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Journal of Rural Health

Daniel Skinner, Berkeley Franz, Kelly Kelleher
PURPOSE: The purpose of this study is to understand the experiences of Appalachian hospitals in undertaking Community Health Needs Assessments (CHNAs). Of particular interest is whether new requirements to undertake regular evaluation and public health programming pose challenges for rural, Appalachian hospitals. METHODS: Using a sample of nonprofit hospitals in Appalachian Ohio, we conducted in-depth qualitative interviews with hospital administrators overseeing community benefit activities and external consultants hired to complete assessments...
May 24, 2017: Journal of Rural Health
Wendy Ringgenberg, Corinne Peek-Asa, Kelley Donham, Marizen Ramirez
OBJECTIVE: We examined work-related homicides and suicides among farm operators/workers in the United States from 1992 to 2010. METHODS: Work-related homicide and suicide cases from 1992 to 2010 were obtained from the Census of Fatal Occupational Injuries. To calculate rates, denominator data on the US working population were also obtained from 2003 to 2010 Current Population Survey. Logistic regression was used to identify factors that were differentially associated with homicide and suicide...
May 2, 2017: Journal of Rural Health
Allison M Crump, Karie Jeter, Samantha Mullins, Amber Shadoan, Craig Ziegler, William J Crump
PURPOSE: The purpose of our study was to determine what effect a rural-based 8-week surgical clerkship during the third year of medical school in a rural setting has on students' opinions about rural living and practice. METHODS: Thirty-three third-year medical students completed a rural health opinion survey at the beginning and end of their 8-week rural rotation and a survey measuring their interest in rural practice after the rotation. The setting was a rural hospital with an average acute care census of 100 that is a regional referral center for 5 rural counties...
May 2, 2017: Journal of Rural Health
Brynn Fowler, N Jewel Samadder, Deanna Kepka, Qian Ding, Lisa Pappas, Anne C Kirchhoff
PURPOSE: Little is known about disparities in colorectal cancer (CRC) incidence and mortality by community-level factors such as metropolitan status. METHODS: This analysis utilized data from the Surveillance, Epidemiology, and End Results (SEER) program from Utah. We included patients diagnosed with CRC from 1991 to 2010. To determine whether associations existed between metropolitan/nonmetropolitan county of residence and CRC incidence, Poisson regression models were used...
April 20, 2017: Journal of Rural Health
Tawana Evans, Megha Ramaswamy, Catherine L Satterwhite
PURPOSE: Unintended pregnancy persists as a public health problem in the United States. Local health departments (LHDs) could play an important role in preventing unintended pregnancy by promoting and providing long-acting reversible contraception (LARC, intrauterine devices [IUDs] and implants), particularly in rural states that may lack robust family planning service infrastructure. The objective of this study was to determine availability of LARC in LHDs in Kansas. METHODS: From October 2015 to January 2016, LHD administrators in Kansas were contacted to participate in a structured, cross-sectional phone survey assessing LARC availability, staff trained to place LARC, the process for obtaining LARC, and barriers to offering LARC...
April 11, 2017: Journal of Rural Health
Paul A Gilbert, Helena H Laroche, Robert B Wallace, Edith A Parker, Susan J Curry
No abstract text is available yet for this article.
April 11, 2017: Journal of Rural Health
Meghan K Mattos, Beth E Snitz, Jennifer H Lingler, Lora E Burke, Lorraine M Novosel, Susan M Sereika
PURPOSE: Mild cognitive impairment (MCI) is a well-recognized risk state for Alzheimer's disease and other dementias. MCI is rapidly increasing among older adults in general and has not yet been examined in older adults within the Appalachian region. Our objective was to compare MCI symptom severity among older rural and urban Appalachian adults with MCI at an initial neuropsychological testing visit. METHODS: A cross-sectional, descriptive study of older Appalachian adults with MCI was conducted using data from the National Alzheimer's Coordinating Center Uniform Data Set...
April 2017: Journal of Rural Health
Rachel V Smith, April M Young, Ursula L Mullins, Jennifer R Havens
PURPOSE: Examination of the association of antisocial personality disorder (ASPD) with substance use and HIV risk behaviors within the social networks of rural people who use drugs. METHODS: Interviewer-administered questionnaires were used to assess substance use, HIV risk behavior, and social network characteristics of drug users (n = 503) living in rural Appalachia. The MINI International Psychiatric Interview was used to determine whether participants met DSM-IV criteria for ASPD and Axis-I psychological comorbidities (eg, major depressive disorder, posttraumatic stress disorder, generalized anxiety disorder)...
April 2017: Journal of Rural Health
Amenah A Agunwamba, Ichiro Kawachi, David R Williams, Lila J Finney Rutten, Patrick M Wilson, Kasisomayajula Viswanath
OBJECTIVE: Disparities in tobacco use persist despite successful policies reducing use within the United States. In particular, the prevalence of tobacco use in rural and certain minority communities is significantly higher compared to that of their counterparts. In this work, we examine the impact of rurality, mental health, and racial discrimination on tobacco use. METHODS: Data come from the 2003 California Health Interview Survey (n = 42,044). Modified Poisson regression models were adjusted for age, sex, race/ethnicity, birth origin, education, income, insurance, and marital status...
April 2017: Journal of Rural Health
Yan Lin, Michael C Wimberly
PURPOSE: The purpose of this study was to examine the geographic variations of late-stage diagnosis in colorectal cancer (CRC) and breast cancer as well as to investigate the effects of 3 neighborhood-level factors-socioeconomic deprivation, urban/rural residence, and spatial accessibility to health care-on the late-stage risks. METHODS: This study used population-based South Dakota cancer registry data from 2001 to 2012. A total of 4,878 CRC cases and 6,418 breast cancer cases were included in the analyses...
April 2017: Journal of Rural Health
Nabil Natafgi, Jure Baloh, Paula Weigel, Fred Ullrich, Marcia M Ward
PURPOSE: The aim of the study was to examine whether Critical Access Hospitals (CAHs), the predominant type of hospital in small and isolated rural areas, perform better than, the same as, or worse than Prospective Payment System (PPS) hospitals on measures of quality. METHODS: The Healthcare Cost and Utilization Project State Inpatient Databases and American Hospital Association annual survey data were used for analyses. A total of 35,674 discharges from 136 nonfederal general hospitals with fewer than 50 beds were included in the analyses: 14,296 from 100 CAHs and 21,378 from 36 PPS hospitals...
April 2017: Journal of Rural Health
Jen Jen Chang, Joanne Salas, Maya Tabet, Zachary Kasper, Keith Elder, Holly Staley, Ross C Brownson
PURPOSE: This study examined the association between body mass index (BMI) changes over time and the risk of elevated depressive symptoms in a cohort of Midwestern rural adults. METHODS: The longitudinal study used data from a telephone survey in 2005 including 1,475 men and women enrolled in the Walk the Ozarks to Wellness Project from 12 rural communities in Missouri, Arkansas, and Tennessee. Multilevel random intercept mixed models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between BMI calculated from self-reported height and body weight and elevated depressive symptoms, adjusting for sociodemographic, behavioral, and medical variables...
April 2017: Journal of Rural Health
Daniel Bechtold, G G Salvatierra, Emily Bulley, Alex Cypro, Kenn B Daratha
BACKGROUND: The value of early invasive revascularization for patients suffering acute myocardial infarction (AMI) is well known. However, access to revascularization services varies geographically and demographically. Previous studies have not examined the influence of rural residence on revascularization rates and outcomes among patients hospitalized with AMI. METHODS: Our retrospective cohort study included patients hospitalized in Washington State with a primary diagnosis of AMI from 2009 to 2012...
April 2017: Journal of Rural Health
Maisha Toussaint, Kayla Faust, Corinne Peek-Asa, Marizen Ramirez
PURPOSE: Operating or riding on farm equipment is one of the leading causes of farm-related injuries and fatalities among children and adolescents. The aim of this study is to examine environment, crash, vehicle, and occupant characteristics and the probability of injury, given a crash, in youth under age 18 on farm equipment. METHOD: Data from the Departments of Transportation on farm equipment-related crashes across 9 Midwestern states from 2005-2010 were used...
April 2017: Journal of Rural Health
Paula A M Weigel, Fred Ullrich, Chance N Finegan, Marcia M Ward
PURPOSE: Rural bypass of Critical Access Hospitals (CAHs) for elective inpatient and outpatient surgical procedures has not been studied. Residents choosing to have their elective surgeries elsewhere, when the local CAH provides those surgical services, erode their rural hospital's financial base. The purpose of this research is to describe the elective surgical bypass rate, the procedures most commonly bypassed by rural residents, the distribution of volume among CAHs that offer elective surgical services, and factors predictive of bypass...
April 2017: Journal of Rural Health
Leela V Thomas, Kenneth R Wedel, Jan E Christopher
PURPOSE: Diabetes is a chronic condition that requires frequent health care visits for its management. Individuals without nonemergency medical transportation often miss appointments and do not receive optimal care. This study aims to evaluate the association between Medicaid-provided nonemergency medical transportation and diabetes care visits. METHODS: A retrospective analysis was conducted of demographic and claims data obtained from the Oklahoma Medicaid program...
March 28, 2017: Journal of Rural Health
Kevin J Bennett, Matt W Yuen, Melinda A Merrell
RESEARCH OBJECTIVE: Abbeville County Emergency Management Services (ACEMS) began a community paramedicine (CP) program to utilize trained paramedics to serve patients who frequently use the emergency department (ED) and have 1 or more of the following diagnoses: hypertension, diabetes, chronic heart failure, asthma, and chronic obstructive pulmonary disease. The objective of this study was to determine if the CP program reduced ED visits in Abbeville while improving patient outcomes. DESIGN: A pre/posttest with a comparison group study design was used to evaluate the CP program...
March 23, 2017: Journal of Rural Health
Shailendra Prasad, Peiyin Hung, Carrie Henning-Smith, Michelle Casey, Katy Kozhimannil
OBJECTIVE: Workforce issues constrain obstetric care services in rural US hospitals, and one strategy hospitals use is to employ physicians to provide obstetric care. However, little is known about the relationship between hospital employment of maternity care physicians and use of obstetric care procedures in rural hospitals. We examined the association between obstetric physician employment and use of cesareans and nonindicated labor induction. STUDY DESIGN: We conducted a cross-sectional analysis of a telephone survey of all 306 rural hospitals providing obstetric care in 9 states from November 2013 to March 2014 and linked the survey data (N = 263, 86% response rate) to all-payer childbirth data on maternity care utilization from 2013 Statewide Inpatient Database (SID) hospital discharge data...
March 20, 2017: Journal of Rural Health
John R Wheat, James D Leeper, Shannon Murphy, John E Brandon, James R Jackson
PURPOSE: To evaluate the Rural Medical Scholars (RMS) Program's effectiveness to produce rural physicians for Alabama. METHODS: A nonrandomized intervention study compared RMS (1997-2002) with control groups in usual medical education (1991-2002) at the University of Alabama School of Medicine's main and regional campuses. Participants were RMS and others admitted to regular medical education, and the intervention was the RMS Program. Measures assessed the percentage of graduates practicing in rural areas...
March 20, 2017: Journal of Rural Health
John A Batsis, Karen L Whiteman, Matthew C Lohman, Emily A Scherer, Stephen J Bartels
PURPOSE: To ascertain whether rural status impacts self-reported health and whether the effect of rural status on self-reported health differs by obesity status. METHODS: We identified 22,307 subjects aged ≥60 from the Medical Expenditure Panel Survey 2004-2013. Body mass index (BMI) was categorized as underweight, normal, overweight, or obese. Physical and mental component scores of the Short Form-12 assessed self-reported health status. Rural/urban status was defined using metropolitan statistical area...
March 15, 2017: Journal of Rural Health
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