Journal of Rural Health最新文献

{"title":"Addressing Access Barriers in Rural America: A Mixed-Methods Study of Wisconsin's Family Resource Centers","authors":"Joshua P. Mersky,&nbsp;Colleen E. Janczewski,&nbsp;Jack Pollard,&nbsp;Allison Amphlett,&nbsp;ChienTi Plummer Lee,&nbsp;Anna K. Walther,&nbsp;Xiyao Liu","doi":"10.1111/jrh.70201","DOIUrl":"10.1111/jrh.70201","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Family Resource Centers (FRCs) are place-based programs with great potential to address rural access barriers and improve health outcomes, yet empirical evidence on these programs is lacking. Using multiple data sources from a longitudinal investigation in Wisconsin, this mixed-methods study analyzed whether and how FRCs address rural access barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A convergent parallel mixed-methods design was used to gather, analyze, and interpret quantitative and qualitative data. Data from the Child Opportunity Index were used to compare opportunities in rural and nonrural areas statewide and among 646 rural and nonrural families who received support from one of 18 FRCs. Qualitative data gathered from interviews with nine FRC participants and 11 FRC staff were synthesized to describe rural access barriers and facilitators. To compare the types of support received by rural and nonrural families, baseline survey data collected from 646 FRC participants were analyzed using chi-square tests. To test whether FRC participation increased referral connections, follow-up survey data collected from 319 FRC recipients and a matched sample of 458 adults were analyzed via logistic regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Disparities between rural and nonrural ZIP codes were evident statewide and in FRC catchment areas. Qualitative analyses identified rural resource gaps, transportation barriers, and FRC facilitators of family engagement. Baseline survey responses indicated that rural families were more likely to receive resource referrals; nonrural families were more likely to participate in parenting programming and parent−child activities. Longitudinal analyses linked FRC participation to higher rates of resource connections.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>FRCs address social determinants that disproportionately affect rural communities. Implications for public health intervention and policy are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698219","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":"When Workforce Policy Meets Operational Reality: Reflections on the Veterans Health Administration's Contract Buyout Program","authors":"Patrick N. O'Mahen,&nbsp;Aisha N. Khan,&nbsp;Shannon S. Kenyon,&nbsp;Vivian R. Spencer,&nbsp;Sylvia J. Hysong","doi":"10.1111/jrh.70196","DOIUrl":"10.1111/jrh.70196","url":null,"abstract":"","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698169","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 Gaps in Acute Care Access for Rural Veterans: The Reach and Impact of VA's Virtual Emergency and Urgent Care Programs","authors":"Anita A. Vashi,&nbsp;Linda Diem Tran,&nbsp;Tracy Urech,&nbsp;Allison Engstrom Buggaveeti,&nbsp;Liam Rose","doi":"10.1111/jrh.70197","DOIUrl":"10.1111/jrh.70197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the impact of the Veterans Health Administration's (VA) virtual acute care programs—tele-emergency care (TEC) and virtual care visits (VCV)—on short-term utilization, mortality, and costs among rural veterans.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study used national call center data (January 2022–September 2024) linked with VA administrative and community care records. Completed TEC or VCV encounters were grouped by triage acuity: acute (recommended follow-up within 8 h; <i>n</i> = 61,408) and non-acute (&gt;8 h; <i>n</i> = 66,319), and compared with matched controls using propensity-score methods. Primary outcomes were emergency department (ED) visits, hospital admissions, and 30-day mortality. Secondary outcomes included total, inpatient, outpatient, pharmacy, and community care costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Among 631,437 nurse triage calls from rural veterans, virtual care was associated with significantly lower ED visits (acute: −11.87 percentage points (pp), 95% CI −12.47 to −11.26; non-acute: −3.62 pp, 95% CI −4.02 to −3.22) and hospitalizations (acute: −0.55 pp; non-acute: −0.15 pp). Thirty-day mortality did not differ significantly in either group. Total costs were modestly higher in both groups that received virtual care (acute: +$549; non-acute: +$386), driven by outpatient spending and partially offset by lower community care costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Virtual acute care substantially reduced short-term emergency and hospital utilization among rural veterans across both acuity groups but was associated with higher total 30-day costs. These findings highlight the potential of embedded virtual programs to improve access for rural veterans, while underscoring the need to evaluate their long-term value and return on investment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698194","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":"Resilience among Rural Public Health Leaders during the COVID-19 Pandemic: A Hermeneutic Phenomenological Study","authors":"Marta McMillion,&nbsp;Brenna Bernardin,&nbsp;David Nelson","doi":"10.1111/jrh.70204","DOIUrl":"10.1111/jrh.70204","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study explored how rural public health leaders in Wisconsin experienced and sustained resilience during the COVID-19 pandemic, with particular attention to the role of relational connections across professional, personal, and community domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using hermeneutic phenomenology, the study examined the lived experiences of rural county health officers and other supervisory leaders. Twenty semistructured interviews were conducted via Zoom between September and November 2023. Participants were purposively sampled from rural counties, as defined by the National Center for Health Statistics' Urban-Rural Classification Scheme. Interviews were recorded, transcribed, and thematically analyzed through iterative coding and synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Resilience was closely linked to the embeddedness of rural communities. Longstanding trust, shared history, and a sense of mutual responsibility strengthened leaders’ resolve. At the same time, this closeness also increased feelings of scrutiny, blurred personal and professional boundaries, and exposed leaders and their families to hostility. Leaders relied on tightly knit staff teams, cross-jurisdictional peer networks, and supportive governing officials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In rural settings, resilience is co-constructed through community connections. Strengthening peer support and preparing governing bodies to lead with empathy are important for sustaining this workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698229","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":"More Than Activity: The Effect of Sustained Engagement in Digital Alcohol Support Interventions for Regional and Remote Communities","authors":"Katinka van de Ven,&nbsp;Getenet Dessie,&nbsp;Kedir Y. Ahmed,&nbsp;Nicole Lee,&nbsp;Hazel Dalton,&nbsp;Julaine Allan,&nbsp;Subash Thapa","doi":"10.1111/jrh.70192","DOIUrl":"10.1111/jrh.70192","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study examines differences between major city and regional and remote participants in engagement in a digital alcohol support intervention (Daybreak), risky drinking, and psychological distress and tests the mediating role of psychological distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a longitudinal, observational cohort study of Daybreak participants between January 2019 and December 2024 (<i>N</i> = 12,824). Outcomes were risky drinking and psychological distress. Ordered logistic regression examined associations between the outcomes and program engagement, and multilevel generalized structural equation modeling tested mediation by psychological distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>At 6 months, risky drinking scores declined by 42% in major city participants and 57% in regional and remote participants. High engagement in reacting to posts reduced risky drinking in both metro (OR = 0.47, 95% CI 0.27–0.80) and regional and remote areas (OR = 0.42, 95% CI 0.18–0.99). High engagement in post sharing was associated with lower odds of high risky drinking only in major city participants (OR = 0.56, 95% CI 0.33–0.98). In regional areas, participants who aimed to quit drinking at registration had lower risky drinking (OR = 0.72, 95% CI 0.53–0.99), while longer program inactivity increased odds of psychological distress (OR = 1.95, 95% CI 1.13–3.38). Psychological distress mediated 56% of the association between post reactions and risky drinking in major city participants and 33% in regional and remote participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Distinct engagement pathways across regional and remote and major city settings suggest the need for more flexible digital program designs. Psychological distress, as a partial mediator, should be both a treatment target and a mechanism of change.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698180","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":"Rural Health Curriculum in Bachelor of Science in Nursing Programs: A Narrative Review","authors":"Kyanna Harris,&nbsp;Hilary N. Touchett,&nbsp;Alexandra Caloudas,&nbsp;Kelley Arredondo","doi":"10.1111/jrh.70200","DOIUrl":"10.1111/jrh.70200","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Rural communities face persistent health disparities and ongoing healthcare workforce shortages, especially in nursing. Despite national attention on strengthening the rural nursing pipeline, little synthesis exists on how rural health is integrated into nursing curricula. This narrative review provides an overview of the current landscape of rural health content within Bachelor of Science in Nursing (BSN) programs in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search of peer-reviewed and institutional sources was conducted using CINAHL, PubMed, ERIC, Scopus, and the Commission on Collegiate Nursing Education (CCNE) database. U.S.-based BSN programs with explicit rural health training or learning components were included. Data were extracted and synthesized using a narrative approach to identify recurring themes and institutional variations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Sixty-three nursing programs met our inclusion criteria; however, many had various courses or initiatives for a total of 93 courses/initiatives. The majority of courses/initiatives were community-focused (<i>n</i> = 59), followed by underserved communities (<i>n</i> = 37). Few BSN programs had explicit rural health content (<i>n</i> = 20) that incorporated rural-specific courses or structured clinical experiences addressing rural practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rural health remains underrepresented in BSN curricula. Findings underscore the need for systematic integration of rural concepts through coursework, simulation, and partnerships with rural healthcare facilities to strengthen the rural nursing workforce.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13440327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680170","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":"Hospital Care at Home for Adults Living in Rural Settings: A Qualitative Evaluation","authors":"Meghna P. Desai,&nbsp;Sarah M. Findeisen,&nbsp;Stephanie C. Blitzer,&nbsp;Mary Frances Barthel,&nbsp;Michelle N. Grinman,&nbsp;Mitchell Wicker,&nbsp;Patricia Dykes,&nbsp;Scott M. Harrison,&nbsp;Steven C. Amrhein,&nbsp;David M. Levine","doi":"10.1111/jrh.70199","DOIUrl":"10.1111/jrh.70199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Describe the perceptions of patients receiving rural home hospital (RHH) care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This is a qualitative evaluation of a randomized controlled trial comparing RHH (intervention) versus brick-and-mortar (BAM) care (control) in three rural sites in the United States and Canada between February 23, 2022, and January 17, 2024. Participants include acutely ill patients who received RHH. RHH programs provided patients with twice-daily nurse/paramedic visits, daily physician visits (remote), hospital-level diagnostics and treatments in the home, and other care tailored to the patient. Patient experience while receiving RHH care analyzed thematically to identify advantages and disadvantages of this model of care in the rural setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We interviewed 38 of 79 RHH patients recruited to our randomized controlled trial. Mean age was 67 (SD 17), 100% were White, 29% female, 82% Medicare recipients, and 62% retired. Patient perceptions clustered around three main themes: (1) perceived quality of care; (2) perceived comfort; and (3) experience with technology. Overall, home hospitalized patients were satisfied with the care they received at home. This was driven by strong rapport with the care team and receiving safe and effective medical care in the comfort of their home. Patients noted perceived comfort from familiar home surroundings and improved social support, nutrition, and sleep. Patients felt technology facilitated their experience and noted it presented a learning curve and occasional barrier to care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>RHH patients reported positive patient experiences principally across perceived quality, comfort, and technology, with some opportunity for improvement in technology interfaces for select patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>NCT05256303</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680828","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":"Recruiting Rural Patients for Clinical Research: Lessons From a Colorectal Cancer Screening Trial","authors":"Gina A. Keppel,&nbsp;Brooke Ike,&nbsp;C. Holly A. Andrilla,&nbsp;Allison M. Cole","doi":"10.1111/jrh.70189","DOIUrl":"10.1111/jrh.70189","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The Colonoscopy Outreach for Rural Communities (CORC) study is a randomized controlled trial testing the effectiveness of a remotely-delivered patient navigation program to increase colonoscopy completion for colorectal cancer (CRC) screening among rural and underserved patients. This study assesses CORC's success in recruiting rural patients and outlines approaches for including rural residents in clinical research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted descriptive analyses of rurality designations for enrolled patients based on their ZIP code using the Federal Office of Rural Health Policy (FORHP) definition and Rural-Urban Commuting Area (RUCA) codes. The primary care organization (PCO) partnership was based on Rural-Urban Continuum Codes (RUCCs). To recruit patients, CORC partnered with two PCOs in urban counties (RUCC = 3) and four PCOs in rural counties (RUCC &gt;3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Of 527 participants, 75% (<i>n</i> = 394) lived in rural areas overall; 43.3% resided in large rural areas, 38.3% in small rural areas, and 18.4% in isolated rural areas. Nearly all (97.3%) participants recruited from the four PCOs located in rural counties lived in FORHP-designated rural areas, whereas urban PCOs contributed both rural (53.3%) and urban participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Partnering with rural PCOs in a pragmatic clinical trial led to successful recruitment of rural patients. Working with PCOs in urban counties also contributed to successful rural patient recruitment. Several key approaches included partnering with primary care to reach patients in their communities, using multiple strategies to understand PCO's populations served, and tailoring recruitment to rural patients’ unique needs. These strategies may help researchers increase the representation of rural populations in clinical research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70189","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609524","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":"Rural Health Workforce Development Through the AHEC Scholars Model","authors":"Danielle Bruno,&nbsp;Taylor O'Shaughnessy,&nbsp;Jennifer D. Taylor","doi":"10.1111/jrh.70193","DOIUrl":"10.1111/jrh.70193","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;It is widely understood that access to health care services is crucial to achieving and maintaining good health. The Indiana AHEC Scholars program was developed to help combat these shortages by providing post-secondary health professions students with a didactic curriculum paired with community-based rural and/or medically underserved experiences in local communities. This study aimed to assess any relationship between students’ engagement in the AHEC Scholars program and both their intent to and actual practice in a rural community post-graduation.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a retrospective cohort study on five cohorts of post-secondary health professions students who engaged in the AHEC Scholars program between 2018 and 2023. We conducted a quantitative analysis using a pre-mid-and post-program evaluation. A paired &lt;i&gt;t&lt;/i&gt;-test was conducted to assess a change between a student's self-reported intent to practice in a rural community at the start of the program compared to the midway point of the program and the end of the program. Additionally, a chi-square test was conducted to assess the relationship between the students’ reported intent to practice in a rural area at the end of the Scholars program and their reported practice location 1 year post-program.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A statistically significant difference was found between the students’ intent to practice in a rural setting before and after their involvement in the AHEC Scholars program with the post-experience scores being significantly higher than the pre-experience scores (&lt;i&gt;p&lt;/i&gt; ≤ 0.01). Additionally, we found a significant change over time, as the students’ reported interest in rural practice increased between the start of the program and the mid-point, (&lt;i&gt;p&lt;/i&gt; ≤ 0.01), as well as a between the midpoint of the program and the end (&lt;i&gt;p&lt;/i&gt; ≤ 0.01). Using a scale wherein 1 is low and 5 is high, the mean score for students’ intent to practice in a rural area between the pretest, mid-point, and posttest evaluation were 3.02, 3.46, and 3.67, respectively. A significant correlation was also found between the students’ intent to practice in a rural area and actual rural practice, &lt;i&gt;p&lt;/i&gt; ≤ 0.001. At the time of 1-year follow-up, 24.6% (&lt;i&gt;n&lt;/i&gt; = 92) of individuals reported employment in a rural area.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Our study highlighted that incorporating didactic and community-based experiences may contribute to health profession education studen","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70193","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609538","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":"National Burden of Bicyclist Hospitalizations in the United States by Rurality, 2016–2020","authors":"Amir Ghanbari,&nbsp;Ryan M. Carnahan,&nbsp;Joseph E. Cavanaugh,&nbsp;Jodie M. Plumert,&nbsp;Elizabeth E. O'Neal,&nbsp;Cara Hamann","doi":"10.1111/jrh.70194","DOIUrl":"10.1111/jrh.70194","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Bicyclist injuries are a major public health concern in the United States, with limited understanding of variations in injury severity and discharge outcomes by rurality. This study provides a national assessment of bicycling-related hospitalizations, focusing on differences by rurality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Using HCUP-NIS data (2016–2020), bicycling-related hospitalizations were identified. Descriptive analyses characterized demographic and regional trends. Multivariable logistic regression, stratified by rural/urban patient residence, was used to assess factors associated with non-routine discharges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Between 2016 and 2020, an estimated 124,000 bicyclist-related hospitalizations occurred, resulting in more than $10 billion in hospital costs. Overall, 31.2% resulted in non-routine discharge, including 1.4% deaths. Hospitalizations were stable through 2019 but increased by &gt;20% in 2020. Urban residents accounted for most cases (91.1%). Cases were predominantly male (80%); aged 31–70 (65.4%) and hospitalized in the South (31.2%) or West (36.4%). Increasing age showed a strong dose–response relationship with non-routine discharge in both settings (e.g., age ≥ 71: OR_rural = 15.71, 95% confidence interval [CI]: 9.52–25.93; OR_urban = 12.18, 95% CI: 10.21–14.52). Motor-vehicle involvement increased the odds of non-routine discharge in both settings (OR_rural = 2.53, 95% CI: 1.89–3.40; OR_urban = 1.68, 95% CI: 1.55–1.82).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Bicyclist hospitalizations persisted and slightly increased over the study period. Age was the strongest predictor of non-routine discharge across settings, whereas sex and income effects were significantly associated with outcomes in urban areas. Findings highlight the need for tailored prevention strategies and equitable infrastructure improvements across rural and urban settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"42 3","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70194","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609543","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}