Curtin, Kevin A.; Schweitzer, Ashley; Tuxbury, Kristen; D'Aoust, Janelle A.
Resilience is an important social justice concept that has important implications for educators working with exceptional youth in rural underserved communities who may suffer from the consequences associated with economic hardships. This multi-school qualitative study examined resilience among exceptional youth living in rural poverty through the…
Bergstrand, C R
Ryan's (1971) description of the ideology of "victim-blaming" is briefly reviewed. It is then shown how this strategy for obscuring the causes of a social problem is used against rural, medically underserved communities by health care provider and planning interest groups to "explain" critical shortages of physicians in their areas. In addition to lending further support for the existence of this ideology, a "looping" effect of social policy designed to deal with physician maldistribution is identified. It is argued that this can be viewed as analytically distinct from the ideology itself and that it serves the purpose of further obscuring the larger structural sources of the social problem.
Full Text Available Objectives. To describe the application of teleophthalmology in rural and underserved areas of India. Study Design. This paper describes the major teleophthalmology projects in India and its benefits. Results. Teleophthalmology is the use of telecommunication for electronic transfer of health-related data from rural and underserved areas of India to specialities in urban cities. The MDRF/WDF Rural Diabetes Project has proved to be very beneficial for improvement of quality health care in Tamilnadu and can be replicated at the national level. This community outreach programme using telemedicine facilities has increased awareness of eye diseases, improved access to specialized health care, helped in local community empowerment, and provided employment opportunities. Early detection of sight threatening disorders by teleophthalmology and prompt treatment can help decrease visual impairment. Conclusion. Teleophthalmology can be a very effective model for improving eye care delivery system in rural and underserved areas of India.
Full Text Available of methodologies, encompassing ethnographic and quantitative approaches, is used to study the need to expand connectivity in Dwesa and the social impact of providing Internet connection to this rural area. Our findings confirm the need to connect more areas...
... 24 Housing and Urban Development 1 2010-04-01 2010-04-01 false Central Cities, Rural Areas, and...) Housing Goals § 81.13 Central Cities, Rural Areas, and Other Underserved Areas Housing Goal. (a) Purpose... cities, rural areas, and other underserved areas is intended to achieve increased purchases by the GSEs...
Full Text Available Purpose: To determine the prevalence of uncorrected refractive errors, need for spectacles, and the determinants of unmet need in underserved rural areas of Iran. Methods: In a cross-sectional study, multistage cluster sampling was done in 2 underserved rural areas of Iran. Then, all subjects underwent vision testing and ophthalmic examinations including the measurement of uncorrected visual acuity (UCVA, best corrected visual acuity, visual acuity with current spectacles, auto-refraction, retinoscopy, and subjective refraction. Need for spectacles was defined as UCVA worse than 20/40 in the better eye that could be corrected to better than 20/40 with suitable spectacles. Results: Of the 3851 selected individuals, 3314 participated in the study. Among participants, 18.94% [95% confidence intervals (CI: 13.48â24.39] needed spectacles and 11.23% (95% CI: 7.57â14.89 had an unmet need. The prevalence of need for spectacles was 46.8% and 23.8% in myopic and hyperopic participants, respectively. The prevalence of unmet need was 27% in myopic, 15.8% in hyperopic, and 25.46% in astigmatic participants. Multiple logistic regression showed that education and type of refractive errors were associated with uncorrected refractive errors; the odds of uncorrected refractive errors were highest in illiterate participants, and the odds of unmet need were 12.13, 5.1, and 4.92 times higher in myopic, hyperopic and astigmatic participants as compared with emmetropic individuals. Conclusion: The prevalence of uncorrected refractive errors was rather high in our study. Since rural areas have less access to health care facilities, special attention to the correction of refractive errors in these areas, especially with inexpensive methods like spectacles, can prevent a major proportion of visual impairment. Keywords: Uncorrected refractive errors, Population-based study, Unmet need
Haldeman, Scott; Nordin, Margareta; Outerbridge, Geoff
The world lacks sustainable models of care to manage spinal disorders in poor and underserved communities. The purpose of this article is to: (1) review the rationale and importance of developing a sustainable evidence-based model of care at low cost for people with spinal disorders in underserved...... adequate care, World Spine Care (WSC) was established to "improve lives in underserved communities through sustainable, integrated, evidence-based, spinal care." WSC is comprised of volunteers and institutions from 6 continents and several countries, and incorporates a Board of Directors, an executive......) facilitation of opportunities for training graduate students in a variety of health-related fields. World Spine Care has (a) recognized the enormous need to establish clinical programs aimed at easing the suffering and disability associated with spinal disorders in resource-poor communities, (b) shown...
Lee, Dane M; Nichols, Tommy
The purpose of this paper is to identify the challenges when recruiting and retaining rural physicians and to ascertain methods that make rural physician recruitment and retention successful. There are studies that suggest rural roots is an important factor in recruiting rural physicians, while others look at rural health exposure in medical school curricula, self-actualization, community sense and spousal perspectives in the decision to practice rural medicine. An extensive literature review was performed using Academic Search Complete, PubMed and The Cochrane Collaboration. Key words were rural, rural health, community hospital(s), healthcare, physicians, recruitment, recruiting, retention, retaining, physician(s) and primary care physician(s). Inclusion criteria were peer-reviewed full-text articles written in English, published from 1997 and those limited to USA and Canada. Articles from foreign countries were excluded owing to their unique healthcare systems. While there are numerous articles that call for special measures to recruit and retain physicians in rural areas, there is an overall dearth. This review identifies several articles that suggest recruitment and retention techniques. There is a need for a research agenda that includes valid, reliable and rigorous analysis regarding formulating and implementing these strategies. Rural Americans are under-represented when it comes to healthcare and what research there is to assist recruitment and retention is difficult to find. This paper identify the relevant research and highlights key strategies.
This project will contribute to government efforts in Delta State to improve delivery and use of maternal and child healthcare services in three marginalized rural communities. Maternal and child health concerns According to the World Health Organization, Nigeria's maternal mortality ratio in 2013 was 560, down from 610 in ...
Zayas, Luis E; McGuigan, Denise
Promoting early interest in healthcare careers among youth from underserved areas is one promising strategy for addressing the health professional shortage in such communities, Most career choice studies try to predict outcomes using such traditional measures as grades and test scores, This study examines experiences influencing healthcare career interest among high-school students participating in health professions introductory programs in underserved communities. The opinions of parents and teachers regarding students' motivations are also considered. Seven focus groups (N=51) were conducted in one rural and two largely minority urban communities in New York State designated as health professional shortage areas. Qualitative data analysis involved a theory-driven, immersion and crystallization approach following the experiential learning model. Constructive experiences with the healthcare system, family role-modelpan>ing and support, interactive health-related school activities, the media, inspirational and accessible school staff, and strategic community partnerships, among other factors, facilitated student interest in health professions. Findings suggest that underserved and disenfranchised community environments still pose challenges for furthering healthcare career interest among youth.
Baird, Donnel [BlocPower LLC, New York, NY (United States); Cox, Morris [BlocPower LLC, New York, NY (United States); Harmarneh, Sarey [BlocPower LLC, New York, NY (United States); Zheng, Chen [BlocPower LLC, New York, NY (United States)
BlocPower’s mission is to provide access to energy efficiency financing for underserved communities across the United States. This project, “Crowdsourced Microfinance for Energy Efficiency in Underserved Communities,” is an extension of that goal and is grounded in the principles of providing engineering and financing services to those in need. The project is based on the creation of a BlocPower Marketplace as a central hub for connecting shovel-ready green buildings to institutional investors. This ‘connection’ entails using online crowdfunding to aggregate debt and equity capital from institutional investors to connect to customers (building owners) across various financial portfolios. BlocPower Marketplace is intended to bring social, environmental, and financial returns to investors while also decreasing investor risk by loaning out funds for energy installations in individual buildings. In detail, the intended benefits of crowdsourcing are two-sided. Firstly, for building owners, clean energy retrofit installations improve building operations, reduce utility costs, and reduce harmful impacts to their surrounding environment. Secondly, for institutional investors, they gain access to a new market of energy efficiency and are able to provide debt or equity capital with high financial returns. This gives investors the opportunity to create social and environmental impact in communities around the country as well. With this in mind, BlocPower designed the marketplace to specifically answer exploratory research questions with respect to the pricing of energy financing. Institutional investors typically charge high rates on project financing solutions in the energy space, particularly in low and middle-income communities, because of fears that required debt service will not be made. This makes access to energy capital exorbitantly difficult for those that need it the most. Through this project, BlocPower tested investor appetite to determine if
Chang, Jean; Guy, Mignonne C.; Rosales, Cecilia; de Zapien, Jill G.; Staten, Lisa K.; Fernandez, Maria L.; Carvajal, Scott C.
Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, bas...
Ashford Alfred R
Full Text Available Abstract Background African American and Hispanic women, such as those living in the northern Manhattan and the South Bronx neighborhoods of New York City, are generally underserved with regard to breast cancer prevention and screening practices, even though they are more likely to die of breast cancer than are other women. Primary care physicians (PCPs are critical for the recommendation of breast cancer screening to their patients. Academic detailing is a promising strategy for improving PCP performance in recommending breast cancer screening, yet little is known about the effects of academic detailing on breast cancer screening among physicians who practice in medically underserved areas. We assessed the effectiveness of an enhanced, multi-component academic detailing intervention in increasing recommendations for breast cancer screening within a sample of community-based urban physicians. Methods Two medically underserved communities were matched and randomized to intervention and control arms. Ninety-four primary care community (i.e., not hospital based physicians in northern Manhattan were compared to 74 physicians in the South Bronx neighborhoods of the New York City metropolitan area. Intervention participants received enhanced physician-directed academic detailing, using the American Cancer Society guidelines for the early detection of breast cancer. Control group physicians received no intervention. We conducted interviews to measure primary care physicians' self-reported recommendation of mammography and Clinical Breast Examination (CBE, and whether PCPs taught women how to perform breast self examination (BSE. Results Using multivariate analyses, we found a statistically significant intervention effect on the recommendation of CBE to women patients age 40 and over; mammography and breast self examination reports increased across both arms from baseline to follow-up, according to physician self-report. At post-test, physician
Na, Baeg Ju; Lee, Jin Yong; Kim, Hyun Joo
Public health physicians (PHPs) are certified physicians who are serving in a public health center or subcenter in a rural village, instead of serving in the military. However, the PHP program has recently become the subject of a profound debate, over 30 years after its adoption. In this study, we attempted to ascertain physicians' perspectives on the PHP program, including: whether the PHP policy should continue; if they agree on changing the role of PHPs in healthcare; what would be the desired role of PHPs; and what resources would be required and what possible barriers would be anticipated under the changes. We selected 88 PHPs as our study sample using quota sampling. Over 60% of respondents were in support of continuing the PHP program. They believed some remote islands and mountainous areas are still in need of public healthcare doctors. However, some of them believed that the role of PHPs should be changed to take on community health promotion, because the problem of medically underserved rural areas has almost been resolved. However, people living in rural areas are ageing and suffering from a lack of education and health information. In particular, in order to successfully transition into new roles, PHPs must be provided with continuing education and professional development programs covering their new responsibilities. It is imperative to refurbish the PHP program to meet current needs and continue its central role in public healthcare.
Uscher-Pines, Lori; Rudin, Robert; Mehrotra, Ateev
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute. Given the projected shortfall of physicians in the United States, recruiting retired and semiretired physicians to provide care through telehealth increases the total supply of active physicians and the capacity of the existing workforce. However, programs typically use volunteers in a limited capacity because of uncertainty about the level and duration of commitment. Acknowledging this reality, most programs only use volunteer physicians for curbside consults rather than fully integrating them into longitudinal patient care. The part-time availability of volunteers may also be difficult to incorporate into the workflow of busy safety net clinics. As more physicians volunteer in a growing number of telehealth programs, the dual benefits of enriching the professional lives of volunteers and improving care for underserved communities will make further development of these programs worthwhile.
Lin, Ching-Chiu; Bruce, Bertram C.
Learning for underserved youth is integral to social progress. Yet, too often, young people experience disconnects between their educational experiences and both individual and community needs. Arts can help these youth recover a unity through collective action in the community. Drawing from the experiences of a 4-year interdisciplinary research…
Dusenbery, P.; LaConte, K.; Harold, J. B.; Randall, C.
NASA research programs are helping humanity understand the origin and evolution of galaxies, stars, and planets, and defining the conditions necessary to support life beyond Earth. The Space Science Institute's (SSI) National Center for Interactive Learning (NCIL) was recently funded by NASA`s Science Mission Directorate (SMD) to develop and implement a project called NASA@ My Library: A National Earth and Space Science Initiative That Connects NASA, Public Libraries and Their Communities. As places that offer their services for free, public libraries have become the "public square" by providing a place where members of a community can gather for information, educational programming, and policy discussions. Libraries are developing new ways to engage their patrons in STEM learning, and NCIL's STAR Library Education Network (STAR_Net) has been supporting their efforts for the last eight years, including through a vibrant community of practice that serves both librarians and STEM professionals. Project stakeholders include public library staff, state libraries, the earth and space science education community at NASA, subject matter experts, and informal science educators. The project will leverage high-impact SMD and library events to catalyze partnerships through dissemination of SMD assets and professional development. It will also develop frameworks for public libraries to increase STEM interest pathways in their communities (with supports for reaching underserved audiences). This presentation will summarize the key activities and expected outcomes of the 5-year project.
Fink, John E.; Hummel, Mary L.
This chapter explores the practices of learning communities designed for specific, underserved student populations, highlighting on-campus examples and culminating with a synthesized list of core practices from these "inclusive" learning communities.
Maternal and child health is a priority for Nigeria, but there are significant challenges and opportunities at state levels that influence efforts to reduce deaths. This project will contribute to government efforts in Delta State to improve delivery and use of maternal and child healthcare services in three marginalized rural ...
Ma, Grace X; Shive, Steve; Tan, Yin; Gao, Wanzhen; Rhee, Joanne; Park, Micah; Kim, Jaesool; Toubbeh, Jamil I
Despite evidence of a decline in both incidence and prevalence of colorectal cancer nationwide, it remains the second most commonly diagnosed cancer and the third highest cause of mortality among Asian Americans, including Korean Americans. This community-based and theoretically guided study evaluated a culturally appropriate intervention program that included a bilingual cancer educational program among Korean Americans including information on CRC risks, counseling to address psychosocial and access barriers, and patient navigation assistance. A two-group quasi-experimental design with baseline and post-intervention assessment and a 12-month follow-up on screening was used in the study. Korean Americans (N=167) were enrolled from six Korean churches. The intervention group received culturally appropriate intervention program addressing accessibility and psychosocial barriers, and navigation assistance for screening. The control group received general health education that included cancer-related health issues and screening. There was a significant difference (pbenefits and barriers to screening (p<0.001). At baseline, 13% of participants in the intervention group and 10% in control group reported having had a CRC cancer screening test in the previous year. At the 12-month post-intervention follow-up, 77.4% of participants in the intervention group had obtained screening compared to 10.8% in the control group. While health disparities result from numerous factors, a culturally appropriate and church-based intervention can be highly effective in increasing knowledge of and access to, and in reducing barriers to CRC screening among underserved Koreans.
Hedge, R. S.
SUMMARY 51 suicides in a rural community of Northern Karnataka were studied for incidence, age and sex distribution, methods adopted for suicides, and causes of suicides. Suicides in rural area did not show any difference from urban suicide pattern.
Mpofu, Ratie; Daniels, Priscilla S; Adonis, Tracy-Ann; Karuguti, Wallace M
Poverty, limited access to resources and a lack of infrastructure characterise the division of rural areas from urban South Africa. Low numbers of social welfare professionals compound the problem. With education linked inextricably in social responsibility, higher education institutions (HEIs) are called upon increasingly to create conditions that encourage students and graduates to practise in more socially responsible ways, involving more than mere disciplinary expertise or technical knowledge, and that consider the problems of rural areas. Use of interprofessional education (IPE) programs, based on teamwork, could enable HEIs to train and guide health sciences students in how best to cooperate with each other and combine their skills to mutual benefit. This would enable them to develop professional skills facilitated by interactive engagement within community settings. Referencing experience gained in Australia and elsewhere, the Faculty of Community and Health Sciences (FCHS) at the University of Western Cape (UWC) has developed and applied an IPE program for South Africa. Students were placed in interdisciplinary groups in a rural and underserved municipality of the Western Cape - 17 students participated in a study on the effectiveness of this program. A quantitative self-administered questionnaire, followed by qualitative focus group discussions, established student perceptions of their IPE experience, how the experience influenced their intentions for or against future practice in rural and underserved areas, and their interest in future interprofessional collaboration and practice. More than 75% of the participating students agreed that they had learnt to develop knowledge base, procedural and healthcare practice presentation skills, along with preparing written community health histories. Student willingness to practise in rural areas was evidenced, citing community- and resource-based factors as determinants; however, concerns that some community
Caffrey, Rosalie A
Rural elderly individuals are an underserved population with limited access to health care. There is an increasing need for independent community care nurses to provide assistance to home-based elderly individuals with chronic illnesses to prevent unnecessary medical and placement decisions and, thus, allow them to maintain independence and quality of life. This article describes the rural setting and why community care nurses are needed, and explores strategies for implementing the role of the independent nurse entrepreneur in caring for community-based elderly individuals in rural settings.
Flora, Cornelia Butler; And Others
This book is designed to help identify, analyze, and address problems that are found in rural parts of the United States. It focuses on the community as the place where individuals come together in order to solve those problems. The book's 13 chapters are divided into 4 sections. The first section discusses rural definition and community…
Cooper, S. K.; Petronotis, K. E.; Ferraro, C.; Johnson, K. T. M.; Yarincik, K.
The International Ocean Discovery Program (IODP) is an international marine research collaboration that explores Earth's history and dynamics using ocean-going research platforms to recover data recorded in seafloor sediments and rocks and to monitor subseafloor environments. The JOIDES Resolution is the flagship vessel of IODP and is operated by the National Science Foundation. It is an inspirational hook for STEM Earth and ocean topics for children and the general public of all ages, but is not easily accessible due to its international travels and infrequent U.S. port calls. In response, a consortium of partners has created the Pop-Up/Drill Down Science project. The multi-year project, funded by NSF's Advancing Informal Science Learning program, aims to bring the JR and its science to under-served and rural populations throughout the country. Consisting of an inflatable walk-through ship, a multi-media experience, a giant interactive seafloor map and a series of interactive exhibit kiosks, the exhibit, entitled, In Search of Earth's Secrets: A Pop-Up Science Encounter, will travel to 12 communities throughout the next four years. In each community, the project will partner with local institutions like public libraries and small museums as hosts and to train local Girl Scouts to serve as exhibit facilitators. By working with local communities to select events and venues for pop-up events, the project hopes to bring cutting edge Earth and ocean science in creative new ways to underserved populations and inspire diverse audiences to explore further. This presentation will provide details of the project's goals, objectives and development and provide avenues to become involved.
Harris, Jill; Norton, Amy
Developmental screening of young children is important in all populations, especially underserved communities with known health care disparities. The American Academy of Pediatrics created guidelines and a toolkit for pediatricians to conduct developmental surveillance and screening, yet these guidelines are not uniformly implemented within…
... Guide Rural Health Topics & States Topics View more Oral Health in Rural Communities Adequate access to oral healthcare ... about oral health programs in my area? What oral health disparities are present in rural America? According to ...
Ka'opua, Lana Sue; Mitschke, Diane; Lono, Joelene
The cancer burden falls heavily on Native Hawaiian women, and of particular concern are those living in medically underserved communities where participation in potentially helpful clinical studies may be limited. Difficulty in accrual of Native Hawaiian women to a culturally-grounded intervention led researchers to conduct focus groups aimed at exploring attitudes towards research, use of a traditional Hawaiian practice for family discussion, and study promotion. Social marketing theory guided the development of discussion questions and a survey. Through purposive sampling, 30 women from medically underserved communities were recruited. Content analysis was used to identify major discussion themes. Findings indicate that lack of informational access may be a major barrier to participation. Study information disseminated through community channels with targeted outreach to social and religious organizations, promotion through face-to-face contact with researchers, and culturally tailored messages directed to families were preferred. Community oriented strategies based on linkages with organizational networks may increase participation.
Bouchonville, Matthew F; Hager, Brant W; Kirk, Jessica B; Qualls, Clifford R; Arora, Sanjeev
To determine whether participation in a multidisciplinary telementorship model of healthcare delivery improves primary care provider (PCP) and community health worker (CHW) confidence in managing patients with complex diabetes in medically underserved regions. We applied a well-established healthcare delivery model, Project ECHO (Extension for Community Healthcare Outcomes), to the management of complex diabetes (Endo ECHO) in medically underserved communities. A multidisciplinary team at Project ECHO connected with PCPs and CHWs at 10 health centers across New Mexico for weekly videoconferencing virtual clinics. Participating PCPs and CHWs presented de-identified patients and received best practice guidance and mentor-ship from Project ECHO specialists and network peers. A robust curriculum was developed around clinical practice guidelines and presented by weekly didactics over the ECHO network. After 2 years of participation in Endo ECHO, PCPs and CHWs completed self-efficacy surveys comparing confidence in complex diabetes management to baseline. PCPs and CHWs in rural New Mexico reported significant improvement in self-efficacy in all measures of complex diabetes management, including PCP ability to serve as a local resource for other healthcare providers seeking assistance in diabetes care. Overall self-efficacy improved by 130% in CHWs ( Pcare may be useful in resource-poor communities with limited access to diabetes specialist services. CHW = community health worker; CME = Continuing Medical Education; ECHO = Extension for Community Healthcare Outcomes; FQHC = federally qualified health center; PCP = primary care provider.
Anderson, Tania; Kenney, Jessica; Maple, John
This presentation will feature effective outreach strategies used to recruit, engage, and sustain student involvement from underserved communities in out-of-school science outreach programs. For example, one strategy is to partner with subject matter experts to provide your audience with a deeper understanding of and a unique perspective on current science. Join us to learn more about how you can initiate and sustain a STEM based program in your local community.
Goold, Susan Dorr; Myers, C Daniel; Szymecko, Lisa; Cunningham Collins, Carla; Martinez, Sal; Ledón, Charo; Campbell, Terrance R; Danis, Marion; Cargill, Stephanie Solomon; Kim, Hyungjin Myra; Rowe, Zachary
To learn how minority and underserved communities would set priorities for patient-centered outcomes research (PCOR). Sixteen groups (n = 183) from minority and underserved communities in two states deliberated about PCOR priorities using the simulation exercise CHoosing All Together (CHAT). Most participants were minority, one-third reported income research agendas and interviews with community leaders, clinicians, and key informants. Tablet-based CHAT collected demographic information, individual priorities before and after group deliberation, and groups' priorities. Individuals and groups prioritized research on Quality of Life, Patient-Doctor, Access, Special Needs, and (by total resources spent) Compare Approaches. Those with less than a high school education were less likely to prioritize New Approaches, Patient-Doctor, Quality of Life, and Families/Caregivers. Blacks were less likely to prioritize research on Causes of Disease, New Approaches, and Compare Approaches than whites. Compare Approaches, Special Needs, Access, and Families/Caregivers were significantly more likely to be selected by individuals after compared to before deliberation. Members of underserved communities, in informed deliberations, prioritized research on Quality of Life, Patient-Doctor, Special Needs, Access, and Compare Approaches. © Health Research and Educational Trust.
Gray, Jennifer Emily
A positive relationship between college anatomy students' achievement and academic language proficiency in the context of a learning community was established. For many students the barrier to learning science is language. A relationship exists between low academic language proficiency and lack of success among students, in particular failure among at-risk minority and language-minority students. The sample consisted of Anatomy classes during the Fall semesters of the academic years, 2000, 2001, and 2002 at a community college in Central California having a high percentage of culturally and linguistically diverse students. Students from each semester participated in the academic language proficiency and science achievement studies. Twenty-two of the Fall 2002 students (n = 65) enrolled in the Learning Community (LC) that included instruction in academic language in the context of the anatomy course content. Fall 2002 students (n = 19) also participated in Peer-led Support (PLS) sessions. Fall 2001 students participated in a textbook use study (n = 44) and in a Cooperative-Learning (CL) (n = 35) study. Students in the LC and Non-LC groups took the academic language assessment; their results were correlated with course grades and attendance. Fall 2002 students were compared for: (1) differences regarding self-expectations, (2) program impressions, and (3) demographics. Fall 2001 student reading habits and CL participation were analyzed. Results identified: (1) selected academic language tasks as good predictors of science success, (2) a significant positive relationship between science success and participation in support interventions, (3) no differences in self expectations or demographic characteristics of participants and non-participants in the LC group, and (4) poor textbook reading habits. Results showed a significant positive relationship between academic language proficiency and science achievement in participatory instruction.
Lopez, Naty; Simpser-Rafalin, Sara; Berthold, Peter
We evaluated the acceptability and effectiveness of atraumatic restorative treatment to prevent and treat caries in an underserved community in Mexico. We placed 370 restorations and 193 sealants in 118 children aged 5 to 18; 85% reported no pain, and 93% were comfortable with their restorations. We then evaluated the children 1 and 2 years later. At 2-year evaluation, 66% of restorations and 35% of sealants were retained. Atraumatic restorative treatment is acceptable and effective to control and prevent decay in a socioeconomically deprived community.
Horowitz, Carol R; Eckhardt, Sarah; Talavera, Sandra; Goytia, Crispin; Lorig, Kate
Lifestyle interventions can prevent diabetes through weight loss, but they are rarely translated for use in underserved communities. The aim of this study was to describe how a community-academic partnership formed and developed a program to address local health disparities by developing a low-cost, culturally and economically appropriate, peer-led community-based diabetes prevention program. Using a participatory approach, the partnership chose to focus on diabetes prevention, and co-developed all intervention, recruitment, research, and evaluation strategies. The partnership's philosophy to maintain high clinical and scientific standards paired with their ability to represent and engage the community facilitated the development of a randomized controlled trial that achieved statistically significant and sustained weight loss, and the recruitment of a largely Spanish-speaking, low income, uninsured population. The success of this intervention lies in the partnership's commitment to the community, co-ownership of research, and a careful balance between academic rigor and community engagement and relevance.
Geana, Mugur V; Kimminau, Kim S; Greiner, K Allen
The Latino population is the fastest growing minority in the country, and is expected to reach about 30% of the total U.S. population by 2050. Historically, primary care practitioners are not the preferred source of health information for Latinos living in the United States. Latinos are known to rely more on media, family, and friends to get answers to health-related questions. Choosing the appropriate information source is an important component of health information-seeking behavior; it also represents a major challenge for health communicators trying to deliver information to their target audience. This study explores how ethnicity influences health information source selection among Latinos and White non-Latinos living together in an underserved, multiethnic urban community with poor health status and underlying socioeconomic characteristics. The results suggest that this community manifests a high degree of homogeneity in their usage of health information sources. Nevertheless, there are significant differences between ethnic groups and age groups on perceived usefulness of the health information retrieved from common sources. Our results suggest that health information sources that are interactive, native to the community (e.g., the local pharmacist), and promote active engagement are the most useful in delivering health messages that will be listened to by those living in this underserved, multiethnic urban community.
Harmon, Hobart; Howley, Craig; Smith, Charles; Dickens, Ben
School improvement in rural places cannot succeed without attention to the rural context of learning. Most especially, smaller schools need to be preserved and sustained in rural areas, particularly impoverished communities, for the sake of student achievement and personal development. This school improvement tool suggests the character of a "good…
Chang, Jean; Guy, Mignonne C; Rosales, Cecilia; de Zapien, Jill G; Staten, Lisa K; Fernandez, Maria L; Carvajal, Scott C
Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648) participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30), greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.
Scott C. Carvajal
Full Text Available Hispanics bear a disproportionate burden of diabetes in the United States, yet relations of structural, socio-cultural and behavioral factors linked to diabetes are not fully understood across all of their communities. The current study examines disparities and factors associated with diabetes in adult Hispanics of Mexican-descent (N = 648 participating in a population survey of an underserved rural U.S.-Mexico border community. The overall rate of diabetes prevalence rate in the sample, based on self-report and a glucose testing, was 21%; much higher than rates reported for U.S. adults overall, for all Hispanic adults, or for Mexican American adults specifically. Acculturation markers and social determinants of health indicators were only significantly related to diabetes in models not accounting for age. Older age, greater BMI (>30, greater waist-to-hip ratio as well as lower fruit and vegetable consumption were significantly related to increased likelihood of diabetes when all structural, cultural, behavioral, and biological factors were considered. Models with sets of behavioral factors and biological factors each significantly improved explanation of diabetes relative to prior social ecological theory-guided models. The findings show a critical need for diabetes prevention efforts in this community and suggest that health promotion efforts should particularly focus on increasing fruit and vegetable consumption.
Bazargan, Mohsen; Lindstrom, Richard W; Dakak, Alan; Ani, Chizobam; Wolf, Kenneth E; Edelstein, Ronald A
The objective of this study was to explore the specific factors that influence medical student's choice of primary care as a specialty. Special attention is given to the influence of desire to work in underserved communities on selection of a specialty. A web-based survey of factors affecting choice of specialty was completed by 668 fourth-year students from 32 medical schools. Students interested in primary care reported an increased likelihood of working with underserved populations when compared with other specialties. The independent impact of both student's social compassion attitudes and values, and subjective and reinforcing influences on the selection of primary care, when compared with all other specialties, was strong. Personal practice-oriented considerations showed an independent negative impact on the selection of primary care when compared with surgery and support specialties. Financial considerations strongly influence the selection of support specialties. Medical training experiences showed an independent influence on the selection of surgery over primary care. The need for primary care physicians and specialists in underserved communities is considerable. Addressing health disparities in underserved communities requires a concerted effort to increase the availability of primary care providers in these communities. This study observed that primary care practice or specialty selection by medical students is influenced by individual values and subjective external influences other than predicted by medical training alone. This observation necessitates a closer determination of strategies required to ensure an increase in the number of primary care physicians serving underserved communities.
The present conceptual review explores intercultural healthcare--defined as the integration of traditional medicine and biomedicine as complementary healthcare systems--in minority and underserved communities. This integration can take place at different levels: individuals (patients, healers, biomedical healthcare providers), institutions (health centers, hospitals) or society (government policy). Contemporary ethnobotany research of traditional medicine has primarily dealt with the botanical identification of plants commonly used by local communities, and the identification of health conditions treated with these plants, whereas ethnopharmacology has focused on the bioactivity of traditional remedies. On the other hand, medical anthropology seems to be the scholarship more involved with research into patients' healthcare-seeking itineraries and their interaction with traditional versus biomedical healthcare systems. The direct impact of these studies on public health of local communities can be contested. To compare and discuss the body of scholarly work that deals with different aspects of traditional medicine in underserved and minority communities, and to reflect on how gaps identified in research can be bridged to help improve healthcare in these communities. The literature covers a broad range of information of relevance to intercultural healthcare. This information is fragmented across different scientific and clinical disciplines. A conceptual review of these studies identifies a clear need to devote more attention to ways in which research on traditional medicine can be more effectively applied to improve local public health in biomedical resource-poor settings, or in geographic areas that have disparities in access to healthcare. Scholars studying traditional medicine should prioritize a more interdisciplinary and applied perspective to their work in order to forge a more direct social impact on public health in local communities most in need of
Nicdao, Ethel G.; Trott, Elise M.; Kellett, Nicole C.
Incarceration and community reentry for rural women reflect gendered processes. We draw upon in-depth semi-structured interviews and focus groups to examine the return of women prisoners to underserved rural communities, while attending to the perspectives of their closest social supporters. Our findings underscore the complexity of the reentry process for rural women and its particular impact on their families. We challenge dominant discourses of personal responsibility that detract from the structura violence and injustice shaping reentry experiences for women and their social supporters. We also consider the policy implications of discharge and reentry planning for rural women and their families, as well as strategies to reduce recidivism. PMID:27274615
Shuler, Melinda S; Yeatts, Karin B; Russell, Donald W; Trees, Amy S; Sutherland, Susan E
A substantial proportion of low-income children with asthma living in rural western North Carolina have suboptimal asthma management. To address the needs of these underserved children, we developed and implemented the Regional Asthma Disease Management Program (RADMP); RADMP was selected as one of 13 demonstration projects for the National Asthma Control Initiative (NACI). This observational intervention was conducted from 2009 to 2011 in 20 rural counties and the Eastern Band Cherokee Indian Reservation in western North Carolina. Community and individual intervention components included asthma education in-services and environmental assessments/remediation. The individual intervention also included clinical assessment and management. Environmental remediation was conducted in 13 childcare facilities and 50 homes; over 259 administrative staff received asthma education. Fifty children with mild to severe persistent asthma were followed for up to 2 years; 76% were enrolled in Medicaid. From 12-month pre-intervention to 12-month post-intervention, the total number of asthma-related emergency department (ED) visits decreased from 158 to 4 and hospital admissions from 62 to 1 (p project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.
Kendall, J. S.
Observing the night sky in New York City is a challenge. However, there is a popular, and even club-going, interest in science in New York City. On the edges of that interest, most people that live in New York City have never had the opportunity to look through a telescope, particularly in underserved areas such as Northern Manhattan. The presenter discusses plans for frequent observing sessions utilizing the parks in New York City combined with public classes at the New York Public Library. Both observing sessions and classes will be held in the ethnically, racially and economically diverse Bronx and Manhattan neighborhoods of Washington Heights, Marble Hill and Inwood. Integration with area middle, elementary and high schools is also discussed. Particular issues surrounding publicity and the need for showmanship in an image-driven community with numerous entertainment opportunities are also discussed.
Snowden, Jessica; Darden, Paul; Palumbo, Paul; Saul, Phil; Lee, Jeannette
The institutional development award (IDeA) program was created to increase the competitiveness of investigators in states with historically low success rates for National Institutes of Health (NIH) research funding applications. IDeA states have high numbers of rural and medically underserved residents with disproportionately high rates of infant mortality, obesity, and poverty. This program supports the development and expansion of research infrastructure and research activities in these states. The IDeA States Pediatric Clinical Trials Network (ISPCTN) is part of the environmental influences on child health outcomes program. Its purpose is to build research capacity within IDeA states and provide opportunities for children in IDeA states to participate in clinical trials. This review describes the current and future activities of the network. In its initial year, the ISPCTN created an online series on clinical trials, initiated participation in a study conducted by the pediatric trials network, and proposed two novel clinical trials for obese children. Capacity building and clinical trial implementation will continue in future years. The ISPCTN is uniquely poised to establish and support new pediatric clinical research programs in underserved populations, producing both short and long-term gains in the understanding of child health.
Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A
Caregiver's or maternal depression has been associated with increased asthma morbidity in children from prosperous nations, but little is known about this link in low and middle-income countries. To examine if caregiver's depressive symptoms are associated with poor asthma control and abnormal immune responses in school-aged children. Case-control study of 87 asthmatic children (aged 4-11 years) attending a primary care clinic in an underserved area of Santiago (Chile). Cases were children with poor asthma control (Child Asthma Control Test [cACT] asthma control (cACT ≥20 points). The Beck Depression Inventory-II (BDI) and a locally validated family health vulnerability test (SALUFAM) were used to assess caregivers' depression and family health vulnerability. Serum from participating children was assayed for IFN-γ, IL-4, IL-13, TGF-β, cortisol, and total IgE. The mean (SD) age of study participants was 8.23 (2.15 years), and 55.2% were females. Use of inhaled corticosteroids (ICS), family health vulnerability, and caregiver's depressive symptoms were significantly more common in cases than in controls (65.4% vs. 34.6%, p = 0.003; 41.3% vs. 24.8%, p = 0.07; and 39.1% vs. 19.5%, p = 0.04, respectively). There was no significant difference in the level of any serum biomarkers between groups. In a multivariate analysis, only ICS use was significantly associated with better asthma control (OR = 3.56 [1.34-9.48], p = 0.01). Presence of caregiver's depressive symptoms is associated with poor asthma control among children from an underserved community, but this association was no longer significant after accounting for ICS use.
... DEPARTMENT OF HEALTH AND HUMAN SERVICES 42 CFR Part 5a RIN 0906-AA86 Public Health Service Act... community'' for purposes of the Rural Physician Training Grant Program in section 749B of the Public Health... activities within HHS that relate to rural health care. Section 10501(l) of Public Law 111-148 adds Section...
Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M
Sub-optimal performance of the animal health delivery system in rural areas is common in developing countries including Tanzania. However, penetration of mobile phones and availability of good road network and public transport systems offer opportunities for improving the access of rural communities to diagnostic and advisory services from facilities and expertise located in urban areas. A questionnaire survey on possession and use of mobile phones by pastoral and agro-pastoral communities in Kilosa and Gairo districts was carried out between November and December 2015. A total number of 138 livestock keepers from three villages of Chakwale (54), Mvumi (41) and Parakuyo (43) participated in the study. An e-based system was designed and tested to link rural communities with urban diagnostic facilities. It was observed that the average number of phones possessed by individuals interviewed and household families was 1.1 ± 0.26 (1-2) and 3.5 ± 2.23 (1-10), respectively. It was further observed that out of 138 livestock keepers interviewed, 133 (96.4 %) had feature phones while 10 (7.2 %) of them possessed smartphones. Mobile phone is currently used to support livestock production by communicating on animal health in Parakuyo (18, 41.9 %), Mvumi (18, 43.9 %) and Chakwale (14, 25.9 %). Other contributions of mobile phones in livestock and crop agriculture observed in the study area include: exchange of livestock price information, crop price information, communicating on plant health/diseases, livestock extension and advisory services as well as crop farming extension and advisory services. We also designed and tested an e-based SUAVetDiag® system to support timely diagnosis of infectious disease conditions and prompt advice on case management in veterinary underserved areas. Availability of mobile phones in rural areas, in combination with supporting infrastructure and facilities in urban areas, has potential to stimulate local development and improving
... 12 Banks and Banking 7 2010-01-01 2010-01-01 false Central Cities, Rural Areas, and Other... HOUSING GOALS AND MISSION ENTERPRISE HOUSING GOALS AND MISSION Housing Goals § 1282.13 Central Cities... purchase by each Enterprise of mortgages on housing located in central cities, rural areas, and other...
Hashemi, H; Yekta, A; Jafarzadehpur, E; Doostdar, A; Ostadimoghaddam, H; Khabazkhoob, M
PurposeTo determine the prevalence of visual impairment and blindness in underserved Iranian villages and to identify the most common cause of visual impairment and blindness.Patients and methodsMultistage cluster sampling was used to select the participants who were then invited to undergo complete examinations. Optometric examinations including visual acuity, and refraction were performed for all individuals. Ophthalmic examinations included slit-lamp biomicroscopy and ophthalmoscopy. Visual impairment was determined according to the definitions of the WHO and presenting vision.ResultsOf 3851 selected individuals, 3314 (86.5%) participated in the study. After using the exclusion criteria, the present report was prepared based on the data of 3095 participants. The mean age of the participants was 37.6±20.7 years (3-93 years). The prevalence of visual impairment and blindness was 6.43% (95% confidence interval (CI): 3.71-9.14) and 1.18% (95% CI: 0.56-1.79), respectively. The prevalence of visual impairment varied from 0.75% in participants aged less than 5 years to 38.36% in individuals above the age of 70 years. Uncorrected refractive errors and cataract were the first and second leading causes of visual impairment; moreover, cataract and refractive errors were responsible for 35.90 and 20.51% of the cases of blindness, respectively.ConclusionThe prevalence of visual impairment was markedly high in this study. Lack of access to health services was the main reason for the high prevalence of visual impairment in this study. Cataract and refractive errors are responsible for 80% of visual impairments which can be due to poverty in underserved villages.
Full Text Available are developed to increase the rate of electrification of these rural communities. To gain first hand understanding of the complexity of sustainable energy for rural community development, CSIR undertook a three year investigative project to investigate...
Xu, Melody J; Su, David; Deboer, Rebecca; Garcia, Michael; Tahir, Peggy; Anderson, Wendy; Kinderman, Anne; Braunstein, Steve; Sherertz, Tracy
Familiarity with principles of palliative care, supportive care, and palliative oncological treatment is essential for providers caring for cancer patients, though this may be challenging in global communities where resources are limited. Herein, we describe the scope of literature on palliative oncological care curricula for providers in resource-limited settings. A systematic literature review was conducted using PubMed, Embase, Cochrane Library, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Med Ed Portal databases, and gray literature. All available prospective cohort studies, case reports, and narratives published up to July 2017 were eligible for review. Fourteen articles were identified and referenced palliative care education programs in Argentina, Uganda, Kenya, Australia, Germany, the USA, or multiple countries. The most common teaching strategy was lecture-based, followed by mentorship and experiential learning involving role play and simulation. Education topics included core principles of palliative care, pain and symptom management, and communication skills. Two programs included additional topics specific to the underserved or American Indian/Alaskan Native community. Only one program discussed supportive cancer care, and no program reported educational content on resource-stratified decision-making for palliative oncological treatment. Five programs reported positive participant satisfaction, and three programs described objective metrics of increased educational or research activity. There is scant literature on effective curricula for providers treating cancer patients in resource-limited settings. Emphasizing supportive cancer care and palliative oncologic treatments may help address gaps in education; increased outcome reporting may help define the impact of palliative care curriculum within resource-limited communities.
Vareilles, Ga?lle; Pommier, Jeanine; Marchal, Bruno; Kane, Sumit
Background The recruitment of community health volunteers (CHVs) to support the delivery of health programmes is an established approach in underserved areas and in particular where there are health inequalities due to the scarcity of trained human resources. However, there is a dearth of evidence about what works to improve CHVs? performance. This review aimed to synthesise existing literature to explain why, how and under which circumstances intervention approaches to improve the performanc...
Skizim, Meg; Sothern, Melinda; Blaha, Ondrej; Tseng, Tung Sung; Griffiths, Lauren; Joseph, Jonathan; Nuss, Henry
The aim of the present paper is to assess local residents' awareness of utilizing Supplemental Nutrition Assistance Program (SNAP) benefits to purchase fresh produce at local farmers' markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (La, USA). The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers' markets; 63% of low-income participants never attended a farmers' market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide.
Full Text Available The aim of the present paper is to assess local residents’ awareness of utilizing Supplemental Nutrition Assistance Program (SNAP benefits to purchase fresh produce at local farmers’ markets, and to determine internet use and media preferences of study participants prior to implementation of a social marketing campaign. A needs assessment was conducted to collect baseline data in an underserved neighbourhood in New Orleans (LA, USA. The study was carried out August 2014-May 2015. The assessment revealed that 73% of the respondents were unaware that the SNAP benefits could be used to purchase food in farmers’ markets; 63% of low-income participants never attended a farmers’ market compared to 27% of mid/high-income. Over 50% of the low-income respondents have access to the internet at least once per day. The results show the potential of raising awareness among a wide range of members in the community. This needs assessment will serve as the foundation for a social marketing intervention, which will be disseminated city-wide.
Haq, Cynthia; Grosch, Michelle; Carufel-Wert, Donald
The Leadership Opportunities with Communities, the Underserved, and Special Populations (LOCUS) Program aims to improve medical students' leadership knowledge and skills, to improve self-awareness and motivation for community service, and to provide models for students to integrate community service into their medical careers. The LOCUS program was established as a longitudinal, extracurricular student opportunity at the University of Wisconsin Medical School in the fall of 1998. Up to 15 new students each year are selected for the program through an application and interview process during their first or second year of medical school. Students remain in the program from acceptance until graduation from medical school. Nearly 50 students have enrolled in the program to date. LOCUS fellows are matched with a physician mentor, participate in core curriculum activities, and complete a longitudinal community service project. Mentors are community generalist physicians who have integrated community service into their own careers. Students participate in their mentors' clinical practices one afternoon a month during the first two years, and mentors serve as role models and provide guidance for students' projects and career development. The program administration and staff are supported through federal predoctoral training and Area Health Education Centers (AHEC) grants. The LOCUS core curriculum is delivered through a series of retreats, workshops, and seminars that emphasize active learning methods and include approximately 20 hours of scheduled activities per academic year. The curriculum addresses concepts of leadership in relation to one's self and in relation to others. Students are introduced to methods of self-reflection and develop their own vision and mission statements. Students also discuss the importance of compassion, self-care, striving for balance, avoiding burnout, and being realistic about what they can accomplish. Students practice strategies for
Alaniz, Angela B.
Literature indicates that the use of promising innovations in mental health care can be improved. The advancement of telepsychology is one innovation that has been utilized as a method to reduce rural health disparities and increase the number of people with access to mental health services. This paper describes a successful pilot telepsychology program implemented in a rural community to increase access to mental health services and the model's replication and expansion into four additional communities using concepts described in an Interactive Systems Framework. The Interactive Systems Framework highlights how building local capacity specific to organizational functioning and innovations are necessary to support, deliver, and disseminate innovations within new settings. Based on the knowledge gained from this telepsychology innovation, the application of an Interactive Systems Framework and funding mechanisms are discussed. PMID:27403374
The University of Maine at Machias and Washington County Community College, the two smallest and most remote public institutions in Maine, provide important education and workforce development services in a rural and economically-challenged region. Through an innovative collaboration supported by the National Science Foundation, the two institutions have developed geospatial technology (GST) programs designed to meet the specific workforce needs of the region, affording students with the opportunity to pursue degrees, certificates and minors. Prior to this effort, neither school had the resources to maintain a GST laboratory or to offer courses consistently. The region had almost no GST capacity with which to manage critical environmental resources and grapple with economic, public safety, and public health challenges. Several statewide studies had shown a growing need for more GST technicians and training for incumbent workers. The new programs are designed to produce a small number of specialist technicians with associate's degrees and a large number of ancillary users with significant GST expertise from courses, certificates or minors. Course content is shaped by workforce research in Maine and elsewhere, and all courses are offered in either blended, online or short-term intensive formats to provide access to incumbent workers and extend the geographic reach of the programs. Through the university's Geographic Information Systems (GIS) Service Center, students from both institutions engage in real-world projects, and are linked with employers via internships. This has the added plus of providing low-cost and no-cost GIS services to area clients, generating demand. Many of these projects and internships lead to work for graduates, even through the economic downturn. By creating courses that serve multiple audiences, each contributing a small number to the total enrollment, the programs constitute a sustainable model that serves the growing needs of the region
Scientists observe the world around them in an attempt to understand it. Artists observe the world around them in an attempt to create a reflection or response to the environment. It is critical for the two fields to work together in order to engage and inform the general population. The Consortium for Ocean Leadership, the International Ocean Discovery Program and a series of collaborators are designing a traveling exhibit that will inspire underserved communities in the excitement of exploration, the process of science, and the people and tools required to get there. The project aims to learn more about how to increase access to and awareness of ocean/earth science by bringing a pop-up style museum exhibit to local libraries and public events. As an artist with a science and education background and the graphic designer for this exhibit, this author will highlight the ways this project utilizes art and design to educate underserved populations in ocean and geosciences.
Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah; Begley, Kathy; York, Nancy
Rural, tobacco-growing areas are disproportionately affected by tobacco use, secondhand smoke, and weak tobacco control policies. The purpose was to test the effects of a stage-specific, tailored policy-focused intervention on readiness for smoke-free policy, and policy outcomes in rural underserved communities. A controlled community-based trial including 37 rural counties. Data were collected annually with community advocates (n = 330) and elected officials (n = 158) in 19 intervention counties and 18 comparison counties over 5 years (average response rate = 68%). Intervention communities received policy development strategies from community advisors tailored to their stage of readiness and designed to build capacity, build demand, and translate and disseminate science. Policy outcomes were tracked over 5 years. Communities receiving the stage-specific, tailored intervention had higher overall community readiness scores and better policy outcomes than the comparison counties, controlling for county-level smoking rate, population size, and education. Nearly one-third of the intervention counties adopted smoke-free laws covering restaurants, bars, and all workplaces compared to none of the comparison counties. The stage-specific, tailored policy-focused intervention acted as a value-added resource to local smoke-free campaigns by promoting readiness for policy, as well as actual policy change in rural communities. Although actual policy change and percent covered by the policies were modest, these areas need additional resources and efforts to build capacity, build demand, and translate and disseminate science in order to accelerate smoke-free policy change and reduce the enormous toll from tobacco in these high-risk communities. © 2014 National Rural Health Association.
Carney, Charles L.; Weltsek, Gustave J.; Hall, M. Lynne; Brinn, Ginger
There is ample evidence that arts added to the K-12 curriculum can have many positive learning impacts. Nevertheless, many states do not promote such instruction as an integral part of classroom plans. For particular schools with underserved populations, arts-enhanced curricula can be a powerful learning tool. Beyond arts integration, arts…
Mays, Keith A; Maguire, Meghan
Since 2000, reports have documented the challenges faced by many Americans in receiving oral health care and the consequences of inadequate care such as high levels of dental caries among many U.S. children. To help address this problem, many dental schools now include community-based dental education (CBDE) in their curricula, placing students in extramural clinics where they provide care in underserved communities. CBDE is intended to both broaden the education of future oral health professionals and expand care for patients in community clinics. The aim of this study was to develop a three-year profile of the patients seen and the care provided by students at extramural clinics associated with one U.S. dental school. Three student cohorts participated in the rotations: final-year students in the Doctor of Dental Surgery, Bachelor of Science in Dental Hygiene, and Master of Dental Therapy programs. The study was a retrospective analysis of data retrieved from the school's database for three consecutive academic years. The data included patients' demographics and special health care needs status (based on information collected by students from their patients) and procedures students performed while on rotations. For the three-year period, the results showed a total of 43,128 patients were treated by 418 student providers. Approximately 25% of all encounters were with pediatric patients. Students completed 5,908 child prophylaxis, 5,386 topical fluoride varnish, and 7,678 sealant procedures on pediatric patients. Annually, 7% of the total patients treated had special health care needs. The results show that these students in CBDE rotations provided a substantial amount of oral health care at extramural sites and gained additional experience in caring for a diverse population of patients and performing a wide range of procedures.
Full Text Available Chronic diseases are the most common, costly, and preventable of all health problems in the United States. Chronic diseases represent the leading causes of death and are experienced at higher rates by minority populations (CDC, 2012. Innovative community-based health promotion programs are recommended that meet the diverse needs of underserved populations (Yeary, et al., 2011. LifeSteps is being developed as an evidence-based health promotion program focusing on health and wellness, a domain area defined within the Occupational Therapy Practice Framework (OTPF, 2008. LifeSteps will utilize a client-centered approach to coach individuals in making health behavior changes. Fieldwork and service-learning components are incorporated integrating clinical practice, academic study, and collaboration with community providers. Program evaluation measures based on the Transtheoretical Model (TTM have been identified to address all phases of program planning. The LifeSteps health promotion program aligns with local, national, and international objectives and addresses the need for programs that meet the diverse needs of underserved populations. Occupational therapists are in a unique position for implementing community-based interventions that promote health and contribute to a healthier society.
This paper advocates that community development is the bedrock for national development. For any meaningful development to take place, whether national or global development must have its building blocks or firm-root in rural development. However, the rural communities are characterized by isolation from ideas and ...
McKee, Michael; Schlehofer, Deirdre; Cuculick, Jessica; Starr, Matthew; Smith, Scott; Chin, Nancy P
Cardiovascular disease leads in overall mortality and morbidity in the United States. Cardiovascular disparities remain high among minority and underserved groups. Deaf American Sign Language (ASL) users are an underserved and understudied group that receives little attention from researchers due to language and communication barriers. A recent ASL survey in Rochester, NY, indicated greater cardiovascular risk among Deaf participants. The study objective was to investigate risk perceptions of cardiovascular disease among Deaf ASL users, linking perceptions to features of Deaf culture and communication. This information will be used to inform future strategies to promote cardiovascular health among Deaf adults. Four focus groups were conducted in Rochester, New York, with 22 Deaf participants in ASL. Videotaped sessions were translated and transcribed by a bilingual researcher. A team of investigators coded, analyzed, and identified key themes from the data. Themes centered on five major domains: knowledge, barriers, facilitators, practices, and dissemination. The majority of themes focused on barriers and knowledge. Barriers included lack of health care information access due to language and communication challenges, financial constraints, and stress. Inconsistent knowledge emerged from many key areas of cardiovascular health. The study outlines key themes for improving cardiovascular health knowledge and perceptions among Deaf ASL users. Findings suggest the importance of providing health educational programs and information in ASL to maximize understanding and minimize misconceptions. When caring for Deaf ASL users, providers should take extra effort to ask about cardiovascular risk factors and confirm patients' understanding of these factors. Copyright © 2011 Elsevier Inc. All rights reserved.
Volvovsky, Mariya; Vodopyanov, Dmitry; Inglehart, Marita R
The objectives of this study were to explore 1) how students across the four years of a dental curriculum differed in attitudes towards underserved patients and community service at the beginning and end of each school year; 2) how these attitudes changed as a function of participating in required vs. voluntary community-based activities; and 3) what attitudes faculty members held about the effects of community service-learning on students. Surveys were distributed to 440 students at one dental school at the beginning and end of the school year. The overall response rate for those surveys was 75 percent, with variations among classes: first year, 94 percent; second year, 92 percent; third year, 69 percent; and fourth year, 43 percent. Survey data were also collected from twenty-two students (out of a possible forty-seven) who participated in voluntary service-learning and from fifty-four faculty members (out of approximately 150). The results showed that, at the beginning of the year, the first-year students' attitudes were more positive than the responses of students in all other cohorts. However, at the end of the year, their attitudes were less positive. Participating in voluntary service-learning improved students' attitudes towards treating underserved patients only in the short run, and experiencing ten weeks of community-based dental education did not improve their attitudes. The faculty respondents' attitudes, however, were quite positive. The decrease in students' positive attitudes towards treating underserved patients and participating in community service should raise questions about why this loss of idealism occurred.
Roč. 55, č. 2 (2015), s. 205-226 ISSN 0038-0199 Institutional support: RVO:68378025 Keywords : community satisfaction * rural communities * contextual effects Subject RIV: AO - Sociology, Demography Impact factor: 1.380, year: 2015
Gullapalli N Rao
Full Text Available Blindness is a major global public health problem and recent estimates from World Health Organization (WHO showed that in India there were 62 million visually impaired, of whom 8 million are blind. The Andhra Pradesh Eye Disease Study (APEDS provided a comprehensive estimate for prevalence and causes of blindness for the state of Andhra Pradesh (AP. It also highlighted that uptake of services was also an issue, predominantly among lower socio-economic groups, women, and rural populations. On the basis of this analysis, L V Prasad Eye Institute (LVPEI developed a pyramidal model of eye care delivery. This article describes the LVPEI eye care delivery model. The article discusses infrastructure development, human resource development, and service delivery (including prevention and promotion in the context of primary and secondary care service delivery in rural areas. The article also alludes to opportunities for research at these levels of service delivery and the amenability of the evidence generated at these levels of the LVPEI eye health pyramid for advocacy and policy planning. In addition, management issues related to the sustainability of service delivery in rural areas are discussed. The article highlights the key factors required for the success of the LVPEI rural service delivery model and discusses challenges that need to be overcome to replicate the model. The article concludes by noting the potential to convert these challenges into opportunities by integrating certain aspects of the existing healthcare system into the model. Examples include screening of diabetes and diabetic retinopathy in order to promote higher community participation. The results of such integration can serve as evidence for advocacy and policy.
Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George
The use of value metrics is often dependent on payer-initiated health care management incentives. There is a need for practices to define and manage their own patient panels regardless of payer to participate effectively in population health management. A key step is to define a panel of primary care patients with high comorbidity profiles. Our sample included all patients seen in an urban academic family medicine clinic over a two-year period. The simplified risk stratification was built using internal electronic health record and billing system data based on ICD-9 codes. There were 347 patients classified as high-risk out of the 5,364 patient panel. Average age was 59 years (SD 15). Hypertension (90%), hyperlipidemia (62%), and depression (55%) were the most common conditions among high-risk patients. Simplified risk stratification provides a feasible option for our team to understand and respond to the nuances of population health in our underserved community.
EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... hierarchies and considering local resources and place bound potentials. This paper draws on a study of rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are managed by rural municipalities and local communities. The paper further discusses whether rural...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....
Danielson, Kathy Everts
Lists books with rural or small community themes available for children, grades K-eight, to serve as motivational reading texts or resources in units on farming or rural life in social studies or science. Categorizes selections as informational, poetry, traditional, contemporary realistic fiction, fantasy, historical fiction, or concept books.…
The primary objective of this toolbox is to summarize various known traffic-calming treatments and their effectiveness. This toolbox focuses on roadway-based treatments for speed management, particularly for rural communities with transition zones. E...
Wolff, Marie; Bates, Tovah; Beck, Barbra; Young, Staci; Ahmed, Syed M; Maurana, Cheryl
African Americans suffer significantly more cancer morbidity and mortality than the white population. In order to decrease this differential, it is critical to understand the particular barriers to health and health care that underserved African Americans face. It is also important to identify the critical components of effective cancer prevention programs for this population. The barriers that impede care for underserved African Americans have been identified as: 1) inadequate access to and availability of health care services; 2) competing priorities; 3) lack of knowledge of cancer prevention and screening recommendations; 4) culturally inappropriate or insensitive cancer control materials; 5) low literacy; 6) mistrust of the health care system; and 7) fear and fatalism. Effective programs must incorporate community participation, innovative outreach, use of social networks and trusted social institutions, cultural competence, and a sustained approach. Programs that include these strategies are much more likely to be effective in reducing cancer incidence. Cancer ranks second only to cardiovascular disease as the leading cause of death in the United States. For the majority population, cancer incidence and prevalence have declined in recent years and cure rates for certain cancer diagnoses have improved. This can be attributed to progress in the development and implementation of prevention, early detection, and treatment strategies. However, despite these gains, medically underserved African American populations have not fared as well. When African American-white mortality rates are compared, African Americans are 1.3 times more likely to die of cancer than the general population. Data from the Bureau of Health Information, Wisconsin Department of Health and Family Services indicate that from 1996 to 2000, cancer accounted for 33% of deaths in African Americans aged 45-64 and 34% of deaths for those aged 65-74. To decrease the disparities in cancer morbidity and
Goytia, Elliott J; Rapkin, Bruce; Weiss, Elisa S; Golub, David; Guzman, Vivian; O'Connor, Maureen
Community-based partnerships are an important means of addressing cancer health disparities in medically underserved communities. Public libraries may be ideal partners in this effort. To assess the readiness and capacity of a public library system to implement cancer recruitment and outreach campaigns, 58 librarians in the Queens Borough Public Library System in New York completed self-administered questionnaires before and after a training on breast health, cancer, and screening. Results indicate that they are interested in participating in a cancer outreach campaign and feel it is a critical need in their community. Many librarians lacked the knowledge about cancer and cancer information resources needed to participate optimally. Nevertheless, librarians provide a cultural bridge to medically underserved communities. Partnering with a public library system to improve access to care has great potential, yet a number of challenges need to be overcome.
Charlery, Lindy Callen
, is to be sustainably realized. However, most datasets on rural livelihoods do not accurately account for environmental income and therefore cannot answer this question. The Poverty Environment Network (PEN) project was initiated specifically to address this issue in the assessment of rural livelihoods in developing...... countries. Using a country specific adaptation of the PEN prototype survey instruments, the Community based Natural Forest Management in the Himalayas (ComForM) project was implemented in Nepal for the generation of a panel dataset to allow more dynamic and in-depth analyses. Utilizing this data this Ph......D study focuses on answering two main research questions: 1) What is the importance of environmental income in assessments of poverty and poverty dynamics in rural forest reliant communities? and 2) What are the impacts of infrastructural development, in the form of rural roads, on rural household income...
Chatzistamatiou, Kimon; Chatzaki, Εkaterini; Constantinidis, Τheocharis; Nena, Evangelia; Tsertanidou, Athena; Agorastos, Theodoros
In the present pilot study, the feasibility of a site-of-care cervicovaginal self-sampling methodology for HPV-based screening was tested in 346 women residing in underserved rural areas of Northern Greece. These women provided self-collected cervicovaginal sample along with a study questionnaire. Following molecular testing, using the cobas ® HPV Test, Roche ® , HPV positive women, were referred to colposcopy and upon abnormal findings, to biopsy and treatment. Participation rate was 100%. Regular pap-test examination was reported for 17.1%. Among hrHPV testing, 11.9% were positive and colposcopy/biopsy revealed 2 CIN3 cases. Non-compliance was the most prevalent reason for no previous attendance. Most women reported non-difficulty and non-discomfort in self-sampling (77.6% and 82.4%, respectively). They would choose self-sampling over clinician-sampling (86.2%), and should self-sampling being available, they would test themselves more regularly (92.3%). In conclusion, self-sampling is feasible and well-accepted for HPV-based screening, and could increase population coverage in underserved areas, helping towards successful prevention.
Charlery, Lindy Callen
, is to be sustainably realized. However, most datasets on rural livelihoods do not accurately account for environmental income and therefore cannot answer this question. The Poverty Environment Network (PEN) project was initiated specifically to address this issue in the assessment of rural livelihoods in developing......D study focuses on answering two main research questions: 1) What is the importance of environmental income in assessments of poverty and poverty dynamics in rural forest reliant communities? and 2) What are the impacts of infrastructural development, in the form of rural roads, on rural household income......, inequality, and use of environmental resources? These questions are addressed through four self-contained articles guided by related specific objectives. Guided by a framework for rural livelihoods analysis stemming from the Sustainable Livelihoods Approach, the studies in this thesis integrate qualitative...
Renee A. Oscarson
Full Text Available Despite frequent concerns about youth and young adult migration from rural to urban areas, most measures used to assess youth in rural community research have been developed by adults. Accurate understanding of youth community perceptions necessitates youth input into the research process. The participatory research strategy described here, using photography to describe community, enables youth to define community and identify what they value about their communities. Photographs and explanations of the photographs indicated that youth value places (schools, churches, as well as locations unique to communities and people from those communities. Photovoice, photography-based participatory-action research, is a feasible and engaging method for obtaining youth perspectives on community issues. Further, Photovoice may be adapted to the needs of different age groups and situations.
Full Text Available Concerns about the appropriate use of EBP with ethnic minority clients and the ability of community agencies to implement and sustain EBP persist and emphasize the need for community-academic research partnerships that can be used to develop, adapt, and test culturally responsive EBP in community settings. In this paper, we describe the processes of developing a community-academic partnership that implemented and pilot tested an evidence-based telephone cognitive behavioral therapy program. Originally demonstrated to be effective for urban, middle-income, English-speaking primary care patients with major depression, the program was adapted and pilot tested for use with rural, uninsured, low-income, Latino (primarily Spanish-speaking primary care patients with major depressive disorder in a primary care site in a community health center in rural Eastern Washington. The values of community-based participatory research and community-partnered participatory research informed each phase of this randomized clinical trial and the development of a community-academic partnership. Information regarding this partnership may guide future community practice, research, implementation, and workforce development efforts to address mental health disparities by implementing culturally tailored EBP in underserved communities.
Macey, Erin; Decker, Janet; Eckes, Suzanne
Many claim that the Knowledge is Power Program has experienced success in closing the achievement gap in urban and rural communities across America. Studies suggest that KIPP charter schools enroll an overwhelming proportion of poor and minority students and often outperform their district peers. However, the purpose of this study is not to…
Newell, Steve M; Logan, Henrietta L; Guo, Yi; Marks, John G; Shepperd, James A
Although tablet computers offer advantages in data collection over traditional paper-and-pencil methods, little research has examined whether the 2 formats yield similar responses, especially with underserved populations. We compared the 2 survey formats and tested whether participants' responses to common health questionnaires or perceptions of usability differed by survey format. We also tested whether we could replicate established paper-and-pencil findings via tablet computer. We recruited a sample of low-income community members living in the rural southern United States. Participants were 170 residents (black = 49%; white = 36%; other races and missing data = 15%) drawn from 2 counties meeting Florida's state statutory definition of rural with 100 persons or fewer per square mile. We randomly assigned participants to complete scales (Center for Epidemiologic Studies Depression Inventory and Regulatory Focus Questionnaire) along with survey format usability ratings via paper-and-pencil or tablet computer. All participants rated a series of previously validated posters using a tablet computer. Finally, participants completed comparisons of the survey formats and reported survey format preferences. Participants preferred using the tablet computer and showed no significant differences between formats in mean responses, scale reliabilities, or in participants' usability ratings. Overall, participants reported similar scales responses and usability ratings between formats. However, participants reported both preferring and enjoying responding via tablet computer more. Collectively, these findings are among the first data to show that tablet computers represent a suitable substitute among an underrepresented rural sample for paper-and-pencil methodology in survey research. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.
Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara
This is a retrospective cohort study to evaluate a novel group medical visit (GMV) program using an empowerment curriculum as treatment for pediatric obesity in a federally qualified community health center. Biometric and self-reported data were reviewed from 417 overweight or obese children ages 5-18 attending the pediatric obesity empowerment model GMV program (POEM-GMV) at least twice during a 3-year period. Variables were evaluated using paired means t-test. Pearson's correlation test was used to evaluate variables and the BMI z-score. Subanalysis by gender was performed. The average participant was 10.48 ± 2.53 years old and participated for 301 ± 287 days. BMI z-score reduced from 2.99 ± 0.96 to 2.88 ± 0.88 (p pediatric obesity in an underserved community. There were statistically significantly improved outcomes in obesity, especially for boys. Significant improvement was observed in many lifestyle factors associated with obesity. Weight loss most closely correlated with reduced stress levels and sugary beverage consumption. Additional studies are needed to further evaluate the efficacy of POEM-GMV.
Department of Housing and Urban Development — Federal Housing Finance Agency's (FHFA) Underserved Areas establishes underserved area designations for census tracts in Metropolitan Areas (MSAs), nonmetropolitan...
Crosby, Richard A; Collins, Tom
One largely unexplored barrier to colorectal cancer (CRC) screening is fatalistic beliefs about cancer. The purpose of this study was to identify correlates of ever having endoscopy screenings for CRC and to determine whether fatalism plays a unique role. Because evidence suggests that cancer-associated fatalistic beliefs may be particularly common among rural Americans, the study was conducted in a medically underserved area of rural Appalachia. METHODS: Rural residents (N = 260) between 51 and 75 years of age, from a medically underserved area of Appalachia, Kentucky, were recruited for a cross-sectional study. The outcome measure was assessed by a single item asking whether participants ever had a colonoscopy or flexible sigmoidoscopy. Demographic and health-related correlates of this outcome were selected based on past studies of rural populations. A single item assessed perceptions of fatalism regarding CRC. Age-adjusted analyses of correlates testing significant at the bivariate level were conducted. RESULTS: The analytic sample was limited to 135 rural residents indicating they had ever had CRC endoscopy and 107 indicating never having endoscopy. In age-adjusted analyses, only the measure of fatalism had a significant association with having endoscopy. Those endorsing the statement pertaining to fatalism were 2.3 times more likely (95% CI = 1.24-4.27, P = .008) than the remainder to indicate never having endoscopy. CONCLUSIONS: A community-based approach to the promotion of endoscopy for CRC screening could focus on overcoming CRC-associated fatalism, thereby potentially bringing more unscreened people to endoscopy clinics. © 2017 National Rural Health Association.
Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C
We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical
Full Text Available The World Health Organization conceived “health-promoting schools” as a means of providing the information and support systems necessary for the worldwide changes in behavior that are needed to improve health globally and decrease health care costs. We developed and evaluated a model of progressively implementing health-promoting schools with support from university medical school trainees in Canada and Uganda. The model uses oral health as a medium for establishing rapport and success around a topic with little stigma. The evaluation involved questionnaires of the Canadian trainees about practice intentions before and after involvement in the health-promoting schools to determine whether community-based learning in health-promoting schools resulted in more trainees planning to work in rural areas or underserved countries. We found that Canadian medical trainees cited their personal involvement and perceived ability to effect significant and identifiable positive change in both the school children and the community as reasons why they were more willing to practice in rural or under-served areas.
Full Text Available In this paper the authors want to highlight the opportunity on rural areas and development in termsof durability. The content of sustainable development offers to local communities real and lasting solutions.In this sense for a community to be truly sustainable, it must adopt a holistic approach, taking into accountshort-term environmental and economic sustainability of natural and cultural resources. The authors believethat a sustainable community among its objectives to include their major environmental issues, povertyeradication, improvement of quality of life, developing and maintaining an effective and viable localeconomies, leading to a global vision of sustainable development of all sectors of the community.
DESCRIPTION (provided by applicant): The Puerto Rico NCI Community Oncology Research Program (PRNCORP) will be the principal organization in the island that promotes cancer prevention, control and screening/post-treatment surveillance clinical trials. It will conduct cancer care delivery research and will provide access to treatment and imaging clinical trials conducted under the reorganization of the National Clinical Trials Network (NCTN). It will evaluate disparity issues and outcomes in cancer care delivery and treatments. |
Dept. of Agricultural Extension, Faculty of Agriculture,. University of Nigeria, Nsukka. E-mail: email@example.com. Phone: 08063276459. Abstract. This study examined constraints to gender participation in rural community development in Abia State. A multistage sampling procedure was used in the selection of 120 ...
Nyangara, Florence M; Hai, Tajrina; Zalisk, Kirsten; Ozor, Lynda; Ufere, Joy; Isiguzo, Chinwoke; Abubakar, Ibrahim Ndaliman
Decision makers are searching for reliable data and best practices to support the implementation and scale-up of the integrated community case management (iCCM) programs in underserved areas to reduce under-five mortality in low-income countries. This study assesses data quality and reporting systems of the World Health Organization supported Rapid Access Expansion program implementing iCCM in Abia and Niger States, Nigeria. This cross-sectional study used data from 16 primary health facilities in both states. Data were collected through review of registers and monthly summary reports of 140 community-oriented resource persons (CORPs), assessments of the five dimensions of the data reporting systems and 46 key informant interviews with stakeholders. Data quality was assessed by availability, completeness and consistency. Each component of the reporting system was assessed on a 3-point scale (weak, satisfactory and strong). Results show that both the structure, functions and capabilities, as well as data collection and reporting tools dimensions of the reporting system were strong, scoring (2.80, 2.73) for Abia and (2.88, 2.75) for Niger, respectively. Data management processes and links with national reporting system components scored low 2 s, indicating fair strength. Data availability, completeness and consistency were found to be good, an indication of adequate training and supervision of CORPs and community health extension workers. Indicator definitions and reporting guidelines were the weakest dimension of the system due to lack of data reporting guidelines in both states. In conclusion, the results indicate satisfactory data reporting systems and good quality data during early implementation of iCCM programs in the two states. Hence, countries planning to adopt and implement iCCM programs should first develop structures, establish national standardized tools for collecting and reporting data, provide for adequate training and supervision of community
Odom Walker, Kara; Ryan, Gery; Ramey, Robin; Nunez, Felix L; Beltran, Robert; Splawn, Robert G; Brown, Arleen F
We examined factors influencing physician practice decisions that may increase primary care supply in underserved areas. We conducted in-depth interviews with 42 primary care physicians from Los Angeles County, California, stratified by race/ethnicity (African American, Latino, and non-Latino White) and practice location (underserved vs nonunderserved area). We reviewed transcriptions and coded them into themes by using standard qualitative methods. Three major themes emerged in relation to selecting geographic- and population-based practice decisions: (1) personal motivators, (2) career motivators, and (3) clinic support. We found that subthemes describing personal motivators (e.g., personal mission and self-identity) for choosing a practice were more common in responses among physicians who worked in underserved areas than among those who did not. By contrast, physicians in nonunderserved areas were more likely to cite work hours and lifestyle as reasons for selecting their current practice location or for leaving an underserved area. Medical schools and shortage-area clinical practices may enhance strategies for recruiting primary care physicians to underserved areas by identifying key personal motivators and may promote long-term retention through work-life balance.
Constraints to gender participation in rural community development in Abia State, Nigeria. ... that the federal, state and local governments should be involved in multi-media enlightenment or sensitization to rural communities on the possible strategies for active participation to rural community development projects. This will ...
..., and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy... policies that are of importance to agriculture and rural communities. The purpose of this teleconference is... ENVIRONMENTAL PROTECTION AGENCY [FRL-9737-3] Farm, Ranch, and Rural Communities Committee AGENCY...
Barger, Diana; Pooley, Bertha; Dupuy, Julien Roger; Cardenas, Norma Amparo; Wall, Steve; Owen, Helen; Daviaud, Emmanuelle
To address inequitable access to health services of indigenous communities in the Bolivian highlands, the Bolivian Ministry of Health, with the support of Save the Children-Saving Newborn Lives, conducted operational research to identify, implement and test a package of maternal and newborn interventions using locally recruited, volunteer Community Health Workers (vCHW) between 2008 and 2010. The additional annual economic and financial costs of the intervention were estimated from the perspective of the Bolivian Ministry of Health in two municipalities. The cost of intervention-stimulated increases in facility attendance was estimated with national surveillance data using a pre-post comparison, adjusted for secular trends in facility attendance. Three scale-up scenarios were modelled by varying the levels of coverage and the number (per mother and child pair) and frequency of home visits. Average cost per mother and average cost per home visit are presented in constant 2015 US$. Eighteen per cent of expectant mothers in the catchment area were visited at least once. The annualized additional financial cost of the community-based intervention across both municipalities was $43 449 of which 3% ($1324) was intervention design, 20% ($8474) set-up and 77% ($33 651) implementation. Drivers of additional costs were additional paid staff (68%), 81% of which was for management and support by local implementing partner and 19% of which was for vCHW supervision. The annual financial cost per vCHW was $595. Modelled scale-up scenarios highlight potential efficiency gains. Recognizing local imperatives to reduce inequalities by targeting underserved populations, the observed low coverage by vCHWs resulted in a high cost per mother and child pair ($296). This evaluation raises important questions about this model's ability to achieve its ultimate goals of reducing neonatal mortality and inequalities through behaviour change and increased care seeking and has served to
Mendel, Peter; Ngo, Victoria K.; Dixon, Elizabeth; Stockdale, Susan; Jones, Felica; Chung, Bowen; Jones, Andrea; Masongsong, Zoe; Khodyakov, Dmitry
Community partnered research and engagement strategies are gaining recognition as innovative approaches to improving healthcare systems and reducing health disparities in underserved communities. These strategies may have particular relevance for mental health interventions in low income, minority communities in which there often is great stigma and silence surrounding conditions such as depression and difficulty in implementing improved access and quality of care. At the same time, there is a relative dearth of evidence on the effectiveness of specific community engagement interventions and on the design, process, and context of these interventions necessary for understanding their implementation and generalizability. This paper evaluates one of a number of community engagement strategies employed in the Community Partners in Care (CPIC) study, the first randomized controlled trial of the role of community engagement in adapting and implementing evidence-based depression care. We specifically describe the unique goals and features of a community engagement “kickoff” conference as used in CPIC and provide evidence on the effectiveness of this type of intervention by analyzing its impact on: 1) stimulating a dialogue, sense of collective efficacy, and opportunities for learning and networking to address depression and depression care in the community, 2) activating interest and participation in CPIC’s randomized trial of two different ways to implement evidence-based quality improvement (QI) programs for depression across diverse community agencies, and 3) introducing evidence-based toolkits and collaborative care models to potential participants in both intervention conditions and other community members. We evaluated the effectiveness of the conference through a community-partnered process in which both community and academic project members were involved in study design, data collection and analysis. Data sources include participant conference evaluation
Tanner, Andrea; Kim, Sei-Hill; Friedman, Daniela B; Foster, Caroline; Bergeron, Caroline D
Clinical trials help advance public health and medical research on prevention, diagnosis, screening, treatment, and quality of life. Despite the need for access to quality care in medically underserved areas, clinical trial participation remains low among individuals in rural and African American communities. This study assessed clinical trial research in South Carolina's five main academic medical centers, focusing specifically on clinical trial investigators' perceived barriers to recruitment in the general population and in rural and African American communities. Online survey responses (N = 119) revealed that it was most difficult for investigators to recruit from rural areas and that rural residents were least likely to be represented in medical research, behind both the general public and African Americans. Barriers focusing on communication or awareness proved to be the biggest hurdles to finding potential participants in both the general public and rural communities. Psychological barriers to recruitment were perceived to be most prevalent in African American communities. Study findings provide important insights from the perspective of the clinical trial investigator that will aid in the development of effective communication and education strategies for reaching rural and African American residents with information about clinical trials.
Marshall, Julie; Harding, Sam; Roulstone, Sue
Evidence-based practice includes research evidence, clinical expertise and stakeholder perspectives. Stakeholder perspectives are important and include parental ethno-theories, which embrace views about many aspects of speech, language and communication, language development, and interventions. The Developmental Niche Framework provides a useful theory to understand parental beliefs. Ethnotheories, including those about language development, delay and interventions, may vary cross culturally and are less well understood in relation to families who may be considered 'under-served' or 'hard-to-reach' by speech and language therapy services. Who is considered to be under-served and the reasons why some families are under-served are complex. To describe beliefs and reported practices, in relation to speech and language development, delay and intervention, of parents and carers from a small number of groups in England who were perceived to be under-served in relation to SLT services. As part of a wider National Institute for Health Research (NIHR)-funded study (Child Talk), seven focus groups (with a total of 52 participants) were held with parents from three communities in England. Topics addressed included beliefs about language development, language delay and parents' reported responses to language delay. Data were transcribed and analysed using adapted framework analysis, which also drew on directed content analysis. Four themes resulted that broadly matched the topics addressed in the focus groups: language development and the environment; causes and signs of speech and language delay; responses to concerns about speech, language and communication; and improving SLT. These produced some previously unreported ideas, e.g., about how language develops and the causes of delay. The findings are discussed in relation to previous literature and the Developmental Niche Framework. Clinical implications include ideas about issues for SLTs to discuss with families and the
Waterson, Robert A.; Moffa, Eric D.
To assist rural teachers in fostering students' democratic skills and dispositions, this article examines the convergence of literature on citizenship education, rural communities, and rural education and extrapolates the challenges and possibilities of rural citizenship education for proactive democratic life. Four assertions are elicited from a…
Rios-Ellis, Britt; Becker, Davida; Espinoza, Lilia; Nguyen-Rodriguez, Selena; Diaz, Gaby; Carricchi, Ana; Galvez, Gino; Garcia, Melawhy
Latinos are at an elevated risk for HIV infection. Continued HIV/AIDS stigma presents barriers to HIV testing and affects the quality of life of HIV-positive individuals, yet few interventions addressing HIV/AIDS stigma have been developed for Latinos. An intervention led by community health workers (promotores de salud, or promotores) targeting underserved Latinos in three southwestern U.S. communities was developed to decrease HIV/AIDS stigma and increase HIV knowledge and perception of risk. The intervention was led by HIV-positive and HIV-affected (i.e., those who have, or have had, a close family member or friend with HIV/AIDS) promotores, who delivered interactive group-based educational sessions to groups of Latinos in Spanish and English. To decrease stigma and motivate behavioral and attitudinal change, the educational sessions emphasized positive Latino cultural values and community assets. The participant pool comprised 579 Latino adults recruited in El Paso, Texas (n=204); San Ysidro, California (n=175); and Los Angeles, California (n=200). From pretest to posttest, HIV/AIDS stigma scores decreased significantly (pstigma scores when compared with their male counterparts, which may have been related to a greater increase in HIV/AIDS knowledge scores (p=0.016 and p=0.007, respectively). Promotores interventions to reduce HIV/AIDS stigma and increase HIV-related knowledge, perception of risk, and willingness to discuss sexual risk with partners show promise in reaching underserved Latino communities.
Johnson, Brooke Ronald; Maksutova, Elmira; Boobekova, Aigul; Davletova, Ainura; Kazakbaeva, Chinara; Kondrateva, Yelena; Landoulsi, Sihem; Lazdane, Gunta; Monolbaev, Kubanychbek; Seuc Jo, Armando H
To demonstrate the feasibility and safety of training midlevel healthcare providers (midwives and family nurses) to provide medical abortion and postabortion contraception in underserved areas in Kyrgyzstan. This was an implementation study at four referral facilities and 28 Felsher Obstetric Points in two districts to train their midwives and family nurses to deliver safe and effective abortion care with co-packaged mifepristone-misoprostol and provide contraceptives postabortion. The outcome of abortion - complete abortion, incomplete abortion or o-going pregnancy - was the primary end point measured. An international consultant trained 18 midwives and 14 family nurses (with midwifery diplomas) to provide medical abortion care. Supervising gynecologists based in the referral centers and study investigators based in Bishkek provided monthly monitoring of services and collection of patient management forms. A voluntary self-administered questionnaire at the follow-up visit documented women's acceptability of medical abortion services. All study data were cross-checked and entered into an online data management system for descriptive analysis. Between August 2014 and September 2015, midwives provided medical abortion to 554 women with a complete abortion rate of 97.8%, of whom 62% chose to use misoprostol at home. No women were lost to follow-up. Nearly all women (99.5%) chose a contraceptive method postabortion; 61% of women receiving services completed the acceptability form, of whom more than 99% indicated a high level of satisfaction with the service and would recommend it to a friend. This study demonstrates that trained Kyrgyz midwives and nurses can provide medical abortion safely and effectively. This locally generated evidence can be used by the Kyrgyz Ministry of Health to reduce unintended pregnancy and expand safe abortion care to women in underserved periurban and rural settings. Success in scaling up midwife/nurse provision of medical abortion in
Osmun, W. E.; Poenn, D.; Buie, M.
PROBLEM BEING ADDRESSED: Increasing workload and concerns about physician exhaustion necessitated reorganizing the delivery of obstetric services on Manitoulin Island in Ontario. OBJECTIVE OF PROGRAM: To organize obstetrics in a remote rural community to provide safe, accessible care, improve working conditions for local physicians, and involve the local hospital and health care workers in the solution. MAIN COMPONENTS OF PROGRAM: A prenatal clinic for all obstetric care on the island was est...
Janicke, David M.; Sallinen, Bethany J.; Perri, Michael G.; Lutes, Lesley D.; Silverstein, Janet H.; Brumback, Babette
Purpose: To compare the costs of parent-only and family-based group interventions for childhood obesity delivered through Cooperative Extension Services in rural communities. Methods: Ninety-three overweight or obese children (aged 8 to 14 years) and their parent(s) participated in this randomized controlled trial, which included a 4-month…
McManus, Phil; Walmsley, Jim; Argent, Neil; Baum, Scott; Bourke, Lisa; Martin, John; Pritchard, Bill; Sorensen, Tony
Many studies have highlighted the phenomenon of rural decline in parts of the developed world, summarised as a loss in agricultural employment leading to a decline in the number and size of rural settlements. This study of small towns in part of Australia's inland rural "heartland" employs the concepts of interactional rural community of…
Hamilton, Kara C; Richardson, Mark T; Owens, Teirdre; Morris, Timothy; Hathaway, Elizabeth D; Higginbotham, John C
The overall objective of Project SHAPE (Shaping Health using Activity Photovoice and E-Video) was to improve physical activity levels of rural, medically underserved children by designing and implementing a culturally relevant physical activity intervention. This objective was met by using a community-based participatory research approach to design and implement an intervention that would positively affect the psychosocial constructs related to increasing physical activity, which, in turn, would lead to increases in the time spent in daily physical activity. This article describes the unique design of the intervention including its theoretical framework, its interrelated components, and the logistics involved.
This qualitative study examined recruitment and retention of home support workers (HSWs) providing home support in rural communities. Thirty-two participants were recruited across four island-based communities located in British Columbia, Canada. Thematic analysis of interview data revealed several key themes: (a) how the rural context shapes HSWs' employment decisions and opportunities; (b) why people become (and stay) HSWs in rural communities; and (c) how rurality influences the nature and scope of HSWs' work. These findings suggest that health human resource policies and programs aimed at HSW recruitment and retention should be tailored to characteristics, strengths, and challenges of rural communities.
Mueller-Luckey, Georgia S; Zahnd, Whitney E; Garner, Kyle; Heitkamp, Ruth; Jenkins, Wiley D; Boehler, Michael D; Steward, David E
Community-based participatory research (CBPR) is an effective way to address cancer disparities in medically underserved populations. Our research demonstrates how CBPR principles were used to develop lung cancer and risk factor mini reports for a network of community coalitions in the Illinois Delta Region, a predominately rural region with high lung cancer disparities in southern Illinois. An academic-community partnership, including a community-based medical school, state public health department, and a healthcare system, used CBPR principles to translate epidemiological, behavioral, and demographic data into understandable, comprehensive, yet concise mini reports for each coalition. A cyclical and iterative process was used to draft, revise, and optimize these mini reports to raise awareness about lung cancer disparities in the community and to provide information to help guide the development of interventions that address these disparities. The use of CBPR principles was a successful way to create mini reports about local lung cancer disparities and risk factors that were usable in individual communities. Local coalitions used the mini reports to educate community members at local meetings, to guide strategic planning, and to disseminate information through their respective websites. Additionally, the process of creating these reports built trust among academic-community partners and provided additional avenues of engagement, such as the involvement of an academic partner in the strategic planning process of a local coalition. Using CBPR processes is an effective way to translate epidemiological data into a community-friendly format to address cancer disparities.
Osmun, W E; Poenn, D; Buie, M
Increasing workload and concerns about physician exhaustion necessitated reorganizing the delivery of obstetric services on Manitoulin Island in Ontario. To organize obstetrics in a remote rural community to provide safe, accessible care, improve working conditions for local physicians, and involve the local hospital and health care workers in the solution. A prenatal clinic for all obstetric care on the island was established. It was based at the local hospital and organized by a nurse-midwife. Local physicians rotated through the clinic and provided obstetric coverage on their on-call days. The clinic has helped improve working conditions for local physicians and maintain high-quality obstetric care in this remote area. Local women's initial resistance to the clinic seems to be disappearing with time. Ongoing chart audits reveal intervention rates similar to those found in other Canadian studies of rural obstetric care.
... the global fight against blindness in the rural communities, Rotary International, a humanitarian global organization, encourages all Rotary clubs world wide to undertake annual eye-camps in rural communities as part of their community service. Aim: To report the findings of a one-day eye-camp by the Rotary Club of Port ...
Smathers, Carol A.; Lobb, Jennifer M.
The tool kit Mobilizing Rural Communities to Prevent Childhood Obesity is the product of a seven-state multidisciplinary research project focused on enhancing obesity prevention efforts by integrating community coaching into the work of rural community coalitions. The interactive tool kit is available at no cost both in print form and online, and…
... Communities Committee (FRRCC). The FRRCC provides policy advice, information, and recommendations to the EPA... ENVIRONMENTAL PROTECTION AGENCY [FRL-9747-6] Farm, Ranch, and Rural Communities Committee AGENCY... in the Federal Register on October 3, 2012 [FRL- 9737-3] a Farm, Ranch, and Rural Communities...
Primary production activity and environmental resources hold the key to rural development. The range of activities in primary production forms the basis with which rural communities relate with the environment and carry out rural development activities. This study examined the interactions in manenvironment system and ...
The rise in mobile telephony has continued to bridge the wide disparity between urban and rural dwellers, although there are suggestions that mobile phones have not been optimally utilized by rural dwellers. In view of this, the main aim of this study was to examine mobile phone usage in rural communities of Kwara State, ...
Durand, Marie-Anne; Alam, Shama; Grande, Stuart W; Elwyn, Glyn
Women of low socioeconomic status (SES) diagnosed with early stage breast cancer experience decision-making, treatment and outcome disparities. Evidence suggests that decision aids can benefit underserved patients, when tailored to their needs. Our aim was to develop and test the usability, acceptability and accessibility of a pictorial encounter decision aid targeted at women of low SES diagnosed with early stage breast cancer. Community-based participatory research (CBPR) using think-aloud protocols (phases 1 and 2) and semistructured interviews (phase 3). Underserved community settings (eg, knitting groups, bingo halls, senior centres) and breast clinics. In phase 1, we recruited a convenience sample of clinicians and academics. In phase 2, we targeted women over 40 years of age, of low SES, regardless of breast cancer history, and in phase 3, women of low SES, recently diagnosed with breast cancer. The pictorial encounter decision aid was derived from an evidence-based table comparing treatment options for breast cancer (http://www.optiongrid.org). We assessed the usability, acceptability and accessibility of the pictorial decision aid prototypes using the think-aloud protocol and semistructured interviews. After initial testing of the first prototype with 18 academics and health professionals, new versions were developed and tested with 53 lay individuals in community settings. Usability was high. In response to feedback indicating that the use of cartoon characters was considered insensitive, a picture-only version was developed and tested with 23 lay people in phase 2, and 10 target users in phase 3. Using CBPR methods and iterative user testing cycles improved usability and accessibility, and led to the development of the Picture Option Grid, entirely guided by multiple stakeholder feedback. All women of low SES recently diagnosed with early stage breast cancer found the Picture Option Grid usable, acceptable and accessible. Published by the BMJ Publishing
Community-based Tourism and Rural Development: The Case of the Wechiau Hippo Sanctuary in the Wa West District of Ghana. ... the sustainable management of the Sanctuary. KEY DESCRIPTORS: Community-based Tourism, Nature Conservation, Eco-system maintenance, Participatory Planning; Rural Development.
Jamieson, Shirley; Wendt, Sarah
This paper outlines the findings of an exploratory study conducted in a small rural community in South Australia in 2006. Human service providers, experienced in working with victims and/or perpetrators of domestic violence, were asked about their experiences and perceptions of perpetrator programs in small rural communities. Specifically,…
J. Michael Bowker; James W. Richardson
The purpose of this study was to describe an LP/IO model for evaluating the economic impacts of alternative farm policies on rural communities and demonstrate its capabilities by analyzing the impacts of three farm policies on a rural community in Texas. Results indicate that in the noncrop sector, two groups of industries are most affected by farm policy. The first...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9272-4] Farm, Ranch, and Rural Communities Committee AGENCY... Act, Public Law 92-463, EPA gives notice of a meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9316-5] Farm, Ranch, and Rural Communities Committee AGENCY... Act, Public Law 92-463, EPA gives notice of a meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9200-4] Farm, Ranch, and Rural Communities Committee AGENCY... Act, Public Law 92-463, EPA gives notice of a meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9471-6] Farm, Ranch, and Rural Communities Committee AGENCY... Act, Public Law 92-463, EPA gives notice of a meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9497-6] Farm, Ranch, and Rural Communities Committee AGENCY... Act, Public Law 92-463, EPA gives notice of a meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...
The focused on participation in community development activities, constraints to and benefits derived from participation. It compared rural and urban youth participation in community development activities in Ido local government area of Oyo State. Proportionate random sampling was used to select 2 rural, 1 urban ...
Braak, Willem J.; Lewin, Paul A.
Rural wealth creation and local entrepreneurship are emerging economic development approaches that bring back a sense of self-determination to rural communities. However, their potential is often greatly diminished by preconceived and opposing notions within the community on what drives economic growth. The Dollar Game is an innovative curriculum…
Sep 30, 2012 ... the rural populace on the need and the importance of the Libraries. The rural dwellers need to be told the types of .... Recreational needs of the rural dwellers can be met through the provision of recreational materials like games, story books, especially fictions and humorous films by the rural labraries.
Interviews with 20 high school students in rural upstate New York reveal that students perceived the rural community as offering a sense of safety and belonging while taking away personal privacy and fostering prejudices. Adult interactions perceived as important included community support for the school and adolescent activities and interpersonal…
Wendt, Sarah; Hornosty, Jennie
Research on family violence in rural communities in Australia and Canada has shown that women's experience of family violence is shaped by social and cultural factors. Concern for economic security and inheritance for children, closeness and belonging, and values of family unity and traditional gender roles are factors in rural communities that…
Baral, Kedar; Allison, Jill; Upadhyay, Shambu; Bhandary, Shital; Shrestha, Shrijana; Renouf, Tia
Nepal is a low-income, landlocked country located on the Indian subcontinent between China and India. The challenge of finding human resources for rural community health care settings is not unique to Nepal. In spite of the challenges, the health sector has made significant improvement in national health indices over the past half century. However, in terms of access to and quality of health services and impact, there remains a gross urban-rural disparity. The Patan Academy of Health Sciences (PAHS) has adopted a community-based education model, termed "community based learning and education" (CBLE), as one of the principal strategies and pedagogic methods. This method is linked to the PAHS mission of improving rural health in Nepal by training medical students through real-life experience in rural areas and developing a positive attitude among its graduates towards working in rural areas. This article outlines the PAHS approach of ruralizing the academy, which aligns with the concept of community engagement in health professional education. We describe how PAHS has embedded medical education in rural community settings, encouraging the learning context to be rural, fostering opportunities for community and peripheral health workers to participate in teaching-learning as well as evaluation of medical students, and involving community people in curriculum design and implementation.
Drawing from an ethnographic research in two plural rural communities inhabited by Efik and Ibibio ethnic groups in Nigeria, the paper reveals that in both communities culture bearers made a distinction between community and individual poverty. Both ethnic groups in each community agreed on common indicators, which ...
Cargill, Stephanie Solomon; Baker, Lauren Lyn; Goold, Susan Dorr
Develop an accessible exercise to engage underserved populations about research funding priorities; analyze the criteria they use to prioritize research; contrast these criteria to those currently used by Patient Centered Outcomes Research Institute (PCORI). Academic and community partners collaborated to develop an Ipad exercise to facilitate group deliberation about PCOR funding priorities. 16 groups (n = 183) of underserved individuals in both urban and rural areas participated. Recordings were qualitatively analyzed for prioritization criteria. Analysis yielded ten codes, many of which were similar to PCORI criteria, but all of which challenged or illuminated these criteria. Directly involving underserved populations in determining funding criteria is both feasible and important, and can better fulfill PCORI's goal of incorporating patient priorities.
Jeannette Waegemakers Schiff
Full Text Available Until recently, there was little acknowledgement that homelessness existed in rural areas in Canada. Limited research and scarce data are available to understand the scope and dynamics of rural homelessness in Canada. As suggested in our previous work, there is a need for rural homelessness research to examine themes from a provincial perspective. The aim of this research was to contribute to expanding the knowledge base on the nature of rural homelessness at a provincial level in the Canadian province of Alberta. In order to understand the dynamics of homelessness in rural Alberta, we conducted interviews with service providers and other key stakeholders across Alberta. We examined homelessness dynamics and responses to rural homelessness in 20 rural communities across the province. Across all of the communities in the study, homelessness was reported however, the magnitude of the issue and its dynamics were distinct depending on the local contexts. We also identified several themes which serve as descriptors of rural homelessness issues. We note a number of recommendations emerging from this data which are aimed at building on the experiences, capacities, and strengths of rural communities.
Provision of Information to Rural Communities in Bama Local Government Area of Borno State, Nigeria. Y Aliyu, E Camble ... findings of the study showed that rural people in the Soye district have identifiable information needs mainly in the areas of agriculture, health, government programmes and small scale industries.
Income-generating projects in rural communities: from theory to practice - a personal report. ISSN 0378-5254 Journal of Family Ecology and .... mine aspects of household resources management by women in one of the rural settlements ..... an administrative course presented by the support organisation to help them run the ...
Bright, Larry K.; Evans, Wayne H.; Marmet, Kathy
Outmigration in the rural Upper Midwest prompted a group of citizens and University of South Dakota faculty to form the Center for the Advancement of Rural Communities (ARC). ARC considers how to stimulate traditionally competitive and isolated South Dakota peoples to collaborate for economic, social, educational, political, and cultural gains. As…
The paper canvasses the use of information communication technology to improve public library services in the rural areas. Recommendations were put forward for the overall transformation of public library services culminating in the socio-political development of rural communities. Introduction. Librarianship as a science ...
Apr 14, 2016 ... Abstract. In rural areas, water availability in the right quantity and quality is an important step towards achieving socio-economic development. Thus, the provision of sustainable water supply has been a central issue in Kenya with priority on low-income rural communities and underdeveloped areas with ...
Eller, Ronald; Martinez, Ruben; Pace, Cynthia; Pavel, Michael; Garza, Hector; Barnett, Lynn
This report addresses the Rural Community College Initiative (RCCI) from the American Association of Community Colleges, which seeks to enhance the capacity of targeted community colleges to expand access to postsecondary education and help foster regional economic development. The Ford Foundation has made a decade-long commitment to community…
The Rural Community College Initiative challenges colleges in economically distressed regions to become catalysts for economic and community development and improved access to education. Led by college-community teams, the 24 sites have experimented with strategic approaches that include leadership development, entrepreneurship education, small…
Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen
Background Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs). We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. Methods The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. Results Of 258 initially active participants, 225 (225/258 = 87.2%) successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200 = 85%) attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001). The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001). A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. Conclusion This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired
Full Text Available BACKGROUND: Current educational strategies to integrate HIV care into primary medical care in Central America have traditionally targeted managers or higher-level officials, rather than local health care workers (HCWs. We developed a complementary online and on-site interactive training program to reach local HCWs at the primary care level in underserved communities. METHODS: The training program targeted physicians, nurses, and community HCWs with limited access to traditional onsite training in Panama, Nicaragua, Dominican Republic, and Guatemala. The curriculum focused on principles of HIV care and health systems using a tutor-supported blended educational approach of an 8-week online component, a weeklong on-site problem-solving workshop, and individualized project-based interventions. RESULTS: Of 258 initially active participants, 225 (225/258=87.2% successfully completed the online component and the top 200 were invited to the on-site workshop. Of those, 170 (170/200=85% attended the on-site workshop. In total, 142 completed all three components, including the project phase. Quantitative and qualitative evaluation instruments included knowledge assessments, reflexive essays, and acceptability surveys. The mean pre and post-essay scores demonstrating understanding of social determinants, health system organization, and integration of HIV services were 70% and 87.5%, respectively, with an increase in knowledge of 17.2% (p<0.001. The mean pre- and post-test scores evaluating clinical knowledge were 70.9% and 90.3%, respectively, with an increase in knowledge of 19.4% (p<0.001. A survey of Likert scale and open-ended questions demonstrated overwhelming participant satisfaction with course content, structure, and effectiveness in improving their HIV-related knowledge and skills. CONCLUSION: This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills
Tool to help small towns and rural communities assess their existing policies, plans, codes, and zoning regulations to determine how well they work to create healthy, environmentally resilient, and economically robust places.
... communication skills; and an ability and willingness to participate in a deliberative and collaborative process... that are of importance to agriculture and rural communities. Members serve as representatives from...
Community, social group, and individual level correlates of rural Malawian men's and women's reproductive health intentions and practices. Valerie A Paz-Soldan, Thomas Bisika, Joseph deGraft-Johnson, Amy O Tsui ...
Price, Morgan; Weber-Jahnke, Jens H
This paper describes the Engineering 4 Health (E4H) Challenge, an interdisciplinary and intercultural initiative that, on the one hand, seeks to improve health education of children in under-serviced communities and, on the other, seeks to attract students in British Columbia to professions in engineering and health. The E4H Challenge engages high school and university students in BC to cooperatively design and develop health information and communication technology (ICT) to educate children living in under-serviced communities. The E4H Challenge works with the One Laptop Per Child (OLPC) program to integrate applications for health awareness into the school programs of communities in developing countries. Although applications developed by the E4H Challenge use the low-cost, innovative XO laptop (the "$100 laptop" developed by the OLPC foundation) the software can also be used with other inexpensive hardware.
Full Text Available Abstract Background Major health inequities between urban and rural populations have resulted in rural health as a reform priority across a number of countries. However, while there is some commonality between rural areas, there is increasing recognition that a one size fits all approach to rural health is ineffective as it fails to align healthcare with local population need. Community participation is proposed as a strategy to engage communities in developing locally responsive healthcare. Current policy in several countries reflects a desire for meaningful, high level community participation, similar to Arnstein’s definition of citizen power. There is a significant gap in understanding how higher level community participation is best enacted in the rural context. The aim of our study was to identify examples, in the international literature, of higher level community participation in rural healthcare. Methods A scoping review was designed to map the existing evidence base on higher level community participation in rural healthcare planning, design, management and evaluation. Key search terms were developed and mapped. Selected databases and internet search engines were used that identified 99 relevant studies. Results We identified six articles that most closely demonstrated higher level community participation; Arnstein’s notion of citizen power. While the identified studies reflected key elements for effective higher level participation, little detail was provided about how groups were established and how the community was represented. The need for strong partnerships was reiterated, with some studies identifying the impact of relational interactions and social ties. In all studies, outcomes from community participation were not rigorously measured. Conclusions In an environment characterised by increasing interest in community participation in healthcare, greater understanding of the purpose, process and outcomes is a priority for
Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen
Background The Teaching Health Center Graduate Medical Education (THCGME) program is an Affordable Care Act funding initiative designed to expand primary care residency training in community-based ambulatory settings. Statute suggests, but does not require, training in underserved settings. Residents who train in underserved settings are more likely to go on to practice in similar settings, and graduates more often than not practice near where they have trained. Objective The objective of this study was to describe and quantify federally designated clinical continuity training sites of the THCGME program. Methods Geographic locations of the training sites were collected and characterized as Health Professional Shortage Area, Medically Underserved Area, Population, or rural areas, and were compared with the distribution of Centers for Medicare and Medicaid Services (CMS)-funded training positions. Results More than half of the teaching health centers (57%) are located in states that are in the 4 quintiles with the lowest CMS-funded resident-to-population ratio. Of the 109 training sites identified, more than 70% are located in federally designated high-need areas. Conclusions The THCGME program is a model that funds residency training in community-based ambulatory settings. Statute suggests, but does not explicitly require, that training take place in underserved settings. Because the majority of the 109 clinical training sites of the 60 funded programs in 2014-2015 are located in federally designated underserved locations, the THCGME program deserves further study as a model to improve primary care distribution into high-need communities.
Full Text Available Providing access to remote rural areas presents a unique set of technical and non-technical challenges. These challenges are key issues that arise when deploying wireless networks to remote rural areas in developing countries; long distances between...
Antonio Bustos Jiménez
Full Text Available In the paper the notions of participation and community empowerment in rural schools are analysed through reflection on experiences conducted in different countries. Reference is made to ducational models of participatory development which, from the viewpoint of excellence, result in increasing educational outcomes and higher rates of satisfaction among the targeted rural populations. Taking as point of departure agents which are considered potential generators of knowledge in rural areas, we examine the process of incorporating the wealth of the rural context. The difficulties that the community group usually faces for its legitimacy as a source of input in rural areas are also shown. Finally, we discuss how the teaching staff can positively contribute to their process of joining the school life.
technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care....The Community Hospital Telehealth Consortium (CHTC) is a unique, forward-thinking, community-based healthcare service project organized around 6 not
Larsson, Laura S.; Butterfield, Patricia; Christopher, Suzanne; Hill, Wade
Qualitative description was used to explore how rural community leaders frame, interpret, and give meaning to environmental health issues affecting their constituents and communities. Six rural community leaders discussed growth, vulnerable families, and the action avoidance strategies they use or see used in lieu of adopting health-promoting behaviors. Findings suggest intervention strategies should be economical, use common sense, be sensitive to regional identity, and use local case studies and “inside leadership.” Occupational health nurses addressing the disparate environmental health risks in rural communities are encouraged to use agenda-neutral, scientifically based risk communication efforts and foster collaborative relationships among nurses, planners, industry, and other community leaders. PMID:16562621
Manuela Dora Orboi
Full Text Available The sustainable development is a process taking place at the same time with the complex and sustainable agricultural development; agriculture and the rural area being interdependent sides specific to rural communities. When analysing economic activity in the rural area we should pay a particular attention to the identification of such alternative activities that have a real chance for development and create new jobs that compensate the diminution of labour occupancy degree in agriculture. Opportunities of rural economy represent a source of having alternative income for the population from rural communities in order to escape from poverty and in order to accelerate the social progress in the rural area. Alternative activities with economic, social and cultural impact, providers of jobs and incomes are: the development of agro tourism and rural tourism, processing and promoting foodstuff, local traditional drinks, ecological foodstuff, handicraft and silviculture. Improving the conditions for business in the rural area is a main condition for the generation of economic activities generating jobs in the rural area.
Full Text Available During the past decades, the tourism sector has become an increasing important issue for governments and regional agencies searching for socio-economic development. Especially in the Global South the increasing tourism demand has been seen highly beneficial as evolving tourism can create direct and indirect income and employment effects to the host regions and previously marginalised communities, with potential to aid with the poverty reduction targets. This research note reviews the existing policy and planning frameworks in relation to tourism and rural development in Namibia. Especially the policy aims towards rural community development are overviewed with focus on Community-Based Tourism (CBT initiatives. The research note involves a retrospective review of tourism policies and rural local development initiatives in Namibia where the Ministry of Environment and Tourism (MET initiated a community-based tourism policy. The policy emphasises structures and processes helping local communities to benefit from the tourism sector, and the active and coordinating involvement of communities, especially, is expected to ensure that the benefits of tourism trickle down to the local level where tourist activities take place. However, it is noted that in addition to public policy-makers also other tourism developers and private business environment in Namibia need to recognize the full potential of rural tourism development in order to meet the created politically driven promises at the policy level. In this respect, a national tourism policy could provide an enabling framework, integrating the tourism sector’s development aims to rural and community development needs in future. In addition, there is a need to coordinate a comprehensive vision of what type of rural tourism development or tourism in rural environments holds the most potential to benefit both local communities and the mainstream sector.
Kulig, Judith C; Edge, Dana; Joyce, Brenda
Community resiliency is a theoretical framework useful for describing the process used by communities to address adversity. A mixed-method 2-year case study was conducted to gather information about community resiliency in 2 rural communities. This article focuses on the themes generated from qualitative interviews with 55 members of these communities. The participants viewed community as a place of interdependence and interaction. The majority saw community resiliency as the ability to address challenges. Characteristics included physical and social infrastructure, population characteristics, conceptual characteristics, and problem-solving processes. Barriers included negative individual attitudes and lack of infrastructure in rural communities. Nurses could play a key role in enhancing the resiliency of rural communities by developing and implementing programs based on the Community Resiliency Model, which was supported in this study.
Kathleen May Kevany
Full Text Available This article offers a retrospective examination of the use of appreciative inquiry (AI in a study on rural wellbeing. It provides a reflection on the rationale for choosing AI as a suitable methodology, critiques the application of AI in rural settings and considers its suitability for this inquiry into individual and community wellbeing. The article also considers the value of AI as a participatory research approach for community-university partnerships. A review of the literature on AI is distilled to examine the limitations as well as the utility of AI. Through an effective use of AI, communities of knowledge can be fostered and the knowledge of communities can be valued and harvested to enhance the wellbeing of rural communities. Keywords: appreciative inquiry, wellbeing, rural community, community-university partnerships
Duncan, Cynthia M.; Lamborghini, Nita
In two rural isolated communities in Appalachia and northern New England, differences in local economic opportunities and social capital have produced different social contexts, which vary in extent of social stratification and stigmatization and isolation of the poor. Interviews with low-income women reveal community differences in opportunities…
Congregations in rural communities and their leadership cannot escape these changes that affect their functioning and existence. The key research question is thus: What is the congregational leadership's opinion and argument about leadership in both the congregation and the community? The research indicated that a ...
unemployment. Congregations in rural communities and their leadership cannot escape these changes that affect their functioning and existence. The key research question is thus: What is the congregational leadership's opinion and argument about leadership in both the congregation and the community? The research.
Background: Community Led Total Sanitation (CLTS) is an innovative community led drive to set up pit latrines in rural Kenya with an aim of promoting sustainable sanitation through behaviour change. It's a behaviour change approach based on social capital that triggers households to build pit latrines without subsidy.
... Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and recommendations to the EPA Administrator on a range of environmental issues and policies that... ENVIRONMENTAL PROTECTION AGENCY [FRL-9763-5] Farm, Ranch, and Rural Communities Committee AGENCY...
... Communities Committee Teleconference AGENCY: Environmental Protection Agency (EPA). ACTION: Notice of Public..., EPA gives notice of a teleconference meeting of the Farm, Ranch, and Rural Communities Committee (FRRCC). The FRRCC is a policy-oriented committee that provides policy advice, information, and...
by the local community in adopting the changing environmental conditions was discussed. Rural communities have local knowledge in areas such as weather and seasonal forecasting (44%), drought forecasting (20.9%), crop pest & disease (47%), and weed (99.7%) control methods to adapt to some of the climate change ...
Abstract. At present there is under utilization of maternity service provision in Nigeria, with only a third of childbearing women electing to deliver in ... exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's perceptions of .... community leader distributed an information sheet.
Hosler, Akiko S.
Context: Disparities in the availability of nutritionally important foods and their influence on health have been studied in US urban communities. Purpose: To assess the availability of selected retail foods and cigarettes, and explore ecologic relationships of the availability with obesity and smoking in rural communities. Methods: Inventories of…
A community engagement process identifies environmental priorities to prevent early childhood obesity: the Children's Healthy Living (CHL) program for remote underserved populations in the US Affiliated Pacific Islands, Hawaii and Alaska.
Fialkowski, Marie Kainoa; DeBaryshe, Barbara; Bersamin, Andrea; Nigg, Claudio; Leon Guerrero, Rachael; Rojas, Gena; Areta, Aufa'i Apulu Ropeti; Vargo, Agnes; Belyeu-Camacho, Tayna; Castro, Rose; Luick, Bret; Novotny, Rachel
Underserved minority populations in the US Affiliated Pacific Islands (USAPI), Hawaii, and Alaska display disproportionate rates of childhood obesity. The region's unique circumstance should be taken into account when designing obesity prevention interventions. The purpose of this paper is to (a), describe the community engagement process (CEP) used by the Children's Healthy Living (CHL) Program for remote underserved minority populations in the USAPI, Hawaii, and Alaska (b) report community-identified priorities for an environmental intervention addressing early childhood (ages 2-8 years) obesity, and (c) share lessons learned in the CEP. Four communities in each of five CHL jurisdictions (Alaska, American Samoa, Commonwealth of the Northern Mariana Islands, Guam, Hawai'i) were selected to participate in the community-randomized matched-pair trial. Over 900 community members including parents, teachers, and community leaders participated in the CEP over a 14 month period. The CEP was used to identify environmental intervention priorities to address six behavioral outcomes: increasing fruit/vegetable consumption, water intake, physical activity and sleep; and decreasing screen time and intake of sugar sweetened beverages. Community members were engaged through Local Advisory Committees, key informant interviews and participatory community meetings. Community-identified priorities centered on policy development; role modeling; enhancing access to healthy food, clean water, and physical activity venues; and healthy living education. Through the CEP, CHL identified culturally appropriate priorities for intervention that were also consistent with the literature on effective obesity prevention practices. Results of the CEP will guide the CHL intervention design and implementation. The CHL CEP may serve as a model for other underserved minority island populations.
Full Text Available A significant number of economic, social and environmental problems have accumulated in all areas of Ukraine and pose a serious obstacle to sustainable development. Those problems are particularly acute in the rural areas. The local rural communities in Ukraine have the lowest indicators of economic development, significant social problems, including particularly acute demographic and employment problems, and an unfavorable ecological situation caused by poor municipal infrastructure, land degradation, etc. The vast majority of the rural communities in Ukraine have no plans for their own territories’ development. In such circumstances, the introduction of landscape planning tools is an effective means of identifying the existing development problems and environmental management issues, as well as of defining the best ways for the integrated development of the local rural communities. A number of reasons prevents introduction of such planning in Ukraine, including the flaws in the legislation, lack of interest among managers of rural communities and low activity of local people on the issues which determine the future of their settlements. However, there are examples of successful implementation of landscape planning tools in designing of the plans of rural communities’ development. The authors were a part of the team which, for the first time in Ukraine, undertook this research in the Stepanetsky rural council in Cherkassy region. The results of the research have been welcomed by the management, the residence and the members of the village council and they are being practically implemented. The foregoing demonstrates the relevance and feasibility of landscape planning tools implementation in Ukraine directed at addressing and resolving the problems of the rural communities.
Full Text Available A significant number of economic, social and environmental problems have accumulated in all areas of Ukraine and pose a serious obstacle to sustainable development. Those problems are particularly acute in the rural areas. The local rural communities in Ukraine have the lowest indicators of economic development, significant social problems, including particularly acute demographic and employment problems, and an unfavorable ecological situation caused by poor municipal infrastructure, land degradation, etc. The vast majority of the rural communities in Ukraine have no plans for their own territories’ development. In such circumstances, the introduction of landscape planning tools is an effective means of identifying the existing development problems and environmental management issues, as well as of defining the best ways for the integrated development of the local rural communities. A number of reasons prevents introduction of such planning in Ukraine, including the flaws in the legislation, lack of interest among managers of rural communities and low activity of local people on the issues which determine the future of their settlements. However, there are examples of successful implementation of landscape planning tools in designing of the plans of rural communities’ development. The authors were a part of the team which, for the first time in Ukraine, undertook this research in the Stepanetsky rural council in Cherkassy region. The results of the research have been welcomed by the management, the residence and the members of the village council and they are being practically implemented. The foregoing demonstrates the relevance and feasibility of landscape planning tools implementation in Ukraine directed at addressing and resolving the problems of the rural communities.
Watermeyer, J; Barratt, J
Locally and internationally, there have been renewed calls for equitable access to healthcare services. Simultaneously, caseloads have become more challenging and contexts more complex, which may be overwhelming to new graduates. The South African context offers a particularly interesting example of these challenges. Educators need to use innovative ways to ensure that curricula adequately prepare students for rural community work, while developing a sense of leadership that links clinical practice to theory, policy, ethics and social responsibility. Rural practica offer opportunities for sensitizing and equipping students for working in underserviced communities and a number of international studies have documented their potential usefulness. There is limited research, however, that examines how exposure to rural community work may shape students' responses to the realities of working in such contexts. This study aimed to explore the processes underlying a group of South African speech-language therapy and audiology students' appreciation and understanding of the realities of work in a rural community after a rural practicum. A four-day practicum took place in a rural community in South Africa. The practicum incorporated basic audiological tasks and structured observations. Twenty-five third-year students completed anonymous pre- and post-practicum open-ended questionnaires. The questionnaires explored their expectations and perceptions of the practicum, perceived challenges and benefits of working in rural community areas, and considerations that might need to be taken into account. The questionnaires were analysed and compared using thematic analysis principles. Results revealed a distinction between students' emotional and personal expectations of, and responses to, the practicum compared to their clinical expectations and responses. Before the practicum, students indicated a number of anxieties such as not feeling emotionally prepared or feeling anxious about
Eller, Ronald; Martinez, Ruben; Pace, Cynthia; Pavel, Michael; Barnett, Lynn
This Project Brief focuses on the Ford Foundation's Rural Community College Initiative (RCCI), which aims to help selected community colleges in distressed communities expand their capacity to increase access to postsecondary education and to foster regional economic development. RCCI is geared to specific geographic regions where communities face…
Roberto, Karen A; Brossoie, Nancy; McPherson, Marya C; Pulsifer, Mary Beth; Brown, Patricia N
To identify opportunities and challenges in promoting community support for rural older women experiencing intimate partner violence (IPV). Using community-based participatory research principles, we engaged in an academic-community partnership to analyse the research literature, estimate IPV incidence and prevalence, ascertain professional and older IPV victim perspectives through focus groups and interviews, and develop a collaborative community response plan. This study took place from 2008 to 2010 in the USA. IPV in late life is underreported by victims and often unrecognised by the academic and service community. Professionals, while agreeable to collaborating to support older IPV victims, sought coordination and leadership from domestic violence agencies. Older victims stressed the need for improved professional sensitivity to their unique needs and more service options. The insights generated during this project produced a framework on which rural communities can build to address the hidden and growing problem of late life IPV. © 2013 The Authors. Australasian Journal on Ageing © 2013 ACOTA.
Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K
Given the uncertain cost of delivering community-based cancer screening programs, we developed a Markov simulation model to project the budget impact of implementing a comprehensive colorectal cancer (CRC) prevention program compared with the status quo. The study modeled the impacts on the costs of clinical services, materials, and staff expenditures for recruitment, education, fecal immunochemical testing (FIT), colonoscopy, follow-up, navigation, and initial treatment. We used data from the Against Colorectal Cancer In Our Neighborhoods comprehensive CRC prevention program implemented in El Paso, Texas, since 2012. We projected the 3-year financial consequences of the presence and absence of the CRC prevention program for a hypothetical population cohort of 10,000 Hispanic medically underserved individuals. The intervention cohort experienced a 23.4% higher test completion rate for CRC prevention, 8 additional CRC diagnoses, and 84 adenomas. The incremental 3-year cost was $1.74 million compared with the status quo. The program cost per person was $261 compared with $86 for the status quo. The costs were sensitive to the proportion of high-risk participants and the frequency of colonoscopy screening and diagnostic procedures. The budget impact mainly derived from colonoscopy-related costs incurred for the high-risk group. The effectiveness of FIT to detect CRC was critically dependent on follow-up after positive FIT. Community cancer prevention programs need reliable estimates of the cost of CRC screening promotion and the added budget impact of screening with colonoscopy. Copyright © 2017 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.
Rudenko, Leonid; Maruniak, Eugenia; Lisovskiy, Sergiy
A significant number of economic, social and environmental problems have accumulated in all areas of Ukraine and pose a serious obstacle to sustainable development. Those problems are particularly acute in the rural areas. The local rural communities in Ukraine have the lowest indicators of economic development, significant social problems, including particularly acute demographic and employment problems, and an unfavorable ecological situation caused by poor municipal infrastructure, land de...
Full Text Available Australian rural communities are experiencing some of the worst climactic and economic conditions in decades. Unfortunately, the multiple government and non-government agency responses have reportedly been uncoordinated, sometimes losing sight of their consumers. This article describes a program designed to strengthen and empower resilience in small rural communities and summarises the outcomes, including needs and action planning undertaken. The 97 participants were from eight outer regional or remote towns and communities in the northern Riverina region of New South Wales, Australia. As groups representing their communities, they attended meetings and responded to a series of questions regarding issues arising from the drought, community needs, and actions their community could take to address these issues and needs. The study findings highlight the stress and strain of the climatic conditions and the insecurity of rural incomes, as well as problems with the high cost of transport. The communities recognised a degree of social disintegration but also expressed considerable hope that, by working together and better utilising social agencies, they could develop a social connectedness that would make their communities more resilient. Approaches that empower and facilitate community resilience are suggested as an effective model that governments and non-government agencies can use to encourage social groups that are struggling to build resilience.
The Country Women's Association (CWA) is a nationwide Australian group that started in the 1920s in response to isolated women's need to socialize. The group's activities have expanded greatly over time. It distributes essential food and clothing to needy rural families, and its extensive involvement in incidental education for women includes…
Parker, Lucy Anne; Jobanputra, Kiran; Rusike, Lorraine; Mazibuko, Sikhathele; Okello, Velephi; Kerschberger, Bernhard; Jouquet, Guillaume; Cyr, Joanne; Teck, Roger
To evaluate the feasibility (population reached, costs) and effectiveness (positivity rates, linkage to care) of two strategies of community-based HIV testing and counselling (HTC) in rural Swaziland. Strategies used were mobile HTC (MHTC) and home-based HTC (HBHTC). Information on age, sex, previous testing and HIV results was obtained from routine HTC records. A consecutive series of individuals testing HIV-positive were followed up for 6 months from the test date to assess linkage to care. A total of 9 060 people were tested: 2 034 through MHTC and 7 026 through HBHTC. A higher proportion of children and adolescents (<20 years) were tested through HBHTC than MHTC (57% vs. 17%; P < 0.001). MHTC reached a higher proportion of adult men than HBHTC (42% vs. 39%; P = 0.015). Of 398 HIV-positive individuals, only 135 (34%) were enrolled in HIV care within 6 months. Of 42 individuals eligible for antiretroviral therapy, 22 (52%) started treatment within 6 months. Linkage to care was lowest among people who had tested previously and those aged 20-40 years. HBHTC was 50% cheaper (US$11 per person tested; $797 per individual enrolled in HIV care) than MHTC ($24 and $1698, respectively). In this high HIV prevalence setting, a community-based testing programme achieved high uptake of testing and appears to be an effective and affordable way to encourage large numbers of people to learn their HIV status (particularly underserved populations such as men and young people). However, for community HTC to impact mortality and incidence, strategies need to be implemented to ensure people testing HIV-positive in the community are linked to HIV care. © 2015 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.
... and to gain recognition in the community (ego satisfaction). Age, income, level of formal education significantly influenced respondents\\' participation in community development projects. Keywords: popular participation, community development project. Journal of Agriculture and Social Research Vol. 7 (1) 2007: pp. 70-76.
Wright, Kynna; Norris, Keith; Newman Giger, Joyce; Suro, Zulma
University–community partnerships through coordinated school health programs (CSHP) can play a key role in decreasing child obesity. The main objective of this study was to measure over a 1-year period whether a CSHP with parental, school, and home-based components to promote optimal nutrition will reduce BMI percentiles and z-scores and improve dietary behaviors in a sample of low-income, school-aged children. The intervention included, Kids Nutrition and Fitness, a 6-week nutrition, physical activity educational after-school program, and school activities, including creation of an Advisory Committee that made wellness policies. A randomized controlled pilot study evaluated the effectiveness of the intervention that contrasts 251 (n = 251) predominantly Mexican-American 8 to 12 year olds from low-income Los Angeles–based schools. A mixed model of repeated measures analysis assessed changes in BMI percentiles and z-scores, dietary behaviors, food preferences, knowledge, and self-efficacy measured by a reliable/valid questionnaire. These data were collected at baseline and at 4 and 12 months postintervention. Process measures, collected via focus groups with parents, evaluated parent/community involvement. At the 12-month follow-up, children in the intervention group decreased their BMI on average by 2.80 (p = 0.04) and BMI z-scores on average by 0.48 (p = 0.03) and they increased their daily dietary intake of vegetables on average by 1.51 (p = 0.03), fruit on average by 2.00 (P = 0.001), and 100% fruit juice by 1.12 (p = 0.05). An increase of 1.02 (p = 0.03) was seen in self-efficacy of healthy food choices (p = 0.03). Parent (P = 0.04) and community (p = 0.001) involvement significantly increased to 100% participation by the 12-month follow-up. A CSHP using parent and community involvement was effective in reducing the risk of obesity in school-aged Mexican- American children attending low-income schools. The findings need to be examined in a larger, more
Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim
The mental health of people in rural communities is influenced by the robustness of the mental health ecosystem within each community. Theoretical approaches such as social ecology and social capital are useful when applied to the practical context of promoting environmental conditions which maximise mental health helping capital to enhance resilience and reduce vulnerably as a buffer for mental illness. This paper explores the ecological conditions that affect the mental health and illness of people in rural communities. It proposes a new mental health social ecology framework that makes full use of the locally available unique social capital that is sufficiently flexible to facilitate mental health helping capital best suited to mental health service delivery for rural people in an Australian context.
K.N. IGWE; Elizabeth O. NDUBUISI-OKOH; Odionyenfe Osim AKUMA; Chukwu OKOCHE
The focus of this paper is on information infrastructures that are required for information delivery and development of rural communities in Nigeria. It x-rayed the concepts of information infrastructure, and its types for information delivery in rural areas, which are community information centres, rural school media centres, rural information and communication technology centres as well as community radio stations. The paper concluded that the absence of these rural information infrastructu...
... Applications for the Rural Community Development Initiative (RCDI) for Fiscal Year 2013 AGENCY: Rural Housing... for the Rural Community Development Initiative (RCDI) program. This action is taken to correct the Rural Development State Office contact information. Correction In the Federal Register of August 14...
de Lange, Naydene; Mitchell, Claudia
This article advances the idea that rural youth and teachers are the key in leading community dialogue towards addressing gender-based violence (GBV) in their community through their film making. The youth voices on the realities of GBV in their school and community, in rural KwaZulu-Natal, South Africa, captured through the process of…
Manoel Adir Kischener
Full Text Available The new pattern of modernization of agriculture and rural, in force in most rural areas of Brazil, is also present in the Southwest of Paraná. Thus, considering the marks left by this process, this research tried to see what were the factors that interfere in generational succession and began to influence the family farm's social reproduction strategy. For that, from a qualitative approach, this study sought to compare two rural communities by establishing 25 interviews each and two focus group sessions. The results of this study, it was noticed that the factors that favor the permanence of young people in rural areas were mainly: income, living in society and the inclusion of life projects of the children in the family's social reproduction strategies.
Janevic, Mary R; Baptist, Alan P; Bryant-Stephens, Tyra; Lara, Marielena; Persky, Victoria; Ramos-Valencia, Gilberto; Uyeda, Kimberly; Hazan, Rebecca; Garrity, Ashley; Malveaux, Floyd J
Disparities by race and socioeconomic status persist in pediatric asthma morbidity, mortality, and treatment. Improving parent/provider communication and parents' asthma-management confidence may result in better asthma control in vulnerable populations. The Merck Childhood Asthma Network, Inc. funded an initiative to implement medical-social care coordination to improve asthma outcomes at sites in four low-income, urban communities (Los Angeles, CA; Philadelphia, PA; Chicago, IL; and San Juan, PR.) As part of a cross-site evaluation of this effort, pre- post-program changes in parents' reports of asthma care and management were assessed. Across sites, 805 parents or other caregivers responded to a baseline survey that was repeated one year later following their child's participation in care coordination. Parents' asthma-management confidence, as well as their perceptions of provider access, trust, and communication, were measured with Likert scales. Linear mixed models were used to assess improvement in these variables, across and within sites, adjusting for sociodemographics. Pooled across sites, the adjusted mean estimate for all outcomes showed a significant improvement (p asthma care coordination, as implemented variously in diverse settings, was associated with improvement in parents' perceptions of asthma care and self-reported asthma-management knowledge and confidence. This positive impact on parents may help sustain care coordination's impact on children.
Full Text Available Many tourism projects run by community in the rural areas are labelled as Community-based Rural Tourism (CBRT, a type of a more ‘responsible’ tourism that contributes to sustainable development. However, a framework is needed to enable planners and managers to understand its criteria thus ensuring that the CBRTs fulfil the sustainability requirement. This paper presents findings from a literature review on previous writings in this topic. Findings from an analysis on the criteria of a sustainable CBRT product are discussed. It is found that in order for it to play a role in sustainable development, a CBRT product must focus on competitive management, resource conservation, and benefit creation to the community. The three elements need to be supported, in turn, by community involvement and commitment. As the proposed conceptual framework of sustainable CBRT product can be a basis for further research in CBRT, it offers producing theoretical and practical implications.
Full Text Available Abstract Background Diabetes is an important contributor to the burden of disease in South Africa and prevalence rates as high as 33% have been recorded in Cape Town. Previous studies show that quality of care and health outcomes are poor. The development of an effective education programme should impact on self-care, lifestyle change and adherence to medication; and lead to better control of diabetes, fewer complications and better quality of life. Methods Trial design: Pragmatic cluster randomized controlled trial Participants: Type 2 diabetic patients attending 45 public sector community health centres in Cape Town Interventions: The intervention group will receive 4 sessions of group diabetes education delivered by a health promotion officer in a guiding style. The control group will receive usual care which consists of ad hoc advice during consultations and occasional educational talks in the waiting room. Objective: To evaluate the effectiveness of the group diabetes education programme Outcomes: Primary outcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. Secondary outcomes: self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of life Randomisation: Computer generated random numbers Blinding: Patients, health promoters and research assistants could not be blinded to the health centre’s allocation Numbers randomized: Seventeen health centres (34 in total will be randomly assigned to either control or intervention groups. A sample size of 1360 patients in 34 clusters of 40 patients will give a power of 80% to detect the primary outcomes with 5% precision. Altogether 720 patients were recruited in the intervention arm and 850 in the control arm giving a total of 1570. Discussion The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can
Sokrab, M; Sokrab, A; Elzubeir, M
The aim of this study was to investigate the quality of life (QOL) in people with epilepsy (PWE) living in Khartoum State, Northern Sudan. The region offers a model of urban and suburban communities in developing countries. A cross-sectional study was carried out in the neurology clinic of Khartoum State Hospital and Omer Ibn Alkhatab Health Center in the suburb of Khartoum State. We interviewed PWE living in the city, the suburbs and adjacent villages. Our subjects were known to have been on antiepileptic drugs (AED) for at least 6 months. The impact of epilepsy on the QOL was assessed in the clinic using a 23-item questionnaire with graded scales and check-lists to explored demographic characteristics, seizure control, adverse effects of antiepileptic medication, physical harm, social and psychological impact and stigmatization. Fifty-two females and 48 males between the ages of 10 and 80 years were interviewed. Sixty percent of participants were between 20 and 39 years of age. While on AED treatment, 63% developed at least one seizure at any given time, 49% in the past 6 months and 27% in the past week. Twenty six percent experienced one or more side effect of AEDs. A significant number of respondents admitted that epilepsy had a negative impact on several aspects of their daily life activities, education and social functioning. Of individuals eligible for work, 17% were unemployed or had their job terminated because of epilepsy. Relationships with spouses were affected in 20 % of cases. Fifteen percent felt stigmatized by their illness. None of the participants had received any formal health education or counseling about epilepsy. Epilepsy has a significant impact on several aspects of QOL, particularly physical injury and socioeconomic functioning affecting PWE living in Khartoum State. Poor seizure control, a risk factor for impaired QOL, was common. The overall perceptions of QOL and self satisfaction as stated by our PWE was more favorable when compared to
Fuelwood scarcity is evident in south western Uganda, where households are using sorghum and maize stalks for cooking as alternatives to the traditional fuelwood. The aim of the study was to assess the implications of fuelwood scarcity on livelihoods of rural communities in Nyarubuye sub-county in Kisoro district in south ...
Adaptation to Climate Change in two Rural Communities on the Plains and in the Mountains of Morocco ... Five world-class research teams are working to develop vaccines for neglected livestock diseases in the Global South ... IDRC partner the World Economic Forum is building a hub for inclusive growth solutions.
Oct 2, 2012 ... 9, No. 2, October, 2012. Kwadwo Adusei-Asante and Peter Hancock. When Empowerment Disempowers: A case study of Ghana's Community-Based Rural Development Projects. Nussbaum, M. (2000). Women and Human Development: The Capabilities Approach. Cambridge: Cambridge University Press.
Much of the research on the social sustainability of renewable technologies has focused on local acceptance issues, community benefits from exogenous developments, and matters related to the planning and development process. Grassroots-initiated wind energy schemes as a form of rural enterprise have
The study investigated awareness and usage of the Baobab plant in rural communities in Kwara State, Nigeria. It examined the determinants of the plant's usage as well as constraints to its usage in the State. A three stage random sampling procedure produced the 200 respondents from which primary data used for the ...
2nd ed. San. Francisco: Jossey-Bass Publishers; 1997. p. 41-. 59. 20. Antai D. Rural-urban inequities in childhood immunization in Nigeria: The role of community contexts. Afr J Prim Health Care &. Fam Med 2011;3:238-246. 6 Johns Hopkins Bloomberg School of Public. Health International Vaccine Access Center. (IVAC).
Winschiers-Theophilus, Heike; Zaman, Tariq; Jensen, Kasper Løvborg
In this paper we explore the opportunities of mobile technologies in three of our own development endeavors with rural communities, promoting the preservation of indigenous knowledge. We reflect upon and recognize the fact that the representation of indigenous knowledge will be transformed within...
The prevalence of urinary schistosomiasis in Ikpeshi, a rural community of Edo State, Nigeria showed that 195(65%) out of 300 volunteers harboured Schistosoma haematobium ova in their urine. Eosinophiluria was markedly significant > 5 eosinophilic leucocyturia/hpf and reported among 250 (83.3%) inhabitants. Of these ...
Rodney R. Zwick; David Solan
Community attachment has been related to "sense of place," and by extension to factors such as the natural resource base of a local geographic area and the utilitarian uses of those resources-a functional attachment that helps root people to a place. The purpose of this study was to examine the resource harvest activities of residents of three modern rural...
Active Learner: A Foxfire Journal for Teachers, 1998
The experiences of two teachers describe how BreadNet, an online professional-development and educational conference, enables teachers with similar interests to work together and maintain a sense of community. BreadNet allowed their rural schools to participate in projects with distant schools, leading to improvements in the quantity and quality…
rural community of Rivers state. Blood pressure, BMI, random blood sugar and urine testing were done in accordance with standard protocols. JNC-7 guidelines were adopted for the determination and grading of hypertension. Results: They were 60 males and 92 females (M/F =1:1.5) with a mean age of 48.9 + 14.8years.
Prevalence of smoking among youth in a rural Nigerian community. K O Osungbade, F O Oshiname. Abstract. No Abstract. Tropical Journal of Health Sciences Vol. 15 (1) 2008: pp. 44-48. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.
Scott, Shanda; Miller, Michael T.; Morris, Adam A.
Rural community college students face unique difficulties in higher education for many reasons, including the resources they typically have access to, their collective histories, and in many cases, the preparation they received in high school. These challenges might be low-performing secondary schools, a lack of tradition and precedence in…
Human Immunodeficiency Virus Infection in a rural community of Plateau State: effective control measures still a nightmare? GTA Jombo, DZ Egah, EB Banwat. Abstract. No Abstract. Nigerian Journal of Medicine Vol. 15(1) 2006: 49-52. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...
Objective: to assess the magnitude of Community Led total sanitation (CLts) triggering to certification of Open Defecation free (ODF) villages in rural Kenya. Design: A retrospective descriptive study. Setting: the 47 .... Eldoret, Kenya and the Ethics Review Board of. Médecins sans Frontières, Geneva, Switzerland, on.
To date, studies have sought cause and effect and have neglected the opinion of the people about what they perceive to be problematic and what they believe constitutes satisfactory maternity service provision. An exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's ...
McGranahan, David A.
Whatever migration patterns evolve, changes in the age structure mean that rural communities in general can expect fairly stable elementary school population, reduced high school population, slower growth in new business and employment, and continued increase in the elderly population. (JHZ)
Rural communities have local knowledge in areas such as weather and seasonal forecasting (44%), drought forecasting (20.9%), crop pest & disease (47%), and weed (99.7%) control methods to adapt to some of the climate change impacts. Not all households have the same levels and types of indigenous knowledge.
An epidemiological study was conducted to determine the prevalence and risk factors to tungiasis amongst 1,030 randomly selected individuals in rural communities of Badagry Local Government Area of Lagos State, Nigeria. Hands, feet, elbows and other parts of the body were examined for the presence of clinical signs of ...
Context: Identifying ways to meet the health care needs of older adults is important because their numbers are increasing and they often have more health care issues. High resilience level may be one factor that helps older adults adjust to the hardships associated with aging. Rural community-dwelling older adults often face unique challenges such…
This project aims to strengthen the capacity of communities in the Mantaro Valley to cope with extreme climate events such as drought, frost and floods. It will do so by rigorously documenting their occurrence; their impact on agriculture, rural livelihoods and water availability; and the traditional measures taken by farmers to ...
Sørensen, Jens Fyhn Lykke
Context: Rural communities tend to be underserved by medical services. Low access to medical services affects quality of life and may also affect settlement decisions. The use of telehealth has often been mentioned as an alternative way to provide health care services in remote, underserved areas...... rural area. Method: A representative sample from the island of Ærø (n=1000) was selected and attitudes toward two telehealth applications were examined by structured telephone interviews regarding: 1) video consultation between patient and specialist, and 2) transfer of work tasks from local hospital...... was higher among older people and people with no education beyond primary school. Conclusions: As the rural population in Denmark, as well as in other countries, tends to be older and less educated than the national average, the introduction of telehealth services faces special challenges in rural areas....
Information and Communication Technology services for socio-economic development of low-literacy users in rural communities in developing regions are new research contributions that seek to alleviate poverty in underserved communities. The intended users are still new to these technologies and can be described as ...
Li, Y.-H.; Liao, W.-T.; Tung, C.-P.
The purpose of this study is to develop several water resources simulation models for residence houses, constructed wetlands and farms and then integrate these models for a rural community. Domestic and irrigation water uses are the major water demand in rural community. To build up a model estimating domestic water demand for residence houses, the average water use per person per day should be accounted first, including water uses of kitchen, bathroom, toilet and laundry. On the other hand, rice is the major crop in the study region, and its productive efficiency sometimes depends on the quantity of irrigation water. The water demand can be estimated by crop water use, field leakage and water distribution loss. Irrigation water comes from rainfall, water supply system and reclaimed water which treated by constructed wetland. In recent years, constructed wetlands play an important role in water resources recycle. They can purify domestic wastewater for water recycling and reuse. After treating from constructed wetlands, the reclaimed water can be reused in washing toilets, watering gardens and irrigating farms. Constructed wetland is one of highly economic benefits for treating wastewater through imitating the processing mechanism of natural wetlands. In general, the treatment efficiency of constructed wetlands is determined by evapotranspiration, inflow, and water temperature. This study uses system dynamics modeling to develop models for different water resource components in a rural community. Furthermore, these models are integrated into a whole system. The model not only is utilized to simulate how water moves through different components, including residence houses, constructed wetlands and farms, but also evaluates the efficiency of water use. By analyzing the flow of water, the water resource simulation model can optimizes water resource distribution under different scenarios, and the result can provide suggestions for designing water resource system of a
Bell, Erica J
If climate change is the 21st Century's biggest public health threat, research faces the major challenge of providing adequate evidence for vulnerable communities to adapt to the health effects of climate change. Available information about best practice in climate adaptation suggests it is inclusive of socio-economic disadvantage and local community factors such as access to health services. Since 1995, at least 19 164 papers have been published on climate change in the health sciences and social sciences. This body of literature has not yet been systematically examined for how well it serves rural communities. The ultimate aim of the study was to contribute to better understandings about what climate adaptation research has been done and is needed for rural communities. The two research questions were: 'What kinds of content define climate change research in disciplines that could potentially contribute to adaptation for health?' and 'How is content about rural and Aboriginal communities and best practice in adaptation related to this content?' A quantitative content analysis was performed using 'computational linguistics' Leximancer software. The analysis included 19 164 health and social sciences abstracts, batched by years, from 1 January 1995 to 31 July 2012. The relative frequency and co-occurrence of 52 concepts in these abstracts were mapped, as well as associations with positive or negative sentiment for selected concepts. Aboriginal' concepts tend to be relatively infrequent (3% and 5% overall likelihood of occurrence, respectively) and are more associated with socio-economic concepts in the social sciences than the health sciences. Multiple concepts in the health sciences literature are typically connected with 'disease' and ultimately 'science' storylines, with a 38% likelihood of paired co-occurrence of 'health' and 'disease' concepts alone. The social sciences appear more focused on the local and particular issues of community in climate change than
Seguin, Rebecca A; Lo, Brian K; Sriram, Urshila; Connor, Leah M; Totta, Alison
Rural populations face unique challenges to physical activity that are largely driven by environmental conditions. However, research on rural built environments and physical activity is limited by a paucity of rural-specific environmental assessment tools. The aim of this paper is to describe the development and testing of a rural assessment tool: Inventories for Community Health Assessment in Rural Towns (iCHART). The iCHART tool was developed in 2013 through a multistep process consisting of an extensive literature search to identify existing tools, an expert panel review, and pilot testing in five rural US communities. Tool items represent rural built environment features that influence active living and physical activity: community design, transportation infrastructure, safety, aesthetics, and recreational facilities. To assess reliability, field testing was performed in 26 rural communities across five states between July and November of 2014. Reliability between the research team and community testers was high among all testing communities (average percent agreement = 77%). Agreement was also high for intra-rater reliability (average kappa = 0.72) and inter-rater reliability (average percent agreement = 84%) among community testers. Findings suggest that the iCHART tool provides a reliable assessment of rural built environment features and can be used to inform the development of contextually-appropriate physical activity opportunities in rural communities.
Rebecca A. Seguin
Full Text Available Rural populations face unique challenges to physical activity that are largely driven by environmental conditions. However, research on rural built environments and physical activity is limited by a paucity of rural-specific environmental assessment tools. The aim of this paper is to describe the development and testing of a rural assessment tool: Inventories for Community Health Assessment in Rural Towns (iCHART. The iCHART tool was developed in 2013 through a multistep process consisting of an extensive literature search to identify existing tools, an expert panel review, and pilot testing in five rural US communities. Tool items represent rural built environment features that influence active living and physical activity: community design, transportation infrastructure, safety, aesthetics, and recreational facilities. To assess reliability, field testing was performed in 26 rural communities across five states between July and November of 2014. Reliability between the research team and community testers was high among all testing communities (average percent agreement = 77%. Agreement was also high for intra-rater reliability (average kappa = 0.72 and inter-rater reliability (average percent agreement = 84% among community testers. Findings suggest that the iCHART tool provides a reliable assessment of rural built environment features and can be used to inform the development of contextually-appropriate physical activity opportunities in rural communities.
This paper adopted the political systems theory. According to Laszlo and Krippner (1998) systems theories include contributions from such seminal thinkers as Alfred North Whitehead, Ludwig von Bertalanffy,. Anatol Rapoport, Kenneth ... people, district level government officials and the general community. All the people ...
It will place the migration phenomenon in the context of cyclical household processes, community social capital, broad agrarian change, and government and donor policies. The research will explore how different forms of population mobility affect the management of agricultural land and other resources, where these are ...
Full Text Available The absence of comprehensive plans has resulted in disordered rural development and construction and a mix of new and old buildings in rural communities. Disorganized and blighted spaces have become rural landscape obstacles. After the Rural Rejuvenation Act was passed, rural construction has been guided with plans, and the government expects to enhance surroundings and expand policies through autonomous community development to create a good rural landscape. Through a literature review, this study aims to establish key success factors in autonomous landscape development of rural communities, covering 8 criteria and 28 sub-criteria. A questionnaire survey was conducted among national rural communities, experts, and scholars. The analytic hierarchy process reveals that manpower input has the highest importance, thereby indicating that the improvement of autonomous community development would double with the guidance of community cadres and the participation of artists and experts.
Crampton, Paul E S; McLachlan, John C; Illing, Jan C
The delivery of undergraduate clinical education in underserved areas is increasing in various contexts across the world in response to local workforce needs. A collective understanding of the impact of these placements is lacking. Previous reviews have often taken a positivist approach by only looking at outcome measures. This review addresses the question: What are the strengths and weaknesses for medical students and supervisors of community placements in underserved areas? A systematic literature review was carried out by database searching, citation searching, pearl growing, reference list checking and use of own literature. The databases included MEDLINE, EMBASE, PsycINFO, Web of Science and ERIC. The search terms used were combinations and variations of four key concepts exploring general practitioner (GP) primary care, medical students, placements and location characteristics. The papers were analysed using a textual narrative synthesis. The initial search identified 4923 results. After the removal of duplicates and the screening of titles and abstracts, 185 met the inclusion criteria. These full articles were obtained and assessed for their relevance to the research question; 54 were then included in the final review. Four main categories were identified: student performance, student perceptions, career pathways and supervisor experiences. This review reflects the emergent qualitative data as well as the quantitative data used to assess initiatives. Underserved area placements have produced many beneficial implications for students, supervisors and the community. There is a growing amount of evidence regarding rural, underserved areas, but little in relation to inner city, deprived areas, and none in the UK. © John Wiley & Sons Ltd 2013.
Baquet, Claudia R; Bromwell, Jeanne L; Hall, Margruetta B; Frego, Jacob F
A rural community-academic partnership was developed in 1997 between the Eastern Shore Area Health Education Center (ESAHEC) and the University of Maryland School of Medicine's (UMSOM) Office of Policy and Planning (OPP). The model supports partnered research, bidirectional interactions, and community and health professional education. The primary aim was to develop a sustainable community-academic partnership that addressed health and social issues on the rural Eastern Shore. Mutual respect and trust led to sustained, bidirectional interactions and communication. Community and academic partner empowerment were supported by shared grant funds. Continual refinement of the partnership and programs occurred in response to community input and qualitative and quantitative research. The partnership led to community empowerment, increased willingness to participate in clinical trials and biospecimen donation, leveraged grant funds, partnered research, and policies to support health and social interventions. This partnership model has significant benefits and demonstrates its relevance for addressing complex rural health issues. Innovative aspects of the model include shared university grants, community inclusion on research protocols, bidirectional research planning and research ethics training of partners and communities. The model is replicable in other rural areas of the United States.
Resilience, and specifically the resilience of (rural) communities, is an increasingly-ubiquitous concept, particularly in the contexts of resistance to shocks, climate change, and environmental disasters. The dominant discourse concerning (community) resilience centres around bounce-back from external shocks. In this paper, I argue that it is…
Perry, Cynthia K; Ko, Linda K; Hernandez, Lidia; Ortiz, Rosa; Linde, Sandra
Ciclovias involve the temporary closure of roads to motorized vehicles, allowing for use by bicyclists, walkers, and runners and for other physical activity. Ciclovias have been held in urban and suburban communities in the United States and Latin America. We evaluated the first ciclovia held in a rural, predominantly Latino community in Washington State. Three blocks within a downtown area in a rural community were closed for 5 hours on a Saturday in July 2015. The evaluation included observation counts and participant intercept surveys. On average, 200 participants were present each hour. Fourteen percent of youth (younger than 18 years) were observed riding bikes. No adults were observed riding bikes. A total of 38 surveys were completed. Respondents reported spending on average 2 hours at the ciclovia. Seventy-nine percent reported that they would have been indoors at home involved in sedentary activities (such as watching TV, working on computer) if they had not been at the ciclovia. Regularly held ciclovias, which are free and open to anyone, could play an important role in creating safe, accessible, and affordable places for physical activity in rural areas. Broad community input is important for the success of a ciclovia.
Rizvi, S.F.U.; Mustafa, G.; Khan, M.A.; Kundi, A.
Prevalence of congenital heart disease (CHD) is well established in most of the developed countries, where childbirth is obligatory in hospital and allied facilities. In rural Pakistan the situation is reverse, where most of deliveries take place in homes by traditional birth attendants' therefor true prevalence of CHD in our population is unknown. in rural Pakistan almost 80% children are born at home hence the figures are unknown. This study was designed, to determine the prevalence of congenital heart disease in rural Pakistan. Methods: During a cross-sectional survey of rural population belonging to major ethnic groups living in three provinces of Pakistan to determine the prevalence of rheumatic heart disease (RHD), CHD rates were calculated as a sub study. Nine thousand four hundred and seventy-six (9476) subjects of all ages were screened using cluster sampling technique. Socio-demographic variables were recorded. Auscultation and short physical examination performed for initial screening and final diagnosis was confirmed on M-mode/2D/Doppler. Results: Thirty two patients had RHD, 25 Patients identified with CHD and another 7 patients had mixed CHD and RHD. Overall prevalence for CHD was 3.4/1000. The commonest lesion was Atrial Septal Defect (ASD) 40%, Ventricular Septal Defect (VSD) 35%, Aortic Stenosis (AS) 10%, Atrio Ventricular Septal Defect (AVSD) 5%. Conclusion: This is the first study to report CHD prevalence from multiethnic representative sample from rural communities of Pakistan. Apparently CHD rate seems less compared with facility based data because records of still stillbirths are not available and autopsies are not performed as routine. Very high infant mortality from rural areas of Pakistan also favours high prevalence for CHD; however these figures represent an overall picture of CHD in a community where medical facilities are lacking. (author)
Full Text Available Contemporary rural museums perform not only the traditional tasks but are also the places where both the visitors and the local community members have chances for entertainment and attractive leisure time. Consequently one can find in museums numerous catering offers such as cafes, bistros, snack bars, restaurants, pubs and wine bars. The material presented is the result of theoretical and field studies carried out in the selected open air museums in Poland and focused on newly introduced commercial activities (as catering. Our research results show that the development of sustainable cultural tourism as a generator of income in the open air rural museums is important in the challenging economic time. Museums having catering services of different character could easier overcome financial struggle. Moreover there is no doubt that the introduction of an interesting and ambitious cuisine in the restaurants located in the rural open air museum is of great importance also in other terms: popularization of the food culture, rural tradition of region, healthy diet and lifestyle, chance to increase the museum attractiveness, important economic support to the museum and the local community and the improvement of living quality.
Blenkinsopp, T.; Coles, S.R; Kirwan, K.
The desire for universal access to modern energy and the use of renewable energy technologies (RETs) as a means of delivering low carbon solutions are driven by several local and global factors, including climate change, population increase and future energy security. Social attitudes are a major challenge to overcome in order to successfully introduce low carbon technologies as a sustainable alternative to more traditional means of energy provision. It becomes a challenge to educate the target population in order to counteract any negative preconceptions or scepticisms in using these technologies which can have adverse effect upon their viability and long term success. This work presents the results of a rural energy survey conducted in the Indian state of Maharashtra. The survey highlights the opportunities and attitudes of these rural communities towards sustainable modern energy services and the technologies used to deliver them. Results from the survey show that there is interest in using sustainable or renewable technologies for energy provision and suggest that cost, reliability and ease of use are more important factors than the environmental benefits. A suggestion for a way to improve RET adoption in rural communities is also presented based on the results of this study. - Highlights: • Survey used to assess energy usage and perception of RETs in rural communities. • Despite lack of preference towards one RET the majority believe in their expanded use. • Cost, reliability and ease of use most influential factors when selecting a fuel. • Assessment of community needs can aid RET adoption by improving long term viability
Palmer, Ryan Tyler
There is a severe shortage of rural physicians in America. One reason physicians choose not to practice, or persist in practice, in rural areas is due to a lack of professional community, i.e., community of practice (CoP). Online, "virtual" CoPs, enabled by now common Internet communication technology can help give rural physicians the…
Alleman, Nathan F.; Holly, L. Neal
In the past decade, rural education has been critiqued for contributing to brain drain and social stratification that saps the human, social, and economic resources of rural communities. This article, based on an investigation of six small rural school districts in the same state, offers an alternative view of the role of community groups and…
Common eye diseases in children of rural community in Goro district, Central Ethiopia. Mohammed Shaffi, Abebe Bejiga. Abstract. Background: Very few reports exist regarding the causes of ocular morbidity in children of rural community in. Ethiopia. Objective: To identify the causes of ocular morbidity in children of rural ...
Edwards, Katie M; Mattingly, Marybeth J; Dixon, Kristiana J; Banyard, Victoria L
Drawing on social disorganization theory, the current study examined the extent to which community-level poverty rates and collective efficacy influenced individual reports of intimate partner violence (IPV) perpetration, victimization, and bystander intervention among a sample of 178 young adults (18-24; 67.4% women) from 16 rural counties across the eastern US who completed an online survey that assessed demographic information, IPV perpetration, victimization, bystander intervention, and collective efficacy. We computed each county's poverty rate from the 2007-2011 American Community Survey. Generalized estimating equations demonstrated that after controlling for individual-level income status, community-level poverty positively predicted IPV victimization and perpetration for both men and women. Collective efficacy was inversely related to IPV victimization and perpetration for men; however, collective efficacy was unrelated to IPV victimization and perpetration for women. Whereas IPV bystander intervention was positively related to collective efficacy and inversely related to individual-level income status for both men and women, community-level poverty was unrelated to IPV bystander intervention for both men and women. Overall, these findings provide some support for social disorganization theory in explaining IPV among rural young adults, and underscore the importance of multi-level IPV prevention and intervention efforts focused around community-capacity building and enhancement of collective efficacy.
Shannon, C Ken; Price, Shelia S; Jackson, Jodie
Community-based clinical rotations in rural areas expose dental students to diverse patient populations, practice models, and career opportunities as well as rural culture. The aims of this study at West Virginia University were to determine the best predictors of rural practice, assess the predictive validity of students' intention to practice in a rural area before and after their rural rotations, and evaluate the relationship between students' intention to practice in a rural area and intention to provide care for indigent patients. Online survey data were submitted pre- and post-rural clinical rotation by 432 of 489 dental students over the study period 2001-12, yielding an 88% response rate. In 2013, practice addresses from the West Virginia Board of Dentistry were added to the student database. The results showed that significant predictors of rural practice site were intended rural practice choice, rural hometown, and projected greater practice accessibility for indigent patients. The likelihood of students' predicting they would choose a rural practice increased after completion of their rural rotations. After the rotations, students predicted providing greater accessibility to indigent patients; these changes occurred for those who changed their predictions to rural practice choice after the rotations and those who subsequently entered rural practice. The dental students with a rural background or a greater service orientation were also more likely to expect to enter a rural practice and actually to do so after graduation. These findings suggest that dental school curricula that include rural rotations may increase students' sensitivity to issues of indigent patients and increase students' likelihood of rural practice choice.
Hale, Nathan L; Klaiman, Tamar; Beatty, Kate E; Meit, Michael B
The appropriate role of local health departments (LHDs) as a clinical service provider remains a salient issue. This study examines differences in clinical service provision among rural/urban LHDs for early periodic screening, diagnosis, and treatment (EPSDT) and prenatal care services. Data collected from the 2013 National Association of County and City Health Officials Profile of Local Health Departments Survey was used to conduct a cross-sectional analysis of rural/urban differences in clinical service provision by LHDs. Profile data were linked with the 2013 Area Health Resource File to derive other county-level measures. Data analysis was conducted in 2015. Approximately 35% of LHDs in the analysis provided EPSDT services directly and 26% provided prenatal care. LHDs reporting no others providing these services in the community were four times more likely to report providing EPSDT services directly and six times more likely to provide prenatal care services directly. Rural LHDs were more likely to provide EPSDT (OR=1.46, 95% CI=1.07, 2.00) and prenatal care (OR=2.43, 95% CI=1.70, 3.47) services than urban LHDs. The presence of a Federally Qualified Health Center in the county was associated with reduced clinical service provision by LHDs for EPSDT and prenatal care. Findings suggest that many LHDs in rural communities remain a clinical service provider and a critical component of the healthcare safety net. The unique position of rural LHDs should be considered in national policy discussions around the organization and delivery of public health services, particularly as they relate to clinical services. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
the CHTC). With broad and far-reaching goals, the CHTC set out to improve and expand the opportunity of rural and urban underserved patient...Office of Naval Research Grant # N00014-99-1-0614 Southwest Louisiana Healthcare System, Inc. Lake Charles, LA Final Technical Report Community...the LCMH TeleMedicine Department. Our Lady of the Lake Medical Center in Baton Rouge, Louisiana, focussed on the urban underserved, placing
Full Text Available Abstract Background Latinos comprise the largest racial/ethnic group in the United States and have 2–3 times the prevalence of type 2 diabetes mellitus as Caucasians. Methods and design The Lawrence Latino Diabetes Prevention Project (LLDPP is a community-based translational research study which aims to reduce the risk of diabetes among Latinos who have a ≥ 30% probability of developing diabetes in the next 7.5 years per a predictive equation. The project was conducted in Lawrence, Massachusetts, a predominantly Caribbean-origin urban Latino community. Individuals were identified primarily from a community health center's patient panel, screened for study eligibility, randomized to either a usual care or a lifestyle intervention condition, and followed for one year. Like the efficacious Diabetes Prevention Program (DPP, the LLDPP intervention targeted weight loss through dietary change and increased physical activity. However, unlike the DPP, the LLDPP intervention was less intensive, tailored to literacy needs and cultural preferences, and delivered in Spanish. The group format of the intervention (13 group sessions over 1 year was complemented by 3 individual home visits and was implemented by individuals from the community with training and supervision by a clinical research nutritionist and a behavioral psychologist. Study measures included demographics, Stern predictive equation components (age, gender, ethnicity, fasting glucose, systolic blood pressure, HDL-cholesterol, body mass index, and family history of diabetes, glycosylated hemoglobin, dietary intake, physical activity, depressive symptoms, social support, quality of life, and medication use. Body weight was measured at baseline, 6-months, and one-year; all other measures were assessed at baseline and one-year. All surveys were orally administered in Spanish. Results A community-academic partnership enabled the successful recruitment, intervention, and assessment of Latinos at
Kevin R. Tarlow
Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70, P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.
Trantham, Doug; Sherry, Anne
Mobile crisis management teams provide crisis prevention and intervention services in community settings. The Appalachian Community Services crisis management program shows how such teams can be used to effectively serve rural communities.
Full Text Available The purpose of the study was to investigate the potential impact of distance education on a small, rural, Canadian island community. Presently, the population of small, rural island communities on the west coast of Canada are facing numerous challenges to retain and to attract permanent residents and families and to provide support and direction for those residents who wish to pursue K-12 accreditation, post-secondary education, vocational/trades training and up-grading or life-long learning. A unique set of considerations confront many of these isolated communities if they wish to engage in distance education and training. This set ranges from internet access to excessive travel by secondary students to the lack of centralized facility. For this study, a group of 48 participants were interviewed to determine their perceptions of the potential for distance education to impact on the community's educational, both academic and vocational, life-long learning and economic needs. The results indicated that there were four general areas of purported benefit: academic advancement, an improved quality of life, support for young families and a stabilizing affect on the local economy. Suggestions for the implementation of a suitable distance education resource are noted.
Full Text Available Kelechi O Enwereji,1 Maduaburochukwu C Nwosu,1 Adesola Ogunniyi,2 Paul O Nwani,1 Azuoma L Asomugha,1 Ezinna E Enwereji3 1Neurology Unit, Department of Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria; 2Neurology Unit, Department of Medicine, University College Hospital Ibadan, Oyo State, Nigeria; 3Department of Community Medicine/Nursing Sciences, College of Medicine, Abia State University, Uturu, Abia State, Nigeria Background: The prevalence and incidence of stroke vary from community to community worldwide. Nonetheless, not much is known about the current epidemiology of stroke in rural Nigeria and indeed Africa. Methods: We carried out a two-phase door-to-door survey in a rural, predominantly low-income, community in Anambra, Southeastern Nigeria. We used a modified World Health Organization (WHO protocol for detecting neurological diseases in the first phase, and a stroke-specific questionnaire and neurological examination in the second phase. An equal number of sex- and age-matched stroke-negative subjects were examined. Results: We identified ten stroke subjects in the study. The crude prevalence of stroke in rural Nigeria was 1.63 (95% confidence interval [CI] 0.78–3.00 per 1,000 population. The crude prevalence of stroke in males was 1.99 (95% CI 0.73–4.33 per 1,000, while that for females was 1.28 (95% CI 0.35–3.28 per 1,000 population. The peak age-specific prevalence of stroke was 12.08 (95% CI 3.92–28.19 per 1,000, while after adjustment to WHO world population, the peak was 1.0 (95% CI 0.33–2.33 per 1,000. Conclusion: The prevalence of stroke was found to be higher than previously documented in rural Nigeria, with a slightly higher prevalence in males than females. This is, however, comparable to data from rural Africa. Keywords: Africa, developing country, prevalence
Eller, Ronald; Martinez, Ruben; Pace, Cynthia; Pavel, Michael; Garza, Hector; Barnett, Lynn
The Rural Community College Initiative (RCCI) is a decade-long commitment by the Ford Foundation to community colleges in distressed rural areas of the United States. Through RCCI, the Foundation channels both funds and technical assistance to targeted community colleges to improve access and foster economic development. The RCCI approach includes…
Lindblade, Kim A; Nyenswah, Tolbert; Keita, Sakoba; Diallo, Boubakar; Kateh, Francis; Amoah, Aurora; Nagbe, Thomas K; Raghunathan, Pratima; Neatherlin, John C; Kinzer, Mike; Pillai, Satish K; Attfield, Kathleen R; Hajjeh, Rana; Dweh, Emmanuel; Painter, John; Barradas, Danielle T; Williams, Seymour G; Blackley, David J; Kirking, Hannah L; Patel, Monita R; Dea, Monica; Massoudi, Mehran S; Barskey, Albert E; Zarecki, Shauna L Mettee; Fomba, Moses; Grube, Steven; Belcher, Lisa; Broyles, Laura N; Maxwell, T Nikki; Hagan, Jose E; Yeoman, Kristin; Westercamp, Matthew; Mott, Joshua; Mahoney, Frank; Slutsker, Laurence; DeCock, Kevin M; Marston, Barbara; Dahl, Benjamin
Persons who died of Ebola virus disease at home in rural communities in Liberia and Guinea resulted in more secondary infections than persons admitted to Ebola treatment units. Intensified monitoring of contacts of persons who died of this disease in the community is an evidence-based approach to reduce virus transmission in rural communities.
De Haan, Laura; Boljevac, Tina; Schaefer, Kurt
The study explores how differences in rural community contexts relate to early adolescent alcohol use. Data were gathered from 1,424 adolescents in the sixth through eighth grades in 22 rural Northern Plains communities, as well as 790 adults, parents, teachers, and community leaders. Multilevel modeling analyses revealed that community…
Eller, Ronald; Martinez, Ruben; Pace, Cynthia; Pavel, Michael; Barnett, Lynn
This brief reports on the Ford Foundation's establishment of the Rural Community College Initiative (RCCI) for selected institutions in economically distressed areas of the Southeast, Deep South, Southwest, Appalachia, and western Indian reservations. This is the fourth report in a series by the RCCI Documentation Team. The RCCI program challenges…
Brown, Louis D; Alter, Theodore R; Brown, Leigh Gordon; Corbin, Marilyn A; Flaherty-Craig, Claire; McPhail, Lindsay G; Nevel, Pauline; Shoop, Kimbra; Sterner, Glenn; Terndrup, Thomas E; Weaver, M Ellen
Community research and action projects undertaken by community-university partnerships can lead to contextually appropriate and sustainable community improvements in rural and urban localities. However, effective implementation is challenging and prone to failure when poorly executed. The current paper seeks to inform rural community-university partnership practice through consideration of first-person accounts from five stakeholders in the Rural Embedded Assistants for Community Health (REACH) Network. The REACH Network is a unique community-university partnership aimed at improving rural health services by identifying, implementing, and evaluating innovative health interventions delivered by local caregivers. The first-person accounts provide an insider's perspective on the nature of collaboration. The unique perspectives identify three critical challenges facing the REACH Network: trust, coordination, and sustainability. Through consideration of the challenges, we identified several strategies for success. We hope readers can learn their own lessons when considering the details of our partnership's efforts to improve the delivery infrastructure for rural healthcare.
Full Text Available Thaworn Lorga1, Myo Nyein Aung1,2, Prissana Naunboonruang1, Payom Thinuan1, Nara Praipaksin3, Tida Deesakul3, Utumporn Inwan3, Tawatchai Yingtaweesak4, Pratumpan Manokulanan1, Srisomporn Suangkaew1, Apiradee Payaprom41Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 2Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 3Baan Rekati Health Station, Thasongyang, Tak, Thailand; 4Thasongyang Hospital, Thasongyang, Tak, ThailandBackground: Diabetes is a growing epidemic in both urban and rural communities worldwide.Aim: We aimed to survey fasting plasma glucose (FPG status and awareness of diabetes in the rural Karen ethnic community. We investigated the predictors of impaired fasting plasma glucose (IFG status, which would be easily applicable for prevention of diabetes in a rural community.Materials and methods: This was a community-based cross-sectional study conducted at Thasongyang, the most north-western district in Thailand. A total of 299 Karen ethnic rural residents were included in the study. FPG, body mass index, and waist circumference were prospectively measured. We assessed the awareness of diabetes and lifestyle-related health behavior with closed questionnaires in a rural community setting.Results: On screening for FPG, 16.72% of the Karen ethnic residents had hyperglycemia: 3.68% in the diabetic range and 13.04% in the prediabetic range respectively. After adjustment for age, sex, and BMI, waist circumference (adjusted odds ratio [aOR] 3.5, 95% confidence interval [CI] 1.29–9.57, and having a diabetic blood relative (aOR 4.6, CI 1.81–11.71 are significant predictors of IFG status.Conclusion: It is necessary to promote awareness of diabetes among the Karen ethnic community. Application of simple evidence-based predictors of the prediabetic state may lead to timely and effective prevention of diabetes in rural settings.Keywords: diabetes, prediabetes, fasting plasma
Ahmed, Syed M; Size, Tim; Crouse, Byron; Patterson, Leslie; Gass, Eric; Karon, Sarita L; Lund, Liz; Abert, Connie; Wergin, Amy; Hegranes, Karen; Bishop, Linda; Duffy, Sue; Jacobson, Kevin
The Strong Rural Communities Initiative (SRCI) was created to address the health needs of rural Wisconsin communities through a multifaceted partnership that included the Medical College of Wisconsin (MCW), University of Wisconsin School of Medicine and Public Health (UWSMPH), the Rural Health Development Council (RHDC), and hospitals, public health departments, and businesses in 6 rural communities in Wisconsin. The SRCI provided a broad framework of leadership to assist each of the 6 rural communities in developing and implementing new, collaborative interventions that addressed the specific health needs of the community. Separate assessments were conducted for the communities that partnered with each respective medical school and focused on the processes of community collaboration and partnership function. Assessment approaches included formative and outcome evaluation. Each community independently reported positive outcomes associated with the partnership process and various aspects of community collaboration, including the successes and health impacts of the workplace wellness programs implemented. Assessment data also revealed challenges related to conducting effective community-academic partnerships. The SRCI was established to execute statewide programs in rural communities with the goal to improve the health of people living in those communities. We have gained applicable knowledge regarding the types of challenges that exist in establishing a rural-based community research network between academic partners and community leaders.
Mauro Henrique N. G. Abreu
Full Text Available The present paper examines the relationship between hydrochemical characteristics and endemic dental fluorosis, controlling for variables with information on an individual level. An epidemiological survey was carried out in seven rural communities in two municipalities in the state of Minas Gerais, Brazil. The Thystrup & Fejerskov index was employed by a single examiner for the diagnosis of dental fluorosis. A sampling campaign of deep groundwater in the rural communities of interest was carried out concomitantly to the epidemiological survey for the determination of physiochemical parameters. Multilevel modeling of 276 individuals from seven rural communities was achieved using the non-linear logit link function. Parameters were estimated using the restricted maximum likelihood method. Analysis was carried out considering two response variables: presence (TF 1 to 9 or absence (TF = 0 of any degree of dental fluorosis; and presence (TF ≥ 5—with loss of enamel structure or absence of severe dental fluorosis (TF ≤ 4—with no loss of enamel structure. Hydrogeological analyses revealed that dental fluorosis is influenced by the concentration of fluoride (OR = 2.59 CI95% 1.07–6.27; p = 0.073 and bicarbonate (OR = 1.02 CI95% 1.01–1.03; p = 0.060 in the water of deep wells. No other variable was associated with this prevalence (p > 0.05. More severe dental fluorosis (TF ≥ 5 was only associated with age group (p < 0.05. No other variable was associated to the severe dental fluorosis (p > 0.05. Dental fluorosis was found to be highly prevalent and severe. A chemical element besides fluoride was found to be associated (p > 0.05 to the prevalence of dental fluorosis, although this last finding should be interpreted with caution due to its p value.
Reiger, Sheridan; Harris, Jeffrey R; Chan, Kwun Chuen Gary; Oqueli, Hector Lopez; Kohn, Marlana
We formed a self-funded hypertension treatment group in a resource-poor community in rural Honduras. After training community health workers and creating protocols for standardized treatment, we used group membership fees to maintain the group, purchase generic medications in bulk on the local market, and hire a physician to manage treatment. We then assessed whether participation in the group improved treatment, medication adherence, and hypertension control. This is a program evaluation using quasi-experimental design and no control group. Using data from the 86 members of the hypertension treatment group, we analyzed baseline and follow-up surveys of members, along with 30 months of clinical records of treatment, medication adherence, and blood pressure readings. Our initial hypertension needs assessment revealed that at baseline, community hypertensives relied on the local Ministry of Health clinic as their source of anti-hypertensive medications and reported that irregular supply interfered with medication adherence. At baseline, hypertension group members were mainly female, overweight or obese, physically active, non-smoking, and non-drinking. After 30 months of managing the treatment group, we found a significant increase in medication adherence, from 54.8 to 76.2% (p<0.01), and hypertension control (<140/90 mmHg), from 31.4 to 54.7% (p<0.01). We also found a mean monthly decrease of 0.39 mmHg in systolic blood pressure (p<0.01). At the end of the 30-month observation period, the local Ministry of Health system had increased provision of low-cost anti-hypertensive medications and adopted the hypertension treatment group's treatment protocols. Formation of a self-funded, community-based hypertension treatment group in a rural, resource-poor community is feasible, and group participation may improve treatment, medication adherence, and hypertension control and can serve as a political driver for improving hypertension treatment services provided by the public
Charles C. Harris; William McLaughlin; Greg Brown; Dennis R. Becker
An assessment of small rural communities in the interior and upper Columbia River basin was conducted for the Interior Columbia Basin Ecosystem Management Project (ICBEMP). The characteristics and conditions of the rural communities in this region, which are complex and constantly changing, were examined. The research also assessed the resilience of the regionâs...
LaDue, Robin A.; Marcelley, Josephine
The community mental health movement started with the purpose of providing services dealing with problems and issues specific to individual communities. As the movement grew, it took on the responsibility of delivering services to the "underserved" populations of this country, including children, the elderly, minority groups, and rural-area…
Mobility is extremely important, especially in rural areas, which have dispersed populations and locations. : This study was conducted among rural minority populations to evaluate human transportation needs of the : underserved rural population in Ok...
Highfield, Linda; Ottenweller, Cecelia; Pfanz, Andre; Hanks, Jeanne
Montgomery, Jim C., Ed.; Kitchenham, Andrew D., Ed.
This proceedings of a conference held in May 2000 at Malaspina University-College (British Columbia) contains approximately 63 conference papers, abstracts of papers, and keynote speeches. The conference examined issues affecting rural communities, with major themes being rural education, health, human services, families, and the sustainability of…
Menec, Verena; Bell, Sheri; Novek, Sheila; Minnigaleeva, Gulnara A; Morales, Ernesto; Ouma, Titus; Parodi, Jose F; Winterton, Rachel
With the growing interest worldwide in making communities more age-friendly, it is becoming increasingly important to understand the factors that help or hinder communities in attaining this goal. In this article, we focus on rural and remote communities and present perspectives of 42 experts in the areas of aging, rural and remote issues, and policy who participated in a consensus conference on age-friendly rural and remote communities. Discussions highlighted that strengths in rural and remote communities, such as easy access to local leaders and existing partnerships, can help to further age-friendly goals; however, addressing major challenges, such as lack of infrastructure and limited availability of social and health services, requires regional or national government buy-in and funding opportunities. Age-friendly work in rural and remote communities is, therefore, ideally embedded in larger age-friendly initiatives and supported by regional or national policies, programs, and funding sources.
Stewart, Matthew; Grahmann, Bridget; Fillmore, Ariel; Benson, L Scott
, vulnerability, and preparedness in LMIC communities. The current study established that selected communities near Trujillo, Peru recognize a high disaster impact from earthquakes and infection, but are not adequately prepared for potential future disasters. By identifying high-risk demographics, targeted public health interventions are needed to prepare vulnerable communities in the following areas: emergency food supplies, emergency water plan, medical supplies at home, and establishing evacuation plans. Stewart M , Grahmann B , Fillmore A , Benson LS . Rural community disaster preparedness and risk perception in Trujillo, Peru. Prehosp Disaster Med. 2017;32(4):387-392.
Evans, David V; Keys, Toby; Desnick, Laurel; A Andrilla, C Holly; Bienz, Danielle; Rosenblatt, Roger
Pharmaceutical marketing techniques are effective in changing the behavior of health care providers in ways that deviate from evidence-based practices. To mitigate the influence of pharmaceutical marketing on learners, academic medical centers (AMCs) have adopted policies to limit student/industry interaction. Many clinical experiences occur outside of the AMC. The purpose of this study was to compare medical students' exposure to pharmaceutical marketing in off-campus rural and urban underserved clinical sites. The University of Washington School of Medicine Rural and Underserved Opportunities Program (RUOP) places rising second-year medical students in underserved clinical sites in five northwestern states. We surveyed RUOP students to evaluate their exposure to pharmaceutical marketing. Of 120 students, 86 (72%) completed surveys. Sixty-five (76%) did their RUOP rotation in rural areas. Students in rural locations were more likely to report exposure to pharmaceutical marketing. Distribution of free drug samples was reportedly three times higher in rural than urban sites (54% versus 15%). Doctors meeting with sales representatives were reported as four times higher in rural clinics (40% versus 10%). Students at rural sites reported exposure to pharmaceutical marketing more than those in urban settings. Rural medical educators should provide faculty development for community clinicians on the influences of pharmaceutical marketing on learners. Medical schools must review local clinic and institution-wide policies to limit pharmaceutical marketing exposure to learners in the rural learning environment.
Full Text Available Introduction Rural Development in Cambodia in Transition With nearly 85 percent of its population living in rural communities, it is obvious that rural development issues occupy a prominent place in the overall development of Cambodia. As the country’s population rapidly increases, people in rural areas depend upon agriculture as their means of subsistence. In parallel, agriculture must meet the growing and diversifying urban food demand, while generating resources for export. The complex pro...
Farmer, Jane; Prior, Maria; Taylor, Judy
Study and opinion suggest that health services play a significant role in supporting the social fabric of fragile rural communities. We draw on empirical evidence about the added-value contributions of health services to communities and unite it with theory of capitals to propose a theoretical model depicting how rural health services contribute to community sustainability. While providing an analytical framework, the paper also points to construction of a measurement tool for enabling planners to measure the contributions of diverse sectors to community sustainability and predict or measure the impact of changes to models of service delivery on the future of rural communities. Copyright © 2012 Elsevier Ltd. All rights reserved.
Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.
Context: Alzheimer's patients living in rural communities may face significant barriers to effective outpatient medical care. Purpose: We sought to examine rural-urban differences in risk for ambulatory care sensitive hospitalizations (ACSH), an indicator of access to outpatient care, in community-dwelling veterans with dementia. Methods: Medicare…
School counselors and special educators in rural areas working together can be a powerful team to help schools create a positive school community. In one rural school community, they partnered with faculty and staff to implement a School Wide Positive Behavior support program to improve student outcomes. The counselor and special educator, through…
Genandt, James D.
The traditional role of workforce training by community colleges in support of regional economic development is insufficient to help rural areas survive in a global economy. Rural community colleges are uniquely positioned to provide enhanced economic development support through entrepreneurship and small business development programs. Using…
Flaherty, Mary Grace; Miller, David
Rural residents are at a disadvantage with regard to health status and access to health promotion activities. In many rural communities, public libraries offer support through health information provision; there are also opportunities for engagement in broader community health efforts. In a collaborative effort between an academic researcher and a…
Irons, Thomas G; Moore, Kellan S
Access to health insurance and health care are critical for people living in rural communities, where the safety net is fragile. However, rural communities face challenges as they enroll uninsured people in the health insurance marketplace, educate newly insured individuals on how to use insurance, and coordinate care for those who remain uninsured.
This paper examines the performance of rural community development projects in relation to the work ethic, gender and the level of participation in the process of rural development among the Nandi people of western Kenya. Data for the study were obtained from a survey of 25 randomly-selected community development ...
Di Gropello, Emanuela; Marshall, Jeffery H.
We analyze the effectiveness of the Programa Hondureno de Educacion Comunitaria (PROHECO) community school program in rural Honduras. The data include standardized tests and extensive information on school, teacher, classroom and community features for 120 rural schools drawn from 15 states. Using academic achievement decompositions we find that…
Background: The incidence and prevalence of poor vision and blindness in the world, especially among the rural communities in developing countries is on the increase. This had led to the WHO/IAPB-driven “Vision2020 right to sight: ”global initiative against blindness in rural communities, aimed at reducing global ...
Rivera-Colón, Venessa; Ramos, Roberto; Davis, Jenna L; Escobar, Myriam; Inda, Nikki Ross; Paige, Linda; Palencia, Jeannette; Vives, Maria; Grant, Cathy G; Green, B Lee
It is well documented that cancer is disproportionately distributed in racial/ethnic minority groups and medically underserved communities. In addition, cancer prevention and early detection represent the key defenses to combat cancer. The purpose of this article is to showcase the comprehensive health education and community outreach activities at the H. Lee Moffitt Cancer Center and Research Institute (Moffitt) designed to promote and increase access to and utilization of prevention and early detection services among underserved populations. One of Moffitt's most important conduits for cancer prevention and early detection among underserved populations is through its community education and outreach initiatives, in particular, the Moffitt Program for Outreach Wellness Education and Resources (M-POWER). M-POWER works to empower underserved populations to make positive health choices and increase screening behaviors through strengthening collaboration and partnerships, providing community-based health education/promotion, and increasing access to care. Effective, empowering, and culturally and linguistically competent health education and community outreach, is key to opening the often impenetrable doors of cancer prevention and early detection to this society's most vulnerable populations.
Rachel J. C. Chen
Full Text Available Since the Appalachian Regional Commission (ARC was founded in 1965, various reports have been presented to summarize the progress in terms of economic development, strengths, weaknesses, opportunities, and threats among studied communities in the Appalachian region. The purposes of this study were to investigate (1 the condition and usage of facilities and services in the studied communities; (2 what factors contribute to local growth in improving areas; and (3 what barriers deter growth in the studied communities based on the perceptions of study participants. Ten studied counties were categorized based on their topography, demographics, and economics. Each sub-region has two selected counties (non-distressed and distressed to represent and compare their similar topography and various stages of demographic opportunities and economic development and challenges. Location is recognized as one of the significant factors that affect communities’ development. Counties perform better when they are adjacent to urban areas, own major transportation corridors, and have more supplies of natural resources than those located in more rural areas with fewer resources. This study noted the need to improve communication infrastructure (such as Internet access, broadband, and mobile communications that impact local development opportunities and public safety.
Somporn, Praphun; Ash, Julie; Walters, Lucie
Rural community-based medical education (RCBME), in which medical student learning activities take place within a rural community, requires students, clinical teachers, patients, community members and representatives of health and government sectors to actively contribute to the educational process. Therefore, academics seeking to develop RCBME need to understand the rural context, and the views and needs of local stakeholders. The aim of this review is to examine stakeholder experiences of RCBME programmes internationally. This narrative literature review of original research articles published after 1970 utilises Worley's symbiosis model of medical education as an analysis framework. This model proposes that students experience RCBME through their intersection with multiple clinical, social and institutional relationships. This model seeks to provide a framework for considering the intersecting relationships in which RCBME programmes are situated. Thirty RCBME programmes are described in 52 articles, representing a wide range of rural clinical placements. One-year longitudinal integrated clerkships for penultimate-year students in Anglosphere countries were most common. Such RCBME enables students to engage in work-integrated learning in a feasible manner that is acceptable to many rural clinicians and patients. Academic results are not compromised, and a few papers demonstrate quality improvement for rural health services engaged in RCBME. These programmes have delivered some rural medical workforce outcomes to communities and governments. Medical students also provide social capital to rural communities. However, these programmes have significant financial cost and risk student social and educational isolation. Rural community-based medical education programmes are seen as academically acceptable and can facilitate symbiotic relationships among students, rural clinicians, patients and community stakeholders. These relationships can influence students' clinical
Stuhlmiller, Cynthia M; Tolchard, Barry
There are a number of hard to reach and underserved communities who experience inadequate health care. In Australia, the Aboriginal and Torres Strait Islanders peoples experience low life expectancy, higher levels for chronic disease and elevated smoking and drinking. These problems are further exacerbated when living in regional and rural Australia and poverty. There are growing concerns over helping such groups in order to close the health disparity gap. A student-led clinic (SLC) was developed to address clinical placement shortages while providing free health and social services in an underserved community in regional Australia. Health data was collected from 2086 attendees enrolled in the SLC to determine health changes and outcomes of student-delivered services. A series of health data was routinely collected at all contact points. This included physical health care, behavioural health risk, and chronic disease measures. All data was recorded in an electronic monitoring system. Population data identified some significant and positive changes to health patterns-smoking, waist size, and body mass index. Unfortunately, gaps in data entry precluded more robust findings. It was clear that this community suffered from experiences commonly associated with health disparity and poverty. There were higher risks of drinking alcohol and smoking with raised levels of lifestyle disease including diabetes. Some of these issues were mitigated by the community being able to attend a locally situated community driven clinic.
Ana Rita Marinho Machado
Full Text Available OBJECTIVE To describe the stages of the empowerment process of a group of seniors in a rural community. METHOD Convergent care research whose foundation is to use the scope of practice. Conducted with the proposal to change the practice of 21 seniors and nine health professionals, with the aim of health promotion empowerment. Data were collected during 22 meetings, and group interviews at the end of the intervention. RESULTS Showed that despite the initial impact of the change, the group was able to welcome the new change, taking advantage of the space to express anxieties, share joys, and build new knowledge, which led to the incorporation of changes that reflected in the development of healthy habits and improvements in interpersonal relationships. CONCLUSION The convergent care research consisted of strategy that changed the group's lives, empowering them with health promoting actions.
A one-to-one learning environment, where each participating student and the teacher use a laptop computer, provides an invaluable opportunity for rethinking learning and studying the ways in which children can program computers and learn to think about their own thinking styles and become epistemologists. This article presents a study done in a rural school in Costa Rica in which students used computers to create media. Three important components of the work are described: (1) student-owned technology that can accompany students as they interact at home and in the broader community, (2) activities that are designed with sufficient scope to encourage the appropriation of powerful ideas, and (3) teacher engagement in activity design with simultaneous support from a knowledge network of local and international colleagues and mentors.
Telecenters is one of the promising models recognized by the United Nations (UN) to achieve the global access of ICTs. This paper provides insight in the role and usages of Information and Communication Technology for Development (ICT4D) projects with a specific focus of telecenters in developing...... the policy and actual practices of rural community with respect of ICT development.......Telecenters is one of the promising models recognized by the United Nations (UN) to achieve the global access of ICTs. This paper provides insight in the role and usages of Information and Communication Technology for Development (ICT4D) projects with a specific focus of telecenters in developing...... country Bangladesh. This study covers four aspects of the functioning of telecenters grounded in social, economical and action resources: ‘situated success’, ‘information culture and tradition’, ‘typology of resources’ and ‘functioning’. The study contributes to the theory and practice of ICT...
Ofori, Mf; Ansah, E; Agyepong, I
OBJECTIVES: Pregnant women in malaria-endemic communities are susceptible to Plasmodium falciparum infections, with adverse consequences including maternal anaemia, placental malaria parasitaemia and infant low birth weight (LBW). We sought to assess the prevalence, incidence, and clinical markers...... of pregnancy-associated malaria (PAM) in a rural district of Ghana. METHODS: A total of 294 pregnant women were enrolled and followed passively and actively, monthly and weekly until delivery. Haemoglobin levels, malaria parasitaemia and Hb electrophoresis were done from peripheral blood samples. At delivery......, placental smears were examined for malaria parasites. RESULTS: Prevalence of peripheral blood P. falciparum parasitaemia at enrolment was 19.7% and related to parity. Incidence rate of parasitaemia was 0.06 infections/ person/month [95% confidence interval (CI): 0.04 to 0.08]. Symptomatic infections rose...
Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M
The economic impact of a family physician practicing family medicine in rural Alabama is $1,000,000 a year in economic benefit to the community. The economic benefit of those rural family physicians practicing obstetrics has not been studied. This study was designed to determine whether there was any added economic benefit of rural family physicians practicing obstetrics in rural, underserved Alabama. The Alabama Family Practice Rural Health Board has funded the University of Alabama Family Medicine Obstetrics Fellowship since its beginning in 1986. Family medicine obstetrics fellowship graduates who practice obstetrics in rural, underserved areas were sent questionnaires and asked to participate in the study. The questions included the most common types and average annual numbers of obstetrics/gynecological procedures they performed. Ten physicians, or 77% of the graduates asked to participate in the study, returned the questionnaire. Fourteen common obstetrics/gynecological procedures performed by the graduates were identified. A mean of 115 deliveries were performed. The full-time equivalent reduction in family medicine time to practice obstetrics was 20%. A family physician practicing obstetrics in a rural area adds an additional $488,560 in economic benefit to the community in addition to the $1,000,000 from practicing family medicine, producing a total annual benefit of $1,488,560. The investment of $616,385 from the Alabama Family Practice Rural Health Board resulted in a $399 benefit to the community for every dollar invested. The cumulative effect of fellowship graduates practicing both family medicine and obstetrics in rural, underserved areas over the 26 years studied was $246,047,120. © Copyright 2014 by the American Board of Family Medicine.
Narahari, S R; Ryan, T J; Mahadevan, P E; Bose, K S; Prasanna, K S
The Global Alliance for the Elimination of Lymphatic Filariasis (GAELF) has recommended exploring local health traditions of skin care and a low cost treatment paradigm for rural communities has been proposed by Vaqas and Ryan. Our case study incorporates these promising treatments for use in treating filariasis in rural communities. Patients having lymphedema of one or both lower limbs (skin: normal, thickened or with trophic/warty changes) received treatment components from ayurveda, yoga and biomedicine simultaneously: including soap wash, phanta soaking, Indian manual lymph drainage (IMLD), pre- and post-IMLD yoga exercises, and compression using bandages for 194 days, along with diet restrictions and oral herbal medicines indicated for "elephantiasis" in Ayurveda. Entry points when infected were treated with biomedical drugs. The study was conducted in the reverse pharmacology design. 112 patients and 149 lower limbs completed 194 days of treatment during 2003-2006. Significant improvements were observed in the limb circumference measurements and the frequency of acute dermatolymphangioadenitis, use of preventive antibiotics, and reduction in the number of entry points were also improved. The objective to obtain significant benefit for a common problem using locally available, sustainable and affordable means has been achieved. It has not been our purpose to show that the regimen employed is better than another but the results do pose the question--"Are there components of Ayurvedic medicine that deserve further study?" It is important to understand that the regimen has been delivered mostly at home and that participants we have treated, representing a population suffering from a common problem, have not had access to effective conservative therapy that is culturally acceptable, safe, and efficacious.
Alistair G Auffret
Full Text Available Humans are known for their capacity to disperse organisms long distances. Long-distance dispersal can be important for species threatened by habitat destruction, but research into human-mediated dispersal is often focused upon few and/or invasive species. Here we use citizen science to identify the capacity for humans to disperse seeds on their clothes and footwear from a known species pool in a valuable habitat, allowing for an assessment of the fraction and types of species dispersed by humans in an alternative context. We collected material from volunteers cutting 48 species-rich meadows throughout Sweden. We counted 24,354 seeds of 197 species, representing 34% of the available species pool, including several rare and protected species. However, 71 species (36% are considered invasive elsewhere in the world. Trait analysis showed that seeds with hooks or other appendages were more likely to be dispersed by humans, as well as those with a persistent seed bank. More activity in a meadow resulted in more dispersal, both in terms of species and representation of the source communities. Average potential dispersal distances were measured at 13 km. We consider humans capable seed dispersers, transporting a significant proportion of the plant communities in which they are active, just like more traditional vectors such as livestock. When rural populations were larger, people might have been regular and effective seed dispersers, and the net rural-urban migration resulting in a reduction in humans in the landscape may have exacerbated the dispersal failure evident in declining plant populations today. With the fragmentation of habitat and changes in land use resulting from agricultural change, and the increased mobility of humans worldwide, the dispersal role of humans may have shifted from providers of regular local and landscape dispersal to providers of much rarer long-distance and regional dispersal, and international invasion.
Talbot, Lyn; Walker, Rae
Understanding what undermines or builds social capital is important when estimating the impact that changes in social capital have on people's lives. The aim of this paper is to illustrate how the consequences of neo-liberal policy initiatives have impacted on linking social capital in one small and vibrant rural community in Australia. Policy changes affecting all levels of government and various commercial agencies have undermined people's capability for a range of actions which bring personal and community-wide social and economic returns. Rationalisation and regionalisation of services and commercial agencies, including local government amalgamation, and increased workloads have undermined people's capabilities for community engagement. Policy outcomes are at odds with the stated policy agenda of building community capacity.
Arabella K. M. Hayter
Full Text Available Background: Chronic diseases are now the leading cause of death and disability worldwide; this epidemic has been linked to rapid economic growth and urbanisation in developing countries. Understanding how characteristics of the physical, social, and economic environment affect behaviour in the light of these changes is key to identifying successful interventions to mitigate chronic disease risk. Design: We undertook a qualitative study consisting of nine focus group discussions (FGDs (n=57 in five villages in rural Andhra Pradesh, South India, to understand people's perceptions of community development and urbanisation in relation to chronic disease in rural transitional communities. Specifically, we sought to understand perceptions of change linked to diet, physical activity, and pollution (because these exposures are most relevant to chronic diseases, with the aim of defining future interventions. The transcripts were analysed thematically. Results: Participants believed their communities were currently less healthy, more polluted, less physically active, and had poorer access to nutritious food and shorter life expectancies than previously. There were contradictory perceptions of the effects of urbanisation on health within and between individuals; several of the participants felt their quality of life had been reduced. Conclusions: In the present study, residents viewed change and development within their villages as an inevitable and largely positive process but with some negative health consequences. Understanding how these changes are affecting populations in transitional rural areas and how people relate to their environment may be useful to guide community planning for health. Measures to educate and empower people to make healthy choices within their community may help reduce the spread of chronic disease risk factors in future years.
Kulig, Judith C; Stewart, Norma; Penz, Kelly; Forbes, Dorothy; Morgan, Debra; Emerson, Paige
To describe community satisfaction and attachment among rural and remote registered nurses (RNs) in Canada. Cross-sectional survey of rural and remote RNs in Canada as part of a multimethod study.The sample consisted of a stratified random sample of RNs living in rural areas of the western country and the total population of RNs who worked in three northern regional areas and those in outpost settings. A subset of 3,331 rural and remote RNs who mainly worked in acute care, long-term care, community health, home care, and primary care comprised the sample. The home community satisfaction scale measured community satisfaction, whereas single-item questions measured work community satisfaction and overall job satisfaction. Community variables were compared across practice areas using analysis of variance, whereas a thematic analysis was conducted of the open-ended questions. Home care and community health RNs were significantly more satisfied with their work community than RNs from other practice areas. RNs who grew up in rural communities were more satisfied with their current home community. Four themes emerged from the open-ended responses that describe community satisfaction and community attachment. Recruitment and retention strategies need to include mechanisms that focus on community satisfaction, which will enhance job satisfaction.
Morrison, J; Colbourn, T; Budhathoki, B; Sen, A; Adhikari, D; Bamjan, J; Pathak, S; Basnet, A; Trani, J F; Costello, A; Manandhar, D; Groce, N
There is strong evidence that participatory approaches to health and participatory women's groups hold great potential to improve the health of women and children in resource poor settings. It is important to consider if interventions are reaching the most marginalized, and therefore we examined disabled women's participation in women's groups and other community groups in rural Nepal. People with disabilities constitute 15% of the world's population and face high levels of poverty, stigma, social marginalization and unequal access to health resources, and therefore their access to women's groups is particularly important. We used a mixed methods approach to describe attendance in groups among disabled and non-disabled women, considering different types and severities of disability. We found no significant differences in the percentage of women that had ever attended at least one of our women's groups, between non-disabled and disabled women. This was true for women with all severities and types of disability, except physically disabled women who were slightly less likely to have attended. Barriers such as poverty, lack of family support, lack of self-confidence and attendance in many groups prevented women from attending groups. Our findings are particularly significant because disabled people's participation in broader community groups, not focused on disability, has been little studied. We conclude that women's groups are an important way to reach disabled women in resource poor communities. We recommend that disabled persons organizations help to increase awareness of disability issues among organizations running community groups to further increase their effectiveness in reaching disabled women. © The Author 2015. Published by Oxford University Press.
Kalliny, Medhat; McKenzie, Judith Green
Sleep disorders and occupational hazards, injuries, and illnesses impact an individual's overall health. In the United States, substantial racial, ethnic, and socioeconomic disparities exist in sleep and occupational health. Primary care physicians working in underserved communities should be aware of this disparity and target these higher-risk populations for focused evaluation and intervention. Copyright © 2016 Elsevier Inc. All rights reserved.
Strasser, Roger; Kam, Sophia M; Regalado, Sophie M
Compared to their urban counterparts, rural and remote inhabitants experience lower life expectancy and poorer health status. Nowhere is the worldwide shortage of health professionals more pronounced than in rural areas of developing countries. Sub-Saharan Africa (SSA) includes a disproportionately large number of developing countries; therefore, this article explores SSA in depth as an example. Using the conceptual framework of access to primary health care, sustainable rural health service models, rural health workforce supply, and policy implications, this article presents a review of the academic and gray literature as the basis for recommendations designed to achieve greater health equity. An alternative international standard for health professional education is recommended. Decision makers should draw upon the expertise of communities to identify community-specific health priorities and should build capacity to enable the recruitment and training of local students from underserviced areas to deliver quality health care in rural community settings.
This qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures-different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.
Netshandama, V. O.
The premise of this article is that the "jury is still out" to describe what effective Community Engagement entails in South African higher education institutions. The current discussions about community engagement and service learning do not cover the primary objective of adding value to the community, particularly of the rural-based…
Valmir Cristiano Marques Arruda
Full Text Available There is a growing competition among the various sectors of society in the world for the use of water where agriculture stands out as a major consumer. Since it is carried out in a controlled manner, irrigation with effluents from a Sewage Treatment Plant (STP is a very attractive practice, as it allows a greater supply of water for nobler purposes. This work had the general objective of evaluating the perception of a rural community in the municipality of Pesqueira, Pernambuco, Brasil, in terms of consumption and production of products cultivated with the practice of agricultural reuse. The local population showed acceptance for the cultivation and consumption of products through agricultural reuse, above all, with reliable information on the appropriate quality of the effluents used for irrigation. In the estimated data, the same community had a potential of production of corn, beans and cotton in the order of 19.8 tons, 3.4 tons and 7.7 tons respectively, with the use of treated sewage in irrigation.
Stephenson, Nicole; Blaney, Alexandra; Clifford, Deana; Gabriel, Mourad; Wengert, Greta; Foley, Patrick; Brown, Richard N; Higley, Mark; Buckenberger-Mantovani, Sarah; Foley, Janet
Far northern California forests are highly biodiverse in wildlife reservoirs and arthropod vectors that may propagate rickettsial pathogens in nature. The proximity of small rural communities to these forests puts people and domestic animals at risk of vector-borne infection due to spillover from wildlife. The current study was conducted to document exposure to rickettsial pathogens in people and domestic animals in a rural community, and identify which rickettsiae are present in sylvatic and peri-domestic environments near this community. Blood samples from people, domestic animals (dogs, cats, and horses) and wild carnivores were tested for Rickettsia spp. antibodies and DNA (people and domestic animals only) by serology and real time (RT)-PCR, respectively. Ectoparasites were collected from dogs, wild carnivores and from vegetation by flagging, and tested for Rickettsia spp. DNA by RT-PCR. DNA sequencing of the rickettsial 17kDa protein gene or the ompA gene was used for species identification. Despite a seroprevalence of 3% in people, 42% in dogs, 79% in cats, 33% in gray foxes, and 83% in bobcats, RT-PCR on blood was consistently negative, likely because the sensitivity of this test is low, as Rickettsia spp. do not often circulate in high numbers in the blood. Rickettsia spp. DNA was found in four flea species collected from bobcats and Ctenocephalides felis collected from domestic dogs. All amplicons sequenced from fleas were R. felis. Ixodes pacificus collected by flagging were commonly infected with a Rickettsia sp. endosymbiont. Rickettsia rhipicephali DNA was found in Dermacentor variabilis from dogs, black bears, a gray fox, and a D. occidentalis collected by flagging. Dermacentor variabilis from dogs and black bears also contained R. montanensis DNA. Multiple Rickettsia spp. (including species with zoonotic and pathogenic potential) were found among human biting arthropod vectors of both wild and domestic carnivores and on flags. Knowledge of the
Both, R.; Etsub, E.; Moyer, E.
Although pastoralists are a significant proportion of the rural population in many African countries, they are often underserved with regard to health-related interventions. This paper presents data on an effort to provide information about HIV prevention and treatment to Afar people living in
Waegemakers Schiff, Jeannette; Schiff, Rebecca; Turner, Alina
"Until recently, there was little acknowledgement that homelessness existed in rural areas in Canada. Limited research and scarce data are available to understand the scope and dynamics of rural homelessness in Canada. As suggested in our previous work, there is a need for rural homelessness research to examine themes from a provincial perspective. The aim of this research was to contribute to expanding the knowledge base on the nature of rural homelessness at a provincial level in the Canadi...
Saprii, Lipekho; Richards, Esther; Kokho, Puni; Theobald, Sally
Globally, there is increasing interest in community health worker's (CHW) performance; however, there are gaps in the evidence with respect to CHWs' role in community participation and empowerment. Accredited Social Health Activists (ASHAs), whose roles include social activism, are the key cadre in India's CHW programme which is designed to improve maternal and child health. In a diverse country like India, there is a need to understand how the ASHA programme operates in different underserved Indian contexts, such as rural Manipur. We undertook qualitative research to explore stakeholders' perceptions and experiences of the ASHA scheme in strengthening maternal health and uncover the opportunities and challenges ASHAs face in realising their multiple roles in rural Manipur, India. Data was collected through in-depth interviews (n = 18) and focus group discussions (n = 3 FGDs, 18 participants). Participants included ASHAs, key stakeholders and community members. They were purposively sampled based on remoteness of villages and primary health centres to capture diverse and relevant constituencies, as we believed experiences of ASHAs can be shaped by remoteness. Data were analysed using the thematic framework approach. Findings suggested that ASHAs are mostly understood as link workers. ASHA's ability to address the immediate needs of rural and marginalised communities meant that they were valued as service providers. The programme is perceived to be beneficial as it improves awareness and behaviour change towards maternal care. However, there are a number of challenges; the selection of ASHAs is influenced by power structures and poor community sensitisation of the ASHA programme presents a major risk to success and sustainability. The primary health centres which ASHAs link to are ill-equipped. Thus, ASHAs experience adverse consequences in their ability to inspire trust and credibility in the community. Small and irregular monetary incentives demotivate
Nicole Rourke; Jason Marcks
Nevada Underserved Science Education Program (NUSEP) is a project to examine the effect of implementing new and innovative Earth and space science education curriculum in Nevada schools. The project provided professional development opportunities and educational materials for teachers participating in the program.
Han, Gil-Soo; Wearne, Ben; O'Meara, Peter; McGrail, Matthew; Chesters, Janice
Medical education in Australia is currently entering a new era, including support for the significant extension of medical students and general practitioner (GP) registrars' training programs in rural communities. This commitment to rural medical student and general practitioner recruitment and retention has made the provision of accommodation in rural communities a vital issue. This study has found that approximately half of all medical students on placement with rural GPs are currently accommodated with their GP supervisor or with other practice staff. This is a burden for many GPs and when the anticipated increase in the frequency and length of rural placements occurs what is currently a burden will become unsustainable. The changing gender and cultural demographics of medical students and rural general practitioners will also contribute to stresses on this accommodation system. It is important to have a systematic approach towards more appropriate and sustainable models of accommodation for both medical students and GP registrars.
Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald
Three strategies designed to maximize attendance at educational sessions on chronic disease medication safety in older adults in rural areas were implemented sequentially and compared for cost-effectiveness: 1) existing community groups and events, 2) formal advertisement, and 3) employer-based outreach. Cost-effectiveness was measured by comparing overall cost per attendee recruited and number of attendees per event. The overall cost per attendee was substantially higher for the formal advertising strategy, which produced the lowest number of attendees per event. Leveraging existing community events and employers in rural areas was more cost-effective than formal advertisement for recruiting rural community members.
Full Text Available A cross-sectional study was conducted in four rural communities of northeastern Trinidad to determine the microbial quality of water supply to households and that quality's relationship to source and storage device. Of the 167 household water samples tested, total coliforms were detected in 132 of the samples (79.0%, fecal coliforms in 102 (61.1%, and E. coli in 111 (66.5%. There were significant differences among the towns in the proportion of the samples contaminated with coliforms (P < 0.001 and E. coli (P < 0.001. Of 253 strains of E. coli studied, 4 (1.6% were mucoid, 9 (3.6% were hemolytic, and 37 (14.6% were nonsorbitol fermenters. Of 69 isolates of E. coli tested, 10 (14.5% were verocytotoxigenic. Twenty-eight (14.0% of 200 E. coli isolates tested belonged to enteropathogenic serogroups. Standpipe, the most common water source, was utilized by 57 (34.1% of the 167 households. Treated water (pipeborne in homes, standpipes, or truckborne was supplied to 119 households (71.3%, while 48 households (28.7% used water from untreated sources (rain, river/stream, or well as their primary water supply. The type of household storage device was associated with coli-form contamination. Water stored in drums, barrels, or buckets was more likely to harbor fecal coliforms (74.2% of samples than was water stored in tanks (53.3% of samples, even after controlling for water source (P = 0.04. Compared with water from other sources, water piped into homes was significantly less likely to be contaminated with total coliforms (56.9% versus 88.8%, P < 0.001 and fecal coliforms (41.2% versus 69.8%, P < 0.01, even when the type of storage device was taken into account. However, fecal contamination was not associated with whether the water came from a treated or untreated source. We concluded that the drinking water in rural communities in Trinidad was grossly unfit for human consumption, due both to contamination of various water sources and during household
Jetter, Karen M; Yarborough, Mark; Cassady, Diana L; Styne, Dennis M
To develop a research ethics training course for American Indian/Alaskan Native health clinic staff and community researchers who would be conducting human subjects research. Community-based participatory research methods were used in facilitated discussions of research ethics centered around topics included in the Collaborative Institutional Training Initiative research ethics course. The community-based participatory research approach allowed all partners to jointly develop a research ethics training program that was relevant for American Indian/Alaskan Native communities. All community and clinic partners were able to pass the Collaborative Institutional Training Initiative course they were required to pass so that they could be certified to conduct research with human subjects on federally funded projects. In addition, the training sessions provided a foundation for increased community oversight of research. By using a collaborative process to engage community partners in research ethics discussions, rather than either an asynchronous online or a lecture/presentation format, resulted in significant mutual learning about research ethics and community concerns about research. This approach requires university researchers to invest time in learning about the communities in which they will be working prior to the training. © 2014 Society for Public Health Education.
Full Text Available On-line and distance professional learning communities provides teachers with increased access and flexibility as well as the combination of work and education. It also provides a more learner-centered approach, enrichment and new ways of interacting with teachers in isolated rural areas. For educational administrators, on-line learning offers high quality and usually cost-effective professional development for teachers. It allows upgrading of skills, increased productivity and development of a new learning culture. At the same time, it means sharing of costs, of training time, increased portability of training, and the exchange of creativity, information, and dialogue.
Full Text Available The main focus of the research was to analyse the role of cooperatives in sustaining the livelihoods of local rural communities in Shurugwi District in Zimbabwe. Descriptive survey design was used in this mixed method approach to the study. A questionnaire, interviews and observation methods were employed as the main research instruments. Purposive sampling technique was adopted and data were collected from government officials and from members of the six cooperatives in Shurugwi District. A total of 50 research participants were involved in the study. It was found that cooperatives were established as a strategy to sustain livelihoods of rural communities. With the adoption of cooperatives, people in the rural communities managed to generate employment, boost food production, empower the marginalised, especially women, and promote social cohesion and integration, thereby improving their livelihoods and reducing poverty. Most cooperatives face a number of challenges that include lack of financial support, poor management and lack of management skills, and lack of competitive markets to sell their produce. The study recommends that the government and the banking sector render financial support to cooperatives in rural communities to allow them to expand and diversify their business operations; constant training on leadership and management skills is provided to cooperatives’ members. There is also a need for cooperatives, especially those in the agricultural sector, to form some producer associations so as to easily market their produce. Lastly, the study recommends that future research should focus on investigating issues that hinder the growth of the cooperative movement in rural communities of Zimbabwe. It is hoped that policy-makers, the academia and communities would benefit from the study.
Slack, Marion K.; Cummings, Doyle M.; Borrego, Matthew E.; Fuller, Kathi; Cook, Sherrie
Describes strategies used by five U.S. rural interdisciplinary training grant programs (mainly based in academic institutions) to respond to local needs and promote recruitment in rural communities. Programs provide training to 17 health care disciplines and serve diverse disadvantaged populations. Services are provided through individual clinical…
This book is intended to help people better understand how wood energy is helping to revitalize rural Alaskan communities by reducing energy costs, creating jobs, and helping to educate the next generation. The village of Koyukuk shows how modern wood energy systems can meet the challenges of remote rural Alaska. To fully succeed, however, these...
Malek, Jalaluddin Abdul; Razaq Ahmad, Abdul; Mahzan Awang, Mohd; Alfitri
Telecentres in the 21st century may be able to improve standard of living, quality of life, and stability of knowledge for the rural population. The role of telecentres is widely increasing in developing political and management awareness, economic, socio-culture, technology, education and regulation awareness in rural communities. Telecentres in…
State, Nigeria. A total of 144 community based organization (12 ... questionnaires and the data collected was analyzed using simple descriptive .... based on available resources and rural needs and priorities. 134. 10. 144. 3. Co- ordination and supervision of. Agricultural and rural development projects. 131. 13. 144. 4.
This study investigates the impact of self-help initiatives on rural development in Ibesikpo community of Akwa Ibom State, Nigeria. Self help initiatives were defined in terms of provision of employment, education and health-care. A sample size of 369 rural dwellers was drawn and data were analyzed using simple regression ...
Vergara Camus, Leandro
Examination of the politicization of landless people in the encampments and settlements of the Movimento dos Trabalhadores Rurais Sem-Terra (Landless Rural Workers' Movement-MST) in Brazil suggests that the movement's success rest on the fact that it generates relatively autonomous rural communities
Objective: To ascertain the child gender preferences in an urban and rural community in Enugu State. Materials and Methods: A multistage sampling method was employed to select 245 urban and 243 rural women from households in Enugu State, Eastern Nigeria. A structured questionnaire was used to ascertain child ...
Fink, M.; Lang, R..; Harms, Rainer
In this article, we investigate into local economic restructuring in rural areas that are affected by disruptive technologies. Drawing on an institutionalist framework we apply systematic theory-informed case study analysis of two rural communities in Austria and identify practices that are crucial
Chang, Jen Jen; Salas, Joanne; Habicht, Katherine; Pien, Grace W.; Stamatakis, Katherine A.; Brownson, Ross C.
Purpose: To determine the association between sleep duration and depressive symptoms in a rural setting. Methods: We conducted a cross-sectional study using data from Wave 3 of the Walk the Ozarks to Wellness Project including 12 rural communities in Missouri, Arkansas, and Tennessee (N = 1,204). Sleep duration was defined based on average…
Petrin, Robert A.; Farmer, Thomas W.; Meece, Judith L.; Byun, Soo-yong
Adolescents who grow-up in rural areas often experience a tension between their attachment to the rural lifestyle afforded by their home community and a competing desire to gain educational, social, and occupational experiences that are only available in metropolitan areas. While these diverging pressures are well-documented, there is little…
O'Farrell, Denise; Aubrey, Debra Larsen
This paper examines a regional 2009 H1N1 rural response model, which utilises community partnerships with local government, county emergency management, public health, private healthcare, Medical Reserve Corps volunteers, and other organisations in rural Southeast Idaho. Unique aspects of the collaborative use of federal, state, county, and…
Tuan M. Ha
Full Text Available Various failures of the traditional approach in community development in developing countries have led to the development of a more appropriate and holistic approach to address complex development issues. Systems approaches and cutting-edge tools have recently been embraced to deal with such complexities under contexts of interwoven relationships amongst social economic political cultural and environmental factors. This paper provides reflections on practical value of the Evolutionary Learning Laboratory ELLab through a case study on improving the quality of life for women farmers in northern Vietnam where gender-bias labour hardship and poor living-standard are evident. The first five steps of the participatory systems-based ELLab were implemented during 2013-2014 providing valuable results that have made both practical and theoretical contributions with substantial implications to community development. Our study finds that the context-based results reshaped the original project goal. The approach and framework helped to identify and engage right stakeholders in problem analyses and decision making activities. Fuzzy problems within the complex web of life of the women and rural households were uncovered using relevant systems tools to develop a big picture systems model of the current situation defining levers for systemic interventions. The ELLab helps to build capacity of local people for taking ownership of the process and outcomes to guarantee sustainability and long-term impacts. It also facilitates true participation and co-learning amongst stakeholders triggering transformative learning. Contributions to action research and an innovative mechanism for sharing reflections and lessons at both local and global levels via the online Think2ImpactTM are discussed.
Small schools are often the hub of many rural communities. In the school space, a multiplicity of social, economic and political relationships are sustained, which enhance the vitality of the community. As such, the relationship between small schools and communities is often presented as a powerful one; however, too often as a harmonious, natural…
Davis, Sandra; Crothers, Natalie; Grant, Jeanette; Young, Sari; Smith, Karly
Productive ageing recognises the contribution of older people to economic, social and cultural growth and helps build a sustainable community. Being involved in community life is good for individuals and good for society. However, we know very little about the participation of and contribution by people aged 50 and over in rural communities. This…
The concept of community has been central to the discourse of rural education for generations. At the same time, community has been and continues to be a deeply problematic concept. I begin this analysis with Raymond Williams's characterization of the idea of community as a uniquely positive concept, arguing that this framing is, as Williams…
Full Text Available As an ardent cancer researcher, Dr. Smita Asthana has a vision to create wider awareness on cancer and its prevention, and aims to work on translational research to benefit the general public through the implementation of evidence-based research. “I have been associated with the National Institute of Cancer Prevention and Research (NICPR and Institute of Cytology and Preventive Oncology (ICPO since November 2004 and have progressed over a period of time from being a staff scientist to the current role of a senior scientist,” says Dr. Asthana, who is presently with NICPR’s Biostatistics and Epidemiology division.“I have been working in various positions that deal with the design, execution, and evaluation of medical projects. Recently, we have concluded two major cervical cancer screening projects and conducted a screening of 10,000 women in rural areas,” she tells AMOR. One project, funded by the Indian Council of Medical Research, was carried out 100 km west of New Delhi in the rural town of Dadri “as part of an operational research to see the implementation of VIA (visual inspection with acetic acid and VILI (visual inspection with Lugol's iodine screenings with the help of existing healthcare infrastructure,” she explains.As a leading researcher in cervical cancer screening, she completed an Indo-US collaborative project on the clinical performance of a human papillomavirus (HPV test, used as a strategy for screening cervical cancer in rural communities, with funding from the Bill and Melinda Gates Foundation via the international non-profit global health organization PATH. “The primary objective of the project was to observe the performance of careHPV, a new diagnostic kit, in a rural setup,” she says.CareHPV is a highly sensitive DNA test, which detects 14 different types of the human papillomavirus that cause cervical cancer, providing results more rapidly than other DNA tests and is designed especially for use in clinics
Salawu, Oyetunde T; Odaibo, Alexander B
To assess the epidemiology of urogenital schistosomiasis among pregnant women in rural communities of southwestern Nigeria. The present cross-sectional epidemiologic survey of urogenital schistosomiasis was conducted during 2010-2011 among pregnant women in Yewa North Local Government, Ogun State, Nigeria. The women were microscopically screened for infection with Schistosoma haematobium. Of 313 volunteer participants, 20.8% tested positive for S. haematobium infection. The prevalence of infection was highest (31.5%) among women aged 20-24years. The infection intensity did not differ significantly between age groups (t=1.848, P=0.71). Primigravidae and women in the first trimester of pregnancy had the highest intensity of infection with 33.1 and 27.7 eggs/10mL of urine, respectively. There was an association between disease prevalence and parasite intensity across the age groups (χ(2)=68.82, P=0.02). The prevalence of S. haematobium was not associated with age or pregnancy trimester (P=0.06), but associations existed between intensity of infection and gravidity (P=0.001). The prevalence of urogenital schistosomiasis among pregnant women in Nigeria was high, with younger women and primigravidae at the greatest risk. These data can be used to develop a schistosomiasis control program among pregnant women in the study area. Copyright © 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
Full Text Available Global climate changes are undoubtedly course of the increasing frequency of extreme whether events all over the world. Rural communities belong to the “group of victims” which is greatly jeopardized by consequences of the extreme weather events. Having in mind limited capacities for the preparedness, response and recovery after any kind of emergency it is clear that the rural community mostly needs external help. That is the point of this paper: to make new insights about this important issue, and to discuss: “how to provide adequate help in the rural communities and build adequate adaptive and response capacities”. In many countries agriculture and rural tourism are main economic activities in the rural area and its interruption could be the obstacle for implementation of sustainable development. Various stakeholders omit to be aware of this issue. Emergency agencies and many others have to make the comprehensive plan for rural communities (having in mind all its limitations. In the Republic of Serbia rural communities do not have enough capacity for recovery and usually it takes many years after an event. A minimum of an economic recovery standard has to be created for the rural community. It also has to be a specific contingency plan in the future reorganizations of emergency services in Serbia and at the Western Balkan region. It should be one of the priority issues for stakeholders in the near future in disaster risk reduction. Providing equal access to resources to population in the rural community after the extreme weather event has to be the priority task for policy makers and all actors in emergency management.
Full Text Available The paper is based on the concepts of the learning society and community-led local development, specifically focused on community education in rural areas of the Czech Republic. The research questions are connected with the identification of objective and subjective conditions for the development of community education and with the development of activities of Rural Community Schools, both from the supply and demand perspectives. The aim is fulfilled through a secondary analysis of Rural Community Schools’ websites and mainly through primary research carried out by interviewing techniques with a high level of standardisation, conducted with the main actors (Community Coordinators of Rural Community Schools. The results of the study show the higher importance of subjective conditions for the successful development of community education in the Czech Republic. The paper also identifies the demand for educational activities provided by Rural Community Schools as a positive factor in their development. On the other hand, weaknesses could mainly be seen in cooperation with local partners. This is also the main possibility or necessity for their successful future development.
Meidinger, E.; Tysiachniouk, M.S.
The rapid globalization of forest products markets has placed many rural forest-based communities under considerable pressure to rapidly exploit forest resources. To counter, transnational environmental organizations have promoted programs for forest certification, seeking to use global market
Full Text Available Between the years 2008 and 2010 CSIR Built Environment embarked on a joint project with the Walter Sisulu University (WSU) to develop a rural community sustainable development portal. The portal provides a point for interaction, dialogue...
Liou, Yiing-Mei; Wang, Chia-Wen; Hung, Wen-Jing; Lin, Yu-Chi
Taiwan's high population density frequently blurs the administrative boundaries between communities, leading to indistinct community identifications among the population. The authors used the Helvie energy theory to assess different communities in Taiwan, employing a core (population), four internal energies (chemical, physical, biological, and psychiatric) and nine environment subsystems (transportation, health, education, entertainment, economy, politics, communication, culture, and welfare) in an analysis of urban and rural community samples. Authors found significantly different influences on community health due to different environments and energy exchange factors between the two samples. Urban and rural communities have advantages and requirements that are distinct from one another. The community health nurse (CHN) should consider the specific demands of each community and develop professional roles to incorporate the three degrees of prevention. Authors hope that this article can inspire CHNs to define the critical health problems in their communities, facilitate the development of advanced professional roles, and serve as reference in implementing health plans.
Mendoza-Núñez Víctor; Correa-Muñoz Elsa; de la Luz Martínez-Maldonado María
Abstract Background Education is one of the key elements in the promotion of a thorough paradigm for active aging. The aim of this study is to analyze factors that contribute the empowerment of older adults in a rural Mexican community and, thus, promote active aging. Methods The study was conducted in a rural Mexican community (Valle del Mezquital), based on an action-research paradigm. One hundred and fifty-five elderly subjects with elementary school education participated in a formal trai...
Waheed Atilade Adegbiji
Full Text Available Aims and Objectives: This study aimed at assessing the prevalence of ear, nose, and throat with head and neck diseases in a rural community in Oyo State, Nigeria. Materials and Methods: This is a prospective community-based study of ear, nose, and throat diseases. The study was carried out over a period of 3 months (January to March 2017. Verbal consent was obtained from the village head and participants. A total of 738 individuals were enrolled into the study. Interview-assisted questionnaire was administered to obtain bio data and otorhinolaryngological history from all participants, followed by examination and investigation. Data obtained were collated and statistically analyzed using SPSS version 16. Results: A total of 738 consented participants had various forms of ear, nose, and throat disorders. They constituted 435 (58.9% males and 303 (41.1% females, with a male: female ratio of 1:1. Majority of enrollee were dependent age groups. These age groups were 27.4% (1–10, 25.5% (11–20, and 14.1% (51–60. The occupational status revealed that 28.9% were employed; 9.3% were retired; 45.5% were children/students/apprenticeship; and 16.3% were artisans, homemakers, and farmers. Nasal diseases (34.4% were the most common otorhinolaryngological, head and neck disorders while ear, nose, and throat with head and neck diseases were responsible for 43.4%, 14.6%, and 7.6%, respectively. The common diseases were wax impaction (11.7%, sinusitis (14.4%, and allergic rhinitis (22.6%. Less prevalent otorhinolaryngological, head and neck diseases were vertigo/balance disorder (0.9%, cervical spondylosis (1.6%, and pharyngitis/tonsillitis (2.0%. Common procedures performed included impacted earwax removal (22.8%, aural toilet/dressing (14.4%, pure tone audiometry (32.5%, tympanometry (18.4%, endoscopy (9.8%, and antral irrigation (5.7%. Referred cases of 7.2% were recorded. The barriers experienced by these villagers in seeking otorhinolaryngological
Full Text Available The increasing occurrence of disastrous flooding events and the mounting losses in both life and property values in Zimbabwe have drawn attention to the flooding situation in the country, especially the rural areas. This article explores the resilience of vulnerable rural communities to flood risks associated within increasingly frequent and severe events linked to climate change. Starting by reviewing the current literature on rural livelihoods, resilience and vulnerability research, the paper argues for a coordinated teamwork approach in flood risk mitigation in rural areas. The paper concludes with several recommendations for enhanced resilience to flood hazards.
Leipert, Beverly; Anderson, Emma
For many rural Canadians nursing care is the primary and often the sole access point to health care. As such, rural nurses are an invaluable resource to the health and wellbeing of rural populations. However, due to a nursing workforce that is aging and retiring, limited resources and support, healthcare reform issues, and other factors, these rural professionals are in short supply. Because of limited opportunities to learn about rural practice settings, nursing students may be reluctant to select rural practice locations. Relevant and effective educational initiatives are needed to attract nursing students to underserved rural and remote communities so that rural people receive the health care they require. The purpose of this study was to explore the use of the innovative research approach called photovoice as an educational strategy to foster learning about and interest in rural locations and rural nursing as future practice settings. Fostering of interest in rural may help to address nursing workforce shortages in rural settings. Thirty-eight third and fourth year nursing and health sciences students enrolled in an elective 'Rural Nursing' course used the qualitative research method photovoice to take photographs that represented challenges and facilitators of rural nursing practice. They then engaged in written reflection about their photos. Photos were to be taken in rural settings of their choice, thus fostering both urban and rural student exposure to diverse rural communities. One hundred forty-four photos and reflections were submitted, representing students' appreciation of diverse facilitators and challenges to rural nursing practice. Facilitators included technology, a generalist role, strong sense of community, and slower pace of life. Challenges included inadequate rural education in undergraduate nursing programs, professional isolation, safety issues, few opportunities for professional development, lack of anonymity, and insider/outsider status
Full Text Available This study attempt to examine the impact of self-help projects in rural development using Irepodun Local Government Area as a case study, Kwara State, Nigeria. A sample of 200 respondents was interviewed through the use of questionnaire format. In the course of the study, it was revealed that income encouraged the people to embark on self help projects. Community unions / association contributed immensely in the execution of self help projects and the subsequent rural development. The Chi-square and correlation results, concluded that the inhabitants of the area are not equally satisfied with self help projects and amenities and that there is a relationship between population and self help projects and also that self help projects has increased the standard of living of the people in the area. There is an unequal distribution of self help projects in the study area. And since the level and efficiency of self help projects on rural communities normally influence the development of the rural areas, governments should therefore redirect its rural development towards capital and developmental projects in rural areas and make population be the focus for all communities in the rural areas. This will ensure an equitable distribution of self help projects an essential tool for balanced socio-economic development of the rural areas especially in Nigeria.
Key words: Environmental resources, exploitation, rural development. INTRODUCTION ... exploitation of natural resources for better and more meaningful life. .... X2 Labour. Number. Availability and cost of labour determine how many rural farmers can afford to hire. Where labour is scares, the level of cultivation will be less ...
Nurses have historically played a key role in advocacy and service for all members of the community, including those who are traditionally underserved by other providers or the health system. Nurses from a local Atlanta community health system, both clinical and administrative, have continued this tradition by developing an advocacy and service program for the downtown homeless of Atlanta. From its beginnings as a highly informal volunteer program to its current structure as a strongly integrated community health center for the underserved and homeless of Atlanta, local nurses have demonstrated their strong value of service advocacy. Their leadership, insight, discipline, and strategic development have facilitated the growth of a focused, viable health service network for marginalized people of the city of Atlanta.
Reviews have assessed studies of breast and cervical cancer screening access and utilization for rural women, but none analyze interventions to increase screening rates. A mixed methods literature search identified studies of breast and/or cervical cancer prevention education and patient navigation interventions for rural women. Rural areas need greater implementation and evaluation of screening interventions as these services address the challenges of delivering patient-centered cancer care to un-/underserved communities. The lack of intervention studies on breast and cervical cancer education and patient navigation programs compared to urban studies highlights the need for validation of these programs among diverse, rural populations.
Full Text Available This cross sectional descriptive study was conducted in some rural communities of Sreepur Thana during the month of April 2007. The study population included those aged 50 years or more and residing in the study areas. A total of 226 respondents were selected purposively and were interviewed using a pre-tested questionnaire. The objective of this study was to assess their socio economic condition and identify their health problems. The mean age of the respondents was found to be 62 years. Mean family size and monthly family income was estimated to be 5.31 and Taka 5857.52 respectively. More than half (64.2% of the respondents were illiterate. Fifty eight percent of them were unemployed and 67.3% were found to be dependent on their family members. Most of them (65.5% were found to be suffering from joint pains. Some cardio-respiratory problems like palpitation, dyspnea and chest pain was found to be significantly higher among the female respondents (p<0.03. ECG was done on 22 of them. Left ventricular hypertrophy was detected in 22.7% and ischemic heart disease in 27.27% of them. Systolic hypertension was significantly higher in the females (p<0.01. Majority of the respondents (64.5% were found to have a normal fasting blood sugar level. Symptoms of prostatic enlargement like frequency, urgency, hesitation and post void dribbling of urine was respectively found to be present among 15.9, 62.8, 10.7 and 24.8% of the male respondents. In 11.4% of the female respondents, urinary dribbling was found. The mean age of menopause was estimated to be 48.46 years. Ibrahim Med. Coll. J. 2007; 1(2: 17-20
Highfield, Linda; Bartholomew, L Kay; Hartman, Marieke A; Ford, M Molly; Balihe, Philomene
When community health planners select an evidence-based intervention that has been developed and tested in one situation and adapt it for use in a different situation or community, best practice suggests needs assessment and formative research in the new setting. Cancer prevention planners who are interested in adopting and adapting evidence-based approaches need to base their choices on a sound understanding of the health or behavioral risk problem in which they mean to intervene. This requires a balancing act of weighing community information against a broader perspective from the scientific literature and using the combination to identify and adapt an evidence-based intervention program that is likely to be effective in the new setting. This report is a case study of a community and organizational assessment conducted as a foundation for selecting and recommending adaptation of an evidence-based intervention for improving mammography appointment attendance. We used an inductive sequential exploratory mixed-methods design to inform this process. The process provides a model for formative research grounding evidence-based practice for cancer control planners. Future studies that incorporate findings from needs assessment into the adaptation of the selected intervention program may promote the effective dissemination of evidence-based programs. © 2014 Society for Public Health Education.
Coakes, S J; Kelly, G J
Rural women face a variety of health-related problems, some of which they share with their city sisters. However, the multiple responsibilities of women on the land, and their geographical isolation and lack of support, can lead to physical decline and increased mental strain. It is these factors which are often overlooked in the planning and allocation of funding and services to rural areas. This paper examines the application of community competence and empowerment measures in developing and implementing health services for women in rural Australian communities. A study conducted in the south-west region of Western Australia illustrates the ability of women within rural communities to identify and respond constructively to health issues of concern.
McCall-Hosenfeld, Jennifer S; Weisman, Carol S
Preventive health interventions often occur less frequently among rural women compared to urban women. Preventive counseling is an important feature of comprehensive preventive healthcare provision, but geographic disparities in the receipt of preventive counseling services have not been fully described. In this study the framework of the behavioral model of healthcare utilization was employed to investigate the association between rurality and receiving preventive counseling. It was hypothesized that demographic differences in rural and urban communities, as well as differential healthcare resources, explain rural-urban healthcare disparities in preventive counseling. Data were collected by telephone survey during 2004-2005 for 2002 participants aged 18-45 years in the Central Pennsylvania Women's Health Study. Measures of preventive counseling were based on US Preventive Services Task Force recommendations as of 2004. Multivariable models assessed the independent contribution of rurality to the receipt of counseling for smoking, alcohol/drug use, birth control, nutrition, weight management, and physical activity. Rurality was assessed using Rural-Urban Community Area Codes. All models controlled for variables that predispose individuals to use health services (age, race/ethnicity, educational level), variables that enable or impede healthcare access (having a usual healthcare provider, using an obstetrician-gynecologist, poverty, and continuous health insurance coverage) and need-based variables (health behaviors and indicators). In bivariate analysis, the rural population was older, had lower educational attainment, and was more likely to be White, non-Hispanic. Urban women tended to report seeing an obstetrician-gynecologist more frequently, and engaged more frequently in binge drinking/drug use. Preventive counseling was low among both rural and urban women, and ranged from 12% of the population for alcohol/drug use counseling, to 37% for diet or nutrition
Garney, Whitney R; Drake, Kelly; Wendel, Monica L; McLeroy, Kenneth; Clark, Heather R; Ryder, Byron
Compared with their urban counterparts, rural populations face substantial disparities in terms of health care and health outcomes, particularly with regard to access to health services. To address ongoing inequities, community perspectives are increasingly important in identifying health issues and developing local solutions that are effective and sustainable. This article has been developed by both academic and community representatives and presents a brief case study of the evolution of a regional community of solution (COS) servicing a 7-county region called the Brazos Valley, Texas. The regional COS gave rise to multiple, more localized COSs that implemented similar strategies designed to address access to care within rural communities. The regional COS, known as the Brazos Valley Health Partnership, was a result of a 2002 health status assessment that revealed that rural residents face poorer access to health services and their care is often fragmented. Their localized strategy, called a health resource center, was created as a "one-stop shop" where multiple health and social service providers could be housed to deliver services to rural residents. Initially piloted in Madison County, the resource center model was expanded into Burleson, Grimes, and Leon Counties because of community buy-in at each of these sites. The resource center concept allowed service providers, who previously were able to offer services only in more populous areas, to expand into the rural communities because of reduced overhead costs. The services provided at the health resource centers include transportation, information and referral, and case management along with others, depending on the location. To ensure successful ongoing operations and future planning of the resource centers, local oversight bodies known as health resource commissions were organized within each of the rural communities to represent local COSs. Through collaboration with local entities, these partnerships have
Full Text Available Shabana Amanda Ali,1 Kathleen Ellen Walsh,2 Marita Kloseck1 1Faculty of Health Sciences, University of Western Ontario, London, ON, 2Faculty of Science, University of Western Ontario, London, ON, Canada Introduction: Although there is no cure for osteoarthritis (OA, there are lifestyle modifications that can mitigate symptoms such as pain, and improve management of the disease. This information is not always translated to community-dwelling seniors. Individuals in rural areas often face additional challenges due to geographic isolation and decreased access to community services. Methods: We used qualitative research methodology (hermeneutic phenomenology to better understand the lived experiences of urban and rural community-dwelling seniors diagnosed with OA. We explored their sources of information about OA, how they manage their OA pain, and how OA management could be improved in the community. Purposeful sampling was used to recruit 20 information-rich participants (11 urban, 9 rural in Ontario, Canada. All participants were aged >65 and diagnosed with OA. Semi-structured interviews were conducted, audio recorded, and transcribed verbatim. NVivo 11 Pro qualitative software was used to code transcripts. Results: Thematic analysis revealed 9 key themes where 8 were common to urban and rural participants, and 1 was unique to rural participants. Most significant among the common themes was the description of the social network as a source of OA information, the trial-and-error approach used for OA management, and the individual contextualization of OA management. Our results suggest that there are several common experiences among urban- and rural-dwelling seniors living with OA, including the desire for support over time, but also a unique experience to rural-dwelling seniors, namely lack of access to local care. Conclusion: These findings can be used to improve translation of OA information in both urban and rural communities in Canada
Laws, Reesa; Gillespie, Suzanne; Puro, Jon; Van Rompaey, Stephan; Quach, Thu; Carroll, Joseph; Weir, Rosy Chang; Crawford, Phil; Grasso, Chris; Kaleba, Erin; McBurnie, Mary Ann
The Community Health Applied Research Network, funded by the Health Resources and Services Administration, is a research network comprising 18 Community Health Centers organized into four Research Nodes (each including an academic partner) and a data coordinating center. The network represents more than 500,000 diverse safety net patients across 11 states. The primary objective of this paper is to describe the development and implementation process of the CHARN data warehouse. The methods involved regulatory and governance development and approval, development of content and structure of the warehouse and processes for extracting the data locally, performing validation, and finally submitting data to the data coordinating center. Version 1 of the warehouse has been developed. Tables have been added, the population and the years of electronic health records (EHR) have been expanded for Version 2. It is feasible to create a national, centralized data warehouse with multiple Community Health Center partners using different EHR systems. It is essential to allow sufficient time: (1) to develop collaborative, trusting relationships among new partners with varied technology, backgrounds, expertise, and interests; (2) to complete institutional, business, and regulatory review processes; (3) to identify and address technical challenges associated with diverse data environments, practices, and resources; and (4) to provide continuing data quality assessments to ensure data accuracy.
Report from a technical assistance project to help Madison County, NY, develop a tool to help rural local governments assess how well their policies are helping them achieve the type of development they want.
MBCM) among rural dwellers in Imo State Nigeria. Three hundred and sixty households were randomly selected and data were obtained from them with the use of questionnaires and Focus Group Discussion. The results showed that only 30% of ...
Full Text Available The hydraulic potential in Morocco is limited, droughts are more frequent, resulting of climate change, and increasing water demand relating to the population growth and socio-economic development. Morocco has invested in the urban sanitation sector through the establishment of the National Liquid Sanitation Program. In rural Area, the intervention in this sector remains limited due to various constraints. In order to support the efforts of establishment of the National Rural Assainissment Program (PNAR, we conducted a case study that recommended the treatment of wastewater by an innovative process used for the first time in Morocco. We realized, first, a pilot experiment at the douar (Unstructured Village Talat Marghen within the rural Municipality of Aghouatim a few km from Marrakech. The innovative aspect of the project is managerial proposes covering the different technical aspects, management and institutional innovation, to meet the various constraints that characterize the rural areas.
Transport in rural and remote regions receives considerable attention in research, but this is often focussed on specific means of resolving problems in those regions - for example, the role of demand-responsive bus services, or scope for attracting users to rail services. The aim of this paper is to take a broader view, firstly in defining what constitute rural and remote regions, and secondly in considering a wide range of public transport options available. Experience in Britain will be ta...
The study examined the role of community based organizations in rural and Agricultural transformation in Delta State, Nigeria. A total of 144 community based organization (12 from each local government area were selected from 12 out of the 25 local government areas that make up Delta State using stratified and random ...
Chilenski, Sarah M; Syvertsen, Amy K; Greenberg, Mark T
Rural communities make up much of America's heartland, yet we know little about their social organization, and how elements of their social organization relate to crime rates. The current study sought to remedy this gap by examining the associations between two measures of social organization - collective efficacy and social trust - with a number of structural community characteristics, local crime rates, and perceptions of safety in a sample of 27 rural and small town communities in two states. Measures of collective efficacy, social trust, and perceived safety, were gathered from key community members in 2006; other measures were drawn from the 2000 Census and FBI Uniform Crime Reporting system. A series of competing hypotheses were tested to examine the relative importance of social trust and collective efficacy in predicting local crime rates. Results do not support the full generalization of the social disorganization model. Correlational analyses showed that neither collective efficacy nor social trust had a direct association with community crime, nor did they mediate the associations between community structural characteristics and crime. However, perceived safety mediated the association between community crime and both measures of social organization. Analyses suggest that social trust may be more important than collective efficacy when understanding the effect of crime on a community's culture in rural areas. Understanding these associations in rural settings can aid decision makers in shaping policies to reduce crime and juvenile delinquency.
Harrris, Cortney R.
Research studies show that there is a skills gap in American society today. This research study examined employability perceptions of community college students at a rural community college in Mississippi. Students were asked to complete an online survey that questioned the degree of importance placed on several employability skills, as well as…
Awareness Of HIV/AIDS Among Rural Communities In Kwara State And It's Implications On Agricultural Productivity In Nigeria. ... The people selected were male adult, female adults, male youths and female youths so that all the members of these communities were given opportunity to participate in the study.
Stommes, Eileen S.
The need for passenger transportation is widely recognized by rural communities. Shrinking federal funding has led many communities and human service agencies to experiment with innovative approaches to provide transportation services. One such approach is the use of cooperative organizations to provide needed services. A study conducted by the…
Original Research: Evaluation of community-based growth monitoring in rural districts. 2009;22(4). S Afr J Clin Nutr. Site 7. The project volunteer did not give any nutrition education, but there was a community health worker (who previously was a project volunteer) who did. No visual aids were used. (n = 11). Hygiene and ...
Nestel, Debra; Gray, Katherine; Simmons, Margaret; Pritchard, Shane A; Islam, Rumana; Eng, Wan Q; Ng, Adrian; Dornan, Tim
BACKGROUND: This paper explores local community perceptions of a relatively new rural medical school. For the purposes of this paper, community engagement is conceptualized as involvement in planning, delivering, and evaluating the medical program. Although there are several reviews of patient
Houghton, Ruth M.
Identifies social policy issues for rural communities affected by major development projects. Advocates increased attention in legislation by community workers and fuller recognition of social policy as a planning and development priority. Concludes that economics is still the major concern for development projects, rather than social policy. (BR)
Neck pain (NP) is a common health problem which exerts significant stress on physical functioning, work, productivity and health costs. However, there is a dearth of published studies on community prevalence of neck pain in rural communities in Nigeria. This study aimed at finding out the prevalence of NP among people ...
Perceptions and attitudes of a rural community to abortion in the Niger-delta region of Nigeria. ... Almost all agreed that their culture and religion abhors abortion, yetwidely practiced because of the odium associatedwith an unwanted pregnancy in the community. The knowledge of the Nigeria National abortion law even ...
Torres, Irene; Simovska, Venka
paradigm. Findings - The findings help identify and portray different forms of community participation, ranging from a total absence of meaningful participation, through very limited, to consequential participation determined as community influence on the SFP practices to meet the community needs...
Hanlon, Neil; Halseth, Greg; Snadden, David
Community-integrated undergraduate medical education is becoming a more common option for students predisposed to practice in rural and small town places. One such initiative, the Northern Medical Program, has been operating since 2004 in the northern interior of British Columbia, Canada. The NMP's curriculum relies heavily on the involvement of practicing physicians in its host community, Prince George. Drawing on Bourdieu's conceptualization of capital in its different forms, the commitment of the local physician community is understood as social capital derived from cultural capital centred on a collective sense of professional identity forged by conditions of practice in an underserviced area. The findings of this study are discussed with respect to the long-term operation and success of community-integrated medical education programs. Copyright 2010 Elsevier Ltd. All rights reserved.
Paula A White
Full Text Available Sport hunting has reportedly multiple benefits to economies and local communities; however, few of these benefits have been quantified. As part of their lease agreements with the Zambia Wildlife Authority, sport hunting operators in Zambia are required to provide annually to local communities free of charge i.e., provision a percentage of the meat obtained through sport hunting. We characterized provisioning of game meat to rural communities by the sport hunting industry in Zambia for three game management areas (GMAs during 2004-2011. Rural communities located within GMAs where sport hunting occurred received on average > 6,000 kgs per GMA of fresh game meat annually from hunting operators. To assess hunting industry compliance, we also compared the amount of meat expected as per the lease agreements versus observed amounts of meat provisioned from three GMAs during 2007-2009. In seven of eight annual comparisons of these GMAs, provisioning of meat exceeded what was required in the lease agreements. Provisioning occurred throughout the hunting season and peaked during the end of the dry season (September-October coincident with when rural Zambians are most likely to encounter food shortages. We extrapolated our results across all GMAs and estimated 129,771 kgs of fresh game meat provisioned annually by the sport hunting industry to rural communities in Zambia at an approximate value for the meat alone of >US$600,000 exclusive of distribution costs. During the hunting moratorium (2013-2014, this supply of meat has halted, likely adversely affecting rural communities previously reliant on this food source. Proposed alternatives to sport hunting should consider protein provisioning in addition to other benefits (e.g., employment, community pledges, anti-poaching funds that rural Zambian communities receive from the sport hunting industry.
Full Text Available Abstract Background While attraction of doctors to rural settings is increasing in Mali, there is concern for their retention. An orientation course for young practicing rural doctors was set up in 2003 by a professional association and a NGO. The underlying assumption was that rurally relevant training would strengthen doctors' competences and self-confidence, improve job satisfaction, and consequently contribute to retention. Methods Programme evaluation distinguished trainees' opinions, competences and behaviour. Data were collected through participant observation, group discussions, satisfaction questionnaires, a monitoring tool of learning progress, and follow up visits. Retention was assessed for all 65 trainees between 2003 and 2007. Results and discussion The programme consisted of four classroom modules – clinical skills, community health, practice management and communication skills – and a practicum supervised by an experienced rural doctor. Out of the 65 trained doctors between 2003 and 2007, 55 were still engaged in rural practice end of 2007, suggesting high retention for the Malian context. Participants viewed the training as crucial to face technical and social problems related to rural practice. Discussing professional experience with senior rural doctors contributed to socialisation to novel professional roles. Mechanisms underlying training effects on retention include increased self confidence, self esteem as rural doctor, and sense of belonging to a professional group sharing a common professional identity. Retention can however not be attributed solely to the training intervention, as rural doctors benefit from other incentives and support mechanisms (follow up visits, continuing training, mentoring... affecting job satisfaction. Conclusion Training increasing self confidence and self esteem of rural practitioners may contribute to retention of skilled professionals in rural areas. While reorientations of curricula in
van der Hoeven, Marinka; Kruger, Annamarie; Greeff, Minrie
The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economic characteristics, health status, beliefs about health and (access to) health care was collected. The results clearly illustrated differences in socio-economic characteristics, health status, beliefs about health, and health care utilisation. In general, inhabitants of urban communities rated their health significantly better than rural participants. Although most urban and rural participants consider their access to health care as sufficient, they still experienced difficulties in receiving the requested care. The difference in employment rate between urban and rural communities in this study indicated that participants of urban communities were more likely to be employed. Consequently, participants from rural communities had a significantly lower available weekly budget, not only for health care itself, but also for transport to the health care facility. Urban participants were more than 5 times more likely to prefer a medical doctor in private practice (OR:5.29, 95% CI 2.83-988). Recommendations are formulated for infrastructure investments in rural communities, quality of health care and its perception, improvement of household socio-economical status and further research on the consequences of delay in health care seeking behaviour.
Full Text Available This study used observation and interviews with participants in “PunCar Action” to understand how participatory design methods can be applied to the education of rural individuals in information and communication technology (ICT. PunCar Action is a volunteer program in which ICT educators tour the rural communities of Taiwan, offering courses on the use of digital technology. This paper makes three contributions: First, we found that participatory design is an excellent way to teach ICT and Web 2.0 skills, co-create community blogs, and sustain intrinsic motivation to use Web applications. Second, PunCar Action provides an innovative bottom-up intergenerational ICT education model with high penetrability capable of enhancing the confidence of rural residents in the use of ICT. Third, the content of basic courses was based on applications capable of making the lives of elderly individuals more convenient, and the advanced course was based on the co-creation of community blogs aimed at reviving the core functions of communities and expanding local industry. Our research was conducted with the use of a non-quantitative index to measure ICT learning performance of participants from a rural community. The results show that PunCar Action emphasizes interpersonal communication and informational applications and creates a collaborative process that encourages rural residents to take action to close the digital divide.
Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Vallely, Andrew; Homer, Caroline S E; Whittaker, Andrea
to explore men's and women's experiences, beliefs and practices surrounding childbirth in a rural highlands community in Papua New Guinea. a qualitative study comprising focus group discussions, key informant and in depth interviews. the study was undertaken in a rural community in Eastern Highlands Province, Papua New Guinea. 51 women and 26 men participated in 11 focus group discussions. Key informant and in depth interviews were undertaken with 21 women and five men. both women and men recognised the importance of health facility births, linking village births with maternal and newborn deaths. Despite this, many women chose to give birth in the community in circumstances influenced by cultural and customary beliefs and practices. Women giving birth in the community frequently gave birth in an isolated location. Traditional beliefs surrounding reasons for difficult births, including spiritual beliefs were reported along with the use of traditional methods used to help prolonged and difficult births. while the importance of health facility births is recognised in this rural community many women continue to give birth in the village. Identifying and understanding local customs, beliefs and practices, particularly those that may be harmful to women and their newborn infants, is critical to the development of locally-appropriate community-based strategies for improving maternal and infant health in rural communities in PNG and other resource-limited, high burden settings. Copyright © 2014 Elsevier Ltd. All rights reserved.
Allen, Laura; McIntyre, Amanda; Janzen, Shannon; Richardson, Marina; Meyer, Matthew; Ure, David; Teasell, Robert
Rural living has been demonstrated to have an effect on a person's overall health status, and rural residing individuals often have decreased access to health and specialized rehabilitation services. The aim of this study was to determine if there are differences in recovery from stroke between urban and rural-dwelling stroke survivors accessing an in-home, community-based, interdisciplinary, stroke rehabilitation program. Data from a cohort of 1222 stroke survivors receiving care from the Community Stroke Rehabilitation Teams between January 2009 and June 2013 was analyzed. This program delivers stroke rehabilitation care directly in a person's home and community. Functional and psychosocial outcomes were evaluated at baseline, discharge, and six -month follow-up. A series of multiple linear regression analyses was performed to determine if rural versus urban status was a significant predictor of discharge and 6-month health outcomes. The mean age of the rural cohort was 68.8 (±13.1) years (53.6% male), and the urban cohort was 68.4 (±13.0) years (44.8% male). A total of 278 (35.4%) individuals were classified as living in a rural area using the Rurality Index for Ontario. In multivariate linear regression analysis, no significant differences on the Functional Independence Measure, the Stroke Impact Scale, the Hospital Anxiety and Depression Scale, or the Reintegration to Normal Living Index were found between urban and rural cohorts. When provided with access to a home-based, specialized stroke rehabilitation program, rural dwelling stroke survivors make and maintain functional gains comparable to their urban-living counterparts.
Full Text Available Abstract Background Given limited research evidence for community-based alcohol interventions, this study examines the intervention preferences of rural communities and alcohol professionals, and factors that influence their choices. Method Community preferences were identified by a survey of randomly selected individuals across 20 regional Australian communities. The preferences of alcohol professionals were identified by a survey of randomly selected members of the Australasian Professional Society on Alcohol and Other Drugs. To identify preferred interventions and the extent of support for them, a budget allocation exercise was embedded in both surveys, asking respondents to allocate a given budget to different interventions. Tobit regression models were estimated to identify the characteristics that explain differences in intervention preferences. Results Community respondents selected school programs most often (88.0% and allocated it the largest proportion of funds, followed by promotion of safer drinking (71.3%, community programs (61.4% and police enforcement of alcohol laws (60.4%. Professionals selected GP training most often (61.0% and allocated it the largest proportion of funds, followed by school programs (36.6%, community programs (33.8% and promotion of safer drinking (31.7%. Community views were susceptible to response bias. There were no significant predictors of professionals' preferences. Conclusions In the absence of sufficient research evidence for effective community-based alcohol interventions, rural communities and professionals both strongly support school programs, promotion of safer drinking and community programs. Rural communities also supported police enforcement of alcohol laws and professionals supported GP training. The impact of a combination of these strategies needs to be rigorously evaluated.
van der Hoeven, Marinka; Kruger, Annamarie; Greeff, Minrie
Objective The aim of this study was to explore possible differences in health care seeking behaviour among a rural and urban African population. Design A cross sectional design was followed using the infrastructure of the PURE-SA study. Four rural and urban Setswana communities which represented different strata of urbanisation in the North West Province, South Africa, were selected. Structured interviews were held with 206 participants. Data on general demographic and socio-economi...
Miguel Uribe-Gómez; Artemio Cruz-León; Dionicio Juárez-Ramón; Alejandro Lara-Bueno; José L. Romo-Lozano; Ramón Valdivia-Alcalá; Marcos Portillo-Vázquez
Family agricultural is socioeconomically important in rural areas, but in Mexico, from the 80's this production system presents social stagnation. This type of agriculture presents a dynamic reality in the interests of each producer and limiting access to factors of production (land, labor and capital). In this investigation a methodology for analysis and diagnosis of production systems in rural areas, in two communities in the Country Sierra de Huautla Tepalcingo, Morelos, Mexico was applied...
Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C
It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to better mortality outcomes. They bear a disproportionately
Blessing U. Mberu
Full Text Available Background: It is generally assumed that urban slum residents have worse health status when compared with other urban populations, but better health status than their rural counterparts. This belief/assumption is often because of their physical proximity and assumed better access to health care services in urban areas. However, a few recent studies have cast doubt on this belief. Whether slum dwellers are better off, similar to, or worse off as compared with rural and other urban populations remain poorly understood as indicators for slum dwellers are generally hidden in urban averages. Objective: The aim of this study was to compare health and health-related indicators among slum, rural, and other urban populations in four countries where specific efforts have been made to generate health indicators specific to slum populations. Design: We conducted a comparative analysis of health indicators among slums, non-slums, and all urban and rural populations as well as national averages in Bangladesh, Kenya, Egypt, and India. We triangulated data from demographic and health surveys, urban health surveys, and special cross-sectional slum surveys in these countries to assess differences in health indicators across the residential domains. We focused the comparisons on child health, maternal health, reproductive health, access to health services, and HIV/AIDS indicators. Within each country, we compared indicators for slums with non-slum, city/urban averages, rural, and national indicators. Between-country differences were also highlighted. Results: In all the countries, except India, slum children had much poorer health outcomes than children in all other residential domains, including those in rural areas. Childhood illnesses and malnutrition were higher among children living in slum communities compared to those living elsewhere. Although treatment seeking was better among slum children as compared with those in rural areas, this did not translate to
Hay, M; Mercer, A M; Lichtwark, I; Tran, S; Hodgson, W C; Aretz, H T; Armstrong, E G; Gorman, D
An undersupply of generalists doctors in rural communities globally led to widening participation (WP) initiatives to increase the proportion of rural origin medical students. In 2002 the Australian Government mandated that 25% of commencing Australian medical students be of rural origin. Meeting this target has largely been achieved through reduced standards of entry for rural relative to urban applicants. This initiative is based on the assumption that rural origin students will succeed during training, and return to practice in rural locations. One aim of this study was to determine the relationships between student geographical origin (rural or urban), selection scores, and future practice intentions of medical students at course entry and course exit. Two multicentre databases containing selection and future practice preferences (location and specialisation) were combined (5862), representing 54% of undergraduate medical students commencing from 2006 to 2013 across nine Australian medical schools. A second aim was to determine course performance of rural origin students selected on lower scores than their urban peers. Selection and course performance data for rural (461) and urban (1431) origin students commencing 2006-2014 from one medical school was used. For Aim 1, a third (33.7%) of rural origin students indicated a preference for future rural practice at course exit, and even fewer (6.7%) urban origin students made this preference. Results from logistic regression analyses showed significant independent predictors were rural origin (OR 4.0), lower Australian Tertiary Admissions Rank (ATAR) (OR 2.1), or lower Undergraduate Medical and Health Sciences Admissions Test Section 3 (non-verbal reasoning) (OR 1.3). Less than a fifth (17.6%) of rural origin students indicated a preference for future generalist practice at course exit. Significant predictors were female gender (OR 1.7) or lower ATAR (OR 1.2), but not rural origin. Fewer (10.5%) urban origin
Patten, Emma; O'Meara, Peter; Dickson-Swift, Virginia
Few studies have considered the impact of rural migration on rural community engagement. The objective of this research was to undertake a scoping review about the inclusion and exclusion of newcomers in rural community participation to inform design of inclusive participation processes. The scoping review used the six stages of Arksey and O'Malley's methodological framework. Narrative analysis of the articles was structured using three themes of inclusion and exclusion derived from the literature: interpersonal, socio-cultural norms, and structural and organisational processes. Inclusion and exclusion at the interpersonal level is intricate and often represents broader social rules and tensions that newcomers must navigate in order to become involved. Social norms, such as fear of outsiders and difference, can exclude newcomers from participating in a rural community. Newcomer's awareness of these issues means they are mindful of how they contribute and give respect to the social position of existing residents. Despite this, resistance to change is experienced by newcomers when contributing in organisational contexts. Formal participation processes can harness the practice and value of rural hospitality that newcomers experience as inclusionary. Deliberately designing group processes and operational norms for inclusion can reduce tensions when change occurs and prevent group loss due to exclusionary practices. © 2015 National Rural Health Alliance Inc.
Spina, John; Menec, Verena H
Age-friendly initiatives are increasingly promoted as a policy solution to healthy aging, The primary objective of this article was to examine older adults' and key stakeholders' perceptions of the factors that either help or hinder a community from becoming age-friendly in the context of rural Manitoba, a Canadian prairie province. Twenty-four older adults and 17 key informants completed a qualitative interview. The findings show that contextual factors including size, location, demographic composition, ability to secure investments, and leadership influence rural communities' ability to become age-friendly. Government must consider the challenges these communities face in becoming more age-friendly and develop strategies to support communities. © The Author(s) 2013.
Full Text Available An understanding of rural communities is fundamental to effective community-based rehabilitation work with persons with disabilities. By removing barriers to community participation, persons with disabilities are enabled to satisfy their fundamental human needs. However, insufficient attention has been paid to the challenges that rural community disability workers (CDWs face in trying to realise these objectives. This qualitative interpretive study, involving in-depth interviews with 16 community disability workers in Botswana, Malawi and South Africa, revealed the complex ways in which poverty, inappropriately used power and negative attitudes of service providers and communities combine to create formidable barriers to the inclusion of persons with disabilities in families and rural communities. The paper highlights the importance of understanding and working with the concept of ‘disability’ from a social justice and development perspective. It stresses that by targeting attitudes, actions and relationships, community disability workers can bring about social change in the lives of persons with disabilities and the communities in which they live.
Federico, Ron, Ed.; And Others
The report describes the design of a community development model for child abuse and neglect which used resources already existing in a rural area. The first section presents basic generalizations about rural areas, services, and rural human services professionals. Section II presents working papers, definitions, and concepts used in the project.…
Beam, Margery Elizabeth
The combination of increasing enrollment and the importance of providing transfer students a solid foundation in science calls for science faculty to evaluate teaching methods in rural community colleges. The purpose of this study was to examine and compare the effectiveness of two teaching methods, inquiry teaching methods and didactic teaching methods, applied in a rural community college earth science course. Two groups of students were taught the same content via inquiry and didactic teaching methods. Analysis of quantitative data included a non-parametric ranking statistical testing method in which the difference between the rankings and the median of the post-test scores was analyzed for significance. Results indicated there was not a significant statistical difference between the teaching methods for the group of students participating in the research. The practical and educational significance of this study provides valuable perspectives on teaching methods and student learning styles in rural community colleges.
Background: Dental caries is the most prevalent oral disease of childhood; however, not much attention has been given to studies on this among the rural Nigerian children. Objectives: The aim of this study is to assess the prevalence and risk factors associated with dental caries in secondary school children residing in the ...
Partner violence is a serious public health problem affecting mostly women. This qualitative study assessed the perceptions of rural Igbo women of Nigeria of intimate partner violence. Information was elicited using in-depth interviews and focus group discussion. Women of childbearing age were selected from the various ...
Ofori, Mf; Ansah, E; Agyepong, I
of pregnancy-associated malaria (PAM) in a rural district of Ghana. METHODS: A total of 294 pregnant women were enrolled and followed passively and actively, monthly and weekly until delivery. Haemoglobin levels, malaria parasitaemia and Hb electrophoresis were done from peripheral blood samples. At delivery...
Thus, the article argues that the indigenous knowledge systems constitute an ontology on its own terms with both theoretical and practical (utilitarian) properties. The argument is that the indigenous knowledge systems reside in the rural areas (sites) and are available as tools for regional transformation processes.
Durst, Ron L.; Reeder, Richard J.
Discusses indirect and long-term rural implications of tax reform: elimination of local sales tax deduction, limits on local bond issues. Summarizes major tax changes affecting agriculture: individual income taxes, corporate tax rates, tax treatment of capital, capital gains, land deductions, cash accounting, development costs, passive losses and…
Rife, John C.; And Others
Interviews with 247 homeless families (including 480 children) in 21 rural Ohio counties found that over two-thirds were headed by young single females. The most frequently cited reasons for homelessness were family conflict or dissolution and economic factors. Implications for service provision and policy development are discussed. (LP)
Background: Helminthic infections are occupationally-related diseases which potentially undermine farmers' work capacity, productivity and life expectancy. These infections are usually under-reported among this group particularly in the rural areas. This study was carried out to determine the prevalence, pattern and factors ...
... rural development in Abia State, Nigeria. In addition to extensive review of official document of Abia State governments, structured questionnaire were used in obtaining data analyzed using means, frequency distribution and percentages. There is evidence that roads in Abia State received attention by way of construction ...
Dec 12, 2011 ... epilepsy X2 = 38.1; P <0.212. Conclusion: Cumulative incidence of epilepsy in rural Tanzanian children following a single uncomplicated FS was small but higher than that reported in developed countries. This risk was influenced independently by the number of recurrent FS, family history of FS, and the ...
Objective: To determine the peri-natal mortality rate (PMR), still birth rate (SBR) and early neonatal death rate (ENDR) in Igueben Local Government Area (LGA) of Edo State. Design: A descriptive cross-sectional study. Setting: Igueben LGA is a rural governmental unit in mid-western Nigeria. Subjects: All women of ...
ABSTRACT. Background. Metabolic syndrome (MS) is primarily the consequence of excess central adiposity but can also result from low grade systemic inflammation inducing insulin resistance. There is a global increase in the prevalence of MS; it is on this background that evaluation of the prevalence of MS in a poor rural ...
Background: Metabolic syndrome (MS) is primarily the consequence of excess central adiposity but can also result from low grade systemic inflammation inducing insulin resistance. There is a global increase in the prevalence of MS; it is on this background that evaluation of the prevalence of MS in a poor rural farming ...
Background: Addressing the nutritional needs of adolescents could be an important step towards breaking the vicious cycle of intergenerational malnutrition. Objective: Assess nutritional status of rural adolescent girls. Design: Cross-sectional. Methods: Anthropometric and socio-demographic information from 211 ...
Full Text Available Richard B FrancoeurSchool of Social Work, Adelphi University, Garden City, NY, USA; Center for the Psychosocial Study of Health and Illness, Columbia University, New York, NY, USAAbstract: This article proposes and develops novel components of community-oriented programs for creating and affording access to safe medication dispensing centers in existing retail pharmacies and in permanent or travelling pharmacy clinics that are guarded by assigned or off-duty police officers. Pharmacists at these centers would work with police, medical providers, social workers, hospital administrators, and other professionals in: planning and overseeing the safe storage of controlled substance medications in off-site community safe-deposit boxes; strengthening communication and cooperation with the prescribing medical provider; assisting the prescribing medical provider in patient monitoring (checking the state prescription registry, providing pill counts and urine samples; expanding access to lower-cost, and in some cases, abuse-resistant formulations of controlled substance medications; improving transportation access for underserved patients and caregivers to obtain prescriptions; and integrating community agencies and social networks as resources for patient support and monitoring. Novel components of two related community-oriented programs, which may be hosted outside of safe medication dispensing centers, are also suggested and described: (1 developing medication purchasing cooperatives (ie, to help patients, families, and health institutions afford the costs of medications, including tamper- or abuse-resistant/deterrent drug formulations; and (2 expanding the role of inner-city methadone maintenance treatment programs in palliative care (ie, to provide additional patient monitoring from a second treatment team focusing on narcotics addiction, and potentially, to serve as an untapped source of opioid medication for pain that is less subject to abuse
Petrie, Dennis J; Doran, Christopher M; Shakeshaft, Anthony P; Sanson-Fisher, Rob
To estimate the alcohol-attributable crime and traffic accidents for rural communities in Australia, controlling for potential bias. For 20 rural communities in New South Wales, Australia, crime and traffic accident data was obtained from police records along with risky alcohol use estimated from a postal questionnaire. The relationship between community levels of risky drinking and crime and traffic accidents that occur in alcohol-related times is analysed controlling for the underlying level of crime by using the rate of incidents that occur in non-alcohol-related times. For the 20 rural communities, it was estimated that risky alcohol use is likely to have attributed to between 1.4 and 7.7 common assaults per 1000 population and between 0.6 and 1.8 serious traffic injuries or fatalities per 1000 population, every year. Rural communities in Australia are experiencing a sizeable amount of potentially avoidable harm due to risky alcohol use. Reducing the population levels of those drinking at risk of acute harm or improving the settings in which drinking takes place may have benefits for these communities, especially in terms of crime and traffic accidents. 2009 Elsevier Ltd. All rights reserved.
Н. В. Морозюк
Full Text Available Purpose is development of practical offers of increase of efficiency of use of resource potential of rural territories for formation of self-sufficiency of territorial communities.Methodology is system approach of scientific knowledge. In thе research were used such methods аs: monographic, generalizations, comparisons, abstract and logical modeling and others.Results. The natural and resource potential of rural ter-ritories of Ukraine and Russia is considered in the article. The conclusion is drawn that at its uniqueness rural communities remain subsidized and people below the poverty line. Result of research is offered development of such directions of use of natural resources: for satisfaction of needs of a community; processing and further realization to locals or outside a community; export out of community limits. The advantages from a position of formation of self-sufficiency of rural communities are considered for each of directions, offers on improvement of the organizational and economic mechanism of their realization are developed.Practical implications. Conclusions of the research can be used in practical activities of public authorities and local government.Purchase on Elibrary.ru > Buy now
Logan, T K; Walker, Robert; Nagle, Laura; Lewis, Jimmie; Wiesenhahn, Donna
While there has been considerable research on prenatal alcohol use, there have been limited studies focused on women in rural and small-town environments. This 2-part study examines gender differences in attitudes and perceived barriers to intervention in large community sample of persons living in rural and small-town environments in Kentucky (n = 3,346). The study also examines rural/small-town prenatal service providers' perceptions of barriers to assessment and intervention with pregnant substance abusers (n = 138). Surveys were administered to a convenience sample of employees and customers from 16 rural and small-town community outlets. There were 1503 males (45%) and 1843 females (55%) ranging in age from under 18 years old to over 66 years old. Surveys also were mailed to prenatal providers in county health departments of the 13-county study area, with 138 of 149 responding. Overall results of the community sample suggest that neither males nor females were knowledgeable about the harmful effects of alcohol use during pregnancy. Results also indicate substantial gender differences in alcohol attitudes, knowledge, and perceived barriers. Further, prenatal care providers identified several barriers in assessment and treatment of pregnant women with alcohol use problems in rural and small-town communities, including lack of knowledge and comfort with assessment as well as a lack of available and accessible treatment for referrals.
Campbell, Bruce B; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent
Men's preventive health and wellness is largely neglected in rural Nicaragua, where a machismo culture prevents men from seeking health care. To address this issue, a men's educational group appointment model was initiated at a rural health post to increase awareness about hypertension, and to train community health leaders to measure blood pressure. Men's hypertension workshops were conducted with patient knowledge pretesting, didactic teaching, and posttesting. Pretesting and posttesting performances were recorded, blood pressures were screened, and community leaders were trained to perform sphygmomanometry. An increase in hypertension-related knowledge was observed after every workshop and community health leaders demonstrated proficiency in sphygmomanometry. In addition, several at-risk patients were identified and follow-up care arranged. Men's educational group appointments, shown to be effective in the United States in increasing patient knowledge and satisfaction, appear to function similarly in a resource-constrained environment and may be an effective mechanism for reaching underserved men in Nicaragua.
Raul Olalde Font
Full Text Available This investigation is framed in the analysis of impacts in the local development starting from the taking of decisions on projects of rural energy in Cuban communities that have as economic main activity the agricultural sector, illustrated the results of a case study where the technological most viable options are selected under the optics of the improvement of indicators of community resources. The methods and used materials are characteristic of a field work with application model are characterized for the taking of decisions in the energy area and their sources SURE, as geographical region the community isolated rural “Manantiales” linked to the agrarian sector in the republic of Cuba and the present period review in the thematic one approached. The main indicators are sketched in each resource of the rural community under the optics of the SURE in their version 3.0, as well the characterization of the prediction of the impacts at each technological option on the resources, is exhibited a mean of impacts and the classification of the technologies according to the level of achievements contribute to the indicators of community resources, obtaining as a result that the hydro energy technology is the most viable option with a value of 100 points in the scale from 0 to 100, followed by the GRID with 91.11 and of the photovoltaic systems based on silicon panels with 90.57, in this case all technologies contribute a significant level of achievements to the local community development.
Selfa, Theresa L; Goe, Richard; Kulcsar, Laszlo; Middendorf, Gerad; Bain, Carmen
The aim of this research was an in-depth analysis of the impacts of biofuels industry and ethanol plants on six rural communities in the Midwestern states of Kansas and Iowa. The goal was to provide a better understanding of the social, cultural, and economic implications of biofuels development, and to contribute to more informed policy development regarding bioenergy.Specific project objectives were: 1. To understand how the growth of biofuel production has affected and will affect Midwestern farmers and rural communities in terms of economic, demographic, and socio-cultural impacts; 2. To determine how state agencies, groundwater management districts, local governments and policy makers evaluate or manage bioenergy development in relation to competing demands for economic growth, diminishing water resources, and social considerations; 3. To determine the factors that influence the water management practices of agricultural producers in Kansas and Iowa (e.g. geographic setting, water management institutions, competing water-use demands as well as producers attitudes, beliefs, and values) and how these influences relate to bioenergy feedstock production and biofuel processing; 4. To determine the relative importance of social-cultural, environmental and/or economic factors in the promotion of biofuels development and expansion in rural communities; The research objectives were met through the completion of six detailed case studies of rural communities that are current or planned locations for ethanol biorefineries. Of the six case studies, two will be conducted on rural communities in Iowa and four will be conducted on rural communities in Kansas. A multi-method or mixed method research methodology was employed for each case study.
This study examined the community self-help projects' implementation procedures in Ekiti South West Local Government Area of Ondo State. The study was carried out in 10 communities randomly selected out of 21 communities in the area. A sample of 41 farmers who had participated in self-help projects were purposively ...
Kot, Megan; Castleden, Heather; Gagnon, Graham A
Studies that explore social capital and political will [corrected] in the context of safe drinking water provision in [corrected] Canada are limited. This paper presents findings from a study that examines the capacity of rural Canadian communities to attain regulatory compliance for drinking water. Interviews were conducted with water operators and managers in ten rural communities across Atlantic Canada to identify the burden of compliance arising from the implementation of, and adherence to, drinking water regulations. This research identifies the operator as being particularly burdened by regulatory compliance, often resulting in negative consequences including job stress and a strained relationship with the community they serve. Findings indicate that while regulations are vital to ensuring safe drinking water, not all communities have the resources in place to rise to the challenge of compliance. As a result, some communities are being negatively impacted by these regulations, rather than benefit from their intended positive effect. Copyright © 2011 Elsevier Ltd. All rights reserved.
Dittrich, Yvonne; Vaidyanathan, Lakshmi; Gonsalves, Timothy A
Information and Communication Technology (ICT) is one of the key enablers for including underserved communities in economic and societal development across the world. Our research analyzes several banking service projects developing technical solutions for rural India. This poster presents...... an experience report based on systematic debriefing of involved project leaders and initiators, triangulated with additional documentation. The concept of Socio-Technical Prototype is developed and used to show how to mitigate the challenges of ICT based banking service provision for socially constrained...
Jennifer B. Averill
Full Text Available Rural populations experience higher rates of illness, less access to health care resources, and lower rates of health insurance coverage than do urban populations. A need exists to identify and address the health care needs of rural communities and other isolated populations and to contextualize the findings in the larger rural health environment. Critical ethnography combined with community-based action research is a constructive approach for improving the health status of rural elders as well as other members of isolated communities. Detailed guidelines on how to initiate an ethnographic community-based action study, as shown through a study that explores the definitions of health, health care perceptions, and health care issues for rural elders in the southwestern United States, highlight the value of this type of research for the study of the health care issues of rural populations.
Omolola A. Adedokun
Full Text Available The study reported in this paper examines the effects of community interactive processes on rural adolescents’ educational achievement. Specifically, the paper explored the direct effects of community interactive processes on rural adolescents’ educational achievement and the indirect effects via self-esteem and delinquency. The method of structural equation modeling was used to analyze data from a nationally representative panel study of rural adolescent boys and girls in 10th grade through 12th grade. The results make a compelling case that communities are conduits for boosting self-esteem, facilitating normative behaviors and academic performance in rural adolescents.
Sep 13, 2017 ... Afin de faire l'état des lieux de la situation environnementale, une enquête transversale a été menée dans trois zones rurales (Layo, Ahua et N'djem) en bordure la lagune Ebrié afin d'identifier les comportements à risque menaçant ..... intestinal infections, polio, typhoid, cholera, etc), economy (e.g. poverty, ...
study done in Doumen-county, the rural area of southern. China, which was 33.01% in subjects aged 50 years and above (1). In other similar study conducted on residents of a tropiCal island in Indonesia, the overall prevalence rate of pterygium was found to be 17% (4), higher than. (8.8%) found in Meskan district which is ...
The implementation of strategies for national and global outcomes has in some instances left rural community resources and practices devalued and disturbed and rural people demoralised with the result that local community sustainability has been compromised. Formal education in Australia is about many things, but is rarely sympathetic towards…
Martínez-Donate, Ana P; Riggall, Ann Josie; Meinen, Amy M; Malecki, Kristen; Escaron, Anne L; Hall, Bev; Menzies, Anne; Garske, Gary; Nieto, F Javier; Nitzke, Susan
Research suggests that the food environment influences individual eating practices. To date, little is known about effective interventions to improve the food environment of restaurants and food stores and promote healthy eating in rural communities. We tested "Waupaca Eating Smart " (WES), a pilot intervention to improve the food environment and promote healthy eating in restaurants and supermarkets of a rural community. WES focused on labeling, promoting, and increasing the availability of healthy foods. We conducted a randomized community trial, with two Midwestern U.S. communities randomly assigned to serve as intervention or control site. We collected process and outcome data using baseline and posttest owner and customer surveys and direct observation methods. The RE-AIM framework was used to guide the evaluation and organize the results. Seven of nine restaurants and two of three food stores invited to participate in WES adopted the intervention. On a 0-4 scale, the average level of satisfaction with WES was 3.14 (SD=0.69) for restaurant managers and 3 (SD=0.0) for store managers. On average, 6.3 (SD=1.1) out of 10 possible intervention activities were implemented in restaurants and 9.0 (SD=0.0) out of 12 possible activities were implemented in food stores. One month after the end of the pilot implementation period, 5.4 (SD=1.6) and 7.5 (SD=0.7) activities were still in place at restaurants and food stores, respectively. The intervention reached 60% of customers in participating food outlets. Restaurant food environment scores improved from 13.4 to 24.1 (p restaurant-and food store-based interventions in rural communities. Pilot outcome data indicated very modest levels of effectiveness, but additional research adequately powered to test the impact of this intervention on food environment scores and customer behaviors needs to be conducted in order to identify its potential to promote healthy eating in rural community settings.
Tucker, Jamie; And Others
Almost everyone who responded to three transportation surveys of rural Handicapped Children's Early Education Program (HCEEP) projects identified transportation as a critical problem in the delivery of services to handicapped children in rural areas. Transportation problems encountered were attributed to environmental/geographic factors,…
Other goals include improved governance through building stronger community institutions and increased community capacity, empowerment and voice, which can in turn provide a vehicle for strengthening local governance in other spheres of social and economic development. Thus, participation has now become an ...
Background: Rwanda is moving towards malaria pre-elimination phase by the year 2017 and the role of the community will be critical. However, there is limited information about community perspective of the malaria elimination strategy. A study was thus designed to explore that. Methods: A descriptive cross-sectional study ...
Mindy S. Crandall; Jane L. Harrison; Claire A. Montgomery
As part of the Integrated Landscape Assessment Project, we developed a methodology for managers to include potential community benefits when considering forest management treatments. To do this, we created a watershed impact score that scores each watershed (potential source of wood material) with respect to the communities that are likely to benefit from increased...
The public library is an institution of inestimable value supported by public fund for the benefit of the society. The use of public libraries is not restricted to any class of persons in the community but it is freely available to all. This article reviews the purpose and role of public libraries in any community. The problems bedeviling ...
As part of the Interior Columbia Basin Ecosystem Management Project, 198 small communities were assessed for their ability to deal with change and the characteristics that contribute to this ability. Scientists conducted on-the-ground studies and had communities assess themselves.The data revealed complex differences, patterns, and underlying relationships....
Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda
In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community. © 2017 John Wiley & Sons Ltd.
Cubbins, Lisa A.; Kasprzyk, Danuta; Montano, Daniel; Jordan, Lucy P.; Woelk, Godfrey
Background: Understanding what factors contribute to alcohol abuse in resource-poor countries is important given its adverse health consequences. Past research shows that social peers influence substance abuse, suggesting that the social environment may be an effective target for reducing alcohol abuse across a population. This study investigates the determinants of alcohol use and abuse in rural Zimbabwe and tests a Community Popular Opinion Leader (CPOL) community-based intervention partly ...
Natural disasters are becoming more common around the world, and it is widely accepted that developing nations show the highest rates of vulnerability. It makes sense to focus preparedness and mitigation efforts in these countries. However, it is important to realize that different teaching styles are required for different cultures with varying education systems and classroom atmospheres. The pedagogical models we use in the US can't be directly exported. A realistic assessment of the situation seen during two years living and working in rural El Salvador is presented, along with methods used and lessons learned.
Kischener, Manoel Adir; Kiyota, Norma; Perondi, Miguel Angelo
O novo padrão de modernização da agricultura e do rural, que vigora na maior parte das regiões rurais do Brasil, também se faz presente no Sudoeste do Paraná. Assim, considerando as marcas deixadas por esse processo, procurou-se verificar quais foram os fatores que interferiram na sucessão geracional e passaram a influenciar a estratégia de reprodução social da agricultura familiar. Para tanto, a partir de uma abordagem qualitativa, esta pesquisa procurou comparar duas comunidades rurais esta...
Context: The issue of health seeking of citizens of a developing country like Nigeria is vital as it directs health policy formulation and resource allocation ... Health facilities in rural communities should be equipped as much as those in the urban areas and incentives increased for health professionals that live in these ...
WILLIAMS, J. EARL
SUBSTANTIAL POVERTY IN RURAL AREAS HAS BEEN CAUSED BY UNEMPLOYMENT DUE TO THE TECHNOLOGICAL REVOLUTION WHICH HAS MECHANIZED AGRICULTURAL OCCUPATIONS WHICH HAVE BEEN THE EXCLUSIVE DOMAIN OF THE FARM LABORER. A WELL-ORGANIZED COMMUNITY ACTION PROGRAM PROVIDES A MEANS OF EFFECTIVELY COMBATING THE RATE OF UNEMPLOYMENT WHICH IS ESPECIALLY HIGH AMONG…
Full Text Available Less than 15% of rural areas of Cameroon have access to grid electricity. Only 53% of the population has access to grid electricity. Notwithstanding, Cameroon has a huge hydropower potential which could be harnessed. Mini grids, powered by pico and micro hydropower plants, are a relatively new rural electrification strategy in Cameroon. Several of such mini grids have been realized in the mountain regions of the country. Some of these systems have been more successful than others. This paper aims to share the experiences of community-based pico and micro hydropower schemes for rural electrification in Cameroon. The paper provides insight to the challenges that three of such mini grid systems powered by pico and micro hydropower plants had encountered and it attempts to identify issues related to their performances. The study was based on personal experience, field visits, participant observations, interviews and focus group discussions with key members of the beneficiary communities and documentations from the local NGO which implemented the schemes. Key findings of this study relate to the description of the main aspects about: planning of a robust system design, organizational aspects, like social cohesion at all levels of scheme management, community leadership and ownership of the system and involvement of the beneficiaries at all stages of the project cycle. These aspects were particularly addressed within the context of rural communities in Cameroon.
Kemausuor, Francis; Bolwig, Simon; Miller, Shelie
This study analyses ex-ante socio-economic impacts of biogas systems using a remote rural community in Ghana as a case study. An analysis was performed for a 300 m3 bio-digester that relies on crop residue and animal manure as feedstock to produce methane gas for cooking using selected bioenergy ...
Ran, Mao-Sheng; Xiang, Meng-Ze; Mao, Wen-Jun; Hou, Zai-Jin; Tang, Mu-Ni; Chen, Eric Yu-Hai; Chan, Cecilia Lai-Wan; Yip, Paul S. F.; Conwell, Yeates
In this study, demographic and clinical characteristics of individuals with schizophrenia in a Chinese rural community who had attempted suicide at some time in their lives and those who had not made a suicide attempt were compared. Among individuals with schizophrenia, subjects with (n = 38) and without (n = 472) a lifetime history of suicide…
Nielsen, Louise Hjort
Little is known from research about barriers to seeking and receiving help following domestic violence, rape, attempted rape, and sexual assault in Denmark. This study examined possible regional differences in reporting rape and sexual assault in urban and rural communities in a large region...
... subsequent cost reporting period, the lesser of their reasonable costs or a target amount. The target amount.... The target amount in subsequent cost ] reporting periods is defined as the preceding cost reporting... establishing cost-based reimbursement for ``rural community hospitals'' to furnish covered inpatient hospital...
This article is essentially written as two linked parts. The first part considers how space, spatiality and history can contribute to understanding and "doing something about" the sustainability of rural communities. This is done by extensive reference to Soja's (1989 & 1996) space and spatial theorising and selective perspectives of…
Okamoto, Scott K.; Po'a-Kekuawela, Ka'ohinani; Chin, Coralee I. H.; Nebre, La Risa H.; Helm, Susana
This qualitative study examined the drug resistance strategies of Hawaiian youth residing in rural communities in Hawai'i. Forty seven youth participated in 14 focus groups which focused on the social and environmental context of drug use for these youth. The findings indicated that there were 47 references to resistance strategies used in drug…
Anaemia in pregnancy is a major public health problem in Nigeria. Iron deficiency is one of the major causes of anaemia in pregnancy. Inadequate iron intake during pregnancy can be dangerous to both baby and mother. Iron status of pregnant women was assessed in two rural and one urban communities in Cross River ...
Barnes, Nancy D.; Harrod, Susan E.
Focuses on efforts in Connecticut to combat teenage pregnancy. Describes a model program that emphasizes a collaborative venture between a state-funded community-based pregnancy prevention program and a regional vocational-technical high school located in a rural setting. Describes Northeast Connecticut Teen Pregnancy Prevention Program and the…
McWhinney, Sharon; McDonald, Andrea; Dawkins-Moultin, Lenna; Outley, Corliss; McKyer, E. Lisako; Thomas, Audrene
A comprehensive understanding of the barriers inhibiting physical activity among children is critical in the fight against childhood obesity. This qualitative interview study examined parents' and children's perceptions of the barriers to physical activity in rural communities of low socioeconomic status. Parents and children concurred that the…
Beaulieu, Lionel J.; Molnar, Joseph J.
Findings from current literature form the basis for this examination of five critical elements of change and development within the local community setting which impact on agriculture: population, employment, land, water, and environment. Renewed rural population growth during the 1970's has reversed small farm trends but placed strains on local…
Pancsofar, Nadya; Vernon-Feagans, Lynne
This study utilized a large sample of two-parent families from low-income rural communities to examine the contributions of father education and vocabulary, during picture book interactions with their infants at 6 months of age, to children's subsequent communication development at 15 months and expressive language development at 36 months. After…
Hastrup, Lene Halling; Aagaard, Jørgen
Purpose: Health economic evidence of assertive community treatment (ACT) in Denmark is limited. The aim of the study was to assess the costs and outcome of ACT among 174 patients with severe and persistent mental illness in a rural area of Denmark. Methods: The study was based on a quasi...
Galt, Kimberly A; Fuji, Kevin T; Faber, Jennifer
To implement a communication network for safety problem identification and solution sharing among rural community pharmacists and to report participating pharmacists' perceived value and impact of the network on patient safety after 1 year of implementation. Action research study. Rural community pharmacies in Nebraska from January 2010 to April 2011. Rural community pharmacists who voluntarily agreed to join the Pharmacists for Patient Safety Network in Nebraska. Pharmacists reported errors, near misses, and safety concerns through Web-based event reporting. A rapid feedback process was used to provide patient safety solutions to consider implementing across the network. Qualitative interviews were conducted 1 year after program implementation with participating pharmacists to assess use of the reporting system, value of the disseminated safety solutions, and perceived impact on patient safety in pharmacies. 30 of 38 pharmacists participating in the project completed the interviews. The communication network improved pharmacist awareness, promoted open discussion and knowledge sharing, contributed to practice vigilance, and led to incorporation of proactive safety prevention practices. Despite low participation in error and near-miss reporting, a dynamic communication network designed to rapidly disseminate evidence-based patient safety strategies to reduce risk was valued and effective at improving patient safety practices in rural community pharmacies.
Huang, Haigen; Placier, Peggy
Our study sought to understand changes in gender inequality in education across four generations of rural Chinese women's educational experiences in a small community in southern China. The 24 interviews and numerous informal conversations with 12 women showed that gender-based favouritism for men and against women undergirded family expectations,…
Full Text Available -1 Heritage and Social Media: Understanding Heritage in Participatory Culture June 2012/Chapter 11 Extending connections between land and people digitally: designing with rural Herero communities in Namibia Bidwell NJ1 and Winschiers-Theophilus H2 1...
Gorlach, Krzysztof; Lostak, Michal; Mooney, Patrick H.
This paper examines the usefulness of the new social movements (NSMs) paradigm in the changing context of East European post-communist societies and their agricultural systems and rural communities. Starting with statements formulated in Western sociology in the context of Western democratic societies about NSMs as a protest against modernity, the…
Chaminuka, P.; Groeneveld, R.A.; Selomane, A.O.; Ierland, van E.C.
This paper analyses the potential for development of ecotourism in rural communities adjacent to Kruger National Park (KNP) in South Africa. We determine preferences of tourists, according to origin and income levels, for ecotourism and their marginal willingness to pay (MWTP) for three ecotourism
Harsini, Somayeh Bakhtiari; Momtaz, Yadollah Abolfathi; Delbari, Ahmad; Sahaf, Robab
Studies have shown that the quality of elderly care is substantially influenced by the attitudes of healthcare staff. The present study aimed to assess the attitude of rural community health workers towards elderly people. A cross-sectional design was employed in this study, which was conducted among all health workers of Harsin city (province of Kermanshah - Iran). The Kogan's Attitudes towards Older People Scale (KOPS) was used to measure data. The statistical program SPSS, version 22 was used to perform the data analysis. The mean age of the participated health workers was 37.59 ± 4.48, about 85% were married and 76% were diploma holders. The average score of attitude was 150.60 ±15.31. About 15% of rural community health workers had negative attitude towards older adults. No significant relationships were observed between age, gender, marital status, work experience and educational status with attitudes toward aging. The findings of this study showed that rural community health workers do not have strong positive attitude towards the elderly. Therefore, it is imperative to develop efforts to improve positive attitudes of rural community health workers towards older adults and aging process. Copyright© Bentham Science Publishers; For any queries, please email at firstname.lastname@example.org.
Charney, Igal; Palgi, Michal
This paper examines the attempts made by the renewing kibbutzim to maintain their way of life as much as possible through the adjustment of their gating mechanisms. In this type of a rural gated community, sorting procedures and admittance criteria of nonmembers are the most notable elements. Background material and interviews with informants at…
Senile cataract and anterior segment eye infection were the two eye diseases most frequently seen in Giwa community. The lack of trachoma seems to indicate that the rural water supplies were relatively clean and safe. The majority of eye problems were age-related, and preventable. Objective: The aim of the study was to ...
Small, rural communities typically do not have adequate water purification systems to sustain their life quality and residents are exposed to pathogens present in drinking water. In Puerto Rico (PR), approximately 4% of the population does not have access to drinking water provi...
E. Van de Poel (Ellen); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)
textabstractThe rural-urban gap in infant mortality rates is explained using a new decomposition method that permits identification of the ontribution of unobserved heterogeneity at the household and the community level. Using Demographic and Health Survey data for six Francophone countries in
The South African government promised that the hosting of the 2010 FIFA World Cup would improve the lives of all South Africans. Therefore, the planning of future mega and large-scale events must focus on ensuring that rural communities benefit directly. This will require linkages with economic activities that can create ...
Full Text Available This paper reports on a study to determine the information requirements of communities in deep rural areas on government services and how this information can be made available to them. The study then proposes an e-government theoretical framework...
Portrays the controversy surrounding schools and education in a rural community experiencing both an influx of urban and suburban newcomers and the effects of urban sprawl. Reports on surveys of student educational attitudes, household information, and outside activities, and on interviews with teachers, school administrators, and residents.…
Yodmongkol, Pitipong; Jaimung, Thunyaporn; Chakpitak, Nopasit; Sureephong, Pradorn
At present, Thailand is confronting a serious problem of alcohol drinking behavior which needs to be solved urgently. This research aimed to identify the semantic factors on alcohol drinking behavior and to use maternal instinct driving for housewives as village health volunteers in rural communities, Thailand. Two methods were implemented as the…
Reynolds, Richard Kent
Hallsburg ISD is a small, rural, K-6 school district struggling to sustain its operations due to reduced funding from the state, decreased enrollment, and a decrease in the local tax base. This Problem in Practice Record of Study examines the sustainability issues associated with this school district and its importance to the community. Key…
Reyes, Maria Eugenia Peña; Chavez, Guillermo Bali; Little, Bertis B; Malina, Robert M
To evaluate the relationship between community well-being based on an index of marginalization and growth status of indigenous rural school children in Oaxaca. Heights and weights of a cross-sectional sample of 11,454 children, 6-14 years, from schools for indigenous rural children (escuelas albergue) in 158 municipios in Oaxaca were measured in 2007. Tertiles of an index of marginalization were used to classify the 158 municipios into three categories of community well-being: lowest (highest marginalization), low, and moderate (lowest marginalization). Multivariate analysis of covariance, controlling for age, relative isolation and population size, was used to compare body size of children by category of community well-being. Contributions of marginalization, isolation and population size to variation in body size were estimated with sex-specific linear regression. Children from municipios lowest in well-being were shorter and lighter than children from municipios low and moderate in well-being. Marginalization and relative isolation accounted for 23% (boys) and 21% (girls) of the variance in height and for 21% of the variance in weight of girls. Marginalization was the predictor of weight in boys (23%). Community well-being was reflected in the growth status of rural indigenous school children. Compromised growth status was consistent with poor health and nutritional conditions that were and are characteristic of rural areas in the state of Oaxaca. 2010 Elsevier B.V. All rights reserved.
In this short contribution the author, a Masters in Environmental Education student, introduces his research into a rural community's knowledge about, attitudes towards and extensive use of plants which grow wild in their locality, with specific reference to their diet. Taking an ethnographic approach to the study of peo-.
In this short contribution the author, a Masters in Environmental Education student, introduces his research into a rural community's knowledge about, attitudes towards and extensive use of plants which grow wild in their locality, with specific reference to their diet. Taking an ethnographic approach to the study of people's ...
Full Text Available Introduction and Aim. Substance abuse imposes hazards on human health in all biopsychosocial aspects. Limited studies exist on epidemiology of substance abuse and its trend in rural areas. The present study aimed to compare substance abuse in one of the rural areas of southeast Iran, in a 12-year period (2000 and 2012. Design and Methods. In a household survey conducted in 2012, in Dashtkhak/Kerman, 1200 individuals above 12 years of age completed a questionnaire to determine their frequency of substance abuse. The questionnaire included the following three areas: demographic characteristics, frequency of substance abuse and ease of access to various drugs. Results. Among 900 completed questionnaires, majority of the participants (61.8% were below 30 years of age and among them 54.4% were male. Cigarette (17.0%, opium (15.7% and opium residue (9.0% were the most frequent substances abused on a daily basis. Based on the participant’s opinion, we conclude that the ease of access to cigarette, waterpipe and opium contributed to their increase in consumption compared with earlier years. Discussion and Conclusion. The steady rise in substance abuse in rural communities demands immediate attention and emergency preventive measures from policy makers.
MacLeod, Martha L P; Stewart, Norma J; Kulig, Judith C; Anguish, Penny; Andrews, Mary Ellen; Banner, Davina; Garraway, Leana; Hanlon, Neil; Karunanayake, Chandima; Kilpatrick, Kelley; Koren, Irene; Kosteniuk, Julie; Martin-Misener, Ruth; Mix, Nadine; Moffitt, Pertice; Olynick, Janna; Penz, Kelly; Sluggett, Larine; Van Pelt, Linda; Wilson, Erin; Zimmer, Lela
In Canada, as in other parts of the world, there is geographic maldistribution of the nursing workforce, and insufficient attention is paid to the strengths and needs of those providing care in rural and remote settings. In order to inform workforce planning, a national study, Nursing Practice in Rural and Remote Canada II, was conducted with the rural and remote regulated nursing workforce (registered nurses, nurse practitioners, licensed or registered practical nurses, and registered psychiatric nurses) with the intent of informing policy and planning about improving nursing services and access to care. In this article, the study methods are described along with an examination of the characteristics of the rural and remote nursing workforce with a focus on important variations among nurse types and regions. A cross-sectional survey used a mailed questionnaire with persistent follow-up to achieve a stratified systematic sample of 3822 regulated nurses from all provinces and territories, living outside of the commuting zones of large urban centers and in the north of Canada. Rural workforce characteristics reported here suggest the persistence of key characteristics noted in a previous Canada-wide survey of rural registered nurses (2001-2002), namely the aging of the rural nursing workforce, the growth in baccalaureate education for registered nurses, and increasing casualization. Two thirds of the nurses grew up in a community of under 10 000 people. While nurses' levels of satisfaction with their nursing practice and community are generally high, significant variations were noted by nurse type. Nurses reported coming to rural communities to work for reasons of location, interest in the practice setting, and income, and staying for similar reasons. Important variations were noted by nurse type and region. The proportion of the rural nursing workforce in Canada is continuing to decline in relation to the proportion of the Canadian population in rural and remote
Odei-Lartey, Eliezer Ofori; Boateng, Dennis; Danso, Samuel; Kwarteng, Anthony; Abokyi, Livesy; Amenga-Etego, Seeba; Gyaase, Stephaney; Asante, Kwaku Poku; Owusu-Agyei, Seth
The reliability of counts for estimating population dynamics and disease burdens in communities depends on the availability of a common unique identifier for matching general population data with health facility data. Biometric data has been explored as a feasible common identifier between the health data and sociocultural data of resident members in rural communities within the Kintampo Health and Demographic Surveillance System located in the central part of Ghana. Our goal was to assess the feasibility of using fingerprint identification to link community data and hospital data in a rural African setting. A combination of biometrics and other personal identification techniques were used to identify individual's resident within a surveillance population seeking care in two district hospitals. Visits from resident individuals were successfully recorded and categorized by the success of the techniques applied during identification. The successes of visits that involved identification by fingerprint were further examined by age. A total of 27,662 hospital visits were linked to resident individuals. Over 85% of those visits were successfully identified using at least one identification method. Over 65% were successfully identified and linked using their fingerprints. Supervisory support from the hospital administration was critical in integrating this identification system into its routine activities. No concerns were expressed by community members about the fingerprint registration and identification processes. Fingerprint identification should be combined with other methods to be feasible in identifying community members in African rural settings. This can be enhanced in communities with some basic Demographic Surveillance System or census information.
Full Text Available The epidemiology of Staphylococcus aureus in the community in Ghana was never investigated prior to this study. The aims of the study were: i to assess prevalence of nasal S. aureus carriage in Ghanaian people living in an urban and a rural area, and ii to identify phenotypic and genotypic traits of strains isolated from the two communities. Nasal swabs were collected from healthy individuals living in an urban community situated in the suburb of the capital city, Accra (n = 353 and in a rural community situated in the Dangme-West district (n = 234. The overall prevalence of nasal carriage was 21% with a significantly higher prevalence in the urban (28% than in the rural community (11% (p<0.0001. The levels of antimicrobial resistance were generally low (<5% except for penicillin (91% and tetracycline (25%. The only two (0.3% MRSA carriers were individuals living in the urban area and had been exposed to hospitals within the last 12 months prior to sampling. Resistance to tetracycline (p = 0.0009 and presence of Panton-Valentine leukocidin (PVL gene (p = 0.02 were significantly higher among isolates from the rural community compared to isolates from the urban community. Eleven MLST clonal complexes (CC were detected based on spa typing of the 124 S. aureus isolates from the two communities: CC8 (n = 36, CC152 (n = 21, CC45 (n = 21, CC15 (n = 18, CC121 (n = 6, CC97 (n = 6, CC30 (n = 5, CC5 (n = 5, CC508 (n = 4, CC9 (n = 1, and CC707 (n = 1. CC8 and CC45 were less frequent in the rural area than in the urban area (p = 0.02. These results reveal remarkable differences regarding carriage prevalence, tetracycline resistance, PVL content and clonal distribution of S. aureus in the two study populations. Future research may be required to establish whether such differences in nasal S. aureus carriage are linked to socio-economic differences between urban and rural communities in this
Sabin, Allison V; Levin, Pamela F
The Affordable Care Act requires nonprofit hospitals to collaborate with public health agencies and community stakeholders to identify and address community health needs. As a rural organization, Wabash County (Indiana) Hospital pursued new approaches to achieve these revised requirements of the community benefit mandate. Using a case study approach, the authors provide a historical review of governmental relationships with nonprofit community hospitals, offer a case study application for implementing legislative mandates and community benefit requirements, share the insights they garnered on their journey to meet the mandates, and conclude that drawing upon the existing resources in the community and using current community assets in novel ways can help conserve time, and also financial, material, and human resources in meeting legislative mandates.
Agricultural activities mainly occur in rural areas; recently, ecological conservation and biological diversity are being emphasized in rural communities to promote sustainable development for rural communities, especially for rural communities in Taiwan. Therefore, since 2005, many rural communities in Taiwan have compiled their own development strategies in order to create their own unique characteristics to attract people to visit and stay in rural communities. By implementing these strategies, young people can stay in their own rural communities and the rural communities are rejuvenated. However, some rural communities introduce artificial construction into the community such that the ecological and biological environments are significantly degraded. The strategies need to be efficiently monitored because up to 67 rural communities have proposed rejuvenation projects. In 2015, up to 440 rural communities were estimated to be involved in rural community rejuvenations. How to monitor the changes occurring in those rural communities participating in rural community rejuvenation such that ecological conservation and ecological diversity can be satisfied is an important issue in rural community management. Remote sensing provides an efficient and rapid method to achieve this issue. Segmentation plays a fundamental role in human perception. In this respect, segmentation can be used as the process of transforming the collection of pixels of an image into a group of regions or objects with meaning. This paper proposed an algorithm based on the multiphase approach to segment the normalized difference vegetation index, NDVI, of the rural communities into several sub-regions, and to have the NDVI distribution in each sub-region be homogeneous. Those regions whose values of NDVI are close will be merged into the same class. In doing so, a complex NDVI map can be simplified into two groups: the high and low values of NDVI. The class with low NDVI values corresponds to those
Full Text Available Abstract Background Alcohol represents a major public health challenge in South Africa, however little is known about the correlates of alcohol use among rural adolescents. This article examines community influences on adolescents’ use of home-brewed alcohol in a rural region of South Africa. Method A total of 1600 high school adolescents between 11 and 16 years of age participated in this study. Seven hundred and forty (46.3% were female and 795 (49.7% were male. Data on gender were missing for 65 students (4.0% of the sample. The age range was 11–29 years (mean age 16.4 years; Standard deviation = 2.79. A survey questionnaire on adolescent risk behavior that examined adolescents’ use of alcohol and various potential community influences on alcohol use was administered. Factor analysis was used to group community-level variables into factors. Multiple logistic regression techniques were then used to examine associations between these community factors and adolescents’ use of home-brewed alcohol. Results The factor analysis yielded five community-level factors that accounted for almost two-thirds of the variance in home-brewed alcohol use. These factors related to subjective adult norms around substance use in the community, negative opinions about one’s neighborhood, perceived levels of adult antisocial behavior in the community, community affirmations of adolescents, and perceived levels of crime and violence in the community (derelict neighborhood. In the logistic regression model, community affirmation was negatively associated with the use of home-brew, whereas higher scores on “derelict neighborhood” and “adult antisocial behavior” were associated with greater odds of drinking home-brew. Conclusion Findings highlight community influences on alcohol use among rural adolescents in South Africa. Feeling affirmed and valued by the broader community appears to protect adolescents against early alcohol use. In
Constable, Sophie; Dixon, Roselyn; Dixon, Robert
As part of strategies to improve dog and community health in rural and remote Indigenous communities, this study investigated preferences and impacts of dog health education programs. Semistructured interviews with 63 residents from five communities explored learning preferences. Though each community differed, on average yarning was preferred by…
Silva, Etna Kaliane Pereira da; Medeiros, Danielle Souto de; Martins, Poliana Cardoso; Sousa, Líllian de Almeida; Lima, Gislane Pereira; Rêgo, Maria Amanda Sousa; Silva, Tainan Oliveira da; Freire, Alessandra Silva; Silva, Fernanda Moitinho
This study aimed to measure the prevalence of food insecurity in a rural area of Northeast Brazil and investigate this outcome according to residence in quilombola communities (descendants of African slaves) versus non-quilombola communities. This was a cross-sectional study in 21 rural communities, 9 of which quilombolas, in 2014, using the Brazilian Food Insecurity Scale (EBIA). Prevalence rates and prevalence ratios were estimated for food insecurity, and Poisson multiple regression analysis with robust variance was performed. Food insecurity was found in 52.1% of the families: 64.9% in quilombola communities and 42% in the others. Food insecurity was associated with belonging to a quilombola community (PR = 1.25), lower economic status (PR = 1.89; 2.98, and 3.22 for status C2, D, and E, respectively), beneficiaries of Bolsa Família program (PR = 1.52), and four or more household members (PR = 1.20). Food insecurity prevalence was high in the entire population, but it was even higher in quilombola communities, even though they belonged to the same coverage area. The results emphasize this population's vulnerability.
Full Text Available Introduction: Management of stroke in the remote rural areas in India faces major challenges because of lack of awareness. Stroke care services can be optimally implemented only if the communities have an understanding of the disease. Method: A population based, cross sectional survey of an adult general population sample between the ages of 31-60 years in a rural block in Tamil Nadu, India was carried out to study their knowledge, attitude, beliefs about cause, signs and symptoms, preventive measures and treatment options of stroke. Results: Of the 174 subjects studied only 69% were aware of the term stroke and 63% were able to list the symptoms. Only a little more than half the participants (58% were aware that diabetes, smoking and hypertension are risk factors for stroke. None of the participants were aware of the endovascular thrombolysis injection for better recovery from stroke. About quarter (23% of the participants did not think that the stroke is an emergency condition and they need to take the patient urgently to the hospital. Only 56% of the participants had checked their blood pressure and 49% for diabetes. A history of having either hypertension or diabetes and stroke in the family was the only factor that was significantly associated with better awareness (p=<0.001 independent of other potential facilitating factors including age, occupation, education and gender. Conclusion: There is a need to educate the rural communities about the risk factors, how to recognize the onset, the preventive measures and optimum care of stroke to reduce the burden.
Li, Lydia W; Liu, Jinyu; Zhang, Zhenmei; Xu, Hongwei
This study aimed to examine whether physical infrastructure and availability of three types of community resources (old-age income support, healthcare facilities, and elder activity centers) in rural villages are associated with depressive symptoms among older adults in rural China. Data were from the 2011 baseline survey of the Chinese Health and Retirement Longitudinal Study (CHARLS). The sample included 3824 older adults aged 60 years or older residing in 301 rural villages across China. A score of 12 on the 10-item Center for Epidemiologic Studies Depression Scale was used as the cutoff for depressed versus not depressed. Village infrastructure was indicated by an index summing deficiency in six areas: drinking water, fuel, road, sewage, waste management, and toilet facilities. Three dichotomous variables indicated whether income support, healthcare facility, and elder activity center were available in the village. Respondents' demographic characteristics (age, gender, marital status, and living arrangements), health status (chronic conditions and physical disability), and socioeconomic status (education, support from children, health insurance, household luxury items, and housing quality) were covariates. Multilevel logistic regression was conducted. Controlling for individuals' socioeconomic status, health status, and demographic characteristics, village infrastructure deficiency was positively associated with the odds of being depressed among rural older Chinese, whereas the provision of income support and healthcare facilities in rural villages was associated with lower odds. Village infrastructure and availability of community resources matter for depressive symptoms in rural older adults. Improving infrastructure, providing old-age income support, and establishing healthcare facilities in villages could be effective strategies to prevent late-life depression in rural China. Copyright © 2014 John Wiley & Sons, Ltd.
Estai, Mohamed; Kruger, Estie; Tennant, Marc
Despite great progress in oral health over the past three decades, the rates of caries remain high in Australia, particularly among underserved populations. The reasons for poor oral health amongst underserved populations are multiple, but rests with socio-economic determinants of health. The present review considers international workforce models that have been created to enhance the recruitment and retention of dental providers in rural areas. Several strategies have been developed to address care access problems in rural areas, including the use of telemedicine and mid-level dental providers (MLDPs). Despite ongoing opposition from dentistry organisations, the Alaska and Minnesota workforce models have proven that developing and deploying dental therapists from rural communities has the potential to address the unmet needs of underserved populations. It is more efficient and cost-effective for MLDPs to perform triage and treat simple cases and for dentists to treat complicated cases. The use of MLDPs is intended to increase the capacity of the dental workforce in areas that are too isolated to entice dentists. Telemedicine has emerged as one solution to address limited access to health care, particularly in locations where there is a lack of providers. Telemedicine not only provides access to care, but also offers support, consultations and access to continuing education for practicing dental providers in rural areas. This strategy has the potential to free up resources to increase care access and reduce oral health disparities, thereby contributing to closing the rural-urban oral health gap. © 2016 FDI World Dental Federation.
Melby, G.; Grubert, E.; Brandt, A. R.
Shale gas development in Pennsylvania has been shown to have a large impact on nearby rural communities, but almost no research has been done on how development of the Marcellus Shale affects urban residents in neighboring cities. The goal of this project is to examine how the social and environmental priorities of urban and rural communities differ and to determine how well informed urban residents are on shale gas development. An anonymous web survey was used to survey 250 residents of Pennsylvania's largest cities on topics like how respondents prioritize different environmental and social factors and how well informed they feel about shale gas development. The results of this survey were compared to findings of previous surveys on rural communities located near energy development. In terms of environmental priorities, urban residents are more concerned about climate change and air pollution than rural residents. Both urban and rural respondents agreed that healthcare and education were their top social concerns, but urban respondents also prioritized housing and employment. Most urban respondents said that they were unfamiliar with shale gas development, although many were still concerned about what its environmental impacts might be. We also found that our results displayed two well known demographic trends: first, Democrats are far more likely to self identify as environmentalists than those who vote Republican, and second, that people of color are far less likely to identify as environmentalists than white respondents. As a result, there are disproportionately fewer self-identifying environmentalists in urban and largely Democrat-leaning areas with racially diverse populations. Our data displayed known trends in urban populations as well as new information on how urban residents differ from their rural counterparts in their views on shale gas development and their broader social and environmental priorities.
Oladeinde, Bankole Henry; Omoregie, Richard; Odia, Ikpomwonsa; Osakue, Eguagie Osareniro
This study aimed at assessing knowledge of HIV/AIDS among residents of three rural communities in Nigeria. A total of 371 persons residing in selected rural communities were recruited for this study. A structured questionnaire was used to collect data from all participants. Results of the study showed a generally high level of awareness of HIV/AIDS in all communities surveyed. However, among study participants, knowledge of mode of prevention and management of HIV infection was poor as was knowledge of HIV status and readiness to utilize free voluntary counseling and testing for HIV/AIDS services. Scale-up of HIV/AIDS education by relevant health authorities is strongly advocated.
Full Text Available Compilation of the ways for developing a county level, helps to: create a vision about community that we want in the future, provide a complete picture of how the economy, environment, infrastructure can improve the county to set development goals and priorities that are reflected in measures to achieve the objectives. Also, the development of these paths of development may underlie a guide for improving community life and to reduce disparities. In this work we performed analysis of investment programs that benefit local communities in Valcea County in the period 2008-2016. Finally, the County development strategy based on RDP measures was set up for the period 2014-2020.
Loreni Elena Baciu
Full Text Available The article reports on a qualitative study of Roma employability in Romania. Being the largest ethnic minority group in Europe, the Roma population is the object of profound marginalization in most of the countries where they reside, by measures such as spatial segregation and exclusion from the formal labour market. This article focuses particularly on the Roma living in rural segregated communities. Inspired by institutional ethnography, the aim is to explore the social organization of rural Roma employability from the standpoint of the Roma themselves. The main obstacles to employment, as they are known and shared by our interviewees, are a lack of available jobs within reach, their own lack of education and a rejection by employers on the grounds of them being Roma. As the analyses show, these obstacles, and the individual’s experiences and knowledge about them, are shaped and maintained by extended translocal relations of administration and governance, thus making the rural Roma dependent on a precarious secondary labour market of low-paid day work for neighbouring farmers. The uncertainty of this work, and the organization and work of everyday life it implies for the people inhabiting these communities, further increases the distance to formal employment. It is this complex set of relations coordinating people’s doings that produce the employability of Roma inhabiting the rural segregated communities.
Gillman, Lawrence M; Vergis, Ashley
Rural/community surgery presents unique challenges to general surgeons. Not only are they required to perform "classic" general surgery procedures, but they are also often expected to be competent in other surgical disciplines. Final-year Canadian-trained residents in general surgery were asked to complete the survey. The survey explored chief residents' career plans for the following year and whether or not they would independently perform various procedures, some general surgical, and others now considered within the domain of the subspecialties. Sixty-four residents (71%) completed the survey. Twenty percent planned to undertake a rural surgical practice, 17% an urban community practice, and 55% had confirmed fellowships. Most residents (>90%) expressed comfort with basic general surgical procedures. However, residents were less comfortable with subspecialty procedures that are still performed by general surgeons in many rural practices. More than half of graduating general surgery residents are choosing subspecialty fellowship training over proceeding directly to practice. Those choosing a rural or community practice are likely to feel ill prepared to replace existing surgeons. Copyright © 2013 Elsevier Inc. All rights reserved.
Elisa Maria Varela Bettencourt
Full Text Available The livestock species play very important economic and socio-cultural roles for the wellbeing of rural households, such as food supply, source of income, asset saving, source of employment, soil fertility, livelihoods, transport, agricultural traction, agricultural diversification and sustainable agricultural production. The aim of this work was to identify and characterize the different roles that livestock and livestock species play in rural communities of Timor-Leste, highlighting the importance of animal production for the wellbeing and rural development, and relate the functions performed by livestock production with economic, social and cultural attributes of the communities. The data used in this study were collected in 2011 through a questionnaire survey in three rural communities in the district of Bobonaro, namely in a mountain area, an irrigation plain and a coastal zone, and were complemented with secondary data. Livestock production in Timor-Leste is predominantly familiar being chickens, pigs, goats, cattle, horses, buffaloes and sheep the main species. Beyond the economic function, each livestock species also performs social and cultural functions.
Conceptual frameworks developed during community development research are important in that they synthesise thinking about project dynamics (summative value) while also serving as frameworks for future research (heuristic value). This article discusses a conceptual framework developed from a case study of the ...
Mar 2, 1977 ... cratic procedures, several obstructions to communities' willingness to acquire land title and the expensiveness of the system. It can be argued that what we are referring to as obstructions are just the normal administrative proce- dures that must be followed by any individual willing to acquire land titles.
... 18% and palm oil 2% respectively. It is recommended that farmers should be seriously engaged in agroforestry practices to enjoy output and profit maximization effects. Keywords: Economic benefit, communities\\' participation, Agro forestry. Journal of Agriculture, Forestry and the Social Sciences Vol. 4 (2) 2006: pp. 13-23 ...
Suggested strategies to reduce fuelwood scarcity in area include: promotion of on farm tree planting activities. (agroforestry) and energy saving technologies, availing alternative energy sources such as electricity, enhancing family planning methods, skilling of communities on income generation enterprises especially girls.
The aim of the study was to identify and appraise the participation of women in household and community decision-making and its implications for their empowerment. Test samples were selected through a multi–stage random sampling technique. A total of ninety respondents were chosen from the five sampled wards, and ...
The community uses the telecentre to improve work related skills, keep in touch with friends and families and look for jobs. The negative finding is that telecentre usage is uneven as users are generally poor male youths with little education. Furthermore, the users face a number of challenges when using the telecentre.
A survey of 118 randomly selected cassava farmers was conducted in Ukpor, Amichi, Osumenyi, Ezinifite, Ekwulummili and Ebenator, communities in Nnewi South Local Government Area of Anambra State using structured interview schedule, to determine the use of improved cassava and local cassavacultivars in the area.
This study found that the rate of alcohol consumption and cigarette smoking was high in this community. It is recommended that any health promoting, preventive or intervention programme for this population should pay emphasis on their alcohol consumption and smoking habits. Key words: hypertension risk factors, ...
Martin, Michael J.; Henry, Anna
The purpose of this study was to develop a substantive theory for community development by school-based agriculture programs through grounded theory methodology. Data for the study included in-depth interviews and field observations from three school-based agriculture programs in three non-metropolitan counties across a Midwestern state. The…
Stokowski, Patricia A.
Three small Colorado towns that faced a declining economy as the mining resource ran out used gambling-based tourism as a strategy for community development. Although economic benefits to the towns have far exceeded expectations, negative social, environmental, and political changes, such as crime alcoholism, traffic problems, and conflicts…
Conclusion: This study shows that the COLNISA strategy has a positive impact on basic social, health and nutritional indices and engenders community participation. A controlled trial is however advocated before its wholesale application. Key Words: COLNISA, underweight, stunted, wasted, nutrition, information. Annals of ...
Apr 27, 2016 ... ... and environmental changes on the health of pastoralist communities around Lake Mburo National Park. They assessed the impact of zoonotic diseases (those of animal origin) on animal and human health, and their effects on livestock value chains with a view to developing strategies to reduce risks and ...
May 5, 2016 ... In a first phase of research, the team investigated the interactions between climate trends, socio-economic factors, local farming practices, and the ecology of vector and ... In addition, households are creating healthier communities by keeping domestic animals, manure, and garbage away from their homes.
Previously colonised, marginalised communities rarely participate in the mainstream archival and records systems throughout the world. Archiving as it is known today is preserving records on paper, electronic, audio-visual and microfilm formats. These media were not present in the pre-colonial era hence the stories, ...
COMMUNITY OF EASTERN NIGERIA; NEED FOR COMBINED MEASURES. S. O. OGBODO, U. I. NWAGHA ... parasitaemia was recorded in 47.2% moderate parasitaemia in 37.4% while severe parasitaemia was recorded in. 15.3% of cases. .... immunodeficiency virus (HIV) positive patients, sickle cell disease, diabetes ...
B S Chavan
Full Text Available Background: Lack of awareness about mental illness prevents patients from getting appropriate mental health care. This is more so in places where there is dearth of adequate mental health professionals. These factors highlight the importance of conducting research to assess public knowledge and attitudes toward mental illness. Hence, the aim of the present study was to assess the prevailing concept of depression in the community. Methods: Two villages in the periphery of Chandigarh were selected and local “Panchayat” of the villages were told to select the local members in the community who were regarded as socially responsible. A total of 48 members were selected and a workshop was conducted by the experts in mental health and the cohort was asked about prevailing concept of depression in the local community. The whole workshop was videotaped and the verbatim of the same was recorded. Results: It was found that majority had beliefs that depression is caused by stressful circumstances or substance use and the depressed individual has decreased interaction, fights and sleeps less. It was also noted that the prevalence was perceived to be low. The first treatment preferences were religious/faith healers or the local practitioners. Reasons for treatment gap were cited as ignorance and misguidance in the community. Conclusions: It was interpreted that depression is mainly linked with stressful events and symptoms being behavioural only. The understanding of somatic and biological symptoms was lacking along with the endogenous risk factors and its causes. Treatment gap exists at the grass root level and reasons such as ignorance and misguidance emerged during the discussion with the community leaders.
Toner, John A; Ferguson, K Della; Sokal, Regina Davis
There is a widening gap between the health care needs of older persons and the treatment skills of the health care professionals who serve them. This gap is especially severe in rural areas, where there is a shortage of and inadequate collaboration between health care professionals and poor access to services for older persons. There is also a special opportunity in rural areas, particularly those designated as "medically underserved," for continuing interprofessional education as a vehicle for retaining health care professionals who tend to leave medically underserved areas for more lucrative professional opportunities elsewhere. In collaboration with the Consortium of New York Geriatric Education Centers, the Columbia-New York Geriatric Education Center at the Stroud Center of Columbia University has developed the Program for Outreach to Interprofessional Services and Education (POISE). The purpose of POISE is to develop, implement, evaluate, and sustain interprofessional education and training for health care learners, while emphasizing improved access to health services for the geriatric population in medically underserved areas. The POISE model was designed as an effective approach to teaching the core geriatrics and gerontology curriculum endorsed by the national (U.S. Department of Health and Human Services) network of Geriatric Education Centers to health care learners in medically underserved areas of upstate New York. This article describes the adaptation and implementation of the POISE model.
Full Text Available Researchers are paying increasing attention to questions of community leadership and rural tourism development. Based on leadership theories and the literature on community leadership and tourism development, this study developed a framework for community leadership in rural tourism development and used it to examine two ancient Chinese villages. We used the longitudinal case study method to collect data, and we used textual analysis to analyze these data. The results show that the rebel leadership characteristic of confrontational actions played an important role in starting the tourism industry in both villages. However, this leadership was difficult to maintain because community leaders and residents had limited power compared to that of outsiders. Losing control of tourism development in the two villages led to banal management, which prevented the emergence of strong community leadership. In the future, we argue that resilient community leadership should be nurtured in the two villages to address more complex problems occurring in tourism development, such as those characterized by vision tensions and conflicts of interest among the stakeholders affected by tourism development. Finally, we suggest that, based on the longitudinal method, future research can focus on the relationship between resilient leadership and the resilience of tourism communities.
Full Text Available A fully sustainable sanitation system was developed for a rural hospital in Haiti. The system operates by converting human waste into biogas and fertilizer without using external energy. It is a hybrid anaerobic/aerobic system that maximizes methane production while producing quality compost. The system first separates liquid and solid human waste at the source to control carbon to nitrogen ratio and moisture content to facilitate enhanced biodegradation. It will then degrade human waste through anaerobic digestion and capture the methane gas for on-site use as a heating fuel. For anaerobic decomposition and methane harvesting a bioreactor with two-stage batch process was designed. Finally, partially degraded human waste is extracted from the bioreactor with two-stage batch process and applied to land farming type aerobic composter to produce fertilizer. The proposed system is optimized in design by considering local conditions such as waste composition, waste generation, reaction temperature, residence time, construction materials, and current practice. It is above ground with low maintenance requirements.
Ranaboldo, Matteo; Lega, Bruno Domenech; Ferrenbach, David Vilar; Ferrer-Martí, Laia; Moreno, Rafael Pastor; García-Villoria, Alberto
Highlights: • The design of 2 off-grid electrification projects in Cape Verde is developed. • Configurations with hybrid renewable energy systems and micro-grids are considered. • A detailed micro-scale wind resource assessment is carried out. • An optimization model is used in order to support the design. • The proposed system is economically beneficial in comparison with diesel generation. - Abstract: Even though Cape Verde has high wind and solar energy resources, the conventional strategy for increasing access to electricity in isolated rural areas is by centralized microgrids with diesel generators. In this study, the design of 2 off-grid electrification projects based on hybrid wind–photovoltaic systems in Cape Verde is developed and analyzed. The design considers some significant novelty features in comparison with previous studies. First a detailed wind resource assessment is carried out combining meso-scale wind climate data and a specialized micro-scale wind flow model. Then a mathematical model is used for the design of off-grid projects considering a combination of individual systems and microgrids. In this study, locations far from the demand points are also considered as possible generation points. Various design configurations are analyzed and compared. The proposed configurations exploit the highest wind potential areas and are economically beneficial in comparison with diesel generator systems
Ilika, Amobi Linus
Partner violence is a serious public health problem affecting mostly women. This qualitative study assessed the perceptions of rural Igbo women of Nigeria of intimate partner violence. Information was elicited using in-depth interviews and focus group discussion. Women of childbearing age were selected from the various women age grades in Ozubulu, Anambra State, Nigeria. Findings revealed that the women generally condone and are complacent with intimate partner violence, perceiving it as cultural and religious norms. The women felt that reprimands, beating and forced sex affecting their physical, mental and reproductive wellbeing are normal in marriage. They did not support reporting such cases to the police or divorcing the man, they would rather prefer reporting to family members. They felt that exiting the marriage would not gain the support of family members. They also expressed fear for the uncertainty in re-marrying, means of livelihood after re-marriage, social stigmatisation, and concern for their children. Socio-cultural norms and structures favour partner violence in Anambra State of Nigeria. There is a need for advocacy and concerted action that will involve the educational, health, civil and religious sectors of the society to evolve sustainable structures that will empower women and provide support to enable victims to react appropriately to violence.
LeFebvre, Andrea M; Dare, Bill; Farrell, Susan J; Cuddeback, Gary S
An emerging focus of Assertive Community Treatment (ACT) teams is the transition of clients to less intensive services, which creates space for individuals in need of ACT and is consistent with a recovery orientation of treatment. However, there is limited research on team transition rates, post-ACT services, and strategies to overcome transition barriers. In addition, few studies have examined differences in these factors among urban and rural ACT teams. To address these knowledge gaps, we interviewed eight ACT teams in urban and rural areas of eastern Ontario regarding their transition rates, processes of transitioning ACT clients to less intensive services, transition barriers, and solutions to overcoming these barriers. On average, teams transitioned about 6% of their clients over our 3-year study period. Urban and rural teams described both similar and distinct clinical and systemic barriers, such as client reluctance to transition and finding psychiatric follow-up outside of ACT. Implications for ACT practice and policy are discussed.
Smith, Michael T; Goebel, Jessica Schroenn; Blignaut, James N
Given the persistence of systemic poverty in, most notably, the rural parts of South Africa, the question is whether the use of biodigesters as a source of energy offers potential solutions to some of the difficulties and development needs faced by people in these areas. At the core, this translates into whether this technology would be financially and economically feasible for installation and use by rural households. Here we conduct both a financial and an economic cost-benefit analysis in one such community based on survey data from 120 households. Analysis of these data and supporting literature reveals that a biodigester is not a financially feasible investment for a rural household. Substantial economic benefits are, however, found to make a biodigester a worthwhile investment from a broader societal perspective. This is a compelling argument for further study and the consideration of government support in the light of broader economy-wide benefits. Copyright © 2013 Elsevier Ltd. All rights reserved.
Cené, Crystal W; Akers, Aletha Y; Lloyd, Stacey W; Albritton, Tashuna; Powell Hammond, Wizdom; Corbie-Smith, Giselle
African Americans (AA) and rural communities often suffer disproportionately from poorer health. Theory-guided research examining how individual- and community-level factors influence health behaviors and contribute to disparities is needed. To understand how a social network model that captures the interplay between individual and community factors might inform community-based interventions to reduce HIV risk in rural AA communities. Qualitative study. Eleven focus groups with 38 AA 16-24 year olds, 42 adults over age 25, and 13 formerly incarcerated individuals held in community settings in two rural, predominantly AA counties in North Carolina. Thirty-seven semi-structured interviews with multiethnic key informants. Semi-structured interviews and focus groups with open-ended questions assessed a) perceptions of multi-level HIV risk determinants from a social network model (individual, interpersonal, social, economic, political and structural) identified through literature review and b) community needs and assets affecting local HIV rates. Qualitative data was analyzed using directive content analysis guided by a social network model. We identified four themes regarding the interaction between individuals and their communities that mediate HIV risk: interpersonal processes, community structural environment, social disorder, and civic engagement. Communities were characterized as having a high degree of cohesiveness, tension, and HIV-related stigma. The community structural environment-characterized by neighborhood poverty, lack of skilled jobs, segregation, political disenfranchisement and institutional racism-was felt to reduce the availability and accessibility of resources to combat HIV. Adults noted an inability to combat social problems due to social disorder, which fuels HIV risk behaviors. Civic engagement as a means of identifying community concerns and developing solutions is limited by churches' reluctance to address HIV-related issues. To combat HIV
Jiménez-González, Alberto; Granados-Cosme, José Arturo; Rosales-Flores, Roselia Arminda
To identify objective and subjective conditions in the lives of pregnant teens within a highly-marginalized community in the state of Puebla, Mexico. Objective and subjective conditions of pregnant teens were evaluated through a mixed methodology (surveys, observation guides and a structured interview guide). The main family characteristic is the absence of a father due to migration, no desire to study or work and the new meaning of pregnancy: the initial social stigma for engaging in a sexual activity and then, the stigma for being a young mother. Objective conditions show family disintegration, lack of access to education at the community, high school and college level as well as unemployment as processes linked to teen pregnancy; thus, making it practically impossible to develop life goals. Subjective conditions center around the reproduction of gender stereotypes related to maternity.
Cheung, Y B
This study is based on interviews conducted in Xiao San Jiang Township, China. This article describes the health care system before and after the reforms of the late 1970s and the impact on community mobilization and health care provision. The success of the Chinese health care system is attributed to mass participation in disease prevention. There were the public health campaigns of the 1950s at the brigade level that mobilized people to adopt personal and environmental sanitation, pest control, and primary health education. There were organizations, such as the Youth Leagues and the Women's Federations. The large groups encouraged use of services, such as family planning services, gynecological screening, and immunization. The Barefoot Doctor and Cooperative Medical Care Insurance Schemes were introduced. Brigades became directly involved in health care delivery, and health workers increased access to primary health services. There was multisectoral collaboration between mass and government organizations. Each commune official had multiple roles and information flowed between sectors. The end result was community mobilization of resources in an organization-intensive social structure and increased hopes for improvements in health. The propaganda was effective in health promotion. In the late 1970s, township management districts and village committees replaced the brigades and communes. The responsibility system gave households responsibility for the productivity of specific plots of land in order to fulfill government quotas. Members of a health project funded by a Hong Kong-based primary health care organization discovered a number of problems. Community mobilization was waning, and mass organizations were not effective. The insurance system collapsed. People tired of political slogans. Although other countries are now adopting community health approaches, China is moving away from this approach.
Background Poor nutritional status of mothers has a direct and indirect consequence on their own health and that of their children. The objective of this study was to determine the relationship between nutritional status of mothers and their children and the risk factors for under-nutrition among mothers and children in rural and urban communities of Lagos State, Nigeria. Methods This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Under-nutrition in mothers and children was determined using standard criteria. Results The prevalence of under-nutrition among mothers was significantly higher in rural than urban communities (10.7% vs. 2.7%, p = 0.014). The prevalences of underweight and stunted children were also significantly higher in rural than urban communities (19.4% vs. 9.3%, p maternal and child under nutrition differs across rural and urban communities. Conclusions The prevalence of maternal and child under-nutrition is high in both communities although higher in rural communities. Efforts at reducing the vicious cycle of under-nutrition among mothers and children should concentrate on addressing risk factors specific for each community. PMID:23880121
Full Text Available Abstract Objective To describe the profile of community health workers – health promoters, traditional birth attendants and traditional healers – in rural Quechua communities from Ayacucho, Peru. Methods Basic quantitative and qualitative information was gathered as part of a community health project implemented between 1997 and 2002 in 40 Andean communities with information from questionnaires, personal interviews and group discussions. Results The majority of current community health workers are men with limited education who are primarily Quechua speakers undertaking their work on a voluntary basis. Health promoters are mostly young, male, high school graduates. There exists a high drop-out rate among these workers. In contrast, traditional healers and traditional birth attendants possess an almost diametrically opposite profile in terms of age, education and drop-out rates, though males still predominate. At the community level the health promoters are the most visible community health workers. Conclusion It is very important to consider and to be aware of the profile of community health workers in order to provide appropriate alternatives when working with these groups as well as with the indigenous population, particularly in terms of culture, language and gender issues.
Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A
Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.
Walsh, Kieran; O'Shea, Eamon
Older adult active retirement groups encompass health promotion, social and community psychological potential. However, little is known about the internal dynamics of these groups or their contribution to individual well-being and the community. This paper examines the Third Age Foundation as an example of one such group operating in a rural area in Ireland and explores the various relationships at work internally and externally. Methodology included: structured and semi-structured interviews, focus groups and a postal survey. A substantial contribution to members' well-being and community competence and cohesion was found. Findings are discussed in reference to the importance of individual and community empowerment, sustainability, social entrepreneurship/leadership and the potential of such models to support community-based living in older age.
El-Jardali, Fadi; Alameddine, Mohamad; Jamal, Diana; Dimassi, Hani; Dumit, Nuhad Y; McEwen, Mary K; Jaafar, Maha; Murray, Susan F
Nursing shortages and maldistribution are priority issues for healthcare systems around the globe. Such imbalances are often aggravated in underserved areas, especially in developing countries. Despite the centrality of this issue, there is a dearth of studies that examine the retention of nurses in underserved areas in the Middle East Region. This study investigates the characteristic and the factors associated with the retention of nurses working in rural areas in Lebanon. This study uses a non-experimental cross-sectional design to survey nurses working in underserved areas of Lebanon. Underserved areas in Lebanon were identified using WHO definition. A total of 103 health facilities (hospitals and primary healthcare centers) located in these areas were identified and all nurses working at these facilities received a copy of the survey questionnaire. The questionnaire included five sections: demographic, work-life, career plan, job satisfaction, and assessment of work environment. Analysis included univariate and bivariate (chi-square, Student's t-test and ANOVA) tests to describe the respondents and examine the significance between nurses' characteristics and their intent to stay. A logistic regression model was constructed to identify factors associated with nurses' intent to stay in underserved areas. A total of 857 nurses from 63 Primary Healthcare (PHC) centers and hospitals responded to the questionnaire (75.5% response rate). Only 35.1% of nurses indicated their intent to stay in their current job over the coming one to three years. Surveyed nurses were most satisfied with relationship with co-workers and least satisfied with extrinsic rewards. Rural nurses working in PHC centers were more satisfied than their hospital counterparts on all aspects of work and had significantly higher intention to stay (62.5% compared to 31.5% in hospitals, P job satisfaction and their intent to stay. This study reveals poor retention of nurses in rural and underserved
Full Text Available It is suggested by various sources (Worldbank, 2000; Cypher, 1997 that investment in infrastructure and modern technologies such as ITC's may break down some of the barriers of access such as physical remoteness for poor rural communities. However there is little existing research that examines this sce-nario at the micro level. This paper uses a case study- the Rural Women's Association (RWA of Sek-huhkuneland, Northern Province, South Africa to examine if E- commerce can enable access to markets in an impoverished, under resourced rural location. This paper has five parts: Part 1 consists of the background and rationale for this study, Part 2 focuses on the education, business acumen and gender issues. Part 3 discusses the current market environment. Part 4 discusses possible business models that can integrate e-commerce in its implementation. Part 5 provides the research questions and the method-ology for this study. The final discussion in this study provides us with a viable e-commerce model that could be used in a rural setting and could provide greater economic development for this community.
The current study explores community perspectives on alcohol abuse prevention strategies in rural Kenya. Data from focus group discussions with members of community organizations and in-depth interviews with a snowball sample of key informants revealed that rural communities view national alcohol abuse prevention interventions as ineffective and messages as unpersuasive in changing this high-risk behavior. The use of ethnic languages, stronger fear appeals, and visual aids were recommended for alcohol prevention messages aimed at communities with low literacy. Community members favored narratives and entertainment-education strategies, which are more engaging, and print media for their educational value. Health activism, although common, was viewed as less effective in motivating individuals to change drinking behavior but more effective in advocacy campaigns to pressure the government to enforce alcohol regulations. This study suggests further empirical research to inform evidence-based prevention campaigns and to understand how to communicate about alcohol-related health risks within communities that embrace alcohol consumption as a cultural norm.
Donfouet, Hermann Pythagore Pierre; Makaudze, Ephias; Mahieu, Pierre-Alexandre; Malin, Eric
In rural Cameroon, many people have no access to quality healthcare services. This is largely attributed to lack of private out-of-pocket payment to finance healthcare services. A community-based prepayment health insurance scheme may be implemented to improve healthcare access in rural areas. This study examines the determinants of willingness-to-pay for a community-based prepayment healthcare system using a contingent valuation method conducted in rural Cameroon. To mitigate potential hypothetical bias, a consequential script is introduced in the questionnaire. The results indicate age, religion, profession, knowledge of community-based health insurance, awareness of usual practice in rural areas, involvement in association and disposable income are the key determinants of willingness to pay for a prepayment health scheme. On average, willingness to pay for the scheme by rural households is 1011 CFA francs/person/month (2.15 US dollars). The results underlie two important implications: first, there is substantial demand for a community healthcare prepayment scheme by rural poor households in Cameroon; second, rural households are averse to health shocks and hence they are willing to sacrifice monthly premium payments to protect themselves (and their households) from unforeseen health-related risks. If government could engage in social marketing strategies such as mass media campaigns and awareness, this could prove vital for encouraging participation by the rural poor in healthcare prepayment scheme in Cameroon.
Mindlis, I; Schuetz-Mueller, J; Shah, S; Appasani, R; Coleman, A; Katz, C L
There is a pressing need to develop community interventions that will address stigma against mental illness in rural India. This cross-sectional study will compare social representations of depression in villages where educational programs have targeted mental illness and stigma versus control villages. Participants from the villages exposed to the educational interventions (n = 146) will be compared with a sample from six control villages (n = 187) in the same geographic region, using a structured questionnaire. The impact of the intervention as a predictor for questionnaire score will be assessed along with socio-demographic variables. The intervention villages showed higher levels of literacy regarding depression and lower levels of stigma, after adjusting for all other socio-demographic variables. While some demographic factors associated with the knowledge and attitudes towards depression are not modifiable, our research provides evidence in favor of the positive influence a community grassroots intervention can have on mental health literacy in rural settings.
Kofi D. Benefo
Full Text Available Using survey and census data for rural Ghana collected in the 1980s, this study examines the ability of women's education to increase interest in fertility regulation and contraception among all women, regardless of their individual and household features. The study finds that, net of her own characteristics, a woman's interest in limiting fertility and using modern contraception increase with the percent of educated women in her community. These results suggest that female education has a greater capacity to introduce novel reproductive ideas and behaviors into rural areas of Africa and thereby transform the demographic landscape in the region than is currently believed. There is also evidence that female education may undermine existing methods of regulating fertility. Other community characteristics that increase women's interest in regulating fertility and contraceptive use in this setting include access to transportation and proximity to urban areas. However, these are not as powerful as women's education in transforming reproductive behavior.
The purpose of this report is to compile completed studies on the economic impact of wind farms in rural communities and then to compare these studies. By summarizing the studies in an Excel spreadsheet, the raw data from a study is easily compared with the data from other studies. In this way, graphs can be made and conclusions drawn. Additionally, the creation of a database in which economic impact studies are summarized allows a greater understanding of the type of information gathered in an economic impact study, the type of information that is most helpful in using these studies to promote wind energy development in rural communities, and the limitations on collecting data for these studies.
John, Deborah; Winfield, Tammy; Etuk, Lena; Hystad, Perry; Langellotto, Gail; Manore, Melinda; Gunter, Kathy
Individual risk factors for obesity are well-known, but environmental characteristics that influence individual risk, especially in rural communities, are not confirmed. Rural communities face unique challenges to implementing environmental strategies, such as walkability, aimed at supporting weight healthy lifestyles. Cooperative Extension, a community-embedded weight health partner, convened and engaged community members in self-exploration of local resources and readiness to change environmental characteristics perceived to promote unhealthy eating and inactivity. This approach leveraged Extension's mission, which includes connecting rural communities with land-grant university resources. HEAL MAPPS™ (Healthy Eating Active Living Mapping Attributes using Participatory Photographic Surveys) was developed as a participatory action research methodology. Adopted by Extension community partners, HEAL MAPPS™ involved residents in photomapping, characterizing, and communicating lived experiences of their rural community, and prioritizing interventions to change the obesogenic context. Extension educators serving rural communities in six Western U.S. states were trained to implement HEAL MAPPS™. Extension engaged community members who mapped and evaluated their encounters with environmental attributes that shape their dietary and activity patterns. The method partnered residents with decision makers in identifying issues, assessing resources and readiness, and prioritizing locally relevant environmental strategies to reduce access disparities for rural populations with high obesity risk. HEAL MAPPS™ revealed differences in resource availability, accessibility, and affordability within and among rural communities, as well as in readiness to address the obesogenic context. Extension functioned successfully as the backbone organization, and local community health partner, cooperatively implementing HEAL MAPPS™ and engaging constituents in shaping weight healthy
Baker, Harold R.
This book examines cases of rural community development initiatives in the United States, Canada, and Europe, identified during a study of multicommunity collaboration projects. Section 1 includes 36 community development ideas operating at provincial, regional, and local levels. Included are ideas such as bank community development corporations,…
Taniguchi, Kyoko; Hirakawa, Yukiko
School management in many sub-Saharan African countries has been enhanced through community participation in an attempt to improve education quality. This study uses field research in a rural district of Malawi to assess how community and parent participation differs between schools, the intentions of communities and parents when carrying out…
Wilde, Glenn R.
A rural library project of the Intermountain Group, a network of four land-grant universities, eight local communities, and the state libraries in Wyoming, Utah, Colorado, and Montana, developed a Community Interest Inventory and solicited information on professional information needs from identified community groups who were users or potential…
Egyir, Beverly; Guardabassi, Luca; Esson, Joseph
of strains isolated from the two communities. Nasal swabs were collected from healthy individuals living in an urban community situated in the suburb of the capital city, Accra (n = 353) and in a rural community situated in the Dangme-West district (n = 234). The overall prevalence of nasal carriage was 21...
Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol
To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.
Barbosa-Cortes, Lourdes; Villasis-Keever, Miguel Angel; Del Prado-Manriquez, Martha; Lopez-Alarcon, Mardia
The study of the incidence of overweight and obesity as well as body composition and insulin resistance in children from rural communities is scarce. The aims of the study were a) to characterize the adiposity and homeostasis model assessment of insulin resistance (HOMA-IR) in school-age children from a rural community and b) to determine factors associated with fat mass and HOMA-IR in this population. A total of 41 school-aged children (15 males and 26 females; 9.9 ± 2.5 years old) from a Mexican rural community was studied. Trained observers had previously assessed the children's nutritional status during the first 6 months of life. Anthropometry, energy intake, physical activity, body composition and biochemical parameters were measured. The overall prevalence of overweight/obesity was 7.3%. The mean energy intake of children was below international recommendations (1,235 ± 400 kcal/day). A higher percentage of fat mass was observed in females (20.3 ± 8.5) than in males (14.1 ± 5.1) (p = 0.006). There were seven children with IR, but we did not observe a correlation between HOMA and BMI percentiles (Pearson's r = 0.09, p = 0.57). In a regression model, gender (females) was the primary factor associated with the percentage of fat mass. The growth velocity during the first 6 months of life was associated with HOMA-IR. There is a low frequency of overweight and obesity in children from rural communities in Mexico. However, these children appear to have increased risk of adiposity and insulin resistance. Copyright © 2015 IMSS. Published by Elsevier Inc. All rights reserved.
Bortolotto, Ieda Maria; Amorozo, Maria Christina de Mello; Neto, Germano Guarim; Oldeland, Jens; Damasceno-Junior, Geraldo Alves
Background Wild plants are used as food for human populations where people still depend on natural resources to survive. This study aimed at identifying wild plants and edible uses known in four rural communities of the Pantanal-Brazil, estimating the use value and understanding how distance to the urban areas, gender, age and number of different environments available in the vicinity can influence the knowledge and use of these plants by local people. Methods Data on edible plants with known...
Foster, Jaime S; Contreras, Dawn; Gold, Abby; Keim, Ann; Oscarson, Renee; Peters, Paula; Procter, Sandra; Remig, Valentina; Smathers, Carol; Mobley, Amy R
Although some researchers have examined nutrition and physical activity policies within urban child care centers, little is known about the potentially unique needs of rural communities. Child care centers serving preschool children located within low-income rural communities (n = 29) from seven states (Indiana, Kansas, Michigan, North Dakota, Ohio, South Dakota, and Wisconsin) were assessed to determine current nutrition and physical activity (PA) practices and policies. As part of a large-scale childhood obesity prevention project, the Community Healthy Living Index's previously validated Early Childhood Program Assessment Tool was used to collect data. Descriptive statistical analysis was conducted to identify high-priority areas. Healthy People 2020 and the Academy of Nutrition and Dietetics' recommendations for nutrition and PA policies in child care centers were used as benchmarks. Reports of not fully implementing (nutrition-related policies or practices within rural early child care centers were identified. Centers not consistently serving a variety of fruits (48%), vegetables (45%), whole grains (41%), limiting saturated fat intake (31%), implementing healthy celebration guidelines (41%), involving children in mealtime (62%), and referring families to nutrition assistance programs (24%) were identified. More than one third of centers also had limited structured PA opportunities. Although eligible, only 48% of the centers participated in the Child and Adult Care Food Program. Overall, centers lacked parental outreach, staff training, and funding/resources to support nutrition and PA. These results provide insight into where child care centers within low-income, rural communities may need assistance to help prevent childhood obesity.
Kim, Woo Jung; Joo, Won-tak; Baek, Jiwon; Sohn, Sung Yun; Namkoong, Kee; Youm, Yoosik; Kim, Hyeon Chang; Park, Yeong-Ran; Chu, Sang Hui; Lee, Eun
Objective Sleep disturbance is common in the elderly, which is result from multi-factorial causes encompassing socio-demographic, behavioral, and clinical factors. We aimed to identify factors associated with insomnia among the elderly in a rural community in South Korea, a country with a rapidly growing aged population. Methods This cross-sectional study used the data from the second wave of the Korean Social life, Health and Ageing Project, which is a cohort study of individuals living in a...
Josyula, Srirama; Taylor, Kathryn K; Murphy, Blair M; Rodas, Dairamise; Kamath-Rayne, Beena D
referrals between health care facilities are important in low-resource settings, particularly in maternal and child health, to transfer pregnant patients to the appropriate level of obstetric care. Our aim was to characterise the obstetrical referrals from a rural clinic to a community referral hospital in Honduras, to identify barriers in effective transport/referral, and to describe subsequent patient outcomes. we performed a descriptive retrospective study of patients referred during a 9-month period. We reviewed patient charts to review diagnosis, referral, and treatment times at both sites to understand the continuity of care. ninety-two pregnant patients were referred from the rural clinic to the community hospital. Twenty six pregnant patients (28%) did not have complete and accurate medical records and were excluded from the study. The remaining 66 patients were our study population. Of the 66 patients, 54 (82%) received antenatal care with an average of 5.5±2.4 visits. The most common diagnoses requiring referral were non-reassuring fetal status, hypertensive disorders of pregnancy, and preterm labour. The time spent in the rural clinic until transfer was 7.35±8.60 hours, and transport times were 4.42±1.07 hours. Of the 66 women transferred, 24 (36%) had different primary diagnoses and 16 (24%) had additional diagnoses after evaluation in the community hospital, whereas the remaining 26 (40%) had diagnoses that remained the same. No system was in place to give feedback to the referring clinic doctors regarding their primary diagnoses. our results demonstrate challenges seen in obstetric transport from a rural clinic to a community hospital in Honduras. Further research is needed for reform of emergency obstetric care management, targeting both healthcare personnel and medical referral infrastructure. The example of Honduras can be taken to motivate change in other resource-limited areas. Copyright © 2015 Elsevier Ltd. All rights reserved.
Parmar, D.; Reinhold, S.; Souares, A.; Savadogo, G.; Sauerborn, R.
Objective: To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa \\ud \\ud Data sources: Data was used from a household survey that collected primary data from randomly selected households, covering 42 villages and 1 town, during 2004-07(n=890). \\ud \\ud Study design: The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004-06. We applied different strategies to control for selection bias...
Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan
Telemental health involves technologies such as videoconferencing to deliver mental health services and education, and to connect individuals and communities for healing and health. In remote and rural First Nations communities there are often challenges to obtaining mental healthcare in the community and to working with external mental health workers. Telemental health is a service approach and tool that can address some of these challenges and potentially support First Nations communities in their goal of improving mental health and wellbeing. Community members' perspectives on the usefulness and appropriateness of telemental health can greatly influence the level of engagement with the service. It appears that no research or literature exists on First Nations community members' perspectives on telemental health, or even on community perspectives on the broader area of technologies for mental health services. Therefore, this article explores the perspectives on telemental health of community members living in two rural and remote First Nations communities in Ontario, Canada. METHODS; This study was part of the VideoCom project, a collaborative research project exploring how remote and rural First Nations communities are using ICTs. This current exploration was conducted with the support of Keewaytinook Okimakanak (KO), our partner in Northwestern Ontario. With the full collaboration of the communities' leadership, a team involving KO staff and VideoCom researchers visited the two communities in the spring of 2010. Using a participatory research design, we interviewed 59 community members, asking about their experiences with and thoughts on using technologies and their attitudes toward telemental health, specifically. A thematic analysis of this qualitative data and a descriptive quantitative analysis of the information revealed the diversity of attitudes among community members. Finally, based on a discussion with the community telehealth staff, a 'ways forward