Journal of Rural Health最新文献

{"title":"POSITION STATEMENT: Support policies to address opioid use disorder among rural communities","authors":"Lisa R. LaRowe PhD, Heather K. Hardin PhD, RN, Amy M. Goetzinger PhD, Kristen R. Fox PhD, Rebecca Kilpatrick PhD, Elizabeth K. Seng PhD, Roger Figueroa PhD, MPH, MSc","doi":"10.1111/jrh.12899","DOIUrl":"10.1111/jrh.12899","url":null,"abstract":"","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A descriptive examination of rurality in the Environmental influences on Child Health Outcomes Cohort: Implications, illustrations, and future directions","authors":"Lacey A. McCormack PhD,&nbsp;Debra A. MacKenzie PhD,&nbsp;Arielle Deutsch PhD,&nbsp;Daniel Beene PhD,&nbsp;Christine W. Hockett PhD,&nbsp;Katherine Ziegler MPH,&nbsp;Emily A. Knapp PhD,&nbsp;Amii M. Kress PhD,&nbsp;Zone R. Li BS,&nbsp;Shivani Bakre MHS,&nbsp;Rima Habre ScD,&nbsp;Lisa Jacobson ScD,&nbsp;Margaret R. Karagas PhD,&nbsp;Kaja LeWinn ScD,&nbsp;Sara S. Nozadi PhD,&nbsp;Akram Alshawabkeh PhD,&nbsp;Izzuddin M. Aris PhD,&nbsp;Traci A. Bekelman PhD,&nbsp;Casper G. Bendixsen PhD,&nbsp;Carlos Camargo MD, DrPH,&nbsp;Andrea E. Cassidy-Bushrow PhD,&nbsp;Lisa Croen PhD,&nbsp;Ferrara Assiamira MD, PhD,&nbsp;Rebecca Fry PhD,&nbsp;Tebeb Gebretsadik MPH,&nbsp;Tina Hartert MD,&nbsp;Kelly A. Hirko PhD,&nbsp;Catherine J. Karr MD, PhD,&nbsp;Itai Kloog PhD,&nbsp;Christine Loftus PhD,&nbsp;Kelsey E. Magee PhD,&nbsp;Cindy McEvoy MD,&nbsp;Jenae M. Neiderhiser PhD,&nbsp;Thomas G. O'Connor PhD,&nbsp;Mike O'Shea MD,&nbsp;Jennifer K. Straughen PhD,&nbsp;Audrey Urquhart MPH,&nbsp;Rosalind Wright MD,&nbsp;Amy J. Elliott PhD,&nbsp;for the ECHO Cohort Consortium","doi":"10.1111/jrh.12908","DOIUrl":"10.1111/jrh.12908","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The Environmental influences on Child Health Outcomes (ECHO) Cohort has enrolled over 60,000 children to examine how early environmental factors (broadly defined) are associated with key child health outcomes. The ECHO Cohort may be well-positioned to contribute to our understanding of rural environments and contexts, which has implications for rural health disparities research. The present study examined the outcome of child obesity to not only illustrate the suitability of ECHO Cohort data for these purposes but also determine how various definitions of rural and urban populations impact the presentation of findings and their interpretation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis uses data from children in the ECHO Cohort study who had residential address information between January 2010 and October 2023, including a subset who also had height and weight data. Several rural-urban classification schemes were examined with and without collapsing into binary rural/urban groupings (ie, the Rural-Urban Continuum Codes, 2010 Rural-Urban Commuting Area [RUCA] Codes, and Urban Influence Codes).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Various rural/urban definitions and classification schemes produce similar obesity prevalence (17%) when collapsed into binary categories (rural vs urban) and for urban participants in general. When all categories within a classification scheme are examined, however, the rural child obesity prevalence ranges from 5.8% to 24%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Collapsing rural-urban classification schemes into binary groupings erases nuance and context needed for interpreting findings, ultimately impacting health disparities research. Future work should leverage both individual- and community-level datasets to provide context, and all categories of classification schemes should be used when examining rural populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medicare Advantage and rural hospital profitability","authors":"Young H. Kim MSPH,&nbsp;Kristin L. Reiter PhD,&nbsp;Kristie W. Thompson MA,&nbsp;George H. Pink PhD","doi":"10.1111/jrh.12905","DOIUrl":"10.1111/jrh.12905","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study compares 2018–2023 Medicare Advantage (MA) days as a percentage of total Medicare days in rural and urban hospitals, describes 2022–2023 operating profitability of rural and urban hospitals by quartiles of MA days as a percentage of total Medicare days, and explores hospital characteristics that may be important for understanding the relationship between MA and profitability of rural hospitals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Financial and hospital data were obtained from the Centers for Medicare &amp; Medicaid Services (CMS) Healthcare Cost Report Information System (HCRIS) for the years 2018 to 2023. Hospitals were assigned to quartiles based on MA days as a percentage of total Medicare days. Descriptive analyses were conducted to compare hospital characteristics and financial performance across quartiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Between 2018–2019 and 2022–2023, the median percentage of total Medicare days from MA grew from 11.3% to 28.0% for rural hospitals. The 2022–2023 median operating margin varied from 0.0% for rural hospitals in Q1 (lowest MA days as a percentage of total Medicare days) to 3.4% for hospitals in Q4 (highest MA days as a percentage of total Medicare days).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Among rural hospitals, higher MA days as a percentage of total Medicare days was found to be associated with higher operating margin. However, results suggest that MA is not randomly distributed: rural hospitals with higher MA days as a percentage of total Medicare days exhibit distinct characteristics. This non-random distribution suggests that descriptive analysis may not fully capture the actual financial impact of MA on rural hospitals. Future research should recognize these complexities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bridging the rural-urban divide: A commentary on Rural-Urban Commuting Area codes","authors":"Michael J. Hankes MPH,&nbsp;Suzanne E. Judd PhD,&nbsp;Raymond Jones PhD","doi":"10.1111/jrh.12911","DOIUrl":"10.1111/jrh.12911","url":null,"abstract":"","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in telehealth utilization between US rural and urban areas during the COVID-19 pandemic","authors":"Redwan Bin Abdul Baten PhD,&nbsp;Fatema Tuz Zohora BDS,&nbsp;Muhammad Umar Hasan Siddiqui MBBS","doi":"10.1111/jrh.12910","DOIUrl":"10.1111/jrh.12910","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>During the COVID-19 pandemic, telehealth services were expanded across the United States to meet the increased demand and safety requirements of care. This observational study aims to understand rural-urban differences in telehealth utilization during the early part of the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individual-level data from the National Health Interview Survey 2020-2021 (age ≥18) were analyzed for this study. The Propensity Score Matching method with multivariable Ordinary Least Square was used to analyze 2 outcome variables—(1) having a medical appointment by video or phone in the past 12 months and (2) having a virtual one for reasons related to the pandemic. Event study models were analyzed to understand the trend of telehealth utilization throughout 6 quarters of the pandemic. Subgroup analysis by health insurance, age, sex, race, citizenship, and disability status was performed to identify underlying disparities between rural and urban residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Analysis reveals that rural respondents (N = 6,984) were 8.7 percentage points (<i>P</i>&lt;.001) less likely than urban respondents (N = 40,207) to have a medical appointment by video or phone. Rural residents were 8.1 percentage points (<i>P</i>&lt;.001) less likely to have had a virtual medical appointment because of reasons related to the COVID-19 pandemic than urban users. The event study showed that rural-urban telehealth utilization disparities persisted throughout the pandemic. Subgroup analysis revealed significant rural-urban disparities in telehealth utilization by demographic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Results demonstrate that rural residents were less likely than urban residents to utilize telehealth services during the COVID-19 pandemic, highlighting concerns about access to care for rural residents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ambulatory care utilization in the first 24 months’ postpartum by rurality and pregnancy-related conditions: A prospective cohort study from Maine","authors":"Sydney M. Bebus RN,&nbsp;Kristin Palmsten ScD,&nbsp;Heather S. Lipkind MD, MS,&nbsp;Christina M. Ackerman-Banks MD,&nbsp;Katherine A. Ahrens MPH, PhD","doi":"10.1111/jrh.12912","DOIUrl":"10.1111/jrh.12912","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To estimate the rate of ambulatory care use among postpartum persons by rurality of residence and pregnancy-related conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used Maine Health Data Organization's All Payer Claims Data for persons who delivered between 2007 and 2019 (N = 121,905). We estimated rates of ambulatory care (nonemergency department outpatient health care) utilization during the first 24 months’ postpartum by level of rurality (urban, large rural, small rural, and isolated rural) and by pregnancy-related conditions (prenatal depression, hypertensive disorders of pregnancy, and gestational diabetes). To estimate rate ratios (RR), we used Poisson regression with an offset for population at risk, adjusting for potential confounders and restricting the analysis to those with continuous insurance (n = 70,431).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The mean monthly rate per 100 deliveries of ambulatory care visits was 86.1; the median number of visits was 12 (interquartile range = 6, 25). Persons living in rural areas had lower monthly rates of visits than persons living in urban areas (adjusted RR ranged from 0.87 [95% CI: 0.85, 0.89] in isolated rural areas to 0.91 [95% CI: 0.90, 0.93] in large rural areas). Persons with prenatal depression (aRR = 2.07; 95% CI: 2.04, 2.11), hypertensive disorders of pregnancy (aRR = 1.07; 95% CI: 1.05, 1.10), and gestational diabetes (aRR = 1.11; 95% CI: 1.08, 1.14) had higher rates of visits than those without these conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>New practices and policies may be needed to improve postpartum ambulatory care access and utilization in rural areas. Postpartum persons with pregnancy-related conditions are accessing ambulatory care at higher rates after delivery, which may reduce their need for acute health care use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of rurality and decreased continuity of care prior to a diagnosis of prediabetes","authors":"Bobbie L. Johannes PhD MPH,&nbsp;Arch G. Mainous III PhD,&nbsp;Alex R. Chang MD MS,&nbsp;H. Lester Kirchner PhD,&nbsp;G. Craig Wood MS,&nbsp;Christopher D. Still DO,&nbsp;Lisa Bailey-Davis DEd RD","doi":"10.1111/jrh.12907","DOIUrl":"10.1111/jrh.12907","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To assess trends in continuity of care (COC) by geographic context (i.e., rural vs urban) among a cohort of persons with prediabetes prior to and after diagnosis of prediabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We use cross-sectional data from Geisinger's electronic health record between 1997 and 2017. Our dependent variable is the Modified Modified Continuity Index (MMCI), a measure of dispersion among primary care providers seen. Our primary independent variable is a binary indicator variable for rurality constructed from the 2010 Census Bureau's Urban and Rural Classification. We control for age, sex, race/ethnicity, and baseline clinical characteristics. We use fractional logistic regression with bootstrapped standard errors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Urban residing patients had greater odds of increased COC in the 3-year period prior to a diagnosis of prediabetes (aOR = 1.10, 95% CI = 1.03, 1.18; <i>P</i> = .007). However, there were no significant differences in COC among rural and urban residing patients upon diagnosis of prediabetes in unadjusted and fully adjusted regression models. Other factors significantly associated with COC across the observed time periods (pre- and post-diagnosis of prediabetes) include age, male, and hypertension in the patients’ problem list at baseline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among persons diagnosed with prediabetes, rurality was associated with decreased COC in the 3-year period prior to being diagnosed. However, in the 3-year period after diagnosis of prediabetes, geographic disparities in COC were not observed. Rural residing patients need enhanced continuity of primary care to potentially improve opportunistic screening for prediabetes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural health research in the 21st century: A commentary on challenges and the role of digital technology","authors":"Mairead Moloney PhD,&nbsp;Jasmine Rubio BS,&nbsp;Israel Palencia BS,&nbsp;Laronda Hollimon MS,&nbsp;Dunia Mejia BS,&nbsp;Azizi Seixas PhD","doi":"10.1111/jrh.12903","DOIUrl":"10.1111/jrh.12903","url":null,"abstract":"&lt;p&gt;Rural health research, fundamental to US public health, has faced significant challenges including inconsistencies in defining rural areas, methodological constraints in studying dispersed populations, and complex social and cultural factors.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; This commentary reexamines these enduring issues and proposes innovative solutions leveraging digital technologies. While acknowledging the potential of these technological approaches, we also address barriers to digital equity in rural settings and suggest practical strategies to overcome them.&lt;/p&gt;&lt;p&gt;Defining “rural” poses significant challenges.&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; Current classification methods typically consider population density, proximity to urban centers, and infrastructure availability. However, these approaches often lead to inconsistencies.&lt;span&gt;&lt;sup&gt;1, 3&lt;/sup&gt;&lt;/span&gt; The US Census, for instance, identifies urban areas based on population density, with non-urban areas classified as rural.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This method, while systematic, often overlooks crucial factors like commuting patterns, employment nature, land use, and access to essential services—including internet connectivity and advanced medical care.&lt;/p&gt;&lt;p&gt;Online tools have emerged to address these limitations by incorporating multiple definitions of rurality. The Rural Health Information Hub's “Am I Rural?” tool exemplifies this approach, integrating seven distinct definitions including data from the US Census, Rural-Urban Commuting Areas, and Federal Office of Rural Health Policy classifications.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; This tool also considers federal grant eligibility and health care professional shortages, providing a more comprehensive assessment of rural status.&lt;/p&gt;&lt;p&gt;The “Am I Rural?” tool illustrates how technological advancements can enhance rural area definition precision.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; By employing a multifaceted approach, these tools enable more accurate representations of rurality in health research. Consequently, this can inform policy decisions and resource allocation more effectively, ultimately benefiting rural communities' health and wellness.&lt;/p&gt;&lt;p&gt;Smaller population size, low population density, and limited access to transportation often pose methodological challenges for rural participant recruitment and retention, particularly if in-person data collection is required.&lt;span&gt;&lt;sup&gt;2, 5&lt;/sup&gt;&lt;/span&gt; Additionally, research questions or scales that are urban-normative (i.e., urban lifestyles or values are viewed as the default/ideal) may alienate respondents, leading to reduced response rates and questionable validity.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Dissemination of rural research findings is often more challenging due to confidentiality concerns in smaller communities.&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;To address these challenges, researchers are increasingly turning to innovative digital approaches. For instance, Vos et al.&lt;span&gt;&lt;sup&gt;8&lt;/sup&gt;&lt;/span&gt; created a standalo","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.12903","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of the Agricultural Producer Barriers to Care Scale (APBCS)","authors":"Noah Hopkins MPH,&nbsp;Chase Reece BSHP,&nbsp;Nathan Hansen PhD,&nbsp;Christina Proctor PhD","doi":"10.1111/jrh.12898","DOIUrl":"10.1111/jrh.12898","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The purpose of this study was to identify and test the factor structure of the Agricultural Producer Barriers to Care Scale (APBCS), which assesses barriers to engaging with health care in rural US farmers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Respondents (<i>n</i> = 1045) completed an online survey that was distributed digitally and in-person by researchers and community partners at farming events and via farm-related social media. Exploratory and Confirmatory Factor Analysis were used to assess the underlying factor structure of the APBCS, and McDonald's omega coefficients were calculated to test the reliability of each factor and the instrument as a whole. Data analysis was conducted in SPSS 28.0 and MPlus Version 7.4.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The exploratory factor analysis (<i>n</i> = 689) indicated a four-factor structure for the APBCS with domains of (i) formal health care challenges, (ii) cultural barriers to help-seeking, (iii) stigma, and (iv) resilience, which explained 38.408% of the overall variance. The confirmatory factor analysis (<i>n</i> = 231) found that a three-factor structure, where questions from “cultural barriers to help seeking” were applied to factors for stigma and resilience, was a better fit for the model than the four-factor model hypothesized by the EFA. The final APBCS showed reliability within each domain, and across the full three-factor scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The APBCS is a promising tool that shows high internal consistency and could inform researchers and practitioners about the structural and cultural barriers to engaging with health care in agricultural producers living in the United States.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The lived experiences and unmet needs of prostate and colorectal male cancer survivors in rural Virginia: A qualitative study.","authors":"Fariha Tariq, Alexander R Lucas, Sherrick Hill, Malik Philips, Vanessa B Sheppard","doi":"10.1111/jrh.12897","DOIUrl":"https://doi.org/10.1111/jrh.12897","url":null,"abstract":"<p><strong>Background: </strong>The goal of this study was to gain an in-depth understanding about the lived experiences and unmet needs of rural male cancer survivors.</p><p><strong>Methods: </strong>Focus groups were conducted with male survivors of prostate (N = 14) and colorectal cancers (N = 10), from rural Virginia. Demographic and clinical information were collected via surveys. A focus group guide contained questions about needs, lifestyles, and social networks of rural male cancer survivors. Focus group data were analyzed using Braun and Clarke's thematic analysis guidelines.</p><p><strong>Results: </strong>Four primary themes emerged from the data: (1) contending with health problems, (2) quality and availability of health care services, (3) coping strategies to navigate survivorship, and (4) advocating for cancer prevention. Survivors had to contend with physical and emotional problems, which were a result of their cancer treatments. Due to their rural location, survivors had difficulty accessing health care services and had a limited understanding of the cancer-related resources that existed in their counties. Family support, religiosity and acceptance served as important coping strategies. Many felt strongly about promoting cancer-related education and awareness.</p><p><strong>Conclusion: </strong>The lived experiences and unmet needs of rural male cancer survivors comprised several challenges, which included health problems and lack of health care access. Coping mechanisms comprised reliance on familial bonds and religion. Findings from this study reveal the need for tailored interventions to target the health care, psychosocial, and informational needs of rural male cancer survivors.</p>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":" ","pages":""},"PeriodicalIF":3.1,"publicationDate":"2024-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142631548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}