational strategies. Discussions were …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Core Sipp Community Collaboration Report, Yvonnie Baik, Mahtab Soleimani, Camille Velarde, Elena E. Martinez, Theresa H. Cruz

Reports & Documents

The New Mexico Core State Injury Prevention Program (Core SIPP), in partnership with the University of New Mexico Division of Prevention and Population Sciences, implemented the Community Collaboration Initiative to support community-led, upstream approaches to injury and violence prevention. Five community-based organizations across New Mexico received funding to develop and implement projects addressing shared risk and protective factors identified through advisory group input and community listening sessions. Programs emphasized youth leadership, mentorship, cultural identity, healthy relationships, mental and behavioral wellness, community connectedness, and access to supportive adults and resources.

Across the five projects, 68 youth participated in programming. A retrospective …

Exploring Primary Care Providers’ Compassionate Care And Their Evidence-Based Practice With Death, Grief, And Loss: Patient Experience And Perspective, Kathryn Krzykala

Dissertations

Research on primary care providers’ (PCPs) education regarding Death, Grief, and Loss (DGL) remains limited. Specifically, data is lacking regarding patients' perceptions and opinions on what they need and expect from their PCPs regarding grief and loss. This exploratory mixed-method study comprised 146 participants who had experienced death and non-death loss. It examined participants' perceptions of 1) PCP compassion, 2) PCP utilization of evidence-based grief and loss practices, 3) their own level of comfort discussing DGL with their PCPs during medical visits, and 4) their personal grief and loss experiences. The findings revealed that PCPs' grief-informed evidence-based treatment, as reflected …

Pendekatan Time-Driven Activity-Based Costing Dan Theoretical Framework Of Acceptability Untuk Estimasi Anggaran Layanan Home-Based Palliative Care Di Yogyakarta, Tatik Hariyanti, Firdaus Hafidz, Arif Budiarto

Jurnal Ekonomi Kesehatan Indonesia

Palliative care services delivered through a home care scheme in Indonesia are not yet included in the National Health Insurance (JKN) benefit package. Through a bridging guarantee scheme, since 2020 the Regional Government of the Special Region of Yogyakarta (DIY) has provided this service to the local population in accordance with applicable regulations. Therefore, a basis for budget allocation that considers the regional conditions of DIY is required. This study employed a mixed-methods approach with an explanatory sequential design, beginning with a quantitative study to estimate the prevalence of the population requiring palliative care services as well as the unit …

Analisis Biaya Standar Pelayanan Minimal (Spm) Kesehatan Menggunakan Aplikasi Siscobikes Di Tingkat Kabupaten/Kota Di Indonesia, Purwa K. Sucahya, Resi Natalia Turnip, Lemi Kurniawan, Bondan Wicaksono Adhi, Iwan Supriyadi, Ni’Matun Nurlaela

Jurnal Ekonomi Kesehatan Indonesia

This research investigates the capacity of the Siscobikes (Health Costing System) application to forecast the financial requirements for the execution of Minimum Service Standards (SPM) within Indonesia’s health sector at the district and city levels.. The study utilized cross-sectional data from 166 districts/cities to ascertain the projected health financing requirements and juxtaposed these estimates with the actual budgetary allocations. The results show that each district/city requires approximately IDR 16 billion annually for SPM. Districts require around IDR 17 billion annually, while cities require approximately IDR 13 billion. Substantial regional disparities are observed: Eastern Indonesia has the highest per capita needs …

Refining Of An Online Rotator Cuff Related Pain Screening Tool (Orcs): A Mixed Methods Refinement Study, Andrew J. Smythe, Rhiannon Whale, Melanie Farlie, Peter Malliaras

Internet Journal of Allied Health Sciences and Practice

Purpose: The purpose of this study is to refine an online rotator cuff related shoulder pain screening tool. Method: A mixed methods item-refinement study was used. The original tool was designed through expert opinion and informal literature review. In this study the original tool was refined over three rounds of cognitive interviews totalling 39 participants. The screening tool consisted of two sections, red flag screening followed by rotator cuff related shoulder pain differential diagnostic items. Results from each round of interviews were summarised and informed a nominal group research panel review process to modify items and develop a finalised version …

Enhancing Sleep Quality Through Sleep Hygiene Education Among Adults In A Faith-Based Community, Denielle Earle-Thompson

Doctor of Nursing Practice Projects

Background

Adults between 18 and 64 years of age require at least seven hours of sleep per night; however, many adults do not meet this recommendation, contributing to increased risks for chronic disease, impaired functioning, mood disturbances, and reduced quality of life. Poor sleep quality has been associated with weakened immunity, cardiovascular disease, diabetes, obesity, anxiety, depression, and decreased daytime performance. Obtaining adequate, good-quality sleep is essential for maintaining overall health and well-being. In faith-based communities, combining health education with spiritual support may provide a holistic approach that addresses both physical and emotional contributors to poor sleep.

Purpose

The purpose …

Rural–Urban Disparities In Monkeypox-Related Behaviors And Attitudes Among Men Who Have Sex With Men, Patcharaporn Krainara, Benjamas Klahan, Rungrot Jaiyong, Jitti Hanprasertpong

Journal of Health Research

Background: Monkeypox (Mpox) is a global health threat, particularly among men who have sex with men (MSM). Despite the predominance of urban cases in Thailand, rural–urban disparities in Mpox-related attitudes and behaviors remain underinvestigated. This study aimed to compare Mpox-related attitudes and preventive behaviors among urban (Chonburi) and rural (Nakhon Nayok) MSM and identify their influencing factors.

Method: This cross-sectional study was conducted between March and April 2025. A total of  842 MSM (421 urban; 421 rural) were recruited via convenience sampling. Data were collected using paper-based, self-administered Health Belief Model (HBM) questionnaires and analyzed using descriptive statistics and multivariable …

School Policy, Health Equity, And Lgbtq+ Youth: Implications Of Mahmoud V. Taylor, Anna Folta

Online/Hybrid MPH Integrative Learning Experience (capstone projects)

School-based policy functions as a critical lever for reducing health disparities among LGBTQ+ youth, who face elevated risks of suicidality, bullying, unsafe school environments, and housing instability. An extensive body of research identifies inclusive school practices—such as affirming curricula, supportive staff, and student organizations—as key protective factors that foster belonging and improve mental health outcomes. However, recent political and legal developments threaten the implementation and consistency of these protections.

Using a structured literature review and comparative policy analysis of federal, state, and district responses, this project integrates public health evidence with legal interpretation to assess how emerging parental opt-out frameworks …