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Journal of Rural Health

Jonathan M Loree, Khodadad R Javaheri, Shilo V Lefresne, Caroline H Speers, Jenny Y Ruan, Jennifer T Chang, Carl J Brown, Hagen F Kennecke, Robert A Olson, Winson Y Cheung
OBJECTIVES: Optimal treatment of rectal cancer (RC) requires multidisciplinary care. We examined whether distance to treatment center or community size impacts access to multimodality care and population-based outcomes in RC. METHODS: Patients diagnosed with stage II/III RC from 1999 to 2009 and treated at 1 of 6 regional cancer centers in British Columbia were reviewed. Distance to treatment center was determined for each patient. Communities were classified as rural, small, medium, and large population centers...
October 7, 2016: Journal of Rural Health
Judith Teich, Mir M Ali, Sean Lynch, Ryan Mutter
PURPOSE: There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. METHODS: Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors...
October 4, 2016: Journal of Rural Health
Janice C Probst, Judith C Barker, Alexandra Enders, Paula Gardiner
PURPOSE: Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health. DESCRIPTION: We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children...
September 28, 2016: Journal of Rural Health
Paula A M Weigel, Fred Ullrich, Marcia M Ward
PURPOSE: Rural bypass for elective surgical procedures is a challenge for critical access hospitals, yet there are opportunities for rural hospitals to improve local retention of surgical candidates through alternative approaches to developing surgery lines of business. In this study we examine the effect of visiting surgical specialists on the odds of rural bypass. METHODS: Discharge data from the 2011 State Inpatient Databases and State Ambulatory Surgery Databases for Iowa were linked to outreach data from the Office of Statewide Clinical Education Programs and Iowa Physician Information System to model the effect of surgeon specialist supply on rural patients' decision to bypass rural critical access hospitals...
September 28, 2016: Journal of Rural Health
Richard A Crosby, Lindsay Stratdman, Tom Collins, Robin Vanderpool
PURPOSE: To determine the return rate of community-delivered fecal immunochemical test (FIT) kits in a rural population and to identify significant predictors of returning kits. METHODS: Residents were recruited in 8 rural Kentucky counties to enroll in the study and receive an FIT kit. Of 345 recruited, 82.0% returned an FIT kit from the point of distribution. These participants were compared to the remainder relative to age, sex, marital status, having an annual income below $15,000, not graduating from high school, not having a regular health care provider, not having health care coverage, being a current smoker, indicating current overweight or obese status, and a scale measure of fatalism pertaining to colorectal cancer...
September 21, 2016: Journal of Rural Health
John A Nelson, Anna Kinder, Anna Satcher Johnson, H Irene Hall, Xiaohong Hu, Donna Sweet, Alyssa Guido, Harold Katner, Jennifer Janelle, Maribel Gonzalez, Natalia Martínez Paz, Charlotte Ledonne, Jason Henry, Theresa Bramel, Jeanne Harris
PURPOSE: The HIV care continuum is used to monitor success in HIV diagnosis and treatment among persons living with HIV in the United States. Significant differences exist along the HIV care continuum between subpopulations of people living with HIV; however, differences that may exist between residents of rural and nonrural areas have not been reported. METHODS: We analyzed the Centers for Disease Control and Prevention's National HIV Surveillance System data on adults and adolescents (≥13 years) with HIV diagnosed in 28 jurisdictions with complete reporting of HIV-related lab results...
September 13, 2016: Journal of Rural Health
Katherine E Rebello, Jeffrey Gosian, Marci Salow, Pamela Sweeney, James L Rudolph, Jane A Driver
PURPOSE: To evaluate the efficacy of the Rural Pharmacological Intervention in Late Life (PILL) program, a quality improvement initiative in which a Boston-based pharmacist provided postdischarge telepharmacy care to veterans from rural Maine. METHODS: Using an automated screening tool, we identified 100 veterans aged 65 and older who had an acute care admission to VA medical centers in Boston or Maine and were at risk of problems with medication management. The PILL pharmacist called patients the week after hospital discharge to reconcile medications, assess adherence, and identify potentially inappropriate drugs...
September 8, 2016: Journal of Rural Health
Nengliang Yao, Héctor E Alcalá, Roger Anderson, Rajesh Balkrishnan
PURPOSE: To document cancer-related health disparities in Appalachia. METHODS: The current study investigated disparities in cancer incidence, mortality, and staging between rural Appalachians and those living outside of rural Appalachia. To accomplish this, mortality data for the United States from 1969 to 2011 were obtained from the National Center for Health Statistics (NCHS) using SEER(*) Stat. These data were used to compare trends in mortality between rural Appalachians, urban Appalachians, rural non-Appalachians, and urban non-Appalachians...
September 7, 2016: Journal of Rural Health
Peter S Liang, Jonathan D Mayer, Jon Wakefield, Cynthia W Ko
PURPOSE: Colorectal cancer (CRC) incidence and mortality in the United States have steadily declined since the 1980s, but racial and socioeconomic disparities remain. The influence of geographic factors is poorly understood and may be affected by evolving insurance coverage and screening test uptake. We characterized temporal trends in the association between geographic and sociodemographic factors and CRC outcomes. METHODS: We used the 1973-2010 SEER-Medicare files to identify patients aged ≥65 years with and without CRC...
August 31, 2016: Journal of Rural Health
Steven A Cohen, Sarah K Cook, Lauren Kelley, Julia D Foutz, Trisha A Sando
BACKGROUND: Obesity affects over one-third of older adults in the United States. Both aging and obesity contribute to an increased risk for chronic disease, early mortality, and additional health care utilization. Obesity rates are higher in rural areas than in urban areas, although findings are mixed. The objectives of this study are to assess potential nonlinearity in the association between rurality and obesity, and to evaluate the potential for socioeconomic status and geographic area to moderate the associations between rurality and obesity...
August 24, 2016: Journal of Rural Health
Matthew C Nattinger, Keith Mueller, Fred Ullrich, Xi Zhu
PURPOSE: The Centers for Medicare & Medicaid Services (CMS) has facilitated the development of Medicare accountable care organizations (ACOs), mostly through the Medicare Shared Savings Program (MSSP). To inform the operation of the Center for Medicare & Medicaid Innovation's (CMMI) ACO programs, we assess the financial performance of rural ACOs based on different levels of rural presence. METHODS: We used the 2014 performance data for Medicare ACOs to examine the financial performance of rural ACOs with different levels of rural presence: exclusively rural, mostly rural, and mixed rural/metropolitan...
August 24, 2016: Journal of Rural Health
Yolanda J McDonald, Daniel W Goldberg, Isabel C Scarinci, Philip E Castle, Jack Cuzick, Michael Robertson, Cosette M Wheeler
PURPOSE: Multiple intrapersonal and structural barriers, including geography, may prevent women from engaging in cervical cancer preventive care such as screening, diagnostic colposcopy, and excisional precancer treatment procedures. Geographic accessibility, stratified by rural and nonrural areas, to necessary services across the cervical cancer continuum of preventive care is largely unknown. METHODS: Health care facility data for New Mexico (2010-2012) was provided by the New Mexico Human Papillomavirus Pap Registry (NMHPVPR), the first population-based statewide cervical cancer screening registry in the United States...
August 24, 2016: Journal of Rural Health
Jane Moeckli, Kenda R Stewart, Sarah Ono, Bruce Alexander, Tyler Goss, Marissa Maier, Phyllis C Tien, M Bryant Howren, Michael E Ohl
PURPOSE: Extension for Community Health Outcomes (ECHO) is a provider-level telemedicine model successfully applied to hepatitis C care, but little is known about its application to Human Immunodeficiency Virus (HIV) care. We performed a mixed-methods evaluation of 3 HIV ECHO programs in the Veterans Health Administration, focusing on uptake by primary care clinics and veterans. METHODS: Administrative data were used to assess program uptake, including adoption (ie, proportion of primary care clinics participating) and reach (ie, proportion of eligible veterans participating)...
August 24, 2016: Journal of Rural Health
Santana D VanDyke, Madelynn D Shell
PURPOSE: This study explored the role of the Health Belief Model in predicting breast cancer screening among women in rural Appalachia. Health beliefs (perceived susceptibility to breast cancer, severity of breast cancer, and benefits and barriers to screening) were used to predict health behavior (mammogram frequency). METHOD: A total of 170 women aged 18-78 were recruited at a free health clinic in central Appalachia. Women completed surveys that assessed demographic characteristics, mammogram frequency, and perceived susceptibility, severity, and benefits and barriers to mammography...
August 22, 2016: 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...
August 10, 2016: Journal of Rural Health
Lance Brendan Young, Christine Timko, Kimberly A Tyler, Kathleen M Grant
PURPOSE: The objective of this study is to determine whether rural residence is associated with trauma exposure or posttraumatic stress disorder symptoms among military veterans seeking treatment for substance use disorder (SUD) through the Department of Veterans Affairs (VA), Delivering mental health services to veterans in rural areas is a challenge, so identifying differences in the causes and outcomes of trauma exposure would assist in effectively targeting service delivery. METHODS: Veterans (N = 196) entering SUD treatment at 3 Midwestern VA treatment centers were designated as either urban or rural, based on rural-urban commuting area (RUCA) codes...
August 9, 2016: Journal of Rural Health
George M Holmes, Brystana G Kaufman, George H Pink
PURPOSE: Annual rates of rural hospital closure have been increasing since 2010, and hospitals that close have poor financial performance relative to those that remain open. This study develops and validates a latent index of financial distress to forecast the probability of financial distress and closure within 2 years for rural hospitals. METHODS: Hospital and community characteristics are used to predict the risk of financial distress 2 years in the future. Financial and community data were drawn for 2,466 rural hospitals from 2000 through 2013...
August 8, 2016: Journal of Rural Health
(no author information available yet)
No abstract text is available yet for this article.
September 2016: Journal of Rural Health
Jennifer Lee, Gina Capra, Thomas Klobucar
No abstract text is available yet for this article.
September 2016: Journal of Rural Health
Mary E Charlton, Michelle A Mengeling, Jennifer A Schlichting, Lan Jiang, Carolyn Turvey, Amal N Trivedi, Kenneth W Kizer, Alan N West
OBJECTIVE: To quantify use of VA and non-VA care among working-age veterans with private insurance by linking VA data to private health insurance plan (PHIP) data. METHODS: Demographics and utilization were compared between dual users of VA and non-VA systems versus single-system users for veterans < 65 living in 2 rural Midwestern states concurrently enrolled in VA health care and a PHIP for ≥ 1 complete federal fiscal year from 2000 to 2010. Chi-square and t-tests were used for univariate analyses...
September 2016: Journal of Rural Health
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