Journal of Rural Health最新文献

{"title":"On the importance of gradation in rural health designations","authors":"Mark Benton PhD","doi":"10.1111/jrh.70012","DOIUrl":"https://doi.org/10.1111/jrh.70012","url":null,"abstract":"","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521769","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":"Exploring access to critical health services for older adults in rural America from 1990 to 2020","authors":"Elizabeth A. Bambury BS,&nbsp;Alexis A. Merdjanoff PhD,&nbsp;Joshua T. Fergen PhD,&nbsp;J. Tom Mueller PhD","doi":"10.1111/jrh.70004","DOIUrl":"https://doi.org/10.1111/jrh.70004","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Rural America has experienced a rapid loss of hospitals since the turn of the century, making access to high-quality health care the top rural health priority. Coinciding with this hospital decline is the growth of a rural population age 65 years or older. The health needs of older adults can require specialty care to support healthy aging. To date, minimal research has been conducted on trends in aging-related health care services in rural areas beyond hospital closures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study uses a 30-year lookback of data from the Area Health Resource Files to describe the trends in local access to hospitals and critical health services important for conditions experienced by older adults in rural America. Results are presented across measures of rurality and population age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Local aging-related access to services such as chemotherapy, oncology, emergency department, geriatric, and home health agencies have been stagnant or declining over time in rural areas. Concerningly, the most remote communities with the highest percent of older adults have the lowest service access.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings shed light on the growing need for policies to support healthy aging among the increasingly older rural population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521770","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":"Evaluating implementation by rural clinics of evidence-based interventions to promote HPV vaccination","authors":"Stephanie Evett MPH,&nbsp;Shelley Walker  ,&nbsp;Grace W. Ryan MPH, PhD,&nbsp;Eliza Steere MPH,&nbsp;Eliza Daly MPH, CHES,&nbsp;Emily A. Janio MPH,&nbsp;Stephanie Pedraza Marin AA,&nbsp;Natoshia M. Askelson MPH, PhD","doi":"10.1111/jrh.70006","DOIUrl":"https://doi.org/10.1111/jrh.70006","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Despite the well-established link between vaccination against human papillomavirus (HPV) and a decreased risk of cancer, HPV vaccine uptake in rural communities is low. Evidence-based interventions (EBIs) to promote HPV vaccination exist but are not universally implemented in rural settings due to various challenges. To understand the support needed by rural clinics in implementing EBIs, the University of Iowa partnered with the American Cancer Society (ACS) to evaluate an ACS HPV Vaccinating Adolescents against Cancers Quality Improvement Learning Collaborative that was delivered to six clinics in two rural health systems. The study aimed to assess the effectiveness of the learning collaborative approach for helping rural clinics implement EBIs aimed at increasing HPV vaccine uptake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Semistructured interviews were conducted with clinic staff at six time points throughout the 2-year intervention. Interviews were conducted over the phone and were recorded and transcribed. Members of the research team coded the interviews using codebooks informed by the interview guides. The analysis compared the health systems and identified the changes they made in response to assistance provided by the collaborative.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinic staff implemented the following EBIs: utilizing the immunization registry, strong provider recommendation, and provider education. Implementation of scheduling next dose fluctuated during the intervention. Differences were noted in the two health systems’ implementation using electronic health records for patient and provider reminders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Small, rural clinics can implement effective EBIs, given proper support. This is important as such EBIs can increase HPV vaccination rates and help prevent HPV-associated cancers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431537","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":"Patient perspectives of the impact of a rural health center closure: A cross-sectional survey","authors":"Mallory Trombetta PharmD,&nbsp;Natalea Suchy PharmD,&nbsp;Adriane N. Irwin PharmD, MS","doi":"10.1111/jrh.70005","DOIUrl":"https://doi.org/10.1111/jrh.70005","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To describe the impact from the closure of a rural community's only health center on chronic health conditions, access to care, and quality of care received from the patient's perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional telephone survey. Adult patients established with a rural health center participated in a 19-item survey at 6 months post-closure to collect data on perceived impacts. Data were summarized using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>There were 249 patients contacted, with 131 participants (52.6% response rate). Participants had a median age of 63 years (interquartile range, 44.5–73.0), and the majority were female (<i>n</i> = 82; 62.6%) and had been established with the health center for over 10 years (<i>n</i> = 79; 60.3%). At 6 months, the majority of participants had established care with another health center (<i>n</i> = 91; 69.5%). Most participants felt that the closure made it more difficult to access care (<i>n</i> = 106; 80.9%) but did not feel the closure reduced the quality of care they were receiving (<i>n</i> = 42; 32.1%). There was no impact perceived on the management of most health conditions, except chronic pain where worsening was the most selected option.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients were able to successfully transition care after closure of their local health center, and most did not perceive an impact on the quality of care received. However, participants reported reduced access to care. Future research might repeat this process, perhaps using a mixed-method approach, to intentionally capture nuances in patient behavior, experiences, and attitudes following the loss of primary care services in rural communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431541","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":"Factors associated with multiple-death suicides among rural US decedents","authors":"Victor A. Soupene PhD, MS,&nbsp;Timothy Hays BS, BA,&nbsp;Jonathan Davis PhD,&nbsp;J. Priyanka Vakkalanka PhD","doi":"10.1111/jrh.70003","DOIUrl":"https://doi.org/10.1111/jrh.70003","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To identify contributing circumstances to multiple-death suicides in rural US counties from law enforcement and coroner/medical examiner narratives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We identified multiple-death suicides as multiple suicides (i.e., two or more decedents) from the National Violent Death Reporting System (NVDRS) between 2013 and 2021. We identified rural decedents from their residence in NVDRS using federal information processing codes linked to Rural–Urban Continuum Codes. Quantitatively, we described demographic characteristics and circumstances leading to the suicide. From narrative law enforcement and coroner/medical examiner reports, we generated codes describing demographic and circumstance information using Dedoose software. We then used inductive content analysis to identify themes related to multiple-death suicides.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Among all multiple-death suicides (<i>n</i> = 50 multiple-death suicides, 99 suicide decedents), decedents were mostly non-Hispanic White (<i>n</i> = 90; 91%), were male (<i>n</i> = 54; 54%), and had a high school diploma or less (<i>n</i> = 51; 56%). We identified four themes: meticulous and considerate planning (e.g., with notes, reasons, and next steps), mutual dependency (e.g., decedents were in separable), unbearable health conditions (e.g., pain, poor quality of life from chronic illnesses), and social factors of despair (e.g., financial strain, legal problems, and interpersonal violence).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Developing strategies for discussing suicidal ideation and improving access to financial resources and health care may reduce multiple-death suicides in the rural United States, particularly among older adults with chronic health problems. Improving other public health initiatives such as interpersonal violence and chronic disease prevention and management may further prevent multiple-death suicides.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143431134","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":"Sleep well and live well: Impact of sleep hygiene intervention on sleep duration in a rural community: A randomized controlled trial (THE SWELL STUDY)","authors":"Sunil Sharma MD, MBA,&nbsp;Robert Stansbury MD,&nbsp;Jad Ramadan MS,&nbsp;Edward Rojas MD,&nbsp;Victor Finomore PhD,&nbsp;Chris Pham MD,&nbsp;Stuart F. Quan MD,&nbsp;Sijin Wen PhD","doi":"10.1111/jrh.70002","DOIUrl":"https://doi.org/10.1111/jrh.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Sleep is a key component of a healthy lifestyle and the Center for Disease Control (CDC) and prevention recommends that adults get at least 7 hours of sleep each night. Within the United States, West Virginia is among the most sleep-deprived states with 42% of the population reporting insufficient sleep per the CDC. Sleep insufficiency in rural populations is linked to disparities in health and accessibility to health care services. The study evaluated the impact of sleep hygiene (SH) education on sleep duration and quality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 12-week randomized controlled trial of participants residing in Harrison County, WV. Baseline data included the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale, and sleep duration as recorded by a sleep wearable. The intervention included an SH video on weeks 3 and 5. The control arm did not receive intervention but were allowed to cross over and receive intervention at week 8.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 100 participants (61 females) were recruited from the community. No changes in sleep duration were observed in intention to treat analysis between Arm 1 and Arm 2 at 7 weeks. In the treatment analysis, the compliant cohort demonstrated a significant increase of 31 minutes mean sleep duration (<i>P</i> = .01) as well as an improvement in the PSQI (6.30 to 5.68 by week 12, <i>P</i> = .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study demonstrates that the introduction of a modest SH intervention may have a beneficial effect on the duration and quality of sleep in a rural community. ClinicalTrials. gov Identifier: NCT04849572</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380441","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":"Impact of Medicaid expansion on stage of diagnosis of lung cancer for rural and urban patients in New Hampshire","authors":"Benjamin Carter PhD,&nbsp;Jasmine Denny MPH,&nbsp;Andrew Lohrer MD, MPH","doi":"10.1111/jrh.70001","DOIUrl":"https://doi.org/10.1111/jrh.70001","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study examines the impact of Medicaid expansion under the Affordable Care Act on the stage of lung cancer diagnosis among rural and urban patients in New Hampshire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from the New Hampshire State Cancer Registry spanning 2010-2019 were analyzed to compare lung cancer diagnosis stages before and after the July 2014 Medicaid expansion. Rural-urban categorization utilized Rural-Urban Continuum Codes, and logistic regression with difference-in-difference analysis assessed the differential effects of Medicaid expansion on late-stage diagnoses between rural and urban patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Post-expansion, there was a significant decrease in the proportion of late-stage lung cancer diagnoses statewide. Rural patients initially had higher rates of late-stage diagnoses compared to urban patients, but post-expansion, this disparity diminished significantly. Logistic regression indicated reduced odds of late-stage diagnosis among rural patients after expansion (OR = 0.719, <i>P</i> =  .035), demonstrating a greater benefit in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Medicaid expansion in New Hampshire was associated with a substantial reduction in late-stage lung cancer diagnoses, particularly benefiting rural patients who historically faced higher barriers to health care access. These findings underscore the potential of Medicaid expansion to mitigate rural-urban disparities in cancer care outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143380440","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":"The U.S dementia belt: Commentary on “Alzheimer's disease and related dementia among Medicare beneficiaries aged ≥ 65 years in rural America, by census region and select demographic characteristics: 2020”","authors":"Qian Huang PhD","doi":"10.1111/jrh.70000","DOIUrl":"https://doi.org/10.1111/jrh.70000","url":null,"abstract":"","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248825","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 comparison of traumatic injury characteristics in rural and urban adults living in Wisconsin","authors":"Kara J. Kallies MS,&nbsp;William J. Koehne MPH,&nbsp;Carissa W. Tomas PhD,&nbsp;Sergey Tarima PhD,&nbsp;Marshall A. Beckman MD,&nbsp;Kirsten M. Beyer PhD, MPH,&nbsp;Laura Cassidy MS, PhD","doi":"10.1111/jrh.12922","DOIUrl":"https://doi.org/10.1111/jrh.12922","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Rural compared to urban populations have higher age-adjusted injury mortality rates. We sought to describe differences in traumatic injury mechanisms, severity, and mortality in Wisconsin adults in rural and urban areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>State trauma registry data were analyzed for adult patients injured in 2021–2022. The Wisconsin Health Innovation Program's rural and urban classification scheme, consisting of urban advantaged, urban, urban underserved, rural advantaged, rural, and rural underserved groups, was used. Multivariable logistic regression models for in-hospital injury mortality and prolonged length of stay (LOS) were developed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Overall, 47,460 patients were included; 14.3% in rural, 9.5% in rural advantaged, 4.1% in rural underserved areas, 35.4% in urban, 22.0% in urban advantaged, and 14.8% in urban underserved areas. Firearm and pedestrian injuries were more common in urban areas, and motor vehicle/transportation injuries were common in rural areas. Lower odds of prolonged LOS were observed in those residing in rural advantaged (OR = 0.70, 95%CI: 0.55–0.90; <i>p</i> = 0.004), rural (OR = 0.66, 95%CI: 0.53–0.82; <i>p</i> &lt; 0.001), and rural underserved (OR = 0.64, 95%CI: 0.50–0.82; <i>p</i> &lt; 0.001) compared to urban advantaged areas. Those in rural underserved areas had higher odds of in-hospital mortality (OR = 1.48, 95%CI: 1.15–1.91; <i>p</i> = 0.003) compared to urban advantaged areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients in rural Wisconsin experienced different injury mechanisms than in urban areas. Those in urban areas were more likely to have a prolonged hospital LOS, but those in rural underserved areas had higher in-hospital mortality. Rural populations may benefit from injury prevention specific to the mechanisms of injury in that area and resource allocation to enhance trauma services.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143248614","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":"“It was a good opportunity for us to be in touch with public health”: Independent community pharmacists’ experiences working with public health before and during COVID-19","authors":"Ellen B. Rubinstein PhD,&nbsp;Anna-Helena Preugschas MPH,&nbsp;Elizabeth Skoy PharmD,&nbsp;Lisa Nagel PharmD,&nbsp;Mary Larson PhD","doi":"10.1111/jrh.12921","DOIUrl":"10.1111/jrh.12921","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Pharmacies have been a significant part of improving population health since before the COVID-19 pandemic. However, little is known about the working relationships between pharmacies and public health entities. This exploratory study describes independent community pharmacists' perceptions during COVID-19 of both pre-existing and newly created relationships with public health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This paper is based on 42 qualitative interviews conducted as part of a broader study on North Dakota pharmacy's role in the COVID-19 pandemic. Authors analyzed interview data both deductively (based on a priori interview questions) and inductively (based on emergent themes). We used key quotes to map working relationships between pharmacy and public health on two axes: personal interactions and service provision.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Interviewees worked at 42 pharmacies (21 urban and 21 rural) and described relationships with public health entities that fell into four categories: (i) service provision with personal interactions predating the pandemic; (ii) service provision without personal interactions predating the pandemic; (iii) personal interactions that evolved during the pandemic; and (iv) service provision that evolved during the pandemic. Rural pharmacists described personal interactions and pre-pandemic service provision more often than urban pharmacists. Most urban pharmacists developed working relationships with public health entities solely because of the pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study begins mapping the range of relationships that can exist between community pharmacies and public health entities. Our data suggest it may be possible to leverage pharmacists to extend public health's reach and improve the health of medically underserved, rural populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 1","pages":""},"PeriodicalIF":3.1,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143081886","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}