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Journal of Rural Health

John Shaver, Akshay Sharma, Rob Stephenson
PURPOSE: Health disparities among LGBTQ people have been documented across various settings and recent research has indicated that many disparities are heightened in the context of rurality. Among these disparities is the decreased rate of primary care utilization by rural LGBTQ individuals. Understanding and addressing provider knowledge and attitudes related to LGBTQ health provides a relevant avenue for addressing underutilization. METHODS: The study presented was a mail-out survey regarding rural primary care providers' knowledge and experiences regarding LGBTQ health...
September 10, 2018: Journal of Rural Health
K Bryant Smalley, Jacob C Warren, Yelena N Tarasenko, K Nikki Barefoot
PURPOSE: The purpose of this study was to examine the importance of rural location in the likelihood of adolescent drunk driving and riding in a vehicle with a driver under the influence while controlling for a variety of student-, school-, and county-level factors. METHODS: Data from the 2013 Georgia Student Health Survey (GSHS) II (a statewide assessment of student health in public school students in Georgia) were analyzed using multilevel binary regressions to examine rural-urban differences in prevalence of driving under the influence (11th and 12th graders only; n = 114,907) and riding with a driver under the influence (9th -12th graders; n = 258,610), controlling for school-level race, gender, and income, in addition to county-level education level, unemployment, alcohol use, and smoking...
August 30, 2018: Journal of Rural Health
Tyrone F Borders
No abstract text is available yet for this article.
August 19, 2018: Journal of Rural Health
Nathan Hale, Kate Beatty, Michael Smith
PURPOSE: Rural communities often experience higher rates of mortality than their urban counterparts, with gaps widening in the foreseeable future. However, the underlying level of socioeconomic vulnerability (area deprivation) among rural communities can vary widely. This study examines rural-urban differences in mortality-related outcomes within comparable levels of deprivation. METHODS: Rural-urban differences in Years of Potential Life Lost (YPLL), derived from the County Health Rankings, were examined across comparable levels of area deprivation using a quantile regression approach...
August 13, 2018: Journal of Rural Health
(no author information available yet)
No abstract text is available yet for this article.
August 7, 2018: Journal of Rural Health
Diane Pilkey, Christy Edwards, Rachel Richards, Lenora M Olson, Michael Ely, Elizabeth A Edgerton
PURPOSE: Critical Access Hospitals (CAHs), often the first point of access for emergency care, see few children and are challenged to remain proficient in caring for pediatric patients. Our analysis provides guidance to facilitate increasing CAHs staffs' ability to provide effective pediatric emergency care. METHODS: The National Pediatric Readiness Project (NPRP) assessment of 4,146 emergency departments (EDs) was linked with the CAHs list from Centers for Medicare and Medicaid Services...
July 30, 2018: Journal of Rural Health
Gweneth B Lazenby, Anna M Powell, Scott A Sullivan, David E Soper
PURPOSE: We sought to determine if infants born in rural counties had an increased risk of contracting HIV. METHODS: Data were obtained from the South Carolina Department of Health and Environmental Control for all women living with HIV delivering from 2004 to 2014. In this retrospective cohort study, maternal and neonatal outcomes from urban and rural counties were compared. Binomial statistical analyses were conducted using Wilcoxon Rank Sum Tests, χ2 or Fisher's exact tests...
July 16, 2018: Journal of Rural Health
Carrie Henning-Smith, Megan Lahr
PURPOSE: This study examines rural-urban differences in employed caregivers' access to workplace supports, negative impacts of caregiving on work, and the association between work and caregiver strain, which can have negative impacts on health. METHODS: We used a cross-sectional analysis of employed caregivers (n = 635) from the 2015 Caregiving in the US survey, including bivariate comparisons of caregiver characteristics, access to workplace benefits, and workplace impacts by rural-urban location, as well as ordered logistic regression models to assess the relationship between workplace benefits and impacts and caregiver strain, stratified by rural-urban location...
June 27, 2018: Journal of Rural Health
Tyrone F Borders
No abstract text is available yet for this article.
December 2018: Journal of Rural Health
Joseph Fonseca, Andrew Chang, Feng Chang
PURPOSE: Misuse of opioids has become a public health concern across North America. Rural patients have limited access to methadone maintenance treatment (MMT), an opioid addiction-treatment service that could be offered by community pharmacists. The aim of this study was to identify rural community pharmacists' perceived barriers, motivations, and solutions to offering MMT to their patients. METHODS: One-on-one, semistructured interviews were conducted with 11 community pharmacists who practice in rural southwestern Ontario...
December 2018: Journal of Rural Health
Emily B Jones
PURPOSE: This study explores correlates of on-site availability of substance use disorder treatment services in federally qualified health centers, including buprenorphine treatment that is critical to addressing the opioid epidemic. METHODS: We employed descriptive and multivariable analyses with weighted 2010 Assessment of Behavioral Health Services survey data and the 2010 Uniform Data System. FINDINGS: In 2010, 47.6% of health centers provided on-site substance use disorder treatment, 12...
December 2018: Journal of Rural Health
Laura J Chavez, Kelly J Kelleher, Steven C Matson, Thomas M Wickizer, Deena J Chisolm
PURPOSE: Rural young adults experience greater unmet need for mental health (MH) and alcohol or drug (AOD) treatment and lower health insurance coverage than urban residents. It is unknown whether Affordable Care Act (ACA) reforms in 2010 (dependent coverage extended to age 26) or 2014 (Medicaid expansion) closed rural/urban gaps in insurance and treatment. The present study compared changes in rates of health insurance, MH treatment, and AOD treatment for rural and urban young adults over a period of ACA reforms...
December 2018: Journal of Rural Health
Michele Staton, Gabriele Ciciurkaite, Jennifer Havens, Martha Tillson, Carl Leukefeld, Matthew Webster, Carrie Oser, Bridgette Peteet
BACKGROUND: Limited research has focused on correlates of injection drug use (IDU) among high-risk subgroups of drug users, particularly women, who may be at increased risk for transmission of infectious diseases such as HIV and Hepatitis C. The purpose of this study is to better understand the contextual and health correlates of IDU among women living in rural Appalachia by examining (1) differences between injectors and noninjectors, and (2) the unique correlates of recent IDU and past IDU...
December 2018: Journal of Rural Health
Joshua D Brown, Amie J Goodin, Jeffery C Talbert
OBJECTIVE: Incidence of neonatal abstinence syndrome (NAS) is increasing due to the rise in opioid use. Rural states like Kentucky have been disproportionally impacted by opioid abuse, and this study determines NAS burden nationally and in Kentucky while quantifying differences in access to care between Appalachian and non-Appalachian counties. METHODS: NAS rates were calculated using National (2013) and Kentucky (2008-2014) National Inpatient Sample discharge data...
December 2018: Journal of Rural Health
Miranda Hill, Amber Huff, Neale Chumbler
PURPOSE: In spite of progress in understanding the importance of social support for health outcomes in Persons Living with HIV (PLWH), more remains to be known about mechanisms of support most beneficial at each stage of HIV treatment. In this study, we use a qualitative analytic approach to investigate the forms and sources of social support deemed most integral to the diagnosis, care engagement, and medication adherence behaviors of a diverse sample of PLWH in a mostly rural health district in the Southeastern United States...
December 2018: Journal of Rural Health
Theresa J Hoeft, John C Fortney, Vikram Patel, Jürgen Unützer
PURPOSE: Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low-resource areas. This review focuses on task-shifting approaches and highlights future directions for research in this area. METHODS: Systematic review on task sharing of mental health care in rural areas of high-income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer-reviewed journals, and (3) outreach to experts for additional articles...
December 2018: Journal of Rural Health
Urshila Sriram, Emily H Morgan, Meredith L Graham, Sara C Folta, Rebecca A Seguin
PURPOSE: Social environments exert an important influence on health behaviors, yet evidence from rural-specific contexts is limited. This study explored how social relationships influence health-related behaviors among midlife and older rural adults at increased risk of chronic disease. METHODS: Seventeen focus groups were conducted with 125 sedentary, overweight/obese adults (aged 40-91 years) residing in "medically underserved" rural Montana towns in 2014...
December 2018: 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...
December 2018: 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...
December 2018: Journal of Rural Health
Debra H Bernat, Kelvin Choi
PURPOSE: To examine cigarette use and the tobacco-related environment among adolescents living in metropolitan and nonmetropolitan areas. METHODS: Data from adolescents ages 14-17 that completed the 2012 Florida Youth Tobacco Survey were analyzed (n = 40,746). This includes a representative sample of middle and high school students throughout the state. RESULTS: Nonmetropolitan adolescents were more likely than metropolitan adolescents to report lifetime smoking, past 30-day smoking, daily smoking, initiating smoking at younger ages, having smoked a greater number of cigarettes in their lifetime and in the past 30 days, friend acceptance of adult smoking, a parent offering them a cigarette, living with a smoker, and that smoking was allowed in their home...
December 2018: Journal of Rural Health
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