Journal of Rural Health最新文献_第3页

Rural-urban differences in smoking quit ratios and cessation-related factors: Results from a nationally representative sample. 戒烟率和戒烟相关因素的城乡差异：全国代表性抽样调查结果。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-08-19 DOI: 10.1111/jrh.12870

Devon Noonan, Suzanne Frisbee, Lorna Bittencourt, Dana Rubenstein, F Joseph McClernon, Dana Mowls Carroll

{"title":"Rural-urban differences in smoking quit ratios and cessation-related factors: Results from a nationally representative sample.","authors":"Devon Noonan, Suzanne Frisbee, Lorna Bittencourt, Dana Rubenstein, F Joseph McClernon, Dana Mowls Carroll","doi":"10.1111/jrh.12870","DOIUrl":"https://doi.org/10.1111/jrh.12870","url":null,"abstract":"Purpose: There are significant rural/urban disparities that exist in cancer and chronic disease morbidity and mortality, many of which are attributed to increased tobacco use prevalence in rural populations compared to urban. Understanding differences in rural and urban tobacco use patterns is key to developing targeted interventions.Methods: Using nationally representative data from Wave 5 of the Population Assessment of Tobacco Use and Health (PATH), we examined weighted frequencies and conducted multivariable logistic regression to examine the use of cessation supports in people who currently smoke with a quit attempt in the last 12 months (recent attempters) by rural and urban status and geographic region. Our second objective was to examine lifetime quitting in rural versus urban people who smoke and by geographic region.Results: Rural people who recently attempted to quit were less likely to use any FDA-approved cessation aids, less likely to use Nicoctine Replacement Therapy (NRT), and less likely to be exposed to a home smoking ban in the adjusted analysis. The adjusted odds of quitting were lower in the rural Northeast, Midwest, and South compared to the urban regions.Conclusions: Findings from this data can serve to inform the development of targeted interventions for rural communities.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005721","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}

引用次数: 0

A qualitative study of end-stage liver disease and liver transplant referral practices among primary care providers in nonurban America. 对美国非城市地区初级医疗服务提供者的终末期肝病和肝移植转诊做法的定性研究。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-08-19 DOI: 10.1111/jrh.12871

Vashisht V Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R Garcia, Natalie Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta

{"title":"A qualitative study of end-stage liver disease and liver transplant referral practices among primary care providers in nonurban America.","authors":"Vashisht V Madabhushi, Matthew Wright, Gabriel Orozco, Allison Murphy, Antonio R Garcia, Natalie Pope, Xiaonan Mei, Alexandra Cocca, Roberto Gedaly, Meera Gupta","doi":"10.1111/jrh.12871","DOIUrl":"https://doi.org/10.1111/jrh.12871","url":null,"abstract":"Purpose: In rural America, the road to obtaining a liver transplant (LTX) often starts at the primary care provider's (PCP's) office. Patients with end-stage liver disease (ESLD) in rural communities experience lower rates of wait-listing and higher mortality. This study identifies issues related to the knowledge and perceptions of ESLD and LTX referral among PCPs in rural Kentucky (KY).Methods: The study protocol involved relying upon a semistructured outline to explore the knowledge, attitude, and perceptions of PCPs toward ESLD and LTX referral among PCPs in rural KY. Inductive thematic analysis was utilized to identify, analyze, and report themes.Findings: From the focus group interviews, three themes were identified: medical culture, gaps in knowledge, and bias against those with self-induced causes of ESLD. Each theme illuminated barriers to referral for transplant evaluation.Conclusions: Knowledge gaps, attitudes in medical culture, and biases surrounding ESLD and LTX referral exist in community medicine practice. This highlights the importance of education, resources, and facilitation of LTX referral processes for PCPs.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005720","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}

引用次数: 0

Rural-urban disparities in cardiovascular disease mortality vary by poverty level and region. 心血管疾病死亡率的城乡差异因贫困程度和地区而异。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-08-16 DOI: 10.1111/jrh.12874

Ahlia Sekkarie, Rebecca C Woodruff, Michele Casper, Angela-Thompson Paul, Adam S Vaughan

{"title":"Rural-urban disparities in cardiovascular disease mortality vary by poverty level and region.","authors":"Ahlia Sekkarie, Rebecca C Woodruff, Michele Casper, Angela-Thompson Paul, Adam S Vaughan","doi":"10.1111/jrh.12874","DOIUrl":"https://doi.org/10.1111/jrh.12874","url":null,"abstract":"Purpose: To examine rural and urban disparities in cardiovascular disease (CVD) death rates by poverty level and region.Methods: Using 2021 county-level population and mortality data for CVD deaths listed as the underlying cause among adults aged 35-64 years, we calculated age-standardized CVD death rates and rate ratios (RR) for 4 categories of counties: high-poverty rural, high-poverty urban, low-poverty rural, and low-poverty urban (referent). Results are presented nationally and by US Census region.Findings: Rural and urban disparities in CVD mortality varied markedly by poverty and region. Nationally, the CVD death rate was highest among high-poverty rural areas (191 deaths per 100,000, RR: 1.76, CI: 1.73-1.78). By region, Southern high-poverty rural areas had the highest CVD death rate (256 deaths per 100,000) and largest disparity relative to low-poverty urban areas (RR: 2.05; CI: 2.01-2.09). In the Midwest and West, CVD death rates among high-poverty areas were higher than low-poverty areas, regardless of rural or urban classification.Conclusions: Results reinforce the importance of prioritizing high-poverty rural areas, especially in the South, in efforts to reduce CVD mortality. These efforts may need to consider socioeconomic conditions and region, in addition to rural and urban disparities.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996773","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}

引用次数: 0

Removing Caps for rural graduate medical education: A policy recommendation to eliminate GME Caps of less than 16 for rurally located hospitals. 取消农村地区毕业后医学教育的上限：关于取消农村地区医院低于 16 个 GME 上限的政策建议。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-08-15 DOI: 10.1111/jrh.12873

Randall Longenecker

引用次数: 0

Adult perceptions of mental health access barriers facing youth in rural Washington State: A group concept mapping study. 成年人对华盛顿州农村地区青少年所面临的心理健康障碍的看法：小组概念绘图研究。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-08-13 DOI: 10.1111/jrh.12866

Janessa M Graves, Demetrius A Abshire, Jessica L Mackelprang, Tracy A Klein, Carmen Gonzalez, Kailee Parrott, Deborah U Eti, Jordan G Ferris, Christina M Chacon, Ashley D Beck

{"title":"Adult perceptions of mental health access barriers facing youth in rural Washington State: A group concept mapping study.","authors":"Janessa M Graves, Demetrius A Abshire, Jessica L Mackelprang, Tracy A Klein, Carmen Gonzalez, Kailee Parrott, Deborah U Eti, Jordan G Ferris, Christina M Chacon, Ashley D Beck","doi":"10.1111/jrh.12866","DOIUrl":"https://doi.org/10.1111/jrh.12866","url":null,"abstract":"Purpose: To explore adult community members' perspectives concerning barriers to mental health care that confront rural-dwelling youth.Methods: Group concept mapping, a participatory community-engaged research method, was used. Adult community members brainstormed and sorted statements describing barriers rural youth encounter in accessing mental health services. Point and cluster maps were created to visualize conceptual similarities between statements. Statements were rated according to their commonness and importance (1: low commonness/importance, 5: high commonness/importance).Findings: Thirty-five adults sorted and/or rated 71 barriers facing rural youth in accessing mental health services. Seven conceptual clusters were identified: system-level barriers, knowledge and communication, youth concerns, parent/guardian concerns, parent/guardian barriers, costs and convenience, and school-level barriers. Within youth concerns, community members also identified a subcluster focused on stigma. Common and important statements related to limited after-school programs and community mental health support initiatives.Conclusions: Group concept mapping methodology provides structure for conceptualizing challenges facing rural youth in accessing mental health services. Policies should be informed by rural community concerns and priorities. After-school and support programs may align with mental health needs identified by rural communities.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977131","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}

引用次数: 0

The effects of the COVID-19 pandemic on urban and rural hospital profitability. COVID-19 大流行对城市和农村医院盈利能力的影响。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-07-30 DOI: 10.1111/jrh.12864

Laura McFadyen, Susie Gurzenda, George Pink, Tyler Malone, Kristin Reiter

{"title":"The effects of the COVID-19 pandemic on urban and rural hospital profitability.","authors":"Laura McFadyen, Susie Gurzenda, George Pink, Tyler Malone, Kristin Reiter","doi":"10.1111/jrh.12864","DOIUrl":"https://doi.org/10.1111/jrh.12864","url":null,"abstract":"Introduction: There are long-standing differences in profitability between rural and urban hospitals. Prior to the COVID-19 Public Health Emergency (PHE), rural hospital profitability was decreasing, while urban hospital profitability was increasing. During the PHE, the Federal Government provided billions of dollars of support to hospitals. Given the prepandemic differences in trends in profitability, it is likely that the PHE funding had different effects on rural hospitals and urban hospitals.Methods: This study uses 2015-2023 Medicare cost report data from acute-care hospitals to assess the impact of COVID-19 PHE funding on hospital profitability. We employ descriptive Kruskal-Wallis and chi-square tests and an interrupted time series analysis to evaluate the effect of PHE funding on operating margins for a stratified sample of rural prospective payment system (PPS), urban PPS, and critical access hospitals (CAHs).Results: We found that the PHE funding was associated with significant increases in operating margins, with rural PPS hospitals experiencing similar increases compared to urban PPS hospitals, and CAHs surpassing both rural and urban PPS hospitals in their margin values. However, if PHE funding had not been provided, our evidence suggests operating margins for all hospitals in 2022-2023 would have been below prepandemic levels.Discussion: This preliminary analysis portrays the importance of the PHE government funding in supporting hospitals during the pandemic, and shows declining profitability trends without the funds. Rural PPS hospitals fare the worst suggesting continued need for financial support if the trend continues.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141857001","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}

引用次数: 0

Home health utilization in the Veterans Health Administration: Are there rural and urban differences? 退伍军人健康管理局的家庭医疗使用情况：农村和城市是否存在差异？

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-07-29 DOI: 10.1111/jrh.12865

Heather Davila, Bradely Mayfield, Michelle A Mengeling, Andrea Holcombe, Kelly R Miell, Erin Jaske, William Iverson, Tammy Walkner, Greg Stewart, Samantha Solimeo

{"title":"Home health utilization in the Veterans Health Administration: Are there rural and urban differences?","authors":"Heather Davila, Bradely Mayfield, Michelle A Mengeling, Andrea Holcombe, Kelly R Miell, Erin Jaske, William Iverson, Tammy Walkner, Greg Stewart, Samantha Solimeo","doi":"10.1111/jrh.12865","DOIUrl":"https://doi.org/10.1111/jrh.12865","url":null,"abstract":"Purpose: Growing numbers of older adults need home health care, yhese services may be more difficult to access for rural Veterans, who represent one-third of Veterans Health Administration (VA) enrollees. Our objective was to examine whether home health use differs within VA based on rurality.Methods: We examined national VA administrative data for 2019-2021 (January 1, 2019 to December 31, 2021) among Veterans ages ≥65 years. Using descriptive and multivariable analyses, we assessed whether rural versus urban Veterans differed in (1) the likelihood of using any home health and (2) for those who received ≥1 visit, number of visits received.Results: Among home health users (n = 107,229, 33.1% rural), rural and urban Veterans were similar in age (77.0 vs. 77.2 years). Rural Veterans were less likely to be highly frail (38.9% rural vs. 40.4% urban) or diagnosed with dementia (13.5% vs. 17.6%). After adjusting for Veterans' characteristics, rural Veterans were more likely to receive any home health (odds ratio: 1.10; 95% confidence interval [CI]: 1.07, 1.13). Among Veterans who received ≥1 home health visit, rurality was associated with considerably fewer expected visits (incident rate ratio: 0.70; 95% CI: 0.68, 0.72).Conclusions: Although rural Veterans were more likely than urban Veterans to receive any home health services, they received considerably fewer home health visits. This difference may represent an access issue for rural Veterans. Future research is needed to identify reasons for these differences and develop strategies to ensure rural Veterans' care needs are equitability addressed.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793946","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}

引用次数: 0

Expanding the opioid use disorder medication treatment workforce in rural communities through the RCORP initiative. 通过 RCORP 计划，扩大农村社区的阿片类药物使用障碍药物治疗队伍。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-07-25 DOI: 10.1111/jrh.12867

C Holly A Andrilla, Sara C Woolcock, Kathleen Meyers, Davis G Patterson

{"title":"Expanding the opioid use disorder medication treatment workforce in rural communities through the RCORP initiative.","authors":"C Holly A Andrilla, Sara C Woolcock, Kathleen Meyers, Davis G Patterson","doi":"10.1111/jrh.12867","DOIUrl":"https://doi.org/10.1111/jrh.12867","url":null,"abstract":"Purpose: The Rural Communities Opioid Response Program (RCORP) was funded to help rural communities improve prevention, treatment, and recovery services for Opioid Use Disorder (OUD), including increasing the supply of clinicians with a Drug Enforcement Administration (DEA) waiver to prescribe buprenorphine, which was required before 2023. This research investigates the impact of RCORP funding on the supply of DEA-waivered clinicians in rural communities.Methods: We used 2017-2022 DEA lists of waivered clinicians to assign clinicians to US counties. Using RCORP service area data, we classified rural counties as either being served by an RCORP grantee or not. We calculated the number of counties in each category with a waivered clinician, clinician-to-population ratios, and treatment slot-to-population ratios.Findings: In 2017, 3.7% more of RCORP funded counties had a waivered clinician than non-RCORP counties. RCORP counties also had 1.2 more waivered clinicians per 100,000 population and 57.5 more treatment slots per 100,000 population compared to non-RCORP counties. From 2017 to 2022, these differences more than doubled. The supply of waivered clinicians varied across Census Divisions. In most Census Divisions, a greater percentage of RCORP counties had a waivered clinician as well as more waivered clinicians and treatment slots per population, except for the Pacific Census Division, which had more clinicians and treatment slots per population in non-RCORP counties.Conclusions: Study findings suggest that federal investments to expand rural OUD patients' access to care may have been successful, but only if increases in clinician supply translate into greater provision of OUD treatment.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762184","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}

引用次数: 0

I offer "Ambulatory Surgical Center-as-Collaborator" to expand availability of colonoscopy with family physicians. 我提供 "门诊手术中心即合作者 "服务，以扩大家庭医生结肠镜检查的可用性。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-07-25 DOI: 10.1111/jrh.12869

James E Hougas

引用次数: 0

Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina. 北卡罗来纳州中风急救医疗服务绕行路线的城乡差异。

IF 3.1 3区医学

Journal of Rural Health Pub Date : 2024-07-25 DOI: 10.1111/jrh.12868

Mehul D Patel, Srihari V Chari, Eric R Cui, Antonio R Fernandez, Arrianna Marie Planey, Edward C Jauch, James E Winslow

{"title":"Rural-urban differences in emergency medical services bypass routing of stroke in North Carolina.","authors":"Mehul D Patel, Srihari V Chari, Eric R Cui, Antonio R Fernandez, Arrianna Marie Planey, Edward C Jauch, James E Winslow","doi":"10.1111/jrh.12868","DOIUrl":"10.1111/jrh.12868","url":null,"abstract":"Purpose: Acute stroke is a serious, time-sensitive condition requiring immediate medical attention. Emergency medical services (EMS) routing and direct transport of acute stroke patients to stroke centers improves timely access to care. This study aimed to describe EMS stroke routing and transports by rurality in North Carolina (NC).Methods: We conducted a retrospective study using existing data on EMS transports of suspected stroke patients in NC in 2019. The primary study outcome was EMS bypass of the nearest hospital for transport to a nonnearest hospital, determined by geographic information systems (GIS) analysis. Incident addresses were geocoded to census tracts and classified as urban, suburban, or rural by Rural-Urban Commuting Area codes. We compared the frequency of bypass and estimated additional transport times by urban, suburban, and rural incident locations.Findings: Of 3666 patients, 1884 (51%) EMS transports bypassed the nearest hospital. Bypass occurred less often for rural EMS incidents (39%) compared to those in urban (57%) and suburban (63%) tracts. The estimated additional transport time for rural bypasses of nonendovascular-capable stroke centers for endovascular-capable stroke centers was a median of 25 min (interquartile range 13-33).Conclusions: Using GIS analysis, we found nearly half of EMS transports of suspected stroke patients in NC bypassed the nearest hospital, including noncertified hospitals and stroke centers. Bypasses occurred less often in rural areas, though incurred significantly longer transport times, compared to urban areas. These findings are important for regional stroke system planning, especially for improving rural access to acute stroke care.","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":null,"pages":null},"PeriodicalIF":3.1,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762186","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}

引用次数: 0