WorldWideScience

Sample records for underserved rural communities

  1. Investigating the Factors of Resiliency among Exceptional Youth Living in Rural Underserved Communities

    Science.gov (United States)

    Curtin, Kevin A.; Schweitzer, Ashley; Tuxbury, Kristen; D'Aoust, Janelle A.

    2016-01-01

    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…

  2. Engaging the underserved: a process model to mobilize rural community health coalitions as partners in translational research.

    Science.gov (United States)

    Davis, Melinda M; Aromaa, Susan; McGinnis, Paul B; Ramsey, Katrina; Rollins, Nancy; Smith, Jamie; Beamer, Beth Ann; Buckley, David I; Stange, Kurt C; Fagnan, Lyle J

    2014-08-01

    Community engagement (CE) and community-engaged research (CEnR) are increasingly recognized as critical elements in research translation. Process models to develop CEnR partnerships in rural and underserved communities are needed. Academic partners transformed four established Community Health Improvement Partnerships (CHIPs) into Community Health Improvement and Research Partnerships (CHIRPs). The intervention consisted of three elements: an academic-community kickoff/orientation meeting, delivery of eight research training modules to CHIRP members, and local community-based participatory research (CBPR) pilot studies addressing childhood obesity. We conducted a mixed methods analysis of pre-/postsurveys, interviews, session evaluations, observational field notes, and attendance logs to evaluate intervention effectiveness and acceptability. Forty-nine community members participated; most (78.7%) attended five or more research training sessions. Session quality and usefulness was high. Community members reported significant increases in their confidence for participating in all phases of research (e.g., formulating research questions, selecting research methods, writing manuscripts). All CHIRP groups successfully conducted CBPR pilot studies. The CHIRP process builds on existing infrastructure in academic and community settings to foster CEnR. Brief research training and pilot studies around community-identified health needs can enhance individual and organizational capacity to address health disparities in rural and underserved communities. © 2014 Wiley Periodicals, Inc.

  3. Building an argument for Internet expansion in Dwesa- an under-serviced rural community in South Africa

    CSIR Research Space (South Africa)

    Dlamini, S

    2014-11-01

    Full Text Available The purpose of this paper is to present research findings that investigate the extent of Internet usage as well as options for extending the current reach of the wireless network in Dwesa, a rural area in South Africa’s Eastern Cape Province. A mix...

  4. Perceptions of cardiovascular health in underserved communities.

    Science.gov (United States)

    Bryant, Lucinda L; Chin, Nancy P; Cottrell, Lesley A; Duckles, Joyce M; Fernandez, I Diana; Garces, D Marcela; Keyserling, Thomas C; McMilin, Colleen R; Peters, Karen E; Samuel-Hodge, Carmen D; Tu, Shin-Ping; Vu, Maihan B; Fitzpatrick, Annette L

    2010-03-01

    Cardiovascular disease is the leading cause of deaths and illnesses in US adults, and the prevalence is disproportionately high in underserved populations. In this study, we assessed respondents' understanding of context-specific differences in knowledge and perceptions of disease, risk, and prevention in 6 underserved communities, with the longer-term goal of developing appropriate interventions. Thirty-nine small-group sessions and 14 interviews yielded data from 318 adults. Each site's researchers coded, analyzed, and extracted key themes from local data. Investigators from all sites synthesized results and identified common themes and differences. Themes clustered in 3 areas (barriers to cardiovascular health, constraints related to multiple roles, and suggestions for effective communications and programs). Barriers spanned individual, social and cultural, and environmental levels; women in particular cited multiple roles (eg, competing demands, lack of self-care). Programmatic suggestions included the following: personal, interactive, social context; information in language that people use; activities built around cultural values and interests; and community orientation. In addition, respondents preferred health-related information from trusted groups (eg, AARP), health care providers (but with noticeable differences of opinion), family and friends, and printed materials. Interventions to decrease barriers to cardiovascular health are needed; these strategies should include family and community context, small groups, interactive methods, culturally sensitive materials, and trusted information sources. New-immigrant communities need culturally and linguistically tailored education before receiving more substantive interventions.

  5. Creating A Sustainable Model of Spine Care in Underserved Communities

    DEFF Research Database (Denmark)

    Haldeman, Scott; Nordin, Margareta; Outerbridge, Geoff

    2015-01-01

    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...... are adapted to and integrated within each community in collaboration with local decision makers, existing health care workers and traditional healers. Cornerstones of WSC's emphasis on long-term sustainability are (1) education of community partners, governments and local health professionals, and (2...

  6. Engaging diverse underserved communities to bridge the mammography divide

    Directory of Open Access Journals (Sweden)

    Cully Angelia

    2011-01-01

    Full Text Available Abstract Background Breast cancer screening continues to be underutilized by the population in general, but is particularly underutilized by traditionally underserved minority populations. Two of the most at risk female minority groups are American Indians/Alaska Natives (AI/AN and Latinas. American Indian women have the poorest recorded 5-year cancer survival rates of any ethnic group while breast cancer is the number one cause of cancer mortality among Latina women. Breast cancer screening rates for both minority groups are near or at the lowest among all racial/ethnic groups. As with other health screening behaviors, women may intend to get a mammogram but their intentions may not result in initiation or follow through of the examination process. An accumulating body of research, however, demonstrates the efficacy of developing 'implementation intentions' that define when, where, and how a specific behavior will be performed. The formulation of intended steps in addition to addressing potential barriers to test completion can increase a person's self-efficacy, operationalize and strengthen their intention to act, and close gaps between behavioral intention and completion. To date, an evaluation of the formulation of implementation intentions for breast cancer screening has not been conducted with minority populations. Methods/Design In the proposed program, community health workers will meet with rural-dwelling Latina and American Indian women one-on-one to educate them about breast cancer and screening and guide them through a computerized and culturally tailored "implementation intentions" program, called Healthy Living Kansas - Breast Health, to promote breast cancer screening utilization. We will target Latina and AI/AN women from two distinct rural Kansas communities. Women attending community events will be invited by CHWs to participate and be randomized to either a mammography "implementation intentions" (MI2 intervention or a

  7. Impact of a regional distributed medical education program on an underserved community: perceptions of community leaders.

    Science.gov (United States)

    Toomey, Patricia; Lovato, Chris Y; Hanlon, Neil; Poole, Gary; Bates, Joanna

    2013-06-01

    To describe community leaders' perceptions regarding the impact of a fully distributed undergraduate medical education program on a small, medically underserved host community. The authors conducted semistructured interviews in 2007 with 23 community leaders representing, collectively, the education, health, economic, media, and political sectors. They reinterviewed six participants from a pilot study (2005) and recruited new participants using purposeful and snowball sampling. The authors employed analytic induction to organize content thematically, using the sectors as a framework, and they used open coding to identify new themes. The authors reanalyzed transcripts to identify program outcomes (e.g., increased research capacity) and construct a list of quantifiable indicators (e.g., number of grants and publications). Participants reported their perspectives on the current and anticipated impact of the program on education, health services, the economy, media, and politics. Perceptions of impact were overwhelmingly positive (e.g., increased physician recruitment), though some were negative (e.g., strains on health resources). The authors identified new outcomes and confirmed outcomes described in 2005. They identified 16 quantifiable indicators of impact, which they judged to be plausible and measureable. Participants perceive that the regional undergraduate medical education program in their community has broad, local impacts. Findings suggest that early observed outcomes have been maintained and may be expanding. Results may be applicable to medical education programs with distributed or regional sites in similar rural, remote, and/or underserved regions. The areas of impact, outcomes, and quantifiable indicators identified will be of interest to future researchers and evaluators.

  8. Crowdsourced Microfinance for Energy Efficiency in Underserved Communities

    Energy Technology Data Exchange (ETDEWEB)

    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)

    2017-06-21

    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

  9. Implementing academic detailing for breast cancer screening in underserved communities

    Directory of Open Access Journals (Sweden)

    Ashford Alfred R

    2007-12-01

    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

  10. Leveraging Telehealth to Bring Volunteer Physicians Into Underserved Communities.

    Science.gov (United States)

    Uscher-Pines, Lori; Rudin, Robert; Mehrotra, Ateev

    2017-06-01

    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.

  11. Engaging with Underserved Urban Communities on Climate Resilience

    Science.gov (United States)

    Akerlof, K.; Moser, F. C.; Baja, K.; Dindinger, J. M.; Chanse, V.; Rowan, K. E.; Rohring, B.

    2016-12-01

    Meeting the needs of urban high-risk/low-resource communities is one of the most critical challenges in improving climate resilience nationally, but little tailored information exists to guide community engagement efforts specifically for these contexts. This case study describes a collaboration between universities, local governments, and community members working in underserved neighborhoods of the City of Baltimore and Prince George's County, Maryland. In service of current and developing community programs, the team surveyed residents door-to-door about their perceptions of the socio-environmental risks they face, their priorities for change, and the ways in which communication may build protective social capital. We highlight theoretical, applied, and pedagogical aspects of the study that inform both the promise and limitations of these collaborations. These include: 1) the role of citizen participation in climate adaptation decision-making; 2) the meaning, use, and potential impact of community data; 3) balancing differing organizational priorities, timelines, and cultures within community-based projects; and 4) research participation of undergraduate students. The results of the survey illuminate climate risk perceptions in neighborhoods facing complex stressors with lessons for communication and engagement in other urban areas facing similar adaptation challenges.

  12. NASA and Public Libraries: Enhancing STEM Literacy in Underserved Communities

    Science.gov (United States)

    Dusenbery, P.; LaConte, K.; Harold, J. B.; Randall, C.

    2016-12-01

    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.

  13. With Educational Benefits for All: Campus Inclusion through Learning Communities Designed for Underserved Student Populations

    Science.gov (United States)

    Fink, John E.; Hummel, Mary L.

    2015-01-01

    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.

  14. Improving Maternal and Child Health in Underserved Rural Areas of ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    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 ...

  15. Chronic disease management in rural and underserved populations: innovation and system improvement help lead to success.

    Science.gov (United States)

    Bolin, Jane; Gamm, Larry; Kash, Bita; Peck, Mitchell

    2005-03-01

    Successful implementation of disease management (DM) is based on the ability of an organization to overcome a variety of barriers to deliver timely, appropriate care of chronic illnesses. Such programs initiate DM services to patient populations while initiating self-management education among medication-resistant patients who are chronically ill. Despite formidable challenges, rural health care providers have been successful in initiating DM programs and have discovered several ways in which these programs benefit their organizations. This research reports on six DM programs that serve large rural and underserved populations and have demonstrated that DM can be successfully implemented in such areas.

  16. Pediatric Asthma Care Coordination in Underserved Communities: A Quasiexperimental Study.

    Science.gov (United States)

    Janevic, Mary R; Stoll, Shelley; Wilkin, Margaret; Song, Peter X K; Baptist, Alan; Lara, Marielena; Ramos-Valencia, Gilberto; Bryant-Stephens, Tyra; Persky, Victoria; Uyeda, Kimberly; Lesch, Julie Kennedy; Wang, Wen; Malveaux, Floyd J

    2016-11-01

    To assess the effect of care coordination on asthma outcomes among children in underserved urban communities. We enrolled children, most of whom had very poorly or not well-controlled asthma, in medical-social care coordination programs in Los Angeles, California; Chicago, Illinois; Philadelphia, Pennsylvania; and San Juan, Puerto Rico in 2011 to 2014. Participants (n = 805; mean age = 7 years) were 60% male, 50% African American, and 42% Latino. We assessed asthma symptoms and health care utilization via parent interview at baseline and 12 months. To prevent overestimation of intervention effects, we constructed a comparison group using bootstrap resampling of matched control cases from previous pediatric asthma trials. At follow-up, intervention participants had 2.2 fewer symptom days per month (SD = 0.3; P < .01) and 1.9 fewer symptom nights per month (SD = 0.35; P < .01) than did the comparison group. The relative risk in the past year associated with the intervention was 0.63 (95% confidence interval [CI] = 0.45, 0.89) for an emergency department visit and 0.69 (95% CI = 0.47, 1.01) for hospitalization. Care coordination may improve pediatric asthma symptom control and reduce emergency department visits. Expanding third-party reimbursement for care coordination services may help reduce pediatric asthma disparities.

  17. The rural community care gerontologic nurse entrepreneur: role development strategies.

    Science.gov (United States)

    Caffrey, Rosalie A

    2005-10-01

    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.

  18. Bringing cutting-edge Earth and ocean sciences to under-served and rural audiences through informal science education

    Science.gov (United States)

    Cooper, S. K.; Petronotis, K. E.; Ferraro, C.; Johnson, K. T. M.; Yarincik, K.

    2017-12-01

    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.

  19. 75 FR 29447 - Public Health Service Act, Rural Physician Training Grant Program, Definition of “Underserved...

    Science.gov (United States)

    2010-05-26

    ..., identified by the Regulatory Information Number (RIN), by any of the following methods: Federal eRulemaking... assisting eligible entities in recruiting students most likely to practice medicine in underserved rural... determined that good cause exists which makes the usual notice and comment procedure impractical, unnecessary...

  20. The Quick Peek Program: A Model for Developmental Screening within Underserved Communities

    Science.gov (United States)

    Harris, Jill; Norton, Amy

    2016-01-01

    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…

  1. Clinical medical education in rural and underserved areas and eventual practice outcomes: A systematic review and meta-analysis.

    Science.gov (United States)

    Raymond Guilbault, Ryan William; Vinson, Joseph Alexander

    2017-01-01

    Undergraduate medical students are enrolled in clinical education programs in rural and underserved urban areas to increase the likelihood that they will eventually practice in those areas and train in a primary care specialty to best serve those patient populations. MEDLINE and Cochrane Library online databases were searched to identify articles that provide a detailed description of the exposure and outcome of interest. A qualitative review of articles reporting outcome data without comparison or control groups was completed using the Medical Education Research Study Quality Instrument (MERSQI). A meta-analysis of articles reporting outcome data with comparison or control groups was completed with statistical and graphical summary estimates. Seven hundred and nine articles were retrieved from the initial search and reviewed based on inclusion and exclusion criteria. Of those, ten articles were identified for qualitative analysis and five articles included control groups and thus were included in the quantitative analysis. Results indicated that medical students with clinical training in underserved areas are almost three times as likely to practice in underserved areas than students who do not train in those areas (relative risk [RR] = 2.94; 95% confidence interval [CI]: 2.17, 4.00). Furthermore, medical students training in underserved areas are about four times as likely to practice primary care in underserved areas than students who do not train in those locations (RR = 4.35; 95% CI: 1.56, 12.10). These estimates may help guide medical school administrators and policymakers to expand underserved clinical training programs to help relieve some of the problems associated with access to medical care among underserved populations.

  2. Liability concerns and shared use of school recreational facilities in underserved communities.

    Science.gov (United States)

    Spengler, John O; Connaughton, Daniel P; Maddock, Jason E

    2011-10-01

    In underserved communities, schools can provide the physical structure and facilities for informal and formal recreation as well as after-school, weekend, and summer programming. The importance of community access to schools is acknowledged by authoritative groups; however, fear of liability is believed to be a key barrier to community access. The purpose of this study was to investigate perceptions of liability risk and associated issues among school administrators in underserved communities. A national survey of school administrators in underserved communities (n=360, response rate of 21%) was conducted in 2009 and analyzed in 2010. Liability perceptions in the context of community access were assessed through descriptive statistics. The majority of respondents (82.2%) indicated concern for liability should someone be injured on school property after hours while participating in a recreational activity. Among those that did not allow community access, 91% were somewhat to very concerned about liability and 86% believed that stronger legislation was needed to better protect schools from liability for after-hours recreational use. Among those who claimed familiarity with a state law that offered them limited liability protection, nearly three fourths were nevertheless concerned about liability. Liability concerns are prevalent among this group of school administrators, particularly if they had been involved in prior litigation, and even if they indicated they were aware of laws that provide liability protection where use occurs after hours. Reducing these concerns will be important if schools are to become locations for recreational programs that promote physical activity outside of regular school hours. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Knowledgeable Neighbors: a mobile clinic model for disease prevention and screening in underserved communities.

    Science.gov (United States)

    Hill, Caterina; Zurakowski, David; Bennet, Jennifer; Walker-White, Rainelle; Osman, Jamie L; Quarles, Aaron; Oriol, Nancy

    2012-03-01

    The Family Van mobile health clinic uses a "Knowledgeable Neighbor" model to deliver cost-effective screening and prevention activities in underserved neighborhoods in Boston, MA. We have described the Knowledgeable Neighbor model and used operational data collected from 2006 to 2009 to evaluate the service. The Family Van successfully reached mainly minority low-income men and women. Of the clients screened, 60% had previously undetected elevated blood pressure, 14% had previously undetected elevated blood glucose, and 38% had previously undetected elevated total cholesterol. This represents an important model for reaching underserved communities to deliver proven cost-effective prevention activities, both to help control health care costs and to reduce health disparities.

  4. Improving cardiovascular health of underserved populations in the community with Life's Simple 7.

    Science.gov (United States)

    Murphy, Marcia Pencak; Coke, Lola; Staffileno, Beth A; Robinson, Janis D; Tillotson, Robin

    2015-11-01

    The purpose of this nurse practitioner (NP) led initiative was to improve the cardiovascular health of two underserved populations in the community using the American Heart Association (AHA) Life's Simple 7 and My Life Check (MLC) tools. Two inner city community sites were targeted: (a) a senior center servicing African American (AA) older adults, and (b) a residential facility servicing homeless women. Preprogram health data (blood pressure, cholesterol, blood glucose levels, body mass index, and health behaviors) were collected to calculate MLC scores. Postprogram health data were obtained on participants with the lowest MLC scores who completed the program. Eight older adults completed the program with a 37.1% increase in average MLC score (6.2 vs. 8.5). Ten women completed the program with a 9.3% decrease in average MLC score (4.3 vs. 3.9). Favorable benefits were observed in the AA older adults. In contrast, similar benefits were not observed in the women, which may be because of a constellation of social, environmental, biological, and mental health factors. NPs are prepared to target community-based settings to address the health of underserved populations. Engaging key stakeholders in the planning and implementation is essential for success. ©2015 American Association of Nurse Practitioners.

  5. Intercultural health and ethnobotany: how to improve healthcare for underserved and minority communities?

    Science.gov (United States)

    Vandebroek, Ina

    2013-07-30

    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

  6. Networking the rural community.

    Science.gov (United States)

    Tiongson, K H; Arneson, S I

    1993-04-01

    A branch network of affiliate hospitals has been providing home care services to rural North Dakota residents successfully for a decade. Here's how this effective system meets the special challenges that a rural environment poses for hiring, training, scheduling, and supporting home care aides.

  7. The Inwood Astronomy Project: 100 Nights in Manhattan---An Outreach Initiative to Underserved Communities

    Science.gov (United States)

    Kendall, J. S.

    2008-11-01

    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.

  8. Using an Interactive Systems Framework to Expand Telepsychology Innovations in Underserved Communities

    OpenAIRE

    Garney, Whitney R.; McCord, Carly E.; Walsh, Michaela V.; Alaniz, Angela B.

    2016-01-01

    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 ...

  9. Caregiver's depressive symptoms and asthma control in children from an underserved community.

    Science.gov (United States)

    Rioseco, Andrea; Serrano, Carolina; Celedón, Juan C; Padilla, Oslando; Puschel, Klaus; Castro-Rodriguez, Jose A

    2017-12-01

    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.

  10. Potential use of mobile phones in improving animal health service delivery in underserved rural areas: experience from Kilosa and Gairo districts in Tanzania.

    Science.gov (United States)

    Karimuribo, Esron D; Batamuzi, Emmanuel K; Massawe, Lucas B; Silayo, Richard S; Mgongo, Frederick O K; Kimbita, Elikira; Wambura, Raphael M

    2016-10-07

    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

  11. The Regional Asthma Disease Management Program (RADMP) for low income underserved children in rural western North Carolina: a National Asthma Control Initiative Demonstration Project.

    Science.gov (United States)

    Shuler, Melinda S; Yeatts, Karin B; Russell, Donald W; Trees, Amy S; Sutherland, Susan E

    2015-01-01

    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 < 0.0001). From baseline to intervention completion, lung function FVC, FEV1, FEF 25-75 increased by 7.2%, 13.2% and 21.1%, respectively (all p < 0.001), and average school absences dropped from 17 to 8.8 days. Healthcare cost avoided 12 months post-intervention were approximately $882,021. The RADMP program resulted in decreased ED visits, hospitalizations, school absences and improved lung function and eNO. This was the first NACI demonstration project to show substantial improvements in healthcare utilization and clinical outcomes among rural asthmatic children.

  12. The prevalence of visual impairment and blindness in underserved rural areas: a crucial issue for future.

    Science.gov (United States)

    Hashemi, H; Yekta, A; Jafarzadehpur, E; Doostdar, A; Ostadimoghaddam, H; Khabazkhoob, M

    2017-08-01

    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.

  13. Integration of Rural Community Pharmacies into a Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis

    Directory of Open Access Journals (Sweden)

    Nicholas E. Hagemeier

    2015-01-01

    Full Text Available Purpose: Practice-based research networks (PBRN seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1 evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2 explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3 explore pharmacy key informant interest in PBRN participation. Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions. Findings: A 47.8% response rate was obtained. Most key informants (88% were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%, improved relationships with providers in the community (75.9%, and professional development opportunities (69.0% were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63% and workflow disruptions (20% as the biggest barriers to PBRN participation. Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas.   Type: Original Research

  14. Understanding the performance of community health volunteers involved in the delivery of health programmes in underserved areas: a realist synthesis

    OpenAIRE

    Vareilles, Ga?lle; Pommier, Jeanine; Marchal, Bruno; Kane, Sumit

    2017-01-01

    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...

  15. Palliative Oncologic Care Curricula for Providers in Resource-Limited and Underserved Communities: a Systematic Review.

    Science.gov (United States)

    Xu, Melody J; Su, David; Deboer, Rebecca; Garcia, Michael; Tahir, Peggy; Anderson, Wendy; Kinderman, Anne; Braunstein, Steve; Sherertz, Tracy

    2017-12-20

    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.

  16. Social marketing for a farmer’s market in an underserved community: A needs assessment

    Directory of Open Access Journals (Sweden)

    Meg Skizim

    2018-01-01

    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.

  17. Collaboration Among Institutions to Bring Geospatial Technology to an Underserved Rural Region

    Science.gov (United States)

    Johnson, T.

    2012-12-01

    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

  18. Pop Up/Drill Down: A Traveling Exhibit Designed to Reach Underserved Communities through Art and Geosciences

    Science.gov (United States)

    Kurtz, N.

    2017-12-01

    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.

  19. A controlled community-based trial to promote smoke-free policy in rural communities.

    Science.gov (United States)

    Hahn, Ellen J; Rayens, Mary Kay; Adkins, Sarah; Begley, Kathy; York, Nancy

    2015-01-01

    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.

  20. Breastfeeding Patterns in the Rural Community of Hilo, Hawai‘i: An Exploration of Existing Data Sets

    OpenAIRE

    Flood, Jeanie L

    2013-01-01

    Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai‘i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai‘i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in...

  1. Oral Health in Rural Communities

    Science.gov (United States)

    ... people with partial edentulism when compared to urban (Urban, 38.4%, High Poverty Rural 51.3%, Other Rural, 45%). Counties with high rates of full edentulism are also rural (Urban, 4.3%, High-Poverty Rural 10.5%, Other Rural, 8.2%). ( Mitchell, ...

  2. Care Provided by Students in Community-Based Dental Education: Helping Meet Oral Health Needs in Underserved Communities.

    Science.gov (United States)

    Mays, Keith A; Maguire, Meghan

    2018-01-01

    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.

  3. LifeSteps: An Evidence-based Health Promotion Program for Underserved Populations – A Community Service Learning Approach

    Directory of Open Access Journals (Sweden)

    Melanie Austin-McCain

    2015-04-01

    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.

  4. Retaining health workforce in rural and underserved areas of India: What works and what doesn't? A critical interpretative synthesis.

    Science.gov (United States)

    Goel, Sonu; Angeli, Federica; Bhatnagar, Nidhi; Singla, Neetu; Grover, Manoj; Maarse, Hans

    2016-01-01

    Human resource for health is critical in quality healthcare delivery. India, with a large rural population (68.8%), needs to urgently bridge the gaps in health workforce deployment between urban and rural areas. We did a critical interpretative synthesis of the existing literature by using a predefined selection criteria to assess relevant manuscripts to identify the reasons for retaining the health workforce in rural and underserved areas. We discuss different strategies for retention of health workforce in rural areas on the basis of four major retention interventions, viz. education, regulation, financial incentives, and personal and professional support recommended by WHO in 2010. This review focuses on the English-language material published during 2005-14 on human resources in health across low- and middle-income countries. Healthcare in India is delivered through a diverse set of providers. Inequity exists in health manpower distribution across states, area (urban-rural), gender and category of health personnel. India is deficient in health system development and financing where health workforce education and training occupy a low priority. Poor governance, insufficient salary and allowances, along with inability of employers to provide safe, satisfying and rewarding work conditions-are causing health worker attrition in rural India. The review suggests that the retention of health workers in rural areas can be ensured by multiplicity of interventions such as medical schools in rural areas, rural orientation of medical education, introducing compulsory rural service in lieu of incentives providing better pay packages and special allowances, and providing better living and working conditions in rural areas. A complex interplay of factors that impact on attraction and retention of health workforce necessitates bundling of interventions. In low-income countries, evidence- based strategies are needed to ensure context-specific, field- tested and cost

  5. Rural Community Development: Bedrock for National Development ...

    African Journals Online (AJOL)

    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 ...

  6. Goal setting using telemedicine in rural underserved older adults with diabetes: experiences from the informatics for diabetes education and telemedicine project.

    Science.gov (United States)

    West, Susan P; Lagua, Carina; Trief, Paula M; Izquierdo, Roberto; Weinstock, Ruth S

    2010-05-01

    To describe the use of telemedicine for setting goals for behavior change and examine the success in achieving these goals in rural underserved older adults with diabetes. Medicare beneficiaries with diabetes living in rural upstate New York who were enrolled in the telemedicine intervention of the Informatics for Diabetes Education and Telemedicine (IDEATel) project (n = 610) participated in home televisits with nurse and dietitian educators every 4-6 weeks for 2-6 years. Behavior change goals related to nutrition, physical activity, monitoring, diabetes health maintenance, and/or use of the home telemedicine unit were established at the conclusion of each televisit and assessed at the next visit. Collaborative goal setting was employed during 18,355 televisits (mean of 33 goal-setting televisits/participant). The most common goals were related to monitoring, followed by diabetes health maintenance, nutrition, exercise, and use of the telemedicine equipment. Overall, 68% of behavioral goals were rated as "improved" or "met." The greatest success was achieved for goals related to proper insulin injection technique and daily foot care. These elderly participants had the most difficulty achieving goals related to use of the computer. No gender differences in goal achievement were observed. Televisits can be successfully used to collaboratively establish behavior change goals to help improve diabetes self-management in underserved elderly rural adults.

  7. The Reality of Sustaining Community-Based Sport and Physical Activity Programs to Enhance the Development of Underserved Youth: Challenges and Potential Strategies

    Science.gov (United States)

    Whitley, Meredith A.; Forneris, Tanya; Barker, Bryce

    2015-01-01

    Many community-based sport and physical activity programs take a positive youth development approach when operating in underserved communities around the world (Forneris, Whitley, & Barker, 2013). However, one of the biggest challenges for these programs is sustainability (Lindsey, 2008). The purpose of this article is to present the 3…

  8. Prevalence and determinants of caesarean section in private and public health facilities in underserved South Asian communities: Cross-sectional analysis of data from Bangladesh, India and Nepal

    NARCIS (Netherlands)

    M. Neuman (Melissa); G. Alcock (Glyn); K. Azad (Kishwar); A. Kuddus (Abdul); D. Osrin (David); N. Shah More (Neena); N. Nair (Nirmala); P. Tripathy (Prasanta); C. Sikorski (Catherine); N. Saville (Naomi); A. Sen (Aman); T. Colbourn (Tim); A.J. Houweling (Tanja); N. Seward (Nadine); A. Manandhar; B. Shrestha (Bhim); A. Costello (Anthony); A. Prost (Audrey)

    2014-01-01

    textabstractObjectives: To describe the prevalence and determinants of births by caesarean section in private and public health facilities in underserved communities in South Asia. Design: Cross-sectional study. Setting: 81 community-based geographical clusters in four locations in Bangladesh, India

  9. Embracing autism in Canadian rural communities.

    Science.gov (United States)

    Hoogsteen, Lindsey; Woodgate, Roberta L

    2013-06-01

    The purpose of this study was to explore the lived experience of Canadian parents living in rural areas who were parenting a child with autism. A phenomenological design described by van Manen was applied to guide this study. This study took place in rural communities of Western Canada. Purposive sampling was used to recruit 26 families parenting a child with autism in rural communities. Participants ranged in age from 26 to 50 years old and lived an average of 197 kilometres away from an urban city. Parents of children with autism took part in audio-taped, in-depth interviews. A total of 26 open-ended interviews were completed over four months with an average of 83 minutes per interview. All interviews and field notes were transcribed verbatim and analyzed using van Manen's selective highlighting approach. When describing the characteristics of living rurally while parenting a child with autism, parents reported that the rural community had (i) less of everything, (ii) safety and familiarity, and (iii) a family of support. Parents believed that although there were disadvantages to living in a rural community, parents felt isolated in terms of services but not in terms of the support received by the community. The results of this study add to our knowledge of parenting experiences with attention to the rural experience and furthermore, recommendations for nurses and health care professionals were provided. © 2013 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  10. Community Satisfaction in Czech Rural Communities: A Multilevel Model

    Czech Academy of Sciences Publication Activity Database

    Bernard, Josef

    2015-01-01

    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

  11. Municipal service provision in rural communities

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    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....

  12. Integrated model of primary and secondary eye care for underserved rural areas: The L V Prasad Eye Institute experience

    Directory of Open Access Journals (Sweden)

    Gullapalli N Rao

    2012-01-01

    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.

  13. Factors associated with differential uptake of seasonal influenza immunizations among underserved communities during the 2009-2010 influenza season.

    Science.gov (United States)

    Vlahov, David; Bond, Keosha T; Jones, Kandice C; Ompad, Danielle C

    2012-04-01

    Influenza vaccination coverage remains low and disparities persist. In New York City, a community-based participatory research project (Project VIVA) worked to address this issue in Harlem and the South Bronx by supplementing existing vaccination programs with non-traditional venues (i.e., community-based organizations). We conducted a 10 min survey to assess access to influenza vaccine as well as attitudes and beliefs towards influenza vaccination that could inform intervention development for subsequent seasons. Among 991 participants recruited using street intercept techniques, 63% received seasonal vaccine only, 11% seasonal and H1N1, and 26% neither; 89% reported seeing a health care provider (HCP) during the influenza season. Correlates of immunization among those with provider visits during the influenza season included being US-born, interest in getting the vaccine, concern about self or family getting influenza, an HCP's recommendation and comfort with government. Among those without an HCP visit, factors associated with immunization included being US born, married, interest in getting the vaccine, understanding influenza information, and concern about getting influenza. Factors associated with lack of interest in influenza vaccine included being born outside the US, Black and uncomfortable with government. In medically underserved areas, having access to routine medical care and understanding the medical implications of influenza play an important role in enhancing uptake of seasonal influenza vaccination. Strategies to improve vaccination rates among Blacks and foreign-born residents need to be addressed. The use of non-traditional venues to provide influenza vaccinations in underserved communities has the potential to reduce health disparities.

  14. LEADERSHIP IN RURAL CONGREGATIONS AND COMMUNITIES ...

    African Journals Online (AJOL)

    unemployment. Congregations in rural communities and their leadership cannot ..... for all leadership styles, definitions and preferences, namely leadership influences the ... Irrespective of whether a leader prefers an autocratic, bureaucratic ...

  15. Migration, Rural Poverty and Community Natural Resource ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Migration, Rural Poverty and Community Natural Resource Management in Cambodia. Cambodia has a ... Cambodia, Far East Asia, Central Asia, South Asia ... Call for new OWSD Fellowships for Early Career Women Scientists now open.

  16. A Practical Risk Stratification Approach for Implementing a Primary Care Chronic Disease Management Program in an Underserved Community.

    Science.gov (United States)

    Xu, Junjun; Williams-Livingston, Arletha; Gaglioti, Anne; McAllister, Calvin; Rust, George

    2018-01-01

    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.

  17. Environmental resources and poverty in rural communities

    DEFF Research Database (Denmark)

    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......Over the last two decades, the burgeoning empirical evidence on the importance of forests and environmental resources to rural livelihoods in developing countries has attracted the attention of policy makers aiming to develop and implement strategies for reducing poverty and improving livelihoods...

  18. Assessing Rural Communities through Youth Photography

    Directory of Open Access Journals (Sweden)

    Renee A. Oscarson

    2012-06-01

    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.

  19. Validation of English and Spanish-language versions of a screening questionnaire for rheumatoid arthritis in an underserved community.

    Science.gov (United States)

    Potter, Jeffrey; Odutola, Jennifer; Gonzales, Christian Amurrio; Ward, Michael M

    2008-08-01

    Questionnaires to screen for rheumatoid arthritis (RA) have been tested in groups that were primarily well educated and Caucasian. We sought to validate the RA questions of the Connective Tissue Disease Screening Questionnaire (CSQ) in ethnic minorities in an underserved community, and to test a Spanish-language version. The Spanish-language version was developed by 2 native speakers. Consecutive English-speaking or Spanish-speaking patients in a community-based rheumatology practice completed the questionnaire. Diagnoses were confirmed by medical record review. Sensitivity and specificity of the questionnaire for a diagnosis of RA were computed for each language version, using 2 groups as controls: patients with noninflammatory conditions, and participants recruited from the community. The English-language version was tested in 53 patients with RA (79% ethnic minorities; mean education level 11.3 yrs), 85 rheumatology controls with noninflammatory conditions, and 82 community controls. Using 3 positive responses as indicating a positive screening test, the sensitivity of the questionnaire was 0.77, the specificity based on rheumatology controls was 0.45, and the specificity based on community controls was 0.94. The Spanish-language version was tested in 55 patients with RA (mean education level 7.8 yrs), 149 rheumatology controls, and 88 community controls. The sensitivity of the Spanish-language version was 0.87, with specificities of 0.60 and 0.97 using the rheumatology controls and community controls, respectively. The sensitivity of the English-language version of the RA questions of the CSQ was lower in this study than in other cohorts, reflecting differences in the performance of the questions in different ethnic or socioeconomic groups. The Spanish-language version demonstrated good sensitivity, and both had excellent specificity when tested in community controls.

  20. Building a Community-Academic Partnership: Implementing a Community-Based Trial of Telephone Cognitive Behavioral Therapy for Rural Latinos

    Directory of Open Access Journals (Sweden)

    Eugene Aisenberg

    2012-01-01

    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.

  1. Self-collected cervicovaginal sampling for site-of-care primary HPV-based cervical cancer screening: a pilot study in a rural underserved Greek population.

    Science.gov (United States)

    Chatzistamatiou, Kimon; Chatzaki, Εkaterini; Constantinidis, Τheocharis; Nena, Evangelia; Tsertanidou, Athena; Agorastos, Theodoros

    2017-11-01

    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.

  2. Evaluating tablet computers as a survey tool in rural communities.

    Science.gov (United States)

    Newell, Steve M; Logan, Henrietta L; Guo, Yi; Marks, John G; Shepperd, James A

    2015-01-01

    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.

  3. Critical Optimism: Reimagining Rural Communities through Libraries

    Directory of Open Access Journals (Sweden)

    Margo Gustina

    2018-04-01

    Full Text Available In Brief: In the absence of governmental agencies and philanthropic support, many rural communities see their local library as the last civic, cultural, or service organization in town. This reality presents obvious challenges to the librarian, and also incredible opportunity. As the primary convener, libraries have the ability to facilitate regeneration in the communities they serve. This article situates rural librarianship within an organizing framework for change and discusses applications of community engagement tools and measures of impact aligned with social wellbeing.

  4. The Knowledge Is Power Program (KIPP): An Analysis of One Model's Efforts to Promote Achievement in Underserved Communities

    Science.gov (United States)

    Macey, Erin; Decker, Janet; Eckes, Suzanne

    2009-01-01

    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…

  5. A mixed-methods examination of communication between oncologists and primary care providers among primary care physicians in underserved communities.

    Science.gov (United States)

    Shen, Megan Johnson; Binz-Scharf, Maria; D'Agostino, Tom; Blakeney, Natasha; Weiss, Elisa; Michaels, Margo; Patel, Shilpa; McKee, M Diane; Bylund, Carma L

    2015-03-15

    Research has demonstrated that communication and care coordination improve cancer patient outcomes. To improve communication and care coordination, it is important to understand primary care providers' (PCPs') perceptions of communication with oncologists as well as PCPs' communication needs. A mixed-methods approach was used in the present study. In the qualitative phase of the study, 18 PCPs practicing in underserved, minority communities were interviewed about their experiences communicating with oncologists. In the quantitative phase of the study, 128 PCPs completed an online survey about their preferences, experiences, and satisfaction with communication with oncologists. Results indicated a PCP-oncologist gap in communication occurred between diagnosis and treatment. PCPs wanted more communication with oncologists, updates on their patients' prognosis throughout treatment, and to be contacted via telephone or email and saw their role as crucial in providing supportive care for their patients. Although PCPs recognize that they play a critical, proactive role in supporting patients throughout the continuum of their cancer care experience, existing norms regarding postreferral engagement and oncologist-PCP communication often hinder activation of this role among PCPs. Expected standards regarding the method, frequency, and quality of postreferral communication should be jointly articulated and made accountable between PCPs and oncologists to help improve cancer patients' quality of care, particularly in minority communities. © 2014 American Cancer Society.

  6. The association between women's self-rated health and satisfaction with environmental services in an underserved community in Lebanon.

    Science.gov (United States)

    Habib, Rima R; Elzein, Kareem; Hojeij, Safa

    2013-01-01

    This research evaluated the association between women's self-rated health and a number of socioeconomic and environmental health indicators relating to drinking water services in an underserved Lebanese community. A population-based, cross-sectional survey using interviews was adopted to obtain information from female homemakers of 2,223 households in the town of Bebnine, Lebanon. The questionnaire included indicators on self-rated health, satisfaction with water quality, source of drinking water, occurrence of diarrhea, and socioeconomic variables, such as education, occupation, and perceived economic status. Self-rated health was categorized as poor, fair, and good. Odds ratios for poor and fair compared to good self-rated health values were calculated using multinomial logistic regression. A total of 712 women (32%) reported poor self-rated health. Women who perceived their household income to be worse than others in town were four times as likely to report poor health. Compared to women who were satisfied with drinking water quality, dissatisfied women were 42% more likely to report poor health. Women living in households reporting recent episodes of diarrheal illness had poorer health ratings than those without. The findings suggest a positive relationship between individual perceptions of water quality and self-rated health. Community concerns over their surrounding environment serve as a primary guide for infrastructural development and government policy.

  7. Pediatric Obesity Empowerment Model Group Medical Visits (POEM-GMV) as Treatment for Pediatric Obesity in an Underserved Community.

    Science.gov (United States)

    Geller, Jeffrey S; Dube, Eileen T; Cruz, Glavielinys A; Stevens, Jason; Keating Bench, Kara

    2015-10-01

    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.

  8. Correlates of Community-Based Colorectal Cancer Screening in a Rural Population: The Role of Fatalism.

    Science.gov (United States)

    Crosby, Richard A; Collins, Tom

    2017-09-01

    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.

  9. Improving collected rainwater quality in rural communities.

    Science.gov (United States)

    Garrido, S; Aviles, M; Ramirez, A; Gonzalez, A; Montellano, L; Gonzalez, B; de la Paz, J; Ramirez, R M

    2011-01-01

    The country of Mexico is facing serious problems with water quality and supply for human use and consumption in rural communities, mainly due to topographic and isolation. In Mexico the average annual precipitation is 1,500 cubic kilometers of water, if 3% of that amount were used, 13 million Mexicans could be supplied with drinking water that they currently do not have access. Considering the limited infrastructure and management in rural communities, which do not receive services from the centralized systems of large cities, a modified pilot multi-stage filtration (MMSF) system was designed, developed, and evaluated for treating collected rainwater in three rural communities, Ajuchitlan and Villa Nicolas Zapata (Morelos State) and Xacxamayo (Puebla State). The efficiencies obtained in the treatment system were: colour and turbidity >93%. It is worth mentioning that the water obtained for human use and consumption complies with the Mexican Standard NOM-127-SSA1-1994.

  10. FHFA Underserved Areas

    Data.gov (United States)

    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...

  11. Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

    Science.gov (United States)

    Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

    2016-01-01

    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

  12. Premises of Sustainable Development on Rural Communities

    Directory of Open Access Journals (Sweden)

    Anca Turtureanu

    2011-05-01

    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.

  13. Puerto Rico NCI Community Oncology Research Program Minority/Underserved | Division of Cancer Prevention

    Science.gov (United States)

    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

  14. Recruiting and retaining primary care physicians in urban underserved communities: the importance of having a mission to serve.

    Science.gov (United States)

    Odom Walker, Kara; Ryan, Gery; Ramey, Robin; Nunez, Felix L; Beltran, Robert; Splawn, Robert G; Brown, Arleen F

    2010-11-01

    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.

  15. The Utility of Rural and Underserved Designations in Geospatial Assessments of Distance Traveled to Healthcare Services: Implications for Public Health Research and Practice

    Directory of Open Access Journals (Sweden)

    Matthew Lee Smith

    2013-01-01

    Full Text Available Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1 review the different definitions of rurality and their purposes; (2 identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3 describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4 examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

  16. The utility of rural and underserved designations in geospatial assessments of distance traveled to healthcare services: implications for public health research and practice.

    Science.gov (United States)

    Smith, Matthew Lee; Dickerson, Justin B; Wendel, Monica L; Ahn, Sangnam; Pulczinski, Jairus C; Drake, Kelly N; Ory, Marcia G

    2013-01-01

    Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.

  17. Bolivia programme evaluation of a package to reach an underserved population: Community-based maternal and newborn care economic analysis.

    Science.gov (United States)

    Barger, Diana; Pooley, Bertha; Dupuy, Julien Roger; Cardenas, Norma Amparo; Wall, Steve; Owen, Helen; Daviaud, Emmanuelle

    2017-10-01

    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

  18. Adolescent health: a rural community's approach.

    Science.gov (United States)

    Groft, Jean N; Hagen, Brad; Miller, Nancy K; Cooper, Natalie; Brown, Sharon

    2005-01-01

    Significant health problems encountered in adulthood often have their roots in health behaviours initiated during adolescence. In order to reverse this trend, school and health personnel, as well as parents and other community members working with high school students, need to be aware of the health-related beliefs and choices that guide the behaviours of teenagers. Although a wide variety of research has been conducted on this topic among urban adolescents, less is known about the health beliefs and behaviors of adolescents residing in rural areas, particularly in Canada. In general, rural Canadians are less healthy than their urban counterparts. Building on the knowledge and understanding of their own community, key stakeholders were invited to engage in the design and implementation of a participatory action research project aimed at understanding and improving the health of rural adolescents. A group of parents, teachers, students, school administrators and public health nurses engaged in a participatory action research project to better understand determinants of the health of rural adolescents at a high school in Western Canada. Group members developed and administered a health survey to 288 students from a small rural high school, in an effort to identify areas of concern and interest regarding health practices and beliefs of rural adolescents, and to take action on these identified concerns. Results indicated some interesting but potentially worrying trends in this population. For example, while frequent involvement in a physical activity was noted by 75.9% of participants, close to half of the females (48%) described their body image as 'a little overweight' or 'definitely overweight', and approximately 25.8% of respondents noted that they skipped meals most of the time. Differences between the genders were apparent in several categories. For example, more girls smoked (16.2%) than boys (12.3%), and more males (55.0%) than females (41%) had tried illegal

  19. Partnered Evaluation of a Community Engagement Intervention: Use of a “Kickoff” Conference in a Randomized Trial for Depression Care Improvement in Underserved Communities

    Science.gov (United States)

    Mendel, Peter; Ngo, Victoria K.; Dixon, Elizabeth; Stockdale, Susan; Jones, Felica; Chung, Bowen; Jones, Andrea; Masongsong, Zoe; Khodyakov, Dmitry

    2013-01-01

    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

  20. Recruitment and retention of home support workers in rural communities.

    Science.gov (United States)

    Sharman, Zena

    2014-01-01

    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.

  1. Increasing Research Capacity in Underserved Communities: Formative and Summative Evaluation of the Mississippi Community Research Fellows Training Program (Cohort 1

    Directory of Open Access Journals (Sweden)

    Danielle Fastring

    2018-02-01

    Full Text Available BackgroundThe Mississippi Community Research Fellows Training Program (MSCRFTP is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants’ community, increase individual and community capacity, and to engage community members as equal partners in the research process.MethodsA comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants’ attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members’ involvement in research, satisfaction with the program, and the program’s impact on the participants’ daily practice and community work.ResultsTwenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p < 0.05. Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as “very high” (76.2%, n = 16 or

  2. Librarian-initiated HIV/AIDS prevention intervention program outcome in rural communities in Oyo State, Nigeria.

    Science.gov (United States)

    Ajuwon, G A; Komolafe-Opadeji, H O; Ikhizama, B

    2013-01-01

    The objective of this study was to meet the HIV/AIDS information and service needs of citizens living in selected rural, underserved communities in Oyo State, Nigeria. This was a librarian-initiated intervention program (pre-post) study of heads of rural households in Oyo State. A questionnaire was used for pre- and post-intervention assessment. The education covered knowledge about HIV/AIDS, routes of transmission, prevention strategies, and attitude toward persons living with HIV. It increased participants' knowledge about AIDS and improved attitude toward those living with HIV. Provision and dissemination of information on HIV/AIDS through librarians to rural settlers is an important prevention strategy and librarians can make major contributions.

  3. Comparison of Program Costs for Parent-Only and Family-Based Interventions for Pediatric Obesity in Medically Underserved Rural Settings

    Science.gov (United States)

    Janicke, David M.; Sallinen, Bethany J.; Perri, Michael G.; Lutes, Lesley D.; Silverstein, Janet H.; Brumback, Babette

    2009-01-01

    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…

  4. Active living environment assessments in four rural Latino communities

    Directory of Open Access Journals (Sweden)

    Cynthia K. Perry

    2015-01-01

    Conclusions: These four rural towns have some policies, programming and infrastructure in place that support active living. The information from the RALA can be used to inform program and policy development to enhance physical activity in these rural communities.

  5. Alaska Native Villages and Rural Communities Water Grant Program

    Science.gov (United States)

    Significant human health and water quality problems exist in Alaska Native Village and other rural communities in the state due to lack of sanitation. To address these issues, EPA created the Alaska Rural and Native Villages Grant Program.

  6. Giving Voice to the Medically Under-Served: A Qualitative Co-Production Approach to Explore Patient Medicine Experiences and Improve Services to Marginalized Communities.

    Science.gov (United States)

    Latif, Asam; Tariq, Sana; Abbasi, Nasa; Mandane, Baguiasri

    2018-01-27

    With an aging population, the appropriate, effective and safe use of medicines is a global health priority. However, "'medically under-served" patients continue to experience significant inequalities around access to healthcare services. This study forms part of a wider project to co-develop and evaluate a digital educational intervention for community pharmacy. The aim of this paper is to explore the medicine needs of patients from marginalized communities and suggest practical way on how services could be better tailored to their requirements. Following ethical approval, qualitative data was gathered from: (1) workshops with patients and professionals ( n = 57 attendees); and (2) qualitative semi-structured interviews (10 patients and 10 pharmacists). Our findings revealed that patients from marginalized communities reported poor management of their medical conditions and significant problems with adherence to prescribed medicines. Their experience of pharmacy services was found to be variable with many experiencing discrimination or disadvantage as a result of their status. This study highlights the plight of medically under-served communities and the need for policy makers to tailor services to an individual's needs and circumstances. Furthermore, patients and professionals can work in collaboration using a co-production approach to develop educational interventions for pharmacy service improvements.

  7. Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities

    Science.gov (United States)

    Butler, Karen M.; Wiggins, Amanda T.; Kostygina, Ganna; Langley, Ronald E.; Hahn, Ellen J.

    2016-01-01

    Abstract Introduction: Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Methods: Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Results: Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Conclusions: Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Implications: Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing

  8. Recall and Effectiveness of Messages Promoting Smoke-Free Policies in Rural Communities.

    Science.gov (United States)

    Rayens, Mary Kay; Butler, Karen M; Wiggins, Amanda T; Kostygina, Ganna; Langley, Ronald E; Hahn, Ellen J

    2016-05-01

    Low-cost media campaigns increase demand for smoke-free policies in underserved rural areas. The study examined the impact of loss- and gain-framed smoke-free print ads on recall and perceived effectiveness in rural communities, controlling for personal characteristics. Following 6- to 9-month print media campaigns in three rural counties, recall and perceived effectiveness of loss-framed (ie, targeting dangers of secondhand smoke [SHS]) and gain-framed (ie, highlighting positive aspects of smoke-free air) ads were assessed using random-digit-dial phone surveys. Respondents were asked if they remembered each ad, whether they liked it, whether they were prompted to contact a smoke-free coalition, whether the ad made them think, and whether it prompted emotion. Mixed modeling assessed whether personal factors predicted ad recall or perceived effectiveness. Loss-framed ads were less likely to be recalled but more likely to prompt emotion. For ads of both frame types, females reported greater recall and perceived effectiveness than males. Those with less education reported higher perceived effectiveness of the ads but lower recall. Nonsmokers were more likely than smokers to perceive the ads as effective. Knowledge of SHS risk and support for smoke-free workplaces were positively associated with recall and effectiveness. Ad recall and perceived effectiveness were associated with framing and demographic and personal characteristics. Smoke-free efforts in rural areas may be bolstered by continuing to promote benefits of smoke-free workplace policies and educate on SHS risks. Rural areas may need to provide a combination of ad types and framing strategies to appeal to a wide audience. Rural communities are disproportionately affected by SHS and less likely to be protected by smoke-free policies. This study adds evidence-based guidance for tailoring rural smoke-free media campaigns using different framing: gain-framed messages (ie, benefits of smoke-free environments) to

  9. Impact of selection strategies on representation of underserved populations and intention to practise: international findings.

    Science.gov (United States)

    Larkins, Sarah; Michielsen, Kristien; Iputo, Jehu; Elsanousi, Salwa; Mammen, Marykutty; Graves, Lisa; Willems, Sara; Cristobal, Fortunato L; Samson, Rex; Ellaway, Rachel; Ross, Simone; Johnston, Karen; Derese, Anselme; Neusy, André-Jacques

    2015-01-01

    Socially accountable medical schools aim to reduce health inequalities by training workforces responsive to the priority health needs of underserved communities. One key strategy involves recruiting students from underserved and unequally represented communities on the basis that they may be more likely to return and address local health priorities. This study describes the impacts of different selection strategies of medical schools that aspire to social accountability on the presence of students from underserved communities in their medical education programmes and on student practice intentions. A cross-sectional questionnaire was administered to students starting medical education in five institutions with a social accountability mandate in five different countries. The questionnaire assessed students' background characteristics, rurality of background, and practice intentions (location, discipline of practice and population to be served). The results were compared with the characteristics of students entering medical education in schools with standard selection procedures, and with publicly available socio-economic data. The selection processes of all five schools included strategies that extended beyond the assessment of academic achievement. Four distinct strategies were identified: the quota system; selection based on personal attributes; community involvement, and school marketing strategies. Questionnaire data from 944 students showed that students at the five schools were more likely to be of non-urban origin, of lower socio-economic status and to come from underserved groups. A total of 407 of 810 (50.2%) students indicated an intention to practise in a non-urban area after graduation and the likelihood of this increased with increasing rurality of primary schooling (p = 0.000). Those of rural origin were statistically less likely to express an intention to work abroad (p = 0.003). Selection strategies to ensure that members of underserved communities

  10. Mobile phone usage in rural communities in Kwara state, Nigeria ...

    African Journals Online (AJOL)

    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, ...

  11. The Attraction of Adjunct Faculty to Rural Community Colleges

    Science.gov (United States)

    Charlier, Hara Dracon

    2010-01-01

    As rural community colleges face mounting fiscal pressure, the ability to attract adjunct faculty members to support the institutional mission becomes increasingly important. Although the professional literature documents differences between rural, suburban, and urban community colleges, the effect of this institutional diversity on the role and…

  12. impacts of alternative farm policies on rural communities

    Science.gov (United States)

    J. Michael Bowker; James W. Richardson

    1989-01-01

    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...

  13. Rural And Urban Youth Participation In Community Development In ...

    African Journals Online (AJOL)

    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 ...

  14. Understanding Contexts of Family Violence in Rural, Farming Communities: Implications for Rural Women's Health

    Science.gov (United States)

    Wendt, Sarah; Hornosty, Jennie

    2010-01-01

    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…

  15. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

    Science.gov (United States)

    Flys, Tamara; González, Rosalba; Sued, Omar; Suarez Conejero, Juana; Kestler, Edgar; Sosa, Nestor; McKenzie-White, Jane; Monzón, Irma Irene; Torres, Carmen-Rosa; Page, Kathleen

    2012-01-01

    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. 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. 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% (pstructure, and effectiveness in improving their HIV-related knowledge and skills. This innovative curriculum utilized technology to target HCWs with limited access to educational resources. Participants benefited from technical skills acquired through the process, and could continue working within their underserved communities while participating in the online component and then implement interventions that successfully converted theoretical knowledge to action to improve integration of HIV care into primary care.

  16. ‘Much clearer with pictures’: using community-based participatory research to design and test a Picture Option Grid for underserved patients with breast cancer

    Science.gov (United States)

    Durand, Marie-Anne; Alam, Shama; Grande, Stuart W; Elwyn, Glyn

    2016-01-01

    Objective 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. Design Community-based participatory research (CBPR) using think-aloud protocols (phases 1 and 2) and semistructured interviews (phase 3). Setting Underserved community settings (eg, knitting groups, bingo halls, senior centres) and breast clinics. Participants 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. Intervention The pictorial encounter decision aid was derived from an evidence-based table comparing treatment options for breast cancer (http://www.optiongrid.org). Outcome measures We assessed the usability, acceptability and accessibility of the pictorial decision aid prototypes using the think-aloud protocol and semistructured interviews. Results 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. Conclusions and relevance 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

  17. Reducing cancer risk in rural communities through supermarket interventions.

    Science.gov (United States)

    McCool, Barent N; Lyford, Conrad P; Hensarling, Natalie; Pence, Barbara; McCool, Audrey C; Thapa, Janani; Belasco, Eric; Carter, Tyra M

    2013-09-01

    Cancer risk is high, and prevention efforts are often minimal in rural communities. Feasible means of encouraging lifestyles that will reduce cancer risk for residents of rural communities are needed. This project developed and tested a model that could be feasibly adopted by rural communities to reduce cancer risk. This model focuses on incorporating multi-faceted cancer risk education in the local supermarket. As the supermarket functions both as the primary food source and an information source in small rural communities, the supermarket focus encourages the development of a community environment supportive of lifestyles that should reduce residents' risk for cancer. The actions taken to implement the model and the challenges that communities would have in implementing the model are identified.

  18. BIOGAS TECHNOLOGY INTRODUCTIONS AS RENEWABLE ENERGY FOR RURAL COMMUNITIES

    Directory of Open Access Journals (Sweden)

    Meita Rumbayan

    2017-03-01

    Full Text Available This paper is the progress report of research action about biogas technology introduction for a rural community in North Sulawesi, Indonesia. The purpose of this study is to discuss biogas technology utilization in the selected rural. The research method is done by literature review, interview, site visit, data collection using questioner and case study of pilot project development in biogas technology for a household in Kosio village indicate a positive response from the local community. The discussion based on literature review, data collection and case study gives some recommendations for further study in term of scenario and guideline for the development of biogas technology for rural communities.

  19. Income-generating projects in rural communities: from theory to ...

    African Journals Online (AJOL)

    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 ...

  20. Barriers to Quality Care for Dying Patients in Rural Communities

    Science.gov (United States)

    Van Vorst, Rebecca F.; Crane, Lori A.; Barton, Phoebe Lindsey; Kutner, Jean S.; Kallail, K. James; Westfall, John M.

    2006-01-01

    Context: Barriers to providing optimal palliative care in rural communities are not well understood. Purpose: To identify health care personnel's perceptions of the care provided to dying patients in rural Kansas and Colorado and to identify barriers to providing optimal care. Methods: An anonymous self-administered survey was sent to health care…

  1. Virtual Rural Community Development: Human Links That Sustain Web Links.

    Science.gov (United States)

    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…

  2. Provision of Information to Rural Communities in Bama Local ...

    African Journals Online (AJOL)

    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.

  3. Rural Action: A Collection of Community Work Case Studies.

    Science.gov (United States)

    Henderson, Paul, Ed.; Francis, David, Ed.

    This book contains 10 case studies of rural community development in England, Wales, Scotland, Ireland, and Catalonia, as seen from the perspective of community-work practitioners. Development projects encompassed such activities as promotion of tourism, establishment of community centers, vocational training for school dropouts, adult community…

  4. Rural Colleges as Catalysts for Community Change: The RCCI Experience.

    Science.gov (United States)

    Rubin, Sarah

    2001-01-01

    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…

  5. Community members' views on Addis Ababa University's rural ...

    African Journals Online (AJOL)

    ... University's rural community health training program: A qualitative study. ... A total of five FGDs and six key informant interviews were conducted using a ... The audio-taped data was later transcribed verbatim and translated into English.

  6. Uses, benefits and challenges of using rural community telecentres ...

    African Journals Online (AJOL)

    Levi Manda

    train staff in customer care. Key words: ... Telecentres also provide space for rural community members to .... card reader and a receipt printer to a full service telecentre that offers ... telecentres is a good development since telecentres target the.

  7. Smart Growth Self-Assessment for Rural Communities

    Science.gov (United States)

    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.

  8. the impact of community participation in rural water management in

    African Journals Online (AJOL)

    USER

    2016-04-14

    Apr 14, 2016 ... underdeveloped areas with poor water resources. ... rural water management is purportedly a key element for community water pro ects to ..... inclusive and integrated approach to water ... Implementation: A regional response.

  9. Indigenous knowledge of Rural Communities for Combating Climate ...

    African Journals Online (AJOL)

    HP

    and extremes, suppress diseases and crop pests and usd to conserve soil moisture so as to increase ..... materials such as leaves, grass clippings, kitchen scraps and yard wastes. As a result, ... consumption in urban and rural communities.

  10. What are Pregnant Women in a Rural Niger Delta Community's ...

    African Journals Online (AJOL)

    Erah

    Buchanan House, Glasgow Caledonian University Email: Caroline. ... exploratory qualitative study was carried out to identify pregnant women in a rural Niger Delta community's perceptions of ..... sometimes you stay for the whole day.

  11. Community participation in rural health: a scoping review

    Directory of Open Access Journals (Sweden)

    Kenny Amanda

    2013-02-01

    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

  12. Conducting a randomized trial in rural and urban safety-net health centers: Added value of community-based participatory research

    Directory of Open Access Journals (Sweden)

    Meera Muthukrishnan

    2018-06-01

    Full Text Available Background: Colorectal cancer (CRC is the second most common cancer in the US. Despite evidence that screening reduces CRC incidence and mortality, screening rates are sub-optimal with disparities by race/ethnicity, income, and geography. Rural-urban differences in CRC screening are understudied even though approximately one-fifth of the US population lives in rural areas. This focus on urban populations limits the generalizability and dissemination potential of screening interventions. Methods: Using community-based participatory research (CBPR principles, we designed a cluster-randomized trial, adaptable to a range of settings, including rural and urban health centers. We enrolled 483 participants across 11 health centers representing 2 separate networks. Both networks serve medically-underserved communities; however one is primarily rural and one primarily urban. Results: Our goal in this analysis is to describe baseline characteristics of participants and examine setting-level differences. CBPR was a critical for recruiting networks to the trial. Patient respondents were predominately female (61.3%, African-American (66.5%, and earned <$1200 per month (87.1%. The rural network sample was older; more likely to be female, white, disabled or retired, and have a higher income, but fewer years of education. Conclusions: Variation in the samples partly reflects the CBPR process and partly reflects inherent differences in the communities. This confirmed the importance of using CBPR when planning for eventual dissemination, as it enhanced our ability to work within diverse settings. These baseline findings indicate that using a uniform approach to implementing a trial or intervention across diverse settings might not be effective or efficient. Keywords: Colorectal cancer screening, Community-based participatory research, Health disparities, Medically underserved populations, Dissemination and implementation, Randomized trial

  13. Rural schools and democratic education. The opportunity for community participation

    Directory of Open Access Journals (Sweden)

    Antonio Bustos Jiménez

    2011-08-01

    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.

  14. Broadband provision to underprivileged rural communities

    CSIR Research Space (South Africa)

    Makitla, I

    2010-09-01

    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...

  15. A novel educational strategy targeting health care workers in underserved communities in Central America to integrate HIV into primary medical care.

    Directory of Open Access Journals (Sweden)

    Tamara Flys

    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

  16. The Engineering 4 Health Challenge - an interdisciplinary and intercultural initiative to foster student engagement in B.C. and improve health care for children in under-serviced communities.

    Science.gov (United States)

    Price, Morgan; Weber-Jahnke, Jens H

    2009-01-01

    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.

  17. A rural African American faith community's solutions to depression disparities.

    Science.gov (United States)

    Bryant, Keneshia; Haynes, Tiffany; Kim Yeary, Karen Hye-Cheon; Greer-Williams, Nancy; Hartwig, Mary

    2014-01-01

    The aim of this study was to explore how a rural African American faith community would address depression within their congregations and the community as a whole. A qualitative, interpretive descriptive methodology was used. The sample included 24 participants representing pastors, parishioners interested in health, and African American men who had experienced symptoms of depression in a community in the Arkansas Delta. The primary data sources for this qualitative research study were focus groups. Participants identified three key players in the rural African American faith community who can combat depression: the Church, the Pastor/Clergy, and the Layperson. The roles of each were identified and recommendations for each to address depression disparities in rural African Americans. The recommendations can be used to develop faith-based interventions for depression targeting the African American faith community. © 2013 Wiley Periodicals, Inc.

  18. Development of Rural Communities by Diversification of Rural Economy in the Context of Sustainable Development

    Directory of Open Access Journals (Sweden)

    Manuela Dora Orboi

    2012-05-01

    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.

  19. Tourism and rural community development in Namibia: policy issues review

    Directory of Open Access Journals (Sweden)

    Erling Kavita

    2016-02-01

    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.

  20. Teaching Health Center Graduate Medical Education Locations Predominantly Located in Federally Designated Underserved Areas.

    Science.gov (United States)

    Barclift, Songhai C; Brown, Elizabeth J; Finnegan, Sean C; Cohen, Elena R; Klink, Kathleen

    2016-05-01

    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.

  1. Children's Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity.

    Science.gov (United States)

    Wilken, Lynne R; Novotny, Rachel; Fialkowski, Marie K; Boushey, Carol J; Nigg, Claudio; Paulino, Yvette; Leon Guerrero, Rachael; Bersamin, Andrea; Vargo, Don; Kim, Jang; Deenik, Jonathan

    2013-10-09

    's Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. NIH clinical trial # NCT01881373.

  2. Community resiliency as a measure of collective health status: perspectives from rural communities.

    Science.gov (United States)

    Kulig, Judith C; Edge, Dana; Joyce, Brenda

    2008-12-01

    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.

  3. Measuring the attractiveness of rural communities in accounting for differences of rural primary care workforce supply.

    Science.gov (United States)

    McGrail, Matthew R; Wingrove, Peter M; Petterson, Stephen M; Humphreys, John S; Russell, Deborah J; Bazemore, Andrew W

    2017-01-01

    Many rural communities continue to experience an undersupply of primary care doctor services. While key professional factors relating to difficulties of recruitment and retention of rural primary care doctors are widely identified, less attention has been given to the role of community and place aspects on supply. Place-related attributes contribute to a community's overall amenity or attractiveness, which arguably influence both rural recruitment and retention relocation decisions of doctors. This bi-national study of Australia and the USA, two developed nations with similar geographic and rural access profiles, investigates the extent to which variations in community amenity indicators are associated with spatial variations in the supply of rural primary care doctors. Measures from two dimensions of community amenity: geographic location, specifically isolation/proximity; and economics and sociodemographics were included in this study, along with a proxy measure (jurisdiction) of a third dimension, environmental amenity. Data were chiefly collated from the American Community Survey and the Australian Census of Population and Housing, with additional calculated proximity measures. Rural primary care supply was measured using provider-to-population ratios in 1949 US rural counties and in 370 Australian rural local government areas. Additionally, the more sophisticated two-step floating catchment area method was used to measure Australian rural primary care supply in 1116 rural towns, with population sizes ranging from 500 to 50 000. Associations between supply and community amenity indicators were examined using Pearson's correlation coefficients and ordinary least squares multiple linear regression models. It was found that increased population size, having a hospital in the county, increased house prices and affluence, and a more educated and older population were all significantly associated with increased workforce supply across rural areas of both countries

  4. Constraints to Gender Participation in Rural Community ...

    African Journals Online (AJOL)

    User

    who reside in the rural areas as family units (Agricultural Extension Society of Nigeria ... cooperatives, individuals through private initiatives, corporate bodies as well as ..... from similar cultural background have many things in common.

  5. Breastfeeding Patterns in the Rural Community of Hilo, Hawai‘i: An Exploration of Existing Data Sets

    Science.gov (United States)

    2013-01-01

    Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai‘i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai‘i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in Hilo was obtained from the Hawai‘i WIC program and includes initiation, duration, exclusivity of breastfeeding, and reasons for not breastfeeding. These data were compared to data from published reports available at the county, state, and national level. The State of Hawai‘i and Hilo exceed national targets for breastfeeding initiation; however, rates soon drop following delivery, and mixed feedings of infants is common. The highest percentage of mothers weaned their infants within the first four weeks postpartum. The reasons the majority of the mothers gave for weaning were tied to breastfeeding situations that are amenable to skilled lactation support (eg, milk supply issues and latch or sucking problems). While available data sets offer valuable information on the breastfeeding patterns in this rural community, there are limitations to their usefulness, primarily due to the inconsistent operational definitions of infant feeding variables used in the surveys, and the lack of availability of community level data. PMID:23520565

  6. Breastfeeding patterns in the rural community of Hilo, Hawai'i: an exploration of existing data sets.

    Science.gov (United States)

    Flood, Jeanie L

    2013-03-01

    Before any breastfeeding promotion effort, an understanding of the existing breastfeeding patterns is essential. Hawai'i County is a rural, ethnically diverse, medically underserved community. The purpose of this study was to describe the breastfeeding patterns of women living in Hilo, Hawai'i. Data from several existing national, state, and local data sets were accessed to identify and describe the breastfeeding patterns of women in this community. Available breastfeeding data about women in Hilo was obtained from the Hawai'i WIC program and includes initiation, duration, exclusivity of breastfeeding, and reasons for not breastfeeding. These data were compared to data from published reports available at the county, state, and national level. The State of Hawai'i and Hilo exceed national targets for breastfeeding initiation; however, rates soon drop following delivery, and mixed feedings of infants is common. The highest percentage of mothers weaned their infants within the first four weeks postpartum. The reasons the majority of the mothers gave for weaning were tied to breastfeeding situations that are amenable to skilled lactation support (eg, milk supply issues and latch or sucking problems). While available data sets offer valuable information on the breastfeeding patterns in this rural community, there are limitations to their usefulness, primarily due to the inconsistent operational definitions of infant feeding variables used in the surveys, and the lack of availability of community level data.

  7. Assessment of community led total sanitation uptake in rural Kenya ...

    African Journals Online (AJOL)

    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.

  8. Factors Affecting Drug Abuse in Adolescent Females in Rural Communities

    Science.gov (United States)

    Renes, Susan L.; Strange, Anthony T.

    2009-01-01

    This article explores factors influencing adolescent female substance use in rural communities. Self-reported data gathered from females 12 to 15 years of age in two northwestern communities in the United States showed an association among gender identity, peer and parental relationships, and substance use. Aggressive masculinity had the strongest…

  9. 78 FR 41795 - Farm, Ranch, and Rural Communities Committee Teleconference

    Science.gov (United States)

    2013-07-11

    ... 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...

  10. Leadership in rural congregations and communities: an exploration ...

    African Journals Online (AJOL)

    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 ...

  11. Developing Leaders: The Role of Competencies in Rural Community Colleges

    Science.gov (United States)

    Eddy, Pamela L.

    2013-01-01

    Pending retirements underscore the need to develop community college campus leaders. Rural community colleges will be particularly hard-hit by changes in leadership as they represent the majority of 2-year colleges and face unique challenges given their location. To help address the anticipated leadership transition, the American Association of…

  12. Community participation to design rural primary healthcare services.

    Science.gov (United States)

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  13. A rural, community-based suicide awareness and intervention program.

    Science.gov (United States)

    Jones, Sharon; Walker, Coralanne; Miles, Alison C J; De Silva, Eve; Zimitat, Craig

    2015-01-01

    Suicide is a prominent public health issue in rural Australia and specifically in Tasmania, which has one of the highest suicide rates in the country. The Community Response to Eliminating Suicide (CORES) program was developed in rural Tasmania in response to a significant number of suicides over a short period of time. CORES is unique in that it is both a community-based and gatekeeper education model. CORES aims to build and empower communities to take ownership of suicide prevention strategies. It also aims to increase the individual community member's interpersonal skills and awareness of suicide risks, while building peer support and awareness of suicide prevention support services within the community itself. Pre- and post-test surveys after the CORES 1-day suicide awareness and intervention program (SAIP) showed significant increases in levels of comfort and confidence in discussing suicide with those who may be contemplating that action. CORES builds community capital through establishing new connections within communities. Establishment of local executive groups, funding and SAIP are key activities of successful CORES programs in communities around Australia. Over half of the initial leaders are still actively involved after a decade, which reflects positively on the quality and outcomes of the program. This study supports CORES as a beneficial and feasible community-based suicide intervention program for rural communities.

  14. "Everybody Knows Everybody Else's Business"-Privacy in Rural Communities.

    Science.gov (United States)

    Leung, Janni; Smith, Annetta; Atherton, Iain; McLaughlin, Deirdre

    2016-12-01

    Patients have a right to privacy in a health care setting. This involves conversational discretion, security of medical records and physical privacy of remaining unnoticed or unidentified when using health care services other than by those who need to know or whom the patient wishes to know. However, the privacy of cancer patients who live in rural areas is more difficult to protect due to the characteristics of rural communities. The purpose of this article is to reflect on concerns relating to the lack of privacy experienced by cancer patients and health care professionals in the rural health care setting. In addition, this article suggests future research directions to provide much needed evidence for educating health care providers and guiding health care policies that can lead to better protection of privacy among cancer patients living in rural communities.

  15. An Innovative Multiphased Strategy to Recruit Underserved Adults into a Randomized Trial of a Community-Based Diabetes Risk Reduction Program

    Science.gov (United States)

    Santoyo-Olsson, Jasmine; Cabrera, Julissa; Freyre, Rachel; Grossman, Melanie; Alvarez, Natalie; Mathur, Deepika; Guerrero, Maria; Delgadillo, Adriana T.; Kanaya, Alka M.; Stewart, Anita L.

    2011-01-01

    Purpose: To conduct and evaluate a two-phased community-based approach to recruit lower socioeconomic status, minority, or Spanish-speaking adults at risk of developing diabetes to a randomized trial of a lifestyle intervention program delivered by a public health department. Design: Within geographic areas comprising our target population, 4 community organizations provided local space for conducting the study and program. Phase I—outreach in venues surrounding these organizations—included diabetes education, a short diabetes risk appraisal (DRA), and diabetes risk screening based on a fasting fingerstick glucose test. Phase II—trial recruitment—began concurrently for those found to be at risk of developing diabetes in Phase I by explaining the study, lifestyle program, and research process. Those interested and eligible enrolled in the 1-year study. Results: Over 2 years, approximately 5,110 individuals received diabetes education, 1,917 completed a DRA, and 1,164 were screened of which 641 (55%) had an elevated fingerstick result of ≥106 mg/dl. Of the study sampling frame—persons over age 25 at risk of developing diabetes (N = 544)—238 (43%) enrolled in the trial; of those who were study eligible (n = 427), 56% enrolled. In the final sample, mean age was 56 years (SD = 17), 78% were ethnic minorities, 32% were Spanish-speaking, and 15% had a high school education or less. Implications: Providing diabetes health education and screening prior to study recruitment may help overcome barriers to research participation in underserved communities, thus helping address difficulties recruiting minority and older populations into research, particularly research pertaining to chronic disease risk factors. PMID:21565823

  16. Reforming Victoria's primary health and community service sector: rural implications.

    Science.gov (United States)

    Alford, K

    2000-01-01

    In 1999 the Victorian primary care and community support system began a process of substantial reform, involving purchasing reforms and a contested selection process between providers in large catchment areas across the State. The Liberal Government's electoral defeat in September 1999 led to a review of these reforms. This paper questions the reforms from a rural perspective. They were based on a generic template that did not consider rural-urban differences in health needs or other differences including socio-economic status, and may have reinforced if not aggravated rural-urban differences in the quality of and access to primary health care in Victoria.

  17. Fostering resilience: Empowering rural communities in the face of hardship

    Directory of Open Access Journals (Sweden)

    Darryl Maybery

    2010-11-01

    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.

  18. Smart sustainable energy for rural community development

    CSIR Research Space (South Africa)

    Szewczuk, S

    2014-10-01

    Full Text Available Reliable access to electricity is a basic precondition for improving people’s lives in rural areas, for enhanced healthcare and education, and for growth within local economies. Currently more than 1.5 billion people worldwide do not have access...

  19. Feasibility and effectiveness of two community-based HIV testing models in rural Swaziland.

    Science.gov (United States)

    Parker, Lucy Anne; Jobanputra, Kiran; Rusike, Lorraine; Mazibuko, Sikhathele; Okello, Velephi; Kerschberger, Bernhard; Jouquet, Guillaume; Cyr, Joanne; Teck, Roger

    2015-07-01

    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.

  20. History, culture, and substance use in a rural Scottish community.

    Science.gov (United States)

    Dean, Alan

    2002-01-01

    This paper provides a detailed discussion of substance use and misuse in a rural community in the Western Highlands of Scotland, United Kingdom. Attention is focused on the way in which patterns of substance use arise from a complex interplay of historical, cultural, social, and personal events. The discussion illustrates how large changes in patterns of intoxication in rural communities can be rendered intelligible through an understanding of the impact of economic, religious, and social changes. The analysis is based on an historical and ethnographic account, carried out between 1987 and 1990 with adolescents, of patterns of use which range from pagan ceremonies in the 16th century to contemporary "soft drug" use.

  1. Budget Impact Analysis of Against Colorectal Cancer In Our Neighborhoods (ACCION): A Successful Community-Based Colorectal Cancer Screening Program for a Medically Underserved Minority Population.

    Science.gov (United States)

    Kim, Bumyang; Lairson, David R; Chung, Tong Han; Kim, Junghyun; Shokar, Navkiran K

    2017-06-01

    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.

  2. Rural Mental Health Ecology: A Framework for Engaging with Mental Health Social Capital in Rural Communities.

    Science.gov (United States)

    Wilson, Rhonda L; Wilson, G Glenn; Usher, Kim

    2015-09-01

    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.

  3. Facilitating community information service for national development ...

    African Journals Online (AJOL)

    Many rural communities have continued to be underserved; hence, information becomes necessary in integrating the needs of the people for sustainable development. Librarians and libraries are charged with providing the information resources and outreaches to the communities to help build the bridge between the ...

  4. Cultivation and Implementation of Community-Engaged Pharmacy Services in a Free Clinic to Enhance Care for the Medically Underserved

    Directory of Open Access Journals (Sweden)

    Emmeline Tran, Pharm.D. Candidate

    2013-01-01

    Full Text Available Partnerships between community free clinics and academic medical centers improve patient outcomes and enhance learning opportunities for students. A community-academic partnership between the Maliheh Free Clinic and the University of Utah College of Pharmacy was formed to fulfill a community need for pharmacy services, to promote interdisciplinary patient care, and to provide an experiential opportunity for students. The Maliheh Free Clinic based in Salt Lake City, Utah provides free primary health care to uninsured individuals who live 150% below federal poverty guidelines. Three pharmacy services were developed and implemented. These include: 1 clinic chart reviews which involve written recommendations following a comprehensive assessment of the patient’s chart examining his or her disease states and the appropriateness of his or her medications; 2 medication reconciliations and discussion of pharmacy-related recommendations with patients during Diabetes Day, an inclusive interdisciplinary patient appointment that addresses important aspects of diabetes care; and 3 an insulin dose adjustment service through a collaborative practice agreement with the clinic to monitor a patient’s blood glucose levels and adjust his or her medications accordingly on a weekly basis.

  5. Building a Future without Gender Violence: Rural Teachers and Youth in Rural Kwazulu-Natal, South Africa, Leading Community Dialogue

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2014-01-01

    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…

  6. Community-Based Rural Tourism: A Proposed Sustainability Framework

    Directory of Open Access Journals (Sweden)

    Kayat Kalsom

    2014-01-01

    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.

  7. Similarities of School Shootings in Rural and Small Town Communities.

    Science.gov (United States)

    Kidd, Scott T.; Meyer, Cheryl L.

    2002-01-01

    A study examined characteristics common among young offenders from rural communities who were involved in multiple-fatality school shootings. Data on six cases involving eight offenders revealed six common offender characteristics: verbal threats, peer rejection, interest in violent media, previous violent behavior, suicidal ideation, and violent…

  8. Prevalence of smoking among youth in a rural Nigerian community ...

    African Journals Online (AJOL)

    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.

  9. Mobile technologies for preservation of indigenous knowledge in rural communities

    DEFF Research Database (Denmark)

    Winschiers-Theophilus, Heike; Rodil, Kasper; Zaman, Tariq

    2013-01-01

    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...

  10. Community : a powerful label? Connecting wind energy to rural Ireland

    NARCIS (Netherlands)

    Walsh, B.M.

    2016-01-01

    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

  11. Malaria elimination practices in rural community residents in ...

    African Journals Online (AJOL)

    53. Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 1, 2015. Malaria elimination practices in rural community residents in Rwanda: A cross sectional study ... is an entirely preventable and treatable disease, provided that effective .... The most way used for malaria prevention, control and elimination.

  12. Tungiasis in rural communities of Badagry Local Government Area ...

    African Journals Online (AJOL)

    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 ...

  13. Community attachment and resource harvesting in rural Denmark

    Science.gov (United States)

    Rodney R. Zwick; David Solan

    2002-01-01

    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...

  14. Determinants of Full Vaccination Status in a Rural Community with ...

    African Journals Online (AJOL)

    Femi

    Department of Community Health, University of Benin Teaching Hospital, Benin City, Nigeria. INTRODUCTION ... Low vaccination coverage in rural areas in Nigeria is associated with ... the requested information in addition to playing ... More than one-third, 109 .... Perceived benefits of vaccination and risks of vaccine-.

  15. Community management and sustainability of rural water facilities in Tanzania

    NARCIS (Netherlands)

    Mandara, C.G.; Butijn, C.A.A.; Niehof, Anke

    2013-01-01

    This paper addresses the question of whether community management in water service delivery affects the sustainability of rural water facilities (RWFs) at village level, in terms of their technical and managerial aspects, and what role capacity building of users and providers plays in this process.

  16. What are pregnant women in a rural Niger Delta community's ...

    African Journals Online (AJOL)

    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 ...

  17. Human Immunodeficiency Virus Infection in a rural community of ...

    African Journals Online (AJOL)

    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 ...

  18. Malaria parasitaemia among pregnant women in a rural community ...

    African Journals Online (AJOL)

    Malaria parasitaemia among pregnant women in a rural community of ... ours, it is a common cause of anaemia in pregnancy in both immune and non-immune ... Apart from the use of nets, drugs and vector control, the prevention of malaria in ...

  19. Resilience in Rural Community-Dwelling Older Adults

    Science.gov (United States)

    Wells, Margaret

    2009-01-01

    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…

  20. 77 FR 65547 - Farm, Ranch, and Rural Communities Committee

    Science.gov (United States)

    2012-10-29

    ... programs that affect and engage agriculture and rural communities. FOR FURTHER INFORMATION CONTACT: Alicia Kaiser, Designated Federal Officer, kaiser.alicia@epa.gov , 202-564-7273, U.S. EPA, Office of the Administrator (1101A), 1200 Pennsylvania Avenue NW., Washington, DC 20460. Dated: October 17, 2012. Alicia...

  1. Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand.

    Science.gov (United States)

    Lorga, Thaworn; Aung, Myo Nyein; Naunboonruang, Prissana; Thinuan, Payom; Praipaksin, Nara; Deesakul, Tida; Inwan, Utumporn; Yingtaweesak, Tawatchai; Manokulanan, Pratumpan; Suangkaew, Srisomporn; Payaprom, Apiradee

    2012-01-01

    Diabetes is a growing epidemic in both urban and rural communities worldwide. 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. 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. 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. 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.

  2. The impact of socially-accountable, community-engaged medical education on graduates in the Central Philippines: Implications for the global rural medical workforce.

    Science.gov (United States)

    Siega-Sur, J L; Woolley, T; Ross, S J; Reeve, C; Neusy, A-J

    2017-10-01

    Developing and retaining a high quality medical workforce, especially within low-resource countries has been a world-wide challenge exacerbated by a lack of medical schools, the maldistribution of doctors towards urban practice, health system inequities, and training doctors in tertiary centers rather than in rural communities. To describe the impact of socially-accountable health professional education on graduates; specifically: their motivation towards community-based service, preparation for addressing local priority health issues, career choices, and practice location. Cross-sectional survey of graduates from two medical schools in the Philippines: the University of Manila-School of Health Sciences (SHS-Palo) and a medical school with a more conventional curriculum. SHS-Palo graduates had significantly (p < 0.05) more positive attitudes to community service. SHS-Palo graduates were also more likely to work in rural and remote areas (p < 0.001) either at district or provincial hospitals (p = 0.032) or in rural government health services (p < 0.001) as Municipal or Public Health Officers (p < 0.001). Graduates also stayed longer in both their first medical position (p = 0.028) and their current position (p < 0.001). SHS-Palo medical graduates fulfilled a key aim of their socially-accountable institution to develop a health professional workforce willing and able, and have a commitment to work in underserved rural communties.

  3. Integrated Water Resources Simulation Model for Rural Community

    Science.gov (United States)

    Li, Y.-H.; Liao, W.-T.; Tung, C.-P.

    2012-04-01

    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

  4. Effects of pediatric asthma care coordination in underserved communities on parent perceptions of care and asthma-management confidence.

    Science.gov (United States)

    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

    2017-06-01

    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.

  5. Comparison and Research on New Rural Community Management Patterns of Shan Dong Province

    Science.gov (United States)

    Fang, Lei; Zhang, Xiaomei

    Rural community is an important institutional innovation,which has important effect and edification to future new rural management.There are three new rural community management patterns in shandong province:divisions of the village community,many villages community and village merge community. This article not only introduce three models,but also compare them in four aspects: community scale, community management,infrastructure,resource utilization.Pointing out the strength and weakness of three models.Drawing a conclusion that village merge community is the active reaction for rural urbanization. And could be the important recommended breed.

  6. Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial.

    Science.gov (United States)

    Mash, Bob; Levitt, Naomi; Steyn, Krisela; Zwarenstein, Merrick; Rollnick, Stephen

    2012-12-24

    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. Pragmatic cluster randomized controlled trialParticipants: Type 2 diabetic patients attending 45 public sector community health centres in Cape TownInterventions: 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. To evaluate the effectiveness of the group diabetes education programmeOutcomes: diabetes self-care activities, 5% weight loss, 1% reduction in HbA1c. self-efficacy, locus of control, mean blood pressure, mean weight loss, mean waist circumference, mean HbA1c, mean total cholesterol, quality of lifeRandomisation: Computer generated random numbersBlinding: Patients, health promoters and research assistants could not be blinded to the health centre's allocationNumbers 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. The study will inform policy makers and managers of the district health system, particularly in low to middle income countries, if this programme can be implemented more widely. Pan African Clinical Trial Registry PACTR201205000380384.

  7. Effectiveness of a group diabetes education programme in underserved communities in South Africa: pragmatic cluster randomized control trial

    Directory of Open Access Journals (Sweden)

    Mash Bob

    2012-12-01

    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

  8. Quality of life in people with epilepsy in Sudan: An example of underserved communities in developing countries.

    Science.gov (United States)

    Sokrab, M; Sokrab, A; Elzubeir, M

    2012-01-01

    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

  9. Ciclovia in a Rural Latino Community: Results and Lessons Learned.

    Science.gov (United States)

    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.

  10. Prevalence of congenital heart disease in rural communities of pakistan

    International Nuclear Information System (INIS)

    Rizvi, S.F.U.; Mustafa, G.; Khan, M.A.; Kundi, A.

    2015-01-01

    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)

  11. The Rural Open Air Museums: Visitors, Community and Place

    Directory of Open Access Journals (Sweden)

    Pawlikowska-Piechotka Anna

    2015-12-01

    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.

  12. Traditional birth attendants (TBAs) as potential agents in promoting male involvement in maternity preparedness: insights from a rural community in Uganda.

    Science.gov (United States)

    Turinawe, Emmanueil Benon; Rwemisisi, Jude T; Musinguzi, Laban K; de Groot, Marije; Muhangi, Denis; de Vries, Daniel H; Mafigiri, David K; Katamba, Achilles; Parker, Nadine; Pool, Robert

    2016-03-12

    Since the 1994 International Conference on Population and Development, male involvement in reproductive health issues has been advocated as a means to improve maternal and child health outcomes, but to date, health providers have failed to achieve successful male involvement in pregnancy care especially in rural and remote areas where majority of the underserved populations live. In an effort to enhance community participation in maternity care, TBAs were trained and equipped to ensure better care and quick referral. In 1997, after the advent of the World Health Organization's Safe Motherhood initiative, the enthusiasm turned away from traditional birth attendants (TBAs). However, in many developing countries, and especially in rural areas, TBAs continue to play a significant role. This study explored the interaction between men and TBAs in shaping maternal healthcare in a rural Ugandan context. This study employed ethnographic methods including participant observation, which took place in the process of everyday life activities of the respondents within the community; 12 focus group discussions, and 12 in-depth interviews with community members and key informants. Participants in this study were purposively selected to include TBAs, men, opinion leaders like village chairmen, and other key informants who had knowledge about the configuration of maternity services in the community. Data analysis was done inductively through an iterative process in which transcribed data was read to identify themes and codes were assigned to those themes. Contrary to the thinking that TBA services are utilized by women only, we found that men actively seek the services of TBAs and utilize them for their wives' healthcare within the community. TBAs in turn sensitize men using both cultural and biomedical health knowledge, and become allies with women in influencing men to provide resources needed for maternity care. In this study area, men trust and have confidence in TBAs; closer

  13. "Hey, I Saw Your Grandparents at Walmart": Teacher Education for Rural Schools and Communities

    Science.gov (United States)

    Eppley, Karen

    2015-01-01

    This is a case study about how teacher education might better prepare rural teacher candidates for rural schools. Parents, teachers, community members, and students associated with a rural school described what is important in the preparation of teachers for today's rural schools. Their goals and wishes for their children's school and community…

  14. Community participation in rural Ecuador’s school feeding programme

    DEFF Research Database (Denmark)

    Torres, Irene; Simovska, Venka

    2017-01-01

    participation can include the possibility of the community challenging the social order at school, and the educational policies and practices. When addressing community participation, counter-participating and non-participating can be also considered as legitimate forms of participating. Originality/value......Purpose - The aim of this paper is to contribute to the debate concerning health education and health promotion at schools, particularly with regard to food and nutrition. Design/methodology/approach - Based on empirical data generated over the course of one year of fieldwork in three rural...... – The study contributes to an understanding of policy implementation and the implications of a HPS approach to health education and health promotion in small rural schools....

  15. ECOLOGICAL ETHICS. VALUES AND NORMS IN LOCAL RURAL COMMUNITIES

    OpenAIRE

    Włodzimierz Kaczocha; Jan Sikora

    2016-01-01

    An important role in sustainable rural development, involving economy, local communities and nature, should be played by ethics. This paper presents a theoretical and empirical characterization of basic problems of ecological ethics. First and foremost, the study characterizes the philosophical fundamentals of this ethics, with emphasis on ontological and anthropological views of selected thinkers. A universal concept of ecological ethics was proposed, containing values and moral norms that p...

  16. Renewable energy for rural communities in Maharashtra, India

    International Nuclear Information System (INIS)

    Blenkinsopp, T.; Coles, S.R; Kirwan, K.

    2013-01-01

    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

  17. Perception of blindness and blinding eye conditions in rural communities.

    Science.gov (United States)

    Ashaye, Adeyinka; Ajuwon, Ademola Johnson; Adeoti, Caroline

    2006-01-01

    PURPOSE: The purpose of this qualitative study was to explore the causes and management of blindness and blinding eye conditions as perceived by rural dwellers of two Yoruba communities in Oyo State, Nigeria. METHODS: Four focus group discussions were conducted among residents of Iddo and Isale Oyo, two rural Yoruba communities in Oyo State, Nigeria. Participants consisted of sighted, those who were partially or totally blind and community leaders. Ten patent medicine sellers and 12 traditional healers were also interviewed on their perception of the causes and management of blindness in their communities. FINDINGS: Blindness was perceived as an increasing problem among the communities. Multiple factors were perceived to cause blindness, including germs, onchocerciasis and supernatural forces. Traditional healers believed that blindness could be cured, with many claiming that they had previously cured blindness in the past. However, all agreed that patience was an important requirement for the cure of blindness. The patent medicine sellers' reports were similar to those of the traditional healers. The barriers to use of orthodox medicine were mainly fear, misconception and perceived high costs of care. There was a consensus of opinion among group discussants and informants that there are severe social and economic consequences of blindness, including not been able to see and assess the quality of what the sufferer eats, perpetual sadness, loss of sleep and dependence on other persons for daily activities. CONCLUSION: Local beliefs associated with causation, symptoms and management of blindness and blinding eye conditions among rural Yoruba communities identified have provided a bridge for understanding local perspectives and basis for implementing appropriate primary eye care programs. PMID:16775910

  18. Technological Education for the Rural Community (TERC) Project: Technical Mathematics for the Advanced Manufacturing Technician

    Science.gov (United States)

    McCormack, Sherry L.; Zieman, Stuart

    2017-01-01

    Hopkinsville Community College's Technological Education for the Rural Community (TERC) project is funded through the National Science Foundation Advanced Technological Education (NSF ATE) division. It is advancing innovative educational pathways for technological education promoted at the community college level serving rural communities to fill…

  19. The Role of Rural Communities in the Postsecondary Preparation of Low-Income Students

    Science.gov (United States)

    Alleman, Nathan F.; Holly, L. Neal

    2014-01-01

    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…

  20. The WAMI Rural Hospital Project. Part 3: Building health care leadership in rural communities.

    Science.gov (United States)

    Elder, W G; Amundson, B A

    1991-01-01

    The WAMI Rural Hospital Project (RHP) intervention combined aspects of community development, strategic planning and organizational development to address the leadership issues in six Northwest rural hospitals. Hospitals and physicians, other community health care providers and local townspeople were involved in this intervention, which was accomplished in three phases. In the first phase, extensive information about organizational effectiveness was collected at each site. Phase two consisted of 30 hours of education for the physician, board, and hospital administrator community representatives covering management, hospital board governance, and scope of service planning. In the third phase, each community worked with a facilitator to complete a strategic plan and to resolve conflicts addressed in the management analyses. The results of the evaluation demonstrated that the greatest change noted among RHP hospitals was improvement in the effectiveness of their governing boards. All boards adopted some or all of the project's model governance plan and had successfully completed considerable portions of their strategic plans by 1989. Teamwork among the management triad (hospital, board, and medical staff) was also substantially improved. Other improvements included the development of marketing plans for the three hospitals that did not initially have them and more effective use of outside consultants. The project had less impact on improving the functioning of the medical chief of staff, although this was not a primary target of the intervention. There was also relatively less community interest in joining regional health care associations. The authors conclude that an intervention program tailored to address specific community needs and clearly identified leadership deficiencies can have a positive effect on rural health care systems.

  1. Meeting the research infrastructure needs of micropolitan and rural communities.

    Science.gov (United States)

    Strasburger, Janette F

    2009-05-01

    In the 1800s, this country chose to establish land-grant colleges to see that the working class could attain higher education, and that the research needs of the agricultural and manufacturing segments of this country could be met. It seems contrary to our origins to see so little support at present for research infrastructure going to the very communities that need such research to sustain their populations, grow their economies, to attract physicians, to provide adequate health care, and to educate, retain, and employ their youth. Cities are viewed as sources for high-paying jobs, yet many of these same jobs could be translated to rural and micropolitan areas, provided that the resources are established to support it. One of the fastest growing economic periods in this country's history was during World War II, when even the smallest and most remote towns contributed substantially to the innovations, manufacture, and production of goods benefiting our nation as a whole. Rural areas have always lagged somewhat behind metropolitan areas in acquisition of new technology. Rural electricity and rural phone access are examples from the past. Testing our universities' abilities to grow distributive research networks beyond their campuses will create a competitive edge regionally, against global workplace, educational, and research competition, and will lay the groundwork for efficiency in research and for new innovation.

  2. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    Directory of Open Access Journals (Sweden)

    Kevin R. Tarlow

    2014-01-01

    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.

  3. Mobile crisis management teams as part of an effective crisis management system for rural communities.

    Science.gov (United States)

    Trantham, Doug; Sherry, Anne

    2012-01-01

    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.

  4. Archaeological Excavation and Deep Mapping in Historic Rural Communities

    Directory of Open Access Journals (Sweden)

    Carenza Lewis

    2015-09-01

    Full Text Available This paper reviews the results of more than a hundred small archaeological “test pit” excavations carried out in 2013 within four rural communities in eastern England. Each excavation used standardized protocols in a different location within the host village, with the finds dated and mapped to create a series of maps spanning more than 3500 years, in order to advance understanding of the spatial development of settlements and landscapes over time. The excavations were all carried out by local volunteers working physically within their own communities, supported and advised by professional archaeologists, with most test pits sited in volunteers’ own gardens or those of their friends, family or neighbors. Site-by-site, the results provided glimpses of the use made by humans of each of the excavated sites spanning prehistory to the present day; while in aggregate the mapped data show how settlement and land-use developed and changed over time. Feedback from participants also demonstrates the diverse positive impacts the project had on individuals and communities. The results are presented and reviewed here in order to highlight the contribution archaeological test pit excavation can make to deep mapping, and the contribution that deep mapping can make to rural communities.

  5. DISTANCE EDUCATION POTENTIAL FOR A CANADIAN RURAL ISLAND COMMUNITY

    Directory of Open Access Journals (Sweden)

    Tom JONES

    2009-04-01

    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.

  6. Gender differentiation in community responses to AIDS in rural Uganda.

    Science.gov (United States)

    Kanyamurwa, J M; Ampek, G T

    2007-01-01

    AIDS has been reported in Africa to push households into poverty and chronic food insecurity. At the same time there are reports of significant household resilience to AIDS. This study explored how a mature epidemic in rural Uganda has affected rural farming households. It focused on gender differences in the experience of AIDS and, in particular, household capabilities to sustain livelihoods. The study compared the vulnerability of male- and female-headed households in relation to their ability to mitigate human resource losses, as well as their access to natural and physical resources, to social networks and to finance capital for production. The findings suggest that when rural households are affected by AIDS, depleting productive resources and directing resources towards immediate needs, there are gender differences in responses to, and in impacts of, the epidemic due to the different resources available to male- and female- headed households. Female-headed households were found to be more vulnerable to AIDS than male-headed counterparts. Women's remarriage opportunities were lower than men's, they faced greater risk of losing control over land and livestock and they accessed less state and private sector support. Women-headed households were more dependent on livelihood support from non-governmental organizations, which were found to provide both welfare and credit support to female-headed households affected by AIDS. Women were found to play an important role in social networks and resources at community level but themselves received little support from many formal community networks and services.

  7. Epidemiology of stroke in a rural community in Southeastern Nigeria

    Directory of Open Access Journals (Sweden)

    Enwereji KO

    2014-06-01

    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

  8. Evaluation of community provision of a preventive cardiovascular programme - the National Health Service Health Check in reaching the under-served groups by primary care in England: cross sectional observational study.

    Science.gov (United States)

    Woringer, Maria; Cecil, Elizabeth; Watt, Hillary; Chang, Kiara; Hamid, Fozia; Khunti, Kamlesh; Dubois, Elizabeth; Evason, Julie; Majeed, Azeem; Soljak, Michael

    2017-06-14

    Cardiovascular disease (CVD) is the leading cause of premature mortality and a major contributor of health inequalities in England. Compared to more affluent and white counterparts, deprived people and ethnic minorities tend to die younger due to preventable CVD associated with lifestyle. In addition, deprived, ethnic minorities and younger people are less likely to be served by CVD prevention services. This study assessed the effectiveness of community-based outreach providers in delivering England's National Health Services (NHS) Health Check programme, a CVD preventive programme to under-served groups. Between January 2008 and October 2013, community outreach providers delivered a preventive CVD programme to 50,573 individuals, in their local communities, in a single consultation without prescheduled appointments. Community outreach providers operated on evenings and weekends as well as during regular business hours in venues accessible to the general public. After exclusion criteria, we analysed and compared socio-demographic data of 43,177 Health Check attendees with the general population across 38 local authorities (LAs). We assessed variation between local authorities in terms of age, sex, deprivation and ethnicity structures using two sample t-tests and within local authority variation in terms of ethnicity and deprivation using Chi squared tests and two sample t-tests respectively. Using Index of Multiple Deprivation, the mean deprivation score of the population reached by community outreach providers was 6.01 higher (p successful in recruiting ethnic minority groups. The mean proportion of men screened was 11.39% lower (p successful in motivating the under-served groups to improve lifestyle, it may reduce health inequalities therein.

  9. Methodology of a diabetes prevention translational research project utilizing a community-academic partnership for implementation in an underserved Latino community

    Directory of Open Access Journals (Sweden)

    Ma Yunsheng

    2009-03-01

    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

  10. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014–2015

    Science.gov (United States)

    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

    2016-01-01

    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. PMID:27268508

  11. Secondary Infections with Ebola Virus in Rural Communities, Liberia and Guinea, 2014-2015.

    Science.gov (United States)

    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

    2016-09-01

    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.

  12. Blind Spots: Small Rural Communities and High Turnover in the Superintendency

    Science.gov (United States)

    Kamrath, Barry; Brunner, C. Cryss

    2014-01-01

    This article examines high superintendency turnover through rural community members' perceptions of such attrition in their districts. Findings indicate that community members perceived high turnover as negative and believed that turnover was created by financial pressures, rural community resistance to educational trends, and bias against…

  13. The Effects of Activity and Aging on Rural Community Living and Consuming.

    Science.gov (United States)

    Miller, Nancy J.; Kim, Soyoung; Schofield-Tomschin, Sherry

    1998-01-01

    Discusses a study of the effects of social activity and aging on variables related to individual motivations, community membership, and consumer behavior of respondents (n=630) living in rural communities. Findings suggest an embeddedness of marketplace activity in the social networks of rural communities. (Author/JOW)

  14. Rural Embedded Assistants for Community Health (REACH) network: first-person accounts in a community-university partnership.

    Science.gov (United States)

    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

    2013-03-01

    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.

  15. Predicting prediabetes in a rural community: a survey among the Karen ethnic community, Thasongyang, Thailand

    Directory of Open Access Journals (Sweden)

    Lorga T

    2012-03-01

    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

  16. Getting to know the island: Artistic experiments in rural community development

    OpenAIRE

    Crawshaw, Julie

    2016-01-01

    This paper makes an original contribution to our understandings of the relational role of artistic practice as part of rural community development. Art-led initiatives are now commonplace in rural development strategies. However, the effects of art in rural community, particularly beyond economic development, have received little attention. In this paper we seek to address this omission by exploring artistic ex- periments as part of community development processes. Theoretically, we draw on r...

  17. Development of community plans to enhance survivorship from colorectal cancer: community-based participatory research in rural communities.

    Science.gov (United States)

    Lengerich, Eugene J; Kluhsman, Brenda C; Bencivenga, Marcyann; Allen, Regina; Miele, Mary Beth; Farace, Elana

    2007-09-01

    In 2002, 10.4% of the 10 million persons alive who have ever been diagnosed with cancer had colorectal cancer (CRC). Barriers, such as distance, terrain, access to care and cultural differences, to CRC survivorship may be especially relevant in rural communities. We tested the hypothesis that teams from rural cancer coalitions and hospitals would develop a Community Plan (CP) to enhance CRC survivorship. We used community-based participatory research and the PRECEDE-PROCEED model to train teams from rural cancer coalitions and hospitals in Pennsylvania and New York. We measured knowledge at three points in time and tested the change with McNemar's test, corrected for multiple comparisons (p < 0.0167). We also conducted a qualitative review of the CP contents. Fourteen (93.3%) of the 15 coalitions or hospitals initially recruited to the study completed a CP. Knowledge in public health, sponsorship of A National Action Plan for Cancer Survivorship, and CRC survivorship and treatment increased. Teams identified perceived barriers and community assets. All teams planned to increase awareness of community assets and almost all planned to enhance treatment-related care and psychosocial care for the CRC survivor; 50% planned to enhance primary care and CRC screening. The study demonstrated the interest and ability of rural organizations to plan to enhance CRC survivorship, including linkage of CRC survivorship to primary care. Rural cancer coalitions and hospitals may be a vehicle to develop local action for A National Action Plan. Access to more comprehensive care for CRC cancer survivors in rural communities appears to be facilitated by the community-based initiative described and investigated in this study. Efforts such as these could be replicated in other rural communities and may impact the care and quality of life of survivors with many types of cancers. While access to health services may be increased through community-based initiatives, we still need to measure

  18. Studying Leadership within Successful Rural Communities in a Southeastern State: A Qualitative Analysis

    Science.gov (United States)

    Ricketts, Kristina G.

    2009-01-01

    Many rural communities are experiencing a diversity of issues, but what part does leadership play in these communities? This qualitative study describes the environment within two communities in the southeast focusing on community variables of psychological sense of community, community leadership, and social capital. Leaders were identified and a…

  19. Enhancing community capacity to support physical activity: the development of a community-based indoor-outdoor walking program.

    Science.gov (United States)

    Riley-Jacome, Mary; Gallant, Mary P; Fisher, Brian D; Gotcsik, Frances S; Strogatz, David S

    2010-04-01

    The University at Albany Prevention Research Center, guided by a needs assessment in two underserved communities (one urban, one rural), initiated a pilot project that opened a public school for community walking in a rural setting. This study examined a 9-week program for potential barriers, benefits, influential factors, and the physical activity levels of program participants. Evaluation was based on daily logs, pedometer diaries, participant surveys, and focus groups. Results indicated that rural schools provide a useful resource for residents and increase participants' physical activity levels. A more comprehensive rural community walking program has been implemented as a result of these findings.

  20. A community-driven hypertension treatment group in rural Honduras.

    Science.gov (United States)

    Reiger, Sheridan; Harris, Jeffrey R; Chan, Kwun Chuen Gary; Oqueli, Hector Lopez; Kohn, Marlana

    2015-01-01

    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

  1. Small rural communities in the inland Northwest: an assessment of small communities in the interior and upper Columbia River basins.

    Science.gov (United States)

    Charles C. Harris; William McLaughlin; Greg Brown; Dennis R. Becker

    2000-01-01

    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 region’s...

  2. Medical student surgery elective in rural Haiti: a novel approach to satisfying clerkship requirements while providing surgical care to an underserved population.

    Science.gov (United States)

    Chin-Quee, Anthony; White, Laura; Leeds, Ira; MacLeod, Jana; Master, Viraj A

    2011-04-01

    The addition of global health programs to medical school training results in graduates with enhanced clinical skills and increased sensitivity to cost issues. Funding from U.S. medical schools has been unable to meet student demand, and therefore it is often a critical limiting factor to the lack of development of these programs. We describe an alternative approach for global health surgical training for medical students. Emory University medical students and faculty, in collaboration with Project Medishare for Haiti, planned, raised funds, and executed a successful short-term surgical camp to supplement available surgical services in rural Haiti. Learning objectives that satisfied Emory University School of Medicine surgery clerkship requirements were crafted, and third-year students received medical school credit for the trip. In the absence of house staff and placed in an under-resourced, foreign clinical environment, the surgical elective described here succeeded in meeting learning objectives for a typical third-year surgical clerkship. Objectives were met through a determined effort to ensure that home institution requirements were aligned properly with learning activities while students were abroad and through a close collaboration between medical students, faculty members, and the administration. Emory University's international surgery elective for medical students demonstrates that opportunities for supervised, independent student-learning and global health service can be integrated into a traditional surgical clerkship. These opportunities can be organized to meet the requirements and expectations for third-year surgery clerkships at other medical colleges. This work also identifies how such trips can be planned and executed in a manner that does not burden strained academic budgets with further demands on resources.

  3. Human transportation needs in rural Oklahoma.

    Science.gov (United States)

    2012-09-01

    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...

  4. Rural Revitalization in New Mexico: A Grass Roots Initiative Involving School and Community

    Science.gov (United States)

    Pitzel, Gerald R.; Benavidez, Alicia C.; Bianchi, Barbara C.; Croom, Linda L.; de la Riva, Brandy R.; Grein, Donna L.; Holloway, James E.; Rendon, Andrew T.

    2007-01-01

    The Rural Education Bureau of the New Mexico Public Education Department has established a program to address the special needs of schools and communities in the extensive rural areas of the state. High poverty rates, depopulation and a general lack of viable economic opportunity have marked rural New Mexico for decades. The program underway aims…

  5. SEX PREFERENCESAMONG RURAL COMMUNITY: PUBLIC HEALTH AND SOCIAL CONCERN

    Directory of Open Access Journals (Sweden)

    Aalok Kumar Singh, Sunil Thitame, Reecha Ghimire

    2015-04-01

    Full Text Available Background: Sex preference is choice of selecting the sex of children by their parents or family members. The objective of the study was to study the existence of sex preference among rural community. Material and methods: A Cross-sectional study was carried out among 200 ever married women of reproductive age group. Random digits sampling method was used to select 10 villages in Rahata Tehsil of Ahmednagar, while systematic sampling was applied for selection of 20 samples in each village. Results: In the previous sex preference for male child was 37.3%, 58.75%, 88.5%, 100% and 100% from firstchild to fifth respectively, while female preference and either sexpreference was decreasing. In the current sex preference for male, female and either was 36.8%, 25% and 38.2% respectively. Future sex preference was 40.9% for male child, 22.7% for female child and 36.4% for either sex. The main reason for son preference was for old age care and support, to continue the family name and earning member in the family. Conclusion: Study confirms that son preference still existsin the rural community of Maharashtra. Attitude for son preference is mainly because of the economic earning, old age care and continuation of the family nameamong all groups.

  6. Widening access to medicine may improve general practitioner recruitment in deprived and rural communities: survey of GP origins and current place of work.

    Science.gov (United States)

    Dowell, J; Norbury, M; Steven, K; Guthrie, B

    2015-10-01

    Widening access to medicine in the UK is a recalcitrant problem of increasing political importance, with associated strong social justice arguments but without clear evidence of impact on service delivery. Evidence from the United States suggests that widening access may enhance care to underserved communities. Additionally, rural origin has been demonstrated to be the factor most strongly associated with rural practice. However the evidence regarding socio-economic and rural background and subsequent practice locations in the UK has not been explored. The aim of this study was to investigate the association between general practitioners' (GPs) socio-economic and rural background at application to medical school and demographic characteristics of their current practice. The study design was a cross-sectional email survey of general practitioners practising in Scotland. Socio-economic status of GPs at application to medical school was assessed using the self-coded National Statistics Socio-Economic Classification. UK postcode at application was used to define urban-rural location. Current practice deprivation and remoteness was measured using NHS Scotland defined measures based on registered patients' postcodes. A survey was sent to 2050 Scottish GPs with a valid accessible email address, with 801 (41.5 %) responding. GPs whose parents had semi-routine or routine occupations had 4.3 times the odds of working in a deprived practice compared to those with parents from managerial and professional occupations (95 % CI 1.8-10.2, p = 0.001). GPs from remote and rural Scottish backgrounds were more likely to work in remote Scottish practices, as were GPs originating from other UK countries. This study showed that childhood background is associated with the population GPs subsequently serve, implying that widening access may positively affect service delivery in addition to any social justice rationale. Longitudinal research is needed to explore this association and the

  7. Making rural and remote communities more age-friendly: experts' perspectives on issues, challenges, and priorities.

    Science.gov (United States)

    Menec, Verena; Bell, Sheri; Novek, Sheila; Minnigaleeva, Gulnara A; Morales, Ernesto; Ouma, Titus; Parodi, Jose F; Winterton, Rachel

    2015-01-01

    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.

  8. Rural Community Disaster Preparedness and Risk Perception in Trujillo, Peru.

    Science.gov (United States)

    Stewart, Matthew; Grahmann, Bridget; Fillmore, Ariel; Benson, L Scott

    2017-08-01

    , 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.

  9. Community Strategic Visioning as a Method to Define and Address Poverty: An Analysis from Select Rural Montana Communities

    Science.gov (United States)

    Lachapelle, Paul; Austin, Eric; Clark, Daniel

    2010-01-01

    Community strategic visioning is a citizen-based planning process in which diverse sectors of a community collectively determine a future state and coordinate a plan of action. Twenty-one communities in rural Montana participated in a multi-phase poverty reduction program that culminated in a community strategic vision process. Research on this…

  10. Big Pharma on the Farm: Students Are Exposed to Pharmaceutical Marketing More Often in Rural Clinics.

    Science.gov (United States)

    Evans, David V; Keys, Toby; Desnick, Laurel; A Andrilla, C Holly; Bienz, Danielle; Rosenblatt, Roger

    2016-07-01

    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.

  11. Exploration on Planning Methods for Rural Communities in the Local Economic and Institutional Contexts

    Institute of Scientific and Technical Information of China (English)

    Ying; WANG; Xin; PAN; Zhilun; XIAO; Xiangwei; CHENG; Caige; LI

    2014-01-01

    This paper reviews the wave of rural community construction, compares the urban and rural areas on the aspects of land property right, financing channels, construction management procedures, and the user-builder difference, and examines the unique characteristics of rural communities. On the basis of that, it proposes some planning methods for the rural community planning and construction, such as encouraging public participation, conducting public facility-oriented planning, and providing house-design menu, and further puts forward some supporting measures and policies.

  12. A Case Study of Rural Community Colleges' Transition to Entrepreneurship

    Science.gov (United States)

    Genandt, James D.

    2017-01-01

    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…

  13. Counselors and Special Educators in Rural Schools Working Together to Create a Positive School Community

    Science.gov (United States)

    Thornton, Frank

    2018-01-01

    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…

  14. Rural Public Libraries as Community Change Agents: Opportunities for Health Promotion

    Science.gov (United States)

    Flaherty, Mary Grace; Miller, David

    2016-01-01

    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…

  15. Rural-Urban Differences in Preventable Hospitalizations among Community-Dwelling Veterans with Dementia

    Science.gov (United States)

    Thorpe, Joshua M.; Van Houtven, Courtney H.; Sleath, Betsy L.; Thorpe, Carolyn T.

    2010-01-01

    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…

  16. Decentralization and Educational Performance: Evidence from the PROHECO Community School Program in Rural Honduras

    Science.gov (United States)

    Di Gropello, Emanuela; Marshall, Jeffery H.

    2011-01-01

    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…

  17. Interactive web-based portals to improve patient navigation and connect patients with primary care and specialty services in underserved communities.

    Science.gov (United States)

    Highfield, Linda; Ottenweller, Cecelia; Pfanz, Andre; Hanks, Jeanne

    2014-01-01

    This article presents a case study in the redesign, development, and implementation of a web-based healthcare clinic search tool for virtual patient navigation in underserved populations in Texas. It describes the workflow, assessment of system requirements, and design and implementation of two online portals: Project Safety Net and the Breast Health Portal. The primary focus of the study was to demonstrate the use of health information technology for the purpose of bridging the gap between underserved populations and access to healthcare. A combination of interviews and focus groups was used to guide the development process. Interviewees were asked a series of questions about usage, usability, and desired features of the new system. The redeveloped system offers a multitier architecture consisting of data, business, and presentation layers. The technology used in the new portals include Microsoft .NET Framework 3.5, Microsoft SQL Server 2008, Google Maps JavaScript API v3, jQuery, Telerik RadControls (ASP.NET AJAX), and HTML. The redesigned portals have 548 registered clinics, and they have averaged 355 visits per month since their launch in late 2011, with the average user visiting five pages per visit. Usage has remained relatively constant over time, with an average of 142 new users (40 percent) each month. This study demonstrates the successful application of health information technology to improve access to healthcare and the successful adoption of the technology by targeted end users. The portals described in this study could be replicated by health information specialists in other areas of the United States to address disparities in healthcare access.

  18. Exploring the Use of Electronic Mobile Technologies among Distance Learners in Rural Communities for Safe and Disruptive Learning

    Science.gov (United States)

    Ntloedibe-Kuswani, Gomang Seratwa

    2013-01-01

    Several studies indicated the potential of electronic mobile technologies in reaching (safe learning) under-served communities and engaging (disruptive learning) disadvantaged peoples affording them learning experiences. However, the potential benefits of (electronic mobile learning) e-mobile learning have not been well understood from the…

  19. Occupational safety and health education and training for underserved populations.

    Science.gov (United States)

    O'Connor, Tom; Flynn, Michael; Weinstock, Deborah; Zanoni, Joseph

    2014-01-01

    This article presents an analysis of the essential elements of effective occupational safety and health education and training programs targeting underserved communities. While not an exhaustive review of the literature on occupational safety and health training, the paper provides a guide for practitioners and researchers to the key factors they should consider in the design and implementation of training programs for underserved communities. It also addresses issues of evaluation of such programs, with specific emphasis on considerations for programs involving low-literacy and limited-English-speaking workers.

  20. Stakeholder views of rural community-based medical education: a narrative review of the international literature.

    Science.gov (United States)

    Somporn, Praphun; Ash, Julie; Walters, Lucie

    2018-03-30

    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

  1. Rural and school community in appreciating knowledge on medical plants

    Directory of Open Access Journals (Sweden)

    Marcílio Souza Carneiro

    2016-05-01

    Isolated communities in the urban environment still use medicinal plants, but such knowledge is not always passed on to new generations. In this scenario, we propose a study with students, teachers, and community residents from Córrego da Ema, Amontada, Ceará, Brazil, aiming to know the wisdom of medicinal plants in a small rural community in the Brazilian semi-arid region. We interviewed the medicinal plant connoisseurs, named as local experts, by using the “snow ball” method. We applied questionnaires to investigate Elementary School students’ knowledge on medicinal plants (pre-tour. These actions provided a basis for planning guided-tours, activities aimed at 51 students, which we carried out along with the 10 experts and 2 local school teachers, whose results (post-tour were assessed by using the same pre-tour questionnaire. Most local experts were women (80%, their families had many people and low education level, factors that contribute to using medicinal plants. Experts cited 35 medicinal plant species. Students cited 24 pre-tour plant species and 28 post-tour plant species. Students increased their knowledge, as there was also a post-tour increase in therapeutic indications and preparation methods, as mentioned. The school played an important role in appreciating this intangible heritage, because it enabled actions involving formal and informal education.

  2. Rural and school community in appreciating knowledge on medical plants

    Directory of Open Access Journals (Sweden)

    Marcílio Souza Carneiro

    2016-05-01

    Full Text Available Isolated communities in the urban environment still use medicinal plants, but such knowledge is not always passed on to new generations. In this scenario, we propose a study with students, teachers, and community residents from Córrego da Ema, Amontada, Ceará, Brazil, aiming to know the wisdom of medicinal plants in a small rural community in the Brazilian semi-arid region. We interviewed the medicinal plant connoisseurs, named as local experts, by using the “snow ball” method. We applied questionnaires to investigate Elementary School students’ knowledge on medicinal plants (pre-tour. These actions provided a basis for planning guided-tours, activities aimed at 51 students, which we carried out along with the 10 experts and 2 local school teachers, whose results (post-tour were assessed by using the same pre-tour questionnaire. Most local experts were women (80%, their families had many people and low education level, factors that contribute to using medicinal plants. Experts cited 35 medicinal plant species. Students cited 24 pre-tour plant species and 28 post-tour plant species. Students increased their knowledge, as there was also a post-tour increase in therapeutic indications and preparation methods, as mentioned. The school played an important role in appreciating this intangible heritage, because it enabled actions involving formal and informal education.

  3. What Can Rural Communities Do to Be Sustained?

    Directory of Open Access Journals (Sweden)

    Rachel J. C. Chen

    2016-09-01

    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.

  4. Empowering a group of seniors in a rural community

    Directory of Open Access Journals (Sweden)

    Ana Rita Marinho Machado

    2015-02-01

    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.

  5. Pregnancy-associated malaria in a rural community of Ghana

    DEFF Research Database (Denmark)

    Ofori, Mf; Ansah, E; Agyepong, I

    2009-01-01

    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...

  6. Rural Community Development Strategy beyond the Access to Information

    DEFF Research Database (Denmark)

    Akther, Farzana

    2012-01-01

    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...

  7. Neurocysticercosis an epidemiological survey in two small rural communities

    Directory of Open Access Journals (Sweden)

    Walter O. Arruda

    1990-12-01

    Full Text Available The authors describe the epidemiological findings related to human taeniasis and cysticercosis, and swine cysticercosis in two small rural communities, Postinho (P and Tigre (T, of South Brazil. The prevalence of epilepsy was 2.04% (P and 2.25% (T. The prevalence of neurocysticercosis was 0.47% (P and 0.93% (T, and prevalence of swine cysticercosis was 12.8% (P and 27.8% (T. Taenia sp. infestation wis detected in 4.3% (P and 4.6% (T of stool examinations. The hyperendemic human taeniasis and cysticercosis and swine cysticercosis seems to be related to poor hygienic habits of the population, and the free access to human excreta by the pigs.

  8. The economic impact of rural family physicians practicing obstetrics.

    Science.gov (United States)

    Avery, Daniel M; Hooper, Dwight E; McDonald, John T; Love, Michael W; Tucker, Melanie T; Parton, Jason M

    2014-01-01

    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.

  9. Humans as long-distance dispersers of rural plant communities.

    Directory of Open Access Journals (Sweden)

    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.

  10. Work setting, community attachment, and satisfaction among rural and remote nurses.

    Science.gov (United States)

    Kulig, Judith C; Stewart, Norma; Penz, Kelly; Forbes, Dorothy; Morgan, Debra; Emerson, Paige

    2009-01-01

    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.

  11. Community perceptions of health and chronic disease in South Indian rural transitional communities: a qualitative study.

    Science.gov (United States)

    Hayter, Arabella K M; Jeffery, Roger; Sharma, Chitra; Prost, Audrey; Kinra, Sanjay

    2015-01-01

    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. 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. 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. 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.

  12. Disabled women's attendance at community women's groups in rural Nepal.

    Science.gov (United States)

    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

    2017-06-01

    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.

  13. Organizational Responsibility for Age-Friendly Social Participation: Views of Australian Rural Community Stakeholders.

    Science.gov (United States)

    Winterton, Rachel

    2016-01-01

    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.

  14. Prevalence of Hypertension in Akwa Ibom State, South-South Nigeria: Rural versus Urban Communities Study

    Directory of Open Access Journals (Sweden)

    Effiong Ekong Akpan

    2015-01-01

    Full Text Available Recent studies have shown an increasing trend in the prevalence of hypertension in rural communities compared to that of the urban communities. This study was therefore carried out to determine the prevalence of hypertension and its predictors (if any in both urban and rural communities of Akwa Ibom State of Nigeria. Subjects and Method. This was a cross-sectional study of urban and rural communities of Akwa Ibom State for the prevalence of hypertension and its predictors. Two urban cities and two rural communities were randomly selected from the three senatorial districts of the state. Hypertension was defined based on the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of Hypertension. Results. Nine hundred and seventy-eight (978 participants were recruited from rural areas and five hundred and ninety (590 from urban centers. The rural populace had higher systolic, diastolic, and mean arterial blood pressure than the urban populace (P<0.001, < 0.002, < 0.001, resp.. The prevalence of hypertension was significantly higher in the rural populace than in the urban populace [44.3% (95% CI 41.1–47.4% versus 28.6% (95% CI 24.9–32.3%]. Age, BMI, and proteinuria were independent predictors of hypertension occurrence. Conclusion. There is an epidemiologic change in the prevalence of hypertension in the rural communities of Nigeria.

  15. Empowering underserved populations through cancer prevention and early detection.

    Science.gov (United States)

    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

    2013-12-01

    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.

  16. Community Development as an Approach to Community Engagement in Rural-Based Higher Education Institutions in South Africa

    Science.gov (United States)

    Netshandama, V. O.

    2010-01-01

    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…

  17. Mobile Phone Intervention to Reduce Youth Suicide in Rural Communities: Field Test.

    Science.gov (United States)

    Pisani, Anthony R; Wyman, Peter A; Gurditta, Kunali; Schmeelk-Cone, Karen; Anderson, Carolyn L; Judd, Emily

    2018-05-31

    Suicide is a leading cause of death among 10- to 19-year-olds in the United States, with 5% to 8% attempting suicide each year. Suicide risk rises significantly during early adolescence and is higher in rural and underserved communities. School-based universal prevention programs offer a promising way of reducing suicide by providing strategies for emotion regulation and encouraging help-seeking behaviors and youth-adult connectedness. However, such programs frequently run into difficulties in trying to engage a broad range of students. Text messaging is a dominant medium of communication among youths, and studies show both efficacy and uptake in text messaging interventions aimed at adolescents. Text-based interventions may, thus, offer a means for school-based universal prevention programs to engage adolescents who would otherwise be difficult to reach. We field tested Text4Strength, an automated, interactive text messaging intervention that seeks to reach a broad range of early adolescents in rural communities. Text4Strength extends Sources of Strength, a peer-led school suicide prevention program, by encouraging emotion regulation, help-seeking behaviors, and youth-adult connectedness in adolescents. The study tested the appeal and feasibility of Text4Strength and its potential to extend universal school-based suicide prevention. We field tested Text4Strength with 42 ninth-grade students. Over 9 weeks, students received 28 interactive message sequences across 9 categories (Sources of Strength introduction, positive friend, mentors, family support, healthy activities, generosity, spirituality, medical access, and emotion regulation strategies). The message sequences included games, requests for advice, questions about students' own experiences, and peer testimonial videos. We measured baseline mental health characteristics, frequency of replies, completion of sequences and video viewing, appeal to students, and their perception of having benefited from the

  18. Production and Perception of Agricultural Reuse in a Rural Community

    Directory of Open Access Journals (Sweden)

    Valmir Cristiano Marques Arruda

    2017-07-01

    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.

  19. 412 awareness and usage of the baobab in rural communities

    African Journals Online (AJOL)

    Osondu

    edible fruits, seeds, leaves, resins, tannins, gums, oils and ... potentials of this free gift of nature and its usage among the rural poor ... Literature Review. Scientific ... 1Department of Agricultural Extension and Rural Development. University of ...

  20. Community health workers in rural India: analysing the opportunities and challenges Accredited Social Health Activists (ASHAs) face in realising their multiple roles.

    Science.gov (United States)

    Saprii, Lipekho; Richards, Esther; Kokho, Puni; Theobald, Sally

    2015-12-09

    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

  1. Occupational Health and Sleep Issues in Underserved Populations.

    Science.gov (United States)

    Kalliny, Medhat; McKenzie, Judith Green

    2017-03-01

    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.

  2. Exercise and Sports Medicine Issues in Underserved Populations.

    Science.gov (United States)

    Morelli, Vincent; Bedney, Daniel L; Eric Dadush, Arie

    2017-03-01

    Primary care providers can make a strong argument for exercise promotion in underserved communities. The benefits are vitally important in adolescent physical, cognitive, and psychological development as well as in adult disease prevention and treatment. In counseling such patients, we should take into account a patient's readiness for change and the barriers to exercise. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Medical students' and GP registrars' accommodation needs in the rural community: insight from a Victorian study.

    Science.gov (United States)

    Han, Gil-Soo; Wearne, Ben; O'Meara, Peter; McGrail, Matthew; Chesters, Janice

    2003-01-01

    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.

  4. Cost-Effective Strategies for Rural Community Outreach, Hawaii, 2010–2011

    Science.gov (United States)

    Barbato, Anna; Holuby, R. Scott; Ciarleglio, Anita E.; Taniguchi, Ronald

    2014-01-01

    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. PMID:25496555

  5. Cost-effective strategies for rural community outreach, Hawaii, 2010-2011.

    Science.gov (United States)

    Pellegrin, Karen L; Barbato, Anna; Holuby, R Scott; Ciarleglio, Anita E; Taniguchi, Ronald

    2014-12-11

    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.

  6. Coaching mental health peer advocates for rural LGBTQ people.

    Science.gov (United States)

    Willging, Cathleen E; Israel, Tania; Ley, David; Trott, Elise M; DeMaria, Catherine; Joplin, Aaron; Smiley, Verida

    Lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) people are affected by mental health disparities, especially in rural communities. We trained peer advocates in rural areas in the fundamentals of mental health, outreach, education, and support for this population. The peer advocates were coached by licensed mental health professionals. We evaluated this process through iterative qualitative analysis of semi-structured interviews and written logs from coaches and advocates. The six major themes comprising the results centered on (1) coaching support, (2) peer advocate skills and preparation, (3) working with help seekers, (4) negotiating diversity, (5) logistical challenges in rural contexts, and (6) systemic challenges. We concluded that peer advocacy for LGBTQ people with mental distress offers an affirmative, community-based strategy to assist the underserved. To be successful, however, peer advocates will likely require ongoing training, coaching, and infrastructural support to negotiate contextual factors that can influence provision of community resources and support to LGBTQ people within rural communities.

  7. Microbial quality of water in rural communities of Trinidad

    Directory of Open Access Journals (Sweden)

    Pedro Welch

    2000-09-01

    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

  8. Microbial quality of water in rural communities of Trinidad

    Directory of Open Access Journals (Sweden)

    Welch Pedro

    2000-01-01

    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

  9. On-line Professional Learning Communities: Increasing Teacher Learning and Productivity in Isolated Rural Communities

    Directory of Open Access Journals (Sweden)

    Dora Salazar

    2010-08-01

    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.

  10. The role of cooperatives in sustaining the livelihoods of rural communities: The case of rural cooperatives in Shurugwi District, Zimbabwe

    Directory of Open Access Journals (Sweden)

    Smart Mhembwe

    2017-04-01

    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.

  11. Self-help initiatives and rural development in Ibesikpo community of ...

    African Journals Online (AJOL)

    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 ...

  12. Cultural Context of School Communities in Rural Hawaii to Inform Youth Violence Prevention

    Science.gov (United States)

    Affonso, Dyanne D.; Mayberry, Linda; Shibuya, June Y.; Archambeau, Olga G.; Correa, Mary; Deliramich, Aimee N.; Frueh, B. Christopher

    2010-01-01

    Background: Escalation of youth violence within a large geographic school-complex area in southeastern rural Hawaii became a major problem in 2006. How cultural forces impact the problem was an impetus to examine youth violence from perspectives of adults and children in rural communities. Gathering these data was an essential first step toward…

  13. The Politics of the MST Autonomous Rural Communities, the State, and Electoral Politics

    NARCIS (Netherlands)

    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

  14. Symbiotic Relationship between Telecentre and Lifelong Learning for Rural Community Development: A Malaysian Experience

    Science.gov (United States)

    Malek, Jalaluddin Abdul; Razaq Ahmad, Abdul; Mahzan Awang, Mohd; Alfitri

    2014-01-01

    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…

  15. Local responses to global technological change – Contrasting restructuring practices in two rural communities in Austria.

    NARCIS (Netherlands)

    Fink, M.; Lang, R..; Harms, Rainer

    2013-01-01

    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

  16. Towards a sustainable knowledge management and development perspective approach: The sustainable rural community development portal

    CSIR Research Space (South Africa)

    Chakwizira, J

    2010-09-01

    Full Text Available development. The philosophy and thinking behind the rural community planning portal is that it will act as a seed for the generation of an inclusive and dynamic rural development agenda that is sensitive and relevant to contemporary issues and challenges...

  17. Children’s Healthy Living (CHL) Program for remote underserved minority populations in the Pacific region: rationale and design of a community randomized trial to prevent early childhood obesity

    Science.gov (United States)

    2013-01-01

    ) framework. Discussion The Children’s Healthy Living Program environmental trial is designed to focus on capacity building and to maximize the likelihood of sustainable impact on childhood obesity-related behaviors and outcomes. The multiple measures at the individual, community, and environment levels are designed to maximize the likelihood of detecting change. This approach enhances the likelihood for identifying and promoting the best methods to promote health and well-being of the children in the underserved US Affiliated Pacific Region. Trial registration NIH clinical trial # NCT01881373 PMID:24107083

  18. Problematizing the Relationship between Rural Small Schools and Communities: Implications for Youth Lives

    Science.gov (United States)

    Cuervo, Hernán

    2014-01-01

    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…

  19. Being Involved in the Country: Productive Ageing in Different Types of Rural Communities

    Science.gov (United States)

    Davis, Sandra; Crothers, Natalie; Grant, Jeanette; Young, Sari; Smith, Karly

    2012-01-01

    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…

  20. A Participatory Systemic Approach To Rural Community Development In Vietnam

    Directory of Open Access Journals (Sweden)

    Tuan M. Ha

    2015-08-01

    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.

  1. Dedicated researcher brings cancer care to rural communities

    Directory of Open Access Journals (Sweden)

    Sharan Bhuller

    2016-10-01

    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

  2. Mitigation Efforts in Rural Communities after Extreme Weather Events - New Insights for Stakeholders

    Directory of Open Access Journals (Sweden)

    Vesela Radovic

    2016-09-01

    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.

  3. Trialing the Community-Based Collaborative Action Research Framework: Supporting Rural Health Through a Community Health Needs Assessment.

    Science.gov (United States)

    Van Gelderen, Stacey A; Krumwiede, Kelly A; Krumwiede, Norma K; Fenske, Candace

    2018-01-01

    To describe the application of the Community-Based Collaborative Action Research (CBCAR) framework to uplift rural community voices while conducting a community health needs assessment (CHNA) by formulating a partnership between a critical access hospital, public health agency, school of nursing, and community members to improve societal health of this rural community. This prospective explorative study used the CBCAR framework in the design, collection, and analysis of the data. The framework phases include: Partnership, dialogue, pattern recognition, dialogue on meaning of pattern, insight into action, and reflecting on evolving pattern. Hospital and public health agency leaders learned how to use the CBCAR framework when conducting a CHNA to meet Affordable Care Act federal requirements. Closing the community engagement gap helped ensure all voices were heard, maximized intellectual capital, synergized efforts, improved communication by establishing trust, aligned resources with initiatives, and diminished power struggles regarding rural health. The CBCAR framework facilitated community engagement and promoted critical dialogue where community voices were heard. A sustainable community-based collaborative was formed. The project increased the critical access hospital's capacity to conduct a CHNA. The collaborative's decision-making capacity was challenged and ultimately strengthened as efforts continue to be made to address rural health.

  4. Safety and community: the maternity care needs of rural parturient women.

    Science.gov (United States)

    Kornelsen, Jude; Grzybowski, Stefan

    2005-06-01

    To investigate rural parturient women's experiences of obstetric care in the context of the social and economic realities of life in rural, remote, and small urban communities. Data collection for this exploratory qualitative study was carried out in 7 rural communities chosen to represent diversity of size, distance to hospital with Caesarean section capability and distance to secondary hospital, usual conditions for transport and access, and cultural and ethnic subpopulations. We interviewed 44 women who had given birth up to 24 months before the study began. When asked about their experiences of giving birth in rural communities, many participants spoke of unmet needs and their associated anxieties. Self-identified needs were largely congruent with the deficit categories of Maslow's hierarchy of needs, which recognizes the contingency and interdependence of physiological needs, the need for safety and security, the need for community and belonging, self-esteem needs, and the need for self-actualization. For many women, community was critical to meeting psychosocial needs, and women from communities that currently have (or have recently had) access to local maternity care said that being able to give birth in their own community or in a nearby community was necessary if their obstetric needs were to be met. Removing maternity care from a community creates significant psychosocial consequences that are imperfectly understood but that probably have physiological implications for women, babies, and families. Further research into rural women's maternity care that considers the loss of local maternity care from multiple perspectives is needed.

  5. Rural community birth: Maternal and neonatal outcomes for planned community births among rural women in the United States, 2004-2009.

    Science.gov (United States)

    Nethery, Elizabeth; Gordon, Wendy; Bovbjerg, Marit L; Cheyney, Melissa

    2017-11-13

    Approximately 22% of women in the United States live in rural areas with limited access to obstetric care. Despite declines in hospital-based obstetric services in many rural communities, midwifery care at home and in free standing birth centers is available in many rural communities. This study examines maternal and neonatal outcomes among planned home and birth center births attended by midwives, comparing outcomes for rural and nonrural women. Using the Midwives Alliance of North America Statistics Project 2.0 dataset of 18 723 low-risk, planned home, and birth center births, rural women (n = 3737) were compared to nonrural women. Maternal outcomes included mode of delivery (cesarean and instrumental delivery), blood transfusions, severe events, perineal lacerations, or transfer to hospital and a composite (any of the above). The primary neonatal outcome was a composite of early neonatal intensive care unit or hospital admissions (longer than 1 day), and intrapartum or neonatal deaths. Analysis involved multivariable logistic regression, controlling for sociodemographics, antepartum, and intrapartum risk factors. Rural women had different risk profiles relative to nonrural women and reduced risk of adverse maternal and neonatal outcomes in bivariable analyses. However, after adjusting for risk factors and confounders, there were no significant differences for a composite of maternal (adjusted odds ratio [aOR] 1.05 [95% confidence interval {CI} 0.93-1.19]) or neonatal (aOR 1.13 [95% CI 0.87-1.46]) outcomes between rural and nonrural pregnancies. Among this sample of low-risk women who planned midwife-led community births, no increased risk was detected by rural vs nonrural status. © 2017 Wiley Periodicals, Inc.

  6. Promoting youth physical activity in rural southern communities: practitioner perceptions of environmental opportunities and barriers.

    Science.gov (United States)

    Edwards, Michael B; Theriault, Daniel S; Shores, Kindal A; Melton, Karen M

    2014-01-01

    Research on youth physical activity has focused on urban areas. Rural adolescents are more likely to be physically inactive than urban youth, contributing to higher risk of obesity and chronic diseases. Study objectives were to: (1) identify perceived opportunities and barriers to youth physical activity within a rural area and (2) identify rural community characteristics that facilitate or inhibit efforts to promote youth physical activity. Thirty in-depth interviews were conducted with expert informants in 2 rural southern US counties. Interviewees were recruited from diverse positions across multiple sectors based on their expert knowledge of community policies and programs for youth physical activity. Informants saw ball fields, natural amenities, and school sports as primary resources for youth physical activity, but they were divided on whether opportunities were abundant or scarce. Physical distance, social isolation, lack of community offerings, and transportation were identified as key barriers. Local social networks facilitated political action and volunteer recruitment to support programs. However, communities often lacked human capital to sustain initiatives. Racial divisions influenced perceptions of opportunities. Despite divisions, there were also examples of pooling resources to create and sustain physical activity opportunities. Developing partnerships and leveraging local resources may be essential to overcoming barriers for physical activity promotion in rural areas. Involvement of church leaders, school officials, health care workers, and cooperative extension is likely needed to establish and sustain youth rural physical activity programs. Allocating resources to existing community personnel and volunteers for continuing education may be valuable. © 2014 National Rural Health Association.

  7. Using Forest Certification to Strengthen Rural Communities: Cases from Northwest Russia.

    NARCIS (Netherlands)

    Meidinger, E.; Tysiachniouk, M.S.

    2006-01-01

    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

  8. Program of active aging in a rural Mexican community: a qualitative approach

    OpenAIRE

    Mendoza-Núñez Víctor; Correa-Muñoz Elsa; de la Luz Martínez-Maldonado María

    2007-01-01

    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...

  9. Detachment from conventional agriculture in rural Japan: An analysis of embedded antifragility in satoyama communities

    OpenAIRE

    Mathé, Daniel Hesby

    2013-01-01

    The thesis examines how socioeconomic and socioecologic changes in rural Japan have affected the embedded antifragility of rural satoyama communities. These communities have traditionally had a high degree of self-sufficiency and been detached from input systems based on synthetic agrichemicals and debt. I spent a month in the Hida region of Japan, where I interviewed villagers in a small mountain village, representatives from the local municipality and observed the conditions for satoyama in...

  10. Building research capacity with members of underserved American Indian/Alaskan Native communities: training in research ethics and the protection of human subjects.

    Science.gov (United States)

    Jetter, Karen M; Yarborough, Mark; Cassady, Diana L; Styne, Dennis M

    2015-05-01

    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.

  11. Linking rural community livelihoods to resilience building in flood risk reduction in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Patrick Gwimbi

    2009-04-01

    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.

  12. Ear, nose, and throat disorders in a nigerian rural community

    Directory of Open Access Journals (Sweden)

    Waheed Atilade Adegbiji

    2017-01-01

    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

  13. An evaluation of the role of rural primary school teachers in community development tasks in southern Sudan

    OpenAIRE

    Ngalam, Jabi Jack

    1987-01-01

    This thesis investigates the role of rural primary school teachers in community development activities within an integrated rural education centres project (IRECs) in southern Sudan. The study explores five areas of importance for an extended teacher's role in rural areas: (i) the school or community environment, (ii) community perception of the teacher's role and its expectations of the school, (iii) teachers' perception of their own role in the community, (iv) teachers' ...

  14. Should Master's Level Training To Provide Rural Services Survive?

    Science.gov (United States)

    Keller, Peter A.

    Despite recent efforts to encourage federal funding of psychological services for underserved populations such as the elderly and residents of rural areas, ample evidence suggests that rural areas are underserved by psychologists. Drawing on data from rural and urban areas in Pennsylvania, this paper argues that master's level training can provide…

  15. 155 Sanitation Indicators in the Rural Communities of the South ...

    African Journals Online (AJOL)

    User

    2012-01-24

    Jan 24, 2012 ... consistently focused on the improvement of water supply and public toilets at ... Igwe et al (2008) reported that access to safe water in the rural areas hovers ... urban centres (>25km) and are typically rural settlements where the main ... groups, with 50.4 percent of them as males and 49.6 percent as females.

  16. Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

    Science.gov (United States)

    Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

    2007-01-01

    Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

  17. Factors that motivate young pharmacists to work in rural communities in the Ukraine.

    Science.gov (United States)

    Anzenberger, Peter; Popov, Sergey B; Ostermann, Herwig

    2011-01-01

    A number of identified factors can influence clinicians' location of practice decisions; however, little is known about the location decisions of pharmacists. In general, males are more likely to work in rural and remote regions, and students with a rural background are more likely to work in rural communities after graduation. In the Ukraine, pharmaceutical health care is important because a patient's first visit is often to the pharmacy, rather than to a GP. This study sought to understand what motivates Ukraine pharmacy students to practice in rural areas. The first part of the study used a quantitative design with questionnaires based on Füglistaller's model for measuring the motivation of entrepreneurs, because working in a rural Ukraine pharmacy means, in most cases, operating a privately owned pharmacy. The second part was qualitative to verify these results. The students' motivation to work in rural areas after graduation depended on their sex and place of birth, but this was not decisive. More influential were the factors that motivate operating a privately owned pharmacy. Within the group that considered working in a privately owned pharmacy in a rural community, motivation was more intrinsic (eg enjoys helping people), while negative factors were more external (eg financial risk). Students from the National University of Pharmacy in Kharkiv comprise the majority of pharmacists in the Ukraine. They are interested in working in a rural area as long as opportunities align with their individual expectations. The two main factors found that would supply more young graduates to rural areas were: (1) improving rural living conditions; and (2) fostering the mental attitude required for operating a private pharmacy. In addition, decreasing related bureaucracy, and increasing financial and fiscal grants may enhance medical and pharmaceutical health care in rural communities of the Ukraine.Key words: graduate pharmacists, living conditions, motivation, privately

  18. Place Identity, Participation, and Emotional Climate in a Rural Community From the Northern Coast of Peru.

    Science.gov (United States)

    Freire, Silvana; Espinosa, Agustín; Rottenbacher, Jan Marc

    2015-01-01

    Currently, in rural communities from the Peruvian northern coast, it is common to find a climate of distrust and pessimism that accompanies the lack of coordinated social action and community participation among residents. This study analyzes the relationships that people develop with regard to the place where they live in, how it associates to the ways they participate in their community and the relationship that these two variables have with the perceived emotional climate, in a rural community from the northern coast of Peru (n = 81). Results indicate that place identity is significantly associated with a high community participation and a climate of trust in the community. Finally, a Path Analysis is performed to analyze comprehensively the relationship between these variables. The results suggest that place identity does have an influence on perceived positive climate in the community, being mediated by the dimensions of community participation.

  19. GERIATRIC HEALTH PROBLEMS IN A RURAL COMMUNITY OF BANGLADESH

    Directory of Open Access Journals (Sweden)

    Shaila Ahmed

    2007-07-01

    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

  20. Rural health care bypass behavior: how community and spatial characteristics affect primary health care selection.

    Science.gov (United States)

    Sanders, Scott R; Erickson, Lance D; Call, Vaughn R A; McKnight, Matthew L; Hedges, Dawson W

    2015-01-01

    (1) To assess the prevalence of rural primary care physician (PCP) bypass, a behavior in which residents travel farther than necessary to obtain health care, (2) To examine the role of community and non-health-care-related characteristics on bypass behavior, and (3) To analyze spatial bypass patterns to determine which rural communities are most affected by bypass. Data came from the Montana Health Matters survey, which gathered self-reported information from Montana residents on their health care utilization, satisfaction with health care services, and community and demographic characteristics. Logistic regression and spatial analysis were used to examine the probability and spatial patterns of bypass. Overall, 39% of respondents bypass local health care. Similar to previous studies, dissatisfaction with local health care was found to increase the likelihood of bypass. Dissatisfaction with local shopping also increases the likelihood of bypass, while the number of friends in a community, and commonality with community reduce the likelihood of bypass. Other significant factors associated with bypass include age, income, health, and living in a highly rural community or one with high commuting flows. Our results suggest that outshopping theory, in which patients bundle services and shopping for added convenience, extends to primary health care selection. This implies that rural health care selection is multifaceted, and that in addition to perceived satisfaction with local health care, the quality of local shopping and levels of community attachment also influence bypass behavior. © 2014 National Rural Health Association.

  1. Evolutionary Approach of Virtual Communities of Practice: A Reflection within a Network of Spanish Rural Schools

    Science.gov (United States)

    Frossard, Frédérique; Trifonova, Anna; Barajas Frutos, Mario

    The isolation of rural communities creates special necessities for teachers and students in rural schools. The present article describes "Rural Virtual School", a Virtual Community of Practice (VCoP) in which Spanish teachers of rural schools share learning resources and teaching methodologies through social software applications. The article arrives to an evolutionary model, in which the use of the social software tools evolves together with the needs and the activities of the VCoP through the different stages of its lifetime. Currently, the community has reached a high level of maturity and, in order to keep its momentum, the members intentionally use appropriate technologies specially designed to enhance rich innovative educational approaches, through which they collaboratively generate creative practices.

  2. A new inter-professional course preparing learners for life in rural communities.

    Science.gov (United States)

    Medves, Jennifer; Paterson, Margo; Chapman, Christine Y; Young, John H; Tata, Elizabeth; Bowes, Denise; Hobbs, Neil; McAndrews, Brian; O'Riordan, Anne

    2008-01-01

    The 'Professionals in Rural Practice' course was developed with the aim of preparing students enrolled in professional programs in Canada to become better equipped for the possible eventuality of professional work in a rural setting. To match the reality of living and working in a rural community, which by nature is interprofessional, the course designers were an interprofessional teaching team. In order to promote group cohesiveness the course included the participation of an interprofessional group of students and instructors from the disciplines of medicine, nursing, occupational therapy, physical therapy, teacher education, and theology. The format of the course included three-hour classes over an eight-week period and a two-day field experience in a rural community. The course utilized various experiential and interactive teaching and learning methods, along with a variety of assessment methods. Data were collected from student participants over two iterations of the course using a mixed methods approach. Results demonstrate that students value the interprofessional and experiential approach to learning and viewed this course as indispensable for gaining knowledge of other professions and preparation for rural practice. The data reveal important organizational and pedagogical considerations specific to interprofessional education, community based action research, and the unique interprofessional nature of training for life and work in a rural community. This study also indicates the potential value of further longitudinal study of participants in this course. Key words: Canada, community based action research, education, interdisciplinary, interprofessional.

  3. POISON CONTROL—Operation of an Information Center in a Rural and Agricultural Community

    Science.gov (United States)

    Bocian, J. J.

    1960-01-01

    The Fresno Community Hospital Poison Control Center has been in operation for about three years, under the sole directorship of the pathologist. All expenses are paid by the hospital. It has served a definite need in the community. As an agricultural and more or less rural community, it shows more poison cases having to do with plants, insecticides, kerosene and fertilizers than do urban communities. PMID:13801875

  4. An exploration of the longer-term impacts of community participation in rural health services design.

    Science.gov (United States)

    Farmer, Jane; Currie, Margaret; Kenny, Amanda; Munoz, Sarah-Anne

    2015-09-01

    This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008-2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project. Only one direct sustained service change was found - introduction of a volunteer first responder scheme in one community. Sustained changes in knowledge were found. The Health Authority that part-funded development of the community participation method, through the original project, had not adopted the new method. Community members tended to attribute lack of further impact to low participation and methods insufficiently attuned to the social nuances of very small rural communities. Managers tended to blame insufficient embedding in the healthcare system and issues around power over service change and budgets. In the absence of convincing formal community governance mechanisms for health issues, rural health practitioners tended to act as conduits between citizens and the Health Authority. The study provides new knowledge about what happens after community participation and highlights a need for more exploration. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Leadership Advocacy: Bringing Nursing to the Homeless and Underserved.

    Science.gov (United States)

    Porter-OʼGrady, Tim

    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.

  6. Improving Sanitation Project Management for Unsewered Rural Communities in Morocco

    Directory of Open Access Journals (Sweden)

    M MAHI

    2015-06-01

    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.

  7. Determinants of Teenage Pregnancy in Rural Communities of Abia ...

    African Journals Online (AJOL)

    Aim: To investigate the determinants of teenage pregnancies in a rural ... demographic status, age of sexual debut, use of condoms, pregnancy and its ... Teenage pregnancy was significantly associated with age, occupation, no education, ...

  8. Use of Modern Birth Control Methods Among Rural Communities in ...

    African Journals Online (AJOL)

    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 ...

  9. Smart Growth Self-Assessment for Rural Communities: Madison County

    Science.gov (United States)

    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.

  10. Community-environment relations and development of rural ...

    African Journals Online (AJOL)

    user

    African Journal of Environmental Science and. Technology ... Structured questionnaire was applied to collect data on 35 independent and 22 dependent variables. .... environment have wide applicability for rural development hence the variables are ...... African Development: A geographical Perspective. Longman,. London.

  11. Assessment of community led total sanitation uptake in rural Kenya

    African Journals Online (AJOL)

    K. N. Ogendo, Bsc, MPH, Living goods Nairobi, Kenya,Ministry of Health, Environmental Health ... led drive to set up pit latrines in rural kenya with an aim of promoting sustainable ... Development and Sustainable Development goals lay.

  12. Use of Modern Birth Control Methods Among Rural Communities in ...

    African Journals Online (AJOL)

    elearning

    ABSTRACT. This paper studied the extent of utilization of Modern Birth Control Methods (MBCM) among rural dwellers in ... respondents used MBCM while 57% of them used the traditional birth control methods. ..... School of Public Health.

  13. Equitable access: Remote and rural communities 'transport needs'

    OpenAIRE

    White, Peter

    2011-01-01

    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...

  14. Participation of rural communities in the process of development

    OpenAIRE

    Ališauskas, Kęstutis; Jankauskienė, Aida; Klovienė, Jurgita

    2010-01-01

    Participation of rural organizations in rural development manifests by two characteristic positions. The first Position exists because many village problems are interrelated: if the economic situation of the place is bad, then in most cases its infrastructure and living conditions are poor as well. In this case problems are tackled in an integral way, i.e., all the problems are viewed as interrelated areas. The second position is based on the principle to bring together as many peoples' initi...

  15. Precommitting to Serve the Underserved

    Science.gov (United States)

    Eyal, Nir; Bärnighausen, Till

    2014-01-01

    In many countries worldwide, especially in Sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas. PMID:22548519

  16. Precommitting to serve the underserved.

    Science.gov (United States)

    Eyal, Nir; Bärnighausen, Till

    2012-01-01

    In many countries worldwide, especially in sub-Saharan Africa, a shortage of physicians limits the provision of lifesaving interventions. One existing strategy to increase the number of physicians in areas of critical shortage is conditioning medical school scholarships on a precommitment to work in medically underserved areas later. Current practice is usually to demand only one year of service for each year of funded studies. We show the effectiveness of scholarships conditional on such precommitment for increasing physician supplies in underserved areas. Then we defend these scholarships against ethical worries that they constitute slavery contracts; rely on involuntary, biased, or unauthorized early consent by a young signatory; put excessive strains on signed commitments; give rise to domination; and raise suspicion of slavery contracts. Importantly, we find that scholarships involving far longer commitment than current practice allows would also withstand these worries. Policymakers should consider introducing conditional scholarships, including long-term versions, as a means to increasing the supply of physicians to medically underserved areas.

  17. The Cooperative Organization And Rural Passenger Transportation: An Approach to Community Development.

    Science.gov (United States)

    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…

  18. Perceptions of Students at a Rural Mississippi Community College Regarding Employability

    Science.gov (United States)

    Harrris, Cortney R.

    2013-01-01

    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…

  19. The Role of Community Based Orgs (Cbos) In Rural and Agricultural ...

    African Journals Online (AJOL)

    The result showed that community based organizations are veritable agents of development in ensuring the agricultural and rural transformation of Delta State. The study recommended that there is need to develop a link between the state and community us so as to increase the managerial and professional capabilities of ...

  20. Perceptions of the Environment for Eating and Exercise in a Rural Community

    Science.gov (United States)

    Maley, Mary Maly; Warren, Barbour S.; Devine, Carol M.

    2010-01-01

    Objective: To understand how members of a rural community perceive the effect of the built, natural, and social environments on their food choice and physical activity behaviors. Methods: A constructivist community environmental assessment was conducted including 17 individual qualitative interviews, 2 focus groups, and photo elicitation (n = 27)…

  1. Community perceptions of a rural medical school : a pilot qualitative study

    NARCIS (Netherlands)

    Nestel, Debra; Gray, Katherine; Simmons, Margaret; Pritchard, Shane A; Islam, Rumana; Eng, Wan Q; Ng, Adrian; Dornan, Tim

    2014-01-01

    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

  2. He Could Be Undocumented: Striving to Be Sensitive to Student Documentation Status in a Rural Community

    Science.gov (United States)

    Crawford, Emily R.; Hairston, Sarah L.

    2018-01-01

    This case study takes place in a Midwestern, politically conservative rural community shortly after a highly contested presidential election. Like other communities, Paisano has experienced demographic change in a relatively short time. Meat processing plants and construction jobs proliferate, attracting migrant workers. One day, secondary school…

  3. Factors Related to Communication of Forest Fire Prevention Messages, a Study of Selected Rural Communities.

    Science.gov (United States)

    Griessman, B. Eugene; Bertrand, Alvin L.

    Two rural Louisiana communities were selected to evaluate the effectiveness of certain types of communication in preventing man-caused forest fires. The communities were selected on the basis of differences in fire occurrence rates and other factors related to conservation. Questionnaires and personal interviews were utilized to determine views of…

  4. Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples.

    Science.gov (United States)

    Smith, Tina Anderson; Adimu, Tanisa Foxworth; Martinez, Amanda Phillips; Minyard, Karen

    2016-01-01

    This paper explores how communities translate evidence-based and promising health practices to rural contexts. A descriptive, qualitative analysis was conducted using data from 70 grantees funded by the Federal Office of Rural Health Policy to implement evidence-based health practices in rural settings. Findings were organized using The Interactive Systems Framework for Dissemination and Implementation. Grantees broadly interpreted evidence-based and promising practices, resulting in the implementation of a patchwork of health-related interventions that fell along a spectrum of evidentiary rigor. The cohort faced common challenges translating recognized practices into rural community settings and reported making deliberate modifications to original models as a result. Opportunities for building a more robust rural health evidence base include investments to incentivize evidence-based programming in rural settings; rural-specific research and theory-building; translation of existing evidence using a rural lens; technical assistance to support rural innovation; and prioritization of evaluation locally.

  5. Appropriate training and retention of community doctors in rural areas: a case study from Mali

    Directory of Open Access Journals (Sweden)

    Coulibaly Seydou

    2008-11-01

    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

  6. Appropriate training and retention of community doctors in rural areas: a case study from Mali.

    Science.gov (United States)

    Van Dormael, Monique; Dugas, Sylvie; Kone, Yacouba; Coulibaly, Seydou; Sy, Mansour; Marchal, Bruno; Desplats, Dominique

    2008-11-18

    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. 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. 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. 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 training institutions are necessary, other types of professional support are needed

  7. Provisioning of game meat to rural communities as a benefit of sport hunting in Zambia.

    Directory of Open Access Journals (Sweden)

    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.

  8. Provisioning of game meat to rural communities as a benefit of sport hunting in Zambia.

    Science.gov (United States)

    White, Paula A; Belant, Jerrold L

    2015-01-01

    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.

  9. Differences in health care seeking behaviour between rural and urban communities in South Africa

    Science.gov (United States)

    2012-01-01

    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-economic characteristics, health status, beliefs about health and (access to) health care was collected. Results 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). Conclusion 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. PMID:22691443

  10. The Community Health Applied Research Network (CHARN) Data Warehouse: a Resource for Patient-Centered Outcomes Research and Quality Improvement in Underserved, Safety Net Populations.

    Science.gov (United States)

    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

    2014-01-01

    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.

  11. The role and organisation of community palliative specialist nursing teams in rural England.

    Science.gov (United States)

    Leadbeater, Maria; Staton, Wendy

    2014-11-01

    This article describes a study that used a qualitative approach, purposive sampling and semi-structured telephone interviews conducted with specialist palliative care nurses from six rural community teams in England. The study investigated how services were organised and the issues of delivering specialist palliative nursing care in a rural area. Qualitative content analysis was used to analyse the data. The findings showed many similarities in that the majority of patients in rural areas were not accessing hospice services and there was a greater reliance on care at home. However, the challenges in delivering care ranged from managing patient expectations, geographical distance, lack of technology to support remote working and education for the specialist palliative care teams. The study makes specific recommendations for rural community specialist palliative care teams.

  12. Participatory Design to Enhance ICT Learning and Community Attachment: A Case Study in Rural Taiwan

    Directory of Open Access Journals (Sweden)

    Yi-Ting Huang

    2015-03-01

    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.

  13. Childbirth in a rural highlands community in Papua New Guinea: a descriptive study.

    Science.gov (United States)

    Vallely, Lisa M; Homiehombo, Primrose; Kelly-Hanku, Angela; Vallely, Andrew; Homer, Caroline S E; Whittaker, Andrea

    2015-03-01

    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.

  14. Community mobilisation with women's groups facilitated by Accredited Social Health Activists (ASHAs to improve maternal and newborn health in underserved areas of Jharkhand and Orissa: study protocol for a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Sinha Rajesh

    2011-07-01

    Full Text Available Abstract Background Around a quarter of the world's neonatal and maternal deaths occur in India. Morbidity and mortality are highest in rural areas and among the poorest wealth quintiles. Few interventions to improve maternal and newborn health outcomes with government-mandated community health workers have been rigorously evaluated at scale in this setting. The study aims to assess the impact of a community mobilisation intervention with women's groups facilitated by ASHAs to improve maternal and newborn health outcomes among rural tribal communities of Jharkhand and Orissa. Methods/design The study is a cluster-randomised controlled trial and will be implemented in five districts, three in Jharkhand and two in Orissa. The unit of randomisation is a rural cluster of approximately 5000 population. We identified villages within rural, tribal areas of five districts, approached them for participation in the study and enrolled them into 30 clusters, with approximately 10 ASHAs per cluster. Within each district, 6 clusters were randomly allocated to receive the community intervention or to the control group, resulting in 15 intervention and 15 control clusters. Randomisation was carried out in the presence of local stakeholders who selected the cluster numbers and allocated them to intervention or control using a pre-generated random number sequence. The intervention is a participatory learning and action cycle where ASHAs support community women's groups through a four-phase process in which they identify and prioritise local maternal and newborn health problems, implement strategies to address these and evaluate the result. The cycle is designed to fit with the ASHAs' mandate to mobilise communities for health and to complement their other tasks, including increasing institutional delivery rates and providing home visits to mothers and newborns. The trial's primary endpoint is neonatal mortality during 24 months of intervention. Additional

  15. "We can see a future here": Place attachment, professional identity, and forms of capital mobilized to deliver medical education in an underserviced area.

    Science.gov (United States)

    Hanlon, Neil; Halseth, Greg; Snadden, David

    2010-09-01

    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.

  16. An empirical approach to selecting community-based alcohol interventions: combining research evidence, rural community views and professional opinion

    Directory of Open Access Journals (Sweden)

    Shakeshaft Anthony

    2012-01-01

    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.

  17. Localizing HIV/AIDS discourse in a rural Kenyan community.

    Science.gov (United States)

    Banda, Felix; Oketch, Omondi

    2011-01-01

    This paper examines the effectiveness of multimodal texts used in HIV/AIDS campaigns in rural western Kenya using multimodal discourse analysis (Kress and Van Leeuwen, 2006; Martin and Rose, 2004). Twenty HIV/AIDS documents (posters, billboards and brochures) are analysed together with interview data (20 unstructured one-on-one interviews and six focus groups) from the target group to explore the effectiveness of the multimodal texts in engaging the target rural audience in meaningful interaction towards behavioural change. It is concluded that in some cases the HIV/AIDS messages are misinterpreted or lost as the multimodal texts used are unfamiliar and contradictory to the everyday life experiences of the rural folk. The paper suggests localization of HIV/AIDS discourse through use of local modes of communication and resources.

  18. Epidemiology of Hymenolepis nana infections in primary school children in urban and rural communities in Zimbabwe.

    Science.gov (United States)

    Mason, P R; Patterson, B A

    1994-04-01

    Fecal specimens were obtained on 3 occasions at 10-12 wk intervals from 315 children in 3 rural villages in Zimbabwe and from 351 children in the high-density suburbs of an adjacent small town. Specimens were examined qualitatively and quantitatively for eggs of Hymenolepis nana, and these were found in 142 (21%) children. Infections occurred more frequently in younger children in the urban area but in older children in rural areas. The prevalence in urban areas (24%) was higher than in rural areas (18%), and in urban areas infection correlated with low "hygiene scores" (determined by observation) and with the presence in the household of an infected sibling. The prevalence of infection in the 3 rural communities did not correlate with availability of water, number of households per toilet, with low "hygiene scores," or with the presence of an infected sibling. Treatment with a single oral dose of 15 mg/kg praziquantel cured 84% of the infected children. New or reinfections occurred more frequently in households that had an infected sibling in an urban but not rural setting. The study demonstrates distinct differences in the transmission of H. nana infection in rural and urban communities. The data suggest intrafamily transmission in urban areas, particularly in households with poor hygiene behavior, leading to primary infection early in life. In rural areas, the prevalence of infection and the incidence of reinfection were highest in children of school age, and there was little evidence for intrafamily transmission of the parasite.

  19. Association between community garden participation and fruit and vegetable consumption in rural Missouri.

    Science.gov (United States)

    Barnidge, Ellen K; Hipp, Pamela R; Estlund, Amy; Duggan, Kathleen; Barnhart, Kathryn J; Brownson, Ross C

    2013-11-19

    Fruit and vegetable consumption reduces chronic disease risk, yet the majority of Americans consume fewer than recommended. Inadequate access to fruits and vegetables is increasingly recognized as a significant contributor to low consumption of healthy foods. Emerging evidence shows the effectiveness of community gardens in increasing access to, and consumption of, fruits and vegetables. Two complementary studies explored the association of community garden participation and fruit and vegetable consumption in rural communities in Missouri. The first was with a convenience sample of participants in a rural community garden intervention who completed self-administered surveys. The second was a population-based survey conducted with a random sample of 1,000 residents in the intervention catchment area. Participation in a community garden was associated with higher fruit and vegetable consumption. The first study found that individuals who worked in a community garden at least once a week were more likely to report eating fruits and vegetables because of their community garden work (X² (125) = 7.78, p = .0088). Population-based survey results show that 5% of rural residents reported participating in a community garden. Those who reported community garden participation were more likely to report eating fruits 2 or more times per day and vegetables 3 or more times per day than those who did not report community garden participation, even after adjusting for covariates (Odds Ratio [OR] = 2.76, 95% Confidence Interval [CI] = 1.35 to 5.65). These complementary studies provide evidence that community gardens are a promising strategy for promoting fruit and vegetable consumption in rural communities.

  20. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Science.gov (United States)

    Mberu, Blessing U.; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C.

    2016-01-01

    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 better mortality

  1. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis.

    Science.gov (United States)

    Mberu, Blessing U; Haregu, Tilahun Nigatu; Kyobutungi, Catherine; Ezeh, Alex C

    2016-01-01

    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

  2. Health and health-related indicators in slum, rural, and urban communities: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Blessing U. Mberu

    2016-12-01

    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

  3. An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

    Science.gov (United States)

    Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

    2014-06-01

    "The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.

  4. What community characteristics help or hinder rural communities in becoming age-friendly? Perspectives from a Canadian prairie province.

    Science.gov (United States)

    Spina, John; Menec, Verena H

    2015-06-01

    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.

  5. Cultural context of school communities in rural Hawaii to inform youth violence prevention.

    Science.gov (United States)

    Affonso, Dyanne D; Mayberry, Linda; Shibuya, June Y; Archambeau, Olga G; Correa, Mary; Deliramich, Aimee N; Frueh, B Christopher

    2010-03-01

    Escalation of youth violence within a large geographic school-complex area in southeastern rural Hawaii became a major problem in 2006. How cultural forces impact the problem was an impetus to examine youth violence from perspectives of adults and children in rural communities. Gathering these data was an essential first step toward school-based youth violence prevention program development. Eight focus groups involving 86 community stakeholders included 51 adults (parent, teachers, school staff, community leaders) and 35 children aged 8-15 years old (3rd- to 10-th grade). Qualitative narrative analysis elicited major themes. Five themes emerged: (1) School-community violence takes on many forms that become entrenched in local culture. (2) Disintegration of community resources and a sense of learned helplessness underlie the escalation of youth violence. (3) Inadequate role modeling coupled with behavioral ambivalence among adults has sustained a climate of local cultural acceptance with youth violence. (4) Connection to cultural values has diminished, leading to a sense of loss in cultural identity among students. (5) Cultural values and practices are potential strategies for youth violence prevention. Cultural and community contextual factors contributed to youth violence in rural Hawaiian communities. Study implications include the need to further investigate the impact of vigilant, community involvement of stakeholders in school-based youth violence prevention program development. Cultural revitalization at family, school, and community levels may be critical success factors of such programs.

  6. The complexity of rural contexts experienced by community disability workers in three southern African countries

    Directory of Open Access Journals (Sweden)

    Margaret Booyens

    2015-06-01

    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.

  7. An investigation into possibilities for implementation of a virtual community of practice delivered via a mobile social network for rural community media in the Eastern Cape, South Africa

    Directory of Open Access Journals (Sweden)

    Oliva Muwanga-Zake

    2017-03-01

    Full Text Available Background: The purpose of this article is to provide an overview of how a virtual community of practice can be delivered via a mobile social networking framework to support rural community media in the Eastern Cape Province of South Africa. Objectives: The article presents the results of a study conducted to ascertain the possibilities of utilising mobile social networking as a means to provide access to required information and knowledge to rural community media through creation of a virtual community of practice. Improving the operational effectiveness of rural community media as a component of the rural community communication process would serve to improve the entire rural community communication process as well, making them more effective tools for availing relevant news and information to rural communities and reflecting the realities of rural communities to their broader environment. Method: The study was conducted on rural community media small micro and medium enterprises (SMMEs in the Eastern Cape Province of South Africa. The study applied an interpretive research philosophy, qualitative research design and multiple–case study approach. Primary data were collected through semi-structured interviews supported by a questionnaire, with secondary data collected via literature review, observation and documentation analysis. Results: Findings were that rural community media do make use of social media and mobile devices in operating their business, require access to generic and domain specific support services and actively engage their peers and stakeholders in this respect, although no formalised structure existed. The authors’ recommendation is to create a formalised virtual community of practice through the establishment of a mobile social network. Conclusion: Because of the fact that rural community SMMEs already utilise mobile devices and social media to operate their businesses, development of a solution based on a mobile social

  8. A Comparison of Didactic and Inquiry Teaching Methods in a Rural Community College Earth Science Course

    Science.gov (United States)

    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.

  9. Heritage and Patrimony of the Peasantry Framework and Rural Development Indicators in Rural Communities in Mexico

    Directory of Open Access Journals (Sweden)

    Fabio Alberto Pachon Ariza

    Full Text Available Abstract: The analytical framework “heritage and patrimony of the peasantry” and its recommended implementation theoretically provide an enhancement over previous methodologies to examine rural development. The current paper measures rural development indicators in six Mexican rural territories, and analyses their interaction in the heritages and patrimonies of the peasantry. The principal indicators that affect the patrimonies in these regions were recognised as Pluriactivity, Social Acknowledgment, Biodiversity and Recycling. Based on these outcomes, the indicators that belong to the Human Patrimony define it as the lowest of all the heritages of the Mexican peasantry. The analysis of the results remarks on the fact that the emphasis of public policies on productive concerns has left out complicated social problems such as the loss of identity, diversity and culture. These matters are becoming the strongest threat affecting the Mexican peasantry to improve their quality of life while respecting their human rights.

  10. Rural communities as sites of knowledge: A case for African ...

    African Journals Online (AJOL)

    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.

  11. Helminthic infections among farmers in a rural community in Oyo ...

    African Journals Online (AJOL)

    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 ...

  12. Perinatal mortality in a rural community | Ewah | East African Medical ...

    African Journals Online (AJOL)

    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 ...

  13. Nutritional Status of Adolescent Girls from Rural Communities of ...

    African Journals Online (AJOL)

    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 ...

  14. Small Business Success in Rural Communities: Explaining the Sex Gap.

    Science.gov (United States)

    Bird, Sharon R.; Sapp, Stephen G.; Lee, Motoko Y.

    2001-01-01

    Supporting a "structural relational" view of small business success, data from 423 small business owners in Iowa suggest that links between owner characteristics, social relational processes, business structure, and success operate differently depending on urban-rural location and owner sex. Female owners had more professional training…

  15. Farmers' Markets in Rural Communities: A Case Study

    Science.gov (United States)

    Alfonso, Moya L.; Nickelson, Jen; Cohen, Danielle

    2012-01-01

    Background: Although the potential health benefits of farmers markets have been discussed for years, there is a dearth of literature to aid health educators in advocating for the development of local farmers markets. Purpose: The purpose of this manuscript is to present a case study of a rural farmers market in southeast Georgia with emphasis on…

  16. environmental health situation of three rural communities living

    African Journals Online (AJOL)

    2017-09-13

    Sep 13, 2017 ... Abstract. In order to update on the state of the environment, a cross-sectional survey was ... rural areas (Layo, Ahua and N'djem) in the front of Ebrié lagoon, to identify risk behaviors threatening .... MATERIAL AND METHODS.

  17. Metabolic Syndrome in a Rural Nigerian Community: Is Central ...

    African Journals Online (AJOL)

    Alasia Datonye

    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 ...

  18. Strong Hearts, Healthy Communities: A Community-Based Randomized Trial for Rural Women.

    Science.gov (United States)

    Seguin, Rebecca A; Paul, Lynn; Folta, Sara C; Nelson, Miriam E; Strogatz, David; Graham, Meredith L; Diffenderfer, Anna; Eldridge, Galen; Parry, Stephen A

    2018-05-01

    The aim of this study was to evaluate a multilevel cardiovascular disease (CVD) prevention program for rural women. This 6-month, community-based, randomized trial enrolled 194 sedentary rural women aged 40 or older with BMI ≥ 25 kg/m 2 . Intervention participants attended 6 months of twice-weekly exercise, nutrition, and heart health classes (48 total) that included individual-, social-, and environment-level components. An education-only control program included didactic healthy lifestyle classes once a month (six total). The primary outcome measures were change in BMI and weight. Within-group and between-group multivariate analyses revealed that only intervention participants decreased BMI (-0.85 units; 95% CI: -1.32 to -0.39; P = 0.001) and weight (-2.24 kg; 95% CI: -3.49 to -0.99; P = 0.002). Compared with controls, intervention participants decreased BMI (difference: -0.71 units; 95% CI: -1.35 to -0.08; P = 0.03) and weight (1.85 kg; 95% CI: -3.55 to -0.16; P = 0.03) and improved C-reactive protein (difference: -1.15 mg/L; 95% CI: -2.16 to -0.15; P = 0.03) and Simple 7, a composite CVD risk score (difference: 0.67; 95% CI: 0.14 to 1.21; P = 0.01). Cholesterol decreased among controls but increased in the intervention group (-7.85 vs. 3.92 mg/dL; difference: 11.77; 95% CI: 0.57 to 22.96; P = 0.04). The multilevel intervention demonstrated modest but superior and meaningful improvements in BMI and other CVD risk factors compared with the control program. © 2018 The Obesity Society.

  19. Perceived community environment and physical activity involvement in a northern-rural Aboriginal community

    Directory of Open Access Journals (Sweden)

    Lévesque Lucie

    2007-12-01

    Full Text Available Abstract Background Type 2 diabetes disproportionately affects Aboriginal peoples in Canada. Ample evidence shows that regular physical activity (PA plays an important role in the prevention and treatment of type 2 diabetes. Evidence is beginning to emerge linking PA to the physical environment but little is known about the relationship between remote rural environments and PA involvement in Aboriginal peoples. This study's purpose was to investigate the relationship between perceptions of the environment and PA and walking patterns in Aboriginal adults in order to inform the planning and implementation of community-relevant PA interventions. Methods Two hundred and sixty three residents (133 women, mean age = 35.6 years, SD = 12.3 and 130 men, mean age = 37.2 years, SD = 13.1 from Moose Factory, Ontario were asked about environmental factors related to walking and PA involvement. Survey items were drawn from standardized, validated questionnaires. Descriptive statistics (means, standard deviations, percentages were calculated. A series of hierarchical multiple regressions were performed to determine associations between walking and overall PA with perceived environmental variables. Results Hierarchical multiple regression to predict walking revealed significant associations between walking and perceived safety and aesthetics. Owning home exercise equipment predicted strenuous PA. Different aspects of the physical environment appear to influence different types of physical activities. The significant amount of variance in behaviour accounted for by perceived environmental variables (5.3% walking included safety, aesthetics, convenience, owning home exercise equipment and comfortable shoes for walking. Conclusion Results suggest that a supportive physical environment is important for PA involvement and that walking and activities of different intensity appear to be mediated by different perceived environmental variables. Implications for PA

  20. Rural and small-town attitudes about alcohol use during pregnancy: a community and provider sample.

    Science.gov (United States)

    Logan, T K; Walker, Robert; Nagle, Laura; Lewis, Jimmie; Wiesenhahn, Donna

    2003-01-01

    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.

  1. Innovation technological energetics in rural communities. Case of study community of “Manantiales”, Villa Clara, Cuba

    Directory of Open Access Journals (Sweden)

    Raul Olalde Font

    2016-10-01

    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.

  2. Ensuring safe access to medication for palliative care while preventing prescription drug abuse: innovations for American inner cities, rural areas, and communities overwhelmed by addiction

    Directory of Open Access Journals (Sweden)

    Francoeur RB

    2011-09-01

    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

  3. Making basic health care accessible to rural communities: a case study of Kiang West district in rural Gambia.

    Science.gov (United States)

    Sanneh, Edward Saja; Hu, Allen H; Njai, Modou; Ceesay, Omar Malleh; Manjang, Buba

    2014-01-01

    This study focuses on lack of access to basic health care, which is one of the hindrances to the development of the poor, and subjects them to the poverty penalty. It also focuses on contributing to the Bottom of the Pyramid in a general sense, in addition to meeting the health needs of communities where people live on less than $1 a day. Strengthened multistakeholder responses and better-targeted, low-cost prevention, and care strategies within health systems are suggested to address the health burdens of poverty-stricken communities. In this study, a multistakeholder model which includes the government, World Health Organization, United Nations Children Emergency Fund, and the Medical Research Council was created to highlight the collaborative approach in rural Gambia. The result shows infant immunization and antenatal care coverage were greatly improved which contributes to the reduction in mortality. This case study also finds that strategies addressing health problems in rural communities are required to achieve 'Millennium Development Goals'. In particular, actual community visits to satellite villages within a district (area of study) are extremely vital to making health care accessible. © 2013 Wiley Periodicals, Inc.

  4. The Biofuels Revolution: Understanding the Social, Cultural and Economic Impacts of Biofuels Development on Rural Communities

    Energy Technology Data Exchange (ETDEWEB)

    Selfa, Theresa L; Goe, Richard; Kulcsar, Laszlo; Middendorf, Gerad; Bain, Carmen

    2013-02-11

    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.

  5. Men's Educational Group Appointments in Rural Nicaragua.

    Science.gov (United States)

    Campbell, Bruce B; Gonzalez, Hugo; Campbell, McKenzie; Campbell, Kent

    2017-03-01

    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.

  6. Unintended consequences of regulating drinking water in rural Canadian communities: examples from Atlantic Canada.

    Science.gov (United States)

    Kot, Megan; Castleden, Heather; Gagnon, Graham A

    2011-09-01

    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.

  7. Development of a Faith-Based Stress Management Intervention in a Rural African American Community.

    Science.gov (United States)

    Bryant, Keneshia; Moore, Todd; Willis, Nathaniel; Hadden, Kristie

    2015-01-01

    Faith-based mental health interventions developed and implemented using a community-based participatory research (CBPR) approach hold promise for reaching rural African Americans and addressing health disparities. To describe the development, challenges, and lessons learned from the Trinity Life Management, a faith-based stress management intervention in a rural African American faith community. The researchers used a CBPR approach by partnering with the African American faith community to develop a stress management intervention. Development strategies include working with key informants, focus groups, and a community advisory board (CAB). The community identified the key concepts that should be included in a stress management intervention. The faith-based "Trinity Life Management" stress management intervention was developed collaboratively by a CAB and an academic research team. The intervention includes stress management techniques that incorporate Biblical principles and information about the stress-distress-depression continuum.

  8. Scars of disengagement: perspectives on community leadership and youth engagement in rural South Africa.

    Science.gov (United States)

    Majee, Wilson; Jooste, Karien; Aziato, Lydia; Anakwe, Adaobi

    2017-08-01

    Given the emerging global youth disengagement epidemic, anticipated population growth, and the threat of continued rural-urban migration among young adults, recent research has focused on community leadership practice and the factors that influence youth engagement at the local level. Studying these practices and factors can elicit interventions that can improve youth engagement and youth health. This study engaged South African rural community leaders in interviews to collect perceptions and experiences on community leadership and factors that influence youth engagement and their health behaviors. Content analysis was used to analyze the data. Emergent themes are categorized into four domains: conceptualizations of leadership, current youth behaviors, barriers to youth engagement, and youth leadership opportunities and potential solutions. Findings demonstrate a clear grasp of the concept of community leadership among community leaders, and an awareness of the complex interplay of social, economic and environmental factors on youth disengagement and the potential interventions to promote more youth participation.

  9. The important role of springs in South Africa's rural water supply: The case study of two rural communities in South Africa

    CSIR Research Space (South Africa)

    Nkuna, Z

    2014-12-01

    Full Text Available rural communities are geographically located in hard to reach areas due to their dispersed nature and bad terrain. In South Africa, these conditions have made it particularly expensive and difficult for water service providers to effect services to rural...

  10. Ageing in rural China: impacts of increasing diversity in family and community resources.

    Science.gov (United States)

    Joseph, A E; Phillips, D R

    1999-06-01

    The majority of China's population lives in rural areas and a pattern is emerging of very uneven provision of support for rural elderly people. Local economic conditions and broad demographic trends are creating diversity in the ability both of rural families to care for their elderly kin and in the capacity of communities to support their elderly residents and family carers. In part as a consequence of China's population policy and the 'one-child policy', future Chinese families will have fewer members and be 'older', but they will continue to be regarded emotionally and in policy as the main source of economic and social support for the elderly. The increasing involvement of women in the paid workforce and the changing geographical distribution of family members resulting from work-related migration, are reducing the ability of families to care for their elderly relatives. The availability of resources other than the family for the care of older persons therefore becomes a key issue. Communities in more prosperous, modernising rural areas are often able to provide their elderly residents with welfare and social benefits previously found almost exclusively in urban areas. However, in poorly developed rural areas, provision is either very patchy or non-existent and the local economy cannot support expansion or improvement. A case study in Zhejiang Province illustrates the favourable provision for ageing in a prosperous modernising rural community, in which entitled elderly residents are provided with an impressive array of financial and social benefits. The paper concludes with a consideration of the policy implications of the growing differentiation of the social and economic capacity of rural communities to support their elderly members.

  11. Community Interactive Processes and Rural Adolescents’ Educational Achievement: Investigating the Mediating Effects of Delinquency and Self-Esteem

    Directory of Open Access Journals (Sweden)

    Omolola A. Adedokun

    2008-09-01

    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.

  12. Developing e-banking services for rural India: making use of socio-technical prototypes

    OpenAIRE

    Dittrich, Yvonne; Vaidyanathan, Lakshmi; Gonsalves, Timothy A; Jhunjhunwala, Ashok

    2017-01-01

    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 ...

  13. Hearing loss and social support in urban and rural communities.

    Science.gov (United States)

    Hay-McCutcheon, Marcia J; Hyams, Adriana; Yang, Xin; Parton, Jason

    2018-04-19

    Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama. The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered. Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss. Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction). Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.

  14. Building the Capacity of States to Ensure Inclusion of Rural Communities in State and Local Primary Violence Prevention Planning

    Science.gov (United States)

    Cook-Craig, Patricia G.; Lane, Karen G.; Siebold, Wendi L.

    2010-01-01

    Rural, frontier, and geographically isolated communities face unique challenges associated with ensuring that they are equal partners in capacity-building and prevention planning processes at the state and local level despite barriers that can inhibit participation. By their nature, rural, frontier, and geographically isolated communities and…

  15. Partnering on a Curriculum To Address the Dental Care Crisis in a Rural Island Community: The First Step of a Career Ladder Program in Dental Assisting.

    Science.gov (United States)

    Pezzoli, J. A.; Johnson, Nancy

    This document describes the curriculum and objectives of the Certificate of Completion in Dental Assisting at Maui Community College, Hawaii. Hawaii is below the national average in oral health care, with as many as 40% of Maui residents being underserved. Dental disease among the uninsured and underinsured in Hawaii is three times the national…

  16. Psychiatric treatment of children and adolescents in rural communities. Myths and realities.

    Science.gov (United States)

    Cook, A D; Copans, S A; Schetky, D H

    1998-07-01

    Rural child and adolescent psychiatry offers many challenges, a varied and interesting practice, and the satisfaction of performing needed and important work in an environment in which one's presence is valued. The successful psychiatrist can expect to be an integrated and appreciated member of the community. The fit is not a good one for every practitioner, however. Not only are incomes lower, although the cost of living is low as well, but practitioners may find they have only exchanged urban stresses for rural pressures. The characteristics important for the child and adolescent psychiatrist are the same for rural and urban settings: flexibility, creativity and innovation, competence, self confidence, a good sense of boundaries, a good balance between personal and private life, supportive personal relationships, and a sense of humor. One must be a child advocate, have a willingness to give of one's self and one's time, and be down to earth, comfortable with oneself, and capable of self entertainment. Training programs with access to rural populations can introduce residents to rural child and adolescent psychiatry while supporting those who are already in practice. The authors hope that this article will promote a dialogue with psychiatrists considering relocation to a rural area and encourage training programs to prepare residents for rural practice.

  17. Attitude about mental illness of health care providers and community leaders in rural Haryana, North India

    Directory of Open Access Journals (Sweden)

    Harshal Ramesh Salve

    2014-12-01

    Full Text Available Background: Attitude about mental illness determines health seeking of the people. Success of National Mental Health Programme (NMHP is dependent on attitude about mental illness of various stakeholders in the programme. Material & Methods: A community based cross-sectional study was carried out in Ballabgarh block of Faridabad district in Haryana. We aimed to study attitude about mental illness of various stakeholders of health care providers (HCP, community leaders in rural area of Haryana, north India. Study area consisting of five Primary Health Centers (PHCs serving 2,12,000 rural population. All HCP working at PHCs, Accredited Social Health Activist (ASHA and community leaders in study area were approached for participation. Hindi version of Opinion about Mental illness Scale for Chinese Community (OMICC was used to study attitude. Results: In total, 467 participants were participated in the study. Of which, HCP, ASHAs and community leaders were 81 (17.4%, 145 (31.0% and 241 (51.6% respectively. Community members reported socially restrictive, pessimistic and stereotyping attitude towards mentally ill person. ASHA and HCP reported stereotyping attitude about person with mental illness. None of the stakeholders reported stigmatizing attitude. Conclusion: Training programme focusing on spectrum of mental illness for HCP and ASHA working in rural area under NMHP programme is needed. Awareness generation of community leaders about bio-medical concept of mental illness is cornerstone of NMHP success in India.

  18. The Issue of Poverty in the Urban and Rural Communities in Romania

    Directory of Open Access Journals (Sweden)

    ELISA PARASCHIV

    2008-03-01

    Full Text Available The main objective of this work is to answer questions which are relevant for the process of preparing anti-poverty strategies.The major discrepancy between the rural and urban environment with respect to the aspects mentioned above is one of the main conclusions. However, the residence environment usually represents only one of the dimensions or one of the influential factors of poverty in Romania, without any systematic study of the differences/resemblances between urban and rural poverty. In this respect, the study represents a complementary study for the previous analyses, a synthesis of the existent knowledge of resemblances between urban poverty and rural poverty and, implicitly, of the adequate political instruments for combating each of these aspects. According to the arguments presented by the author, in Romania, poverty is territorially concentrated, at the level of both the communities and the households, from the perspective of consumerism, and rural poverty is the key issue of poverty in Romania.

  19. Control of deaths from diarrheal disease in rural communities: II. Motivating and monitoring the community.

    Science.gov (United States)

    Kielmann, A A; Nagaty, A; Ajello, C A

    1986-03-01

    In 1980 the Ministry of Health of Egypt undertook a short term investigation into means and methods to reduce the annually excessive number of preschool child deaths from Diarrheal Disease. This investigation sought to identify ways to overcome constraints related to logistics, supplies, and community participation. The unifying theme of this study was to examine the feasibility of stressing Oral Rehydration Therapy (ORT) instead of the then conventional parenteral treatment and heavy use of antibiotics. Study cells were arranged to test feasibility of placing responsibility for the intervention primarily with rural mothers, secondly with itinerant nurses. Appropriate health education programs, revised supervision and data collection systems were developed and implemented. Results limited to mortality indicators demonstrating that mothers could affect a significant decrease in the diarrhea-specific death rate were reported in an earlier paper. In this paper a more comprehensive presentation of various survey data associated with the investigation are presented. These data show that mothers were indeed able to recognize diarrheal disease and institute early and effective treatment, and that they developed remarkable skills of preparing safe oral rehydration fluids from home supplies of sugar and salt. In addition, the data show that health service staff increasingly gained confidence in ORT as demonstrated by increasing rates of utilization of the method, and as mothers indicated ORT to be the preferred method of treatment of diarrheal disease.

  20. Reaching Rural Handicapped Children: The Transportation Situation in Rural Service Delivery. Making It Work in Rural Communities. A Rural Network Monograph.

    Science.gov (United States)

    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,…

  1. Implementing an anti-smoking program in rural-remote communities: challenges and strategies.

    Science.gov (United States)

    Tall, Julie A; Brew, Bronwyn K; Saurman, Emily; Jones, Therese C

    2015-01-01

    Rural-remote communities report higher smoking rates and poorer health outcomes than that of metropolitan areas. While anti-smoking programs are an important measure for addressing smoking and improving health, little is known of the challenges faced by primary healthcare staff implementing those programs in the rural-remote setting. The aim of this study was to explore the challenges and strategies of implementing an anti-smoking program by primary healthcare staff in rural-remote Australia. Guided by a phenomenological approach, semi-structured interviews and focus groups were conducted with health service managers, case managers and general practitioners involved in program implementation in Australian rural-remote communities between 2008 and 2010. Program implementation was reported to be challenged by limited primary and mental healthcare resources and client access to services; limited collaboration between health services; the difficulty of accessing staff training; high levels of community distress and disadvantage; the normalisation of smoking and its deleterious impact on smoking abstinence among program clients; and low morale among health staff. Strategies identified to overcome challenges included appointing tobacco-dedicated staff; improving health service collaboration, access and flexibility; providing subsidised pharmacotherapies and boosting staff morale. Findings may assist health services to better tailor anti-smoking programs for the rural-remote setting, where smoking rates are particularly high. Catering for the unique challenges of the rural-remote setting is necessary if anti-smoking programs are to be efficacious, cost-effective and capable of improving rural-remote health outcomes.

  2. Influence of depression, anxiety and stress on cognitive performance in community-dwelling older adults living in rural Ecuador: results of the Atahualpa Project.

    Science.gov (United States)

    Del Brutto, Oscar H; Mera, Robertino M; Del Brutto, Victor J; Maestre, Gladys E; Gardener, Hannah; Zambrano, Mauricio; Wright, Clinton B

    2015-04-01

    To assess the relationship between cognitive status and self-reported symptoms of depression, anxiety and stress of older adults living in an underserved rural South American population. Community-dwelling Atahualpa residents aged ≥60 years were identified during a door-to-door census, and evaluated with the Depression Anxiety Stress Scale-21 (DASS-21) and the Montreal Cognitive Assessment (MoCA). We explored whether positivity in each of the DASS-21 axes was related to total and domain-specific MoCA performance after adjustment for age, sex and education. A total of 280 persons (59% women; mean age, mean age 70 ± 8 years) were included. Based on established cut-offs for the DASS-21, 12% persons had depression, 15% had anxiety and 5% had stress. Mean total MoCA scores were significantly lower for depressed than for not depressed individuals (15.9 ± 5.5 vs 18.9 ± 4.4, P Depressed participants had significantly lower total and domain-specific MoCA scores for abstraction, short-term memory and orientation. Anxiety was related to significantly lower total MoCA scores (17 ± 4.7 vs 18.8 ± 4.5, P = 0.02), but not to differences in domain-specific MoCA scores. Stress was not associated with significant differences in MoCA scores. The present study suggests that depression and anxiety are associated with poorer cognitive performance in elderly residents living in rural areas of developing countries. © 2014 Japan Geriatrics Society.

  3. Building resilience to food insecurity in rural communities: Evidence from traditional institutions in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Emmanuel Mavhura

    2017-06-01

    Full Text Available Many rural communities that depend on smallholder farming face food insecurity induced by climate-related disasters. In response, some communities are taking the initiative to cope and adapt to climate-related disasters. Using case study material from the Zambezi Valley, Zimbabwe, this article examines how traditional institutions are enhancing resilience to food insecurity in rural areas. The data were collected through interviews and focus groups involving traditional leaders, ward councillors, village civil protection members and villagers selected in the valley. The findings point to how the Zunde raMambo informal safety net, nhimbe form of collective work and the practice of share-rearing arrangement to access draught power help save lives and alleviate food insecurity induced by flood or drought disasters. The study concludes that the three schemes are evidence of community reorganisation or change in response to food insecurity. They are a form of absorptive capacities enabling the community to cope with food insecurity.

  4. The Implementation of TTG Book Service Done By Community Library in Rural Area

    Directory of Open Access Journals (Sweden)

    Pawit Muhammad Yusup

    2016-06-01

    Full Text Available The problem of poverty in rural areas cannot be separated from the following aspects: poverty, lack of education facilities, low level of entrepreneurial skills, health, lack of learning facilities, population distribution, infrastructure and facilities are inadequate, access to information, and other aspects that are still limited. The Village Library and Community Library as part of the affordable infrastructure and learning facilities are, not yet available in every village. This study tried to introduce pilot models Appropriate Technology Implementation Services Book through Rural Libraries and the community library to a number of poor people in the village. The result could contribute in improving the skills of a number of rural poor in entrepreneurship-based reading. This service models can be applied in other similar villages.

  5. Chapter 6: Incorporating rural community characteristics into forest management decisions

    Science.gov (United States)

    Mindy S. Crandall; Jane L. Harrison; Claire A. Montgomery

    2014-01-01

    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...

  6. can volunteer community health workers in rural Uganda provide

    African Journals Online (AJOL)

    Introduction: Integrated community case management (iCCM) involves assessment and treatment of common .... vention units to accommodate budgets, logistics, and su- ... wooden medicine box with a starter supply of pre-pack- ..... chain management and medium-term outcomes. .... Global experience of community health.

  7. Community Participation and Project Sustainability in Rural Nigeria ...

    African Journals Online (AJOL)

    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 ...

  8. Implementation of oral health initiatives by Australian rural communities: Factors for success.

    Science.gov (United States)

    Taylor, Judy; Carlisle, Karen; Farmer, Jane; Larkins, Sarah; Dickson-Swift, Virginia; Kenny, Amanda

    2018-01-01

    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.

  9. Community Participation and Barriers in Rural Tourism: A Case Study in Kiulu, Sabah

    OpenAIRE

    Velnisa Paimin N. F.; Modilih S.; Mogindol S. H.; Johnny C.; Thamburaj J. A.

    2014-01-01

    The paper presents an investigation on local community participation and barriers in rural tourism. It identifies two sides of community participation in tourism as identified by Timothy [5], which are; the benefits point of view and from the decision making process perspective. It also identifies the communities’ barriers in engaging in tourism and uses Tosun’s [18] approach in examining the barriers. A total of eighty-three questionnaire forms were completed by respondents from seven villag...

  10. Building a community of practice in rural medical education: growing our own together.

    Science.gov (United States)

    Longenecker, Randall L; Schmitz, David

    2017-01-01

    This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice. However, by the 1980s, these programs were not yet producing the desired numbers of rural physicians. In response, in 1986, Maudlin and others at the family medicine residency in Spokane developed the first 1-2 RTT in Colville, Washington. In the 1990s, and by 2000, early news of success led to a peak of 35 active programs. However, over the next decade these programs experienced significant hardship due to a lack of funding and a general decline in student interest in family medicine. By 2010, only 25 programs remained. In 2010, in an effort to sustain the 1-2 RTT as a national strategy in training physicians for rural practice, a federally funded consortium of individuals and programs established the RTT Technical Assistance program (RTT TA). Building on the pattern of peer support and collaboration set by earlier groups, the RTT TA consortium expanded the existing community of practice in rural medical education in support of RTTs. In-person meetings, peer consultation and visitation, coordinated efforts at student recruitment, and collaborative rural medical education research were all elements of the consortium's strategy. Rather than anchoring its efforts in medical schools or hospitals, this consortium engaged as partners a wider variety of stakeholders. This included physician educators still living and practicing in rural communities ('local experts'), rural medical educator peers, program directors

  11. Field Testing of a Small Water Purification System for Non-PRASA Rural Communities

    Science.gov (United States)

    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...

  12. Theoretical framework for government information service delivery to deep rural communities in South Africa

    CSIR Research Space (South Africa)

    Mvelase, PS

    2009-10-01

    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...

  13. Family Perspectives on Pathways to Mental Health Care for Children and Youth in Rural Communities

    Science.gov (United States)

    Boydell, Katherine M.; Pong, Raymond; Volpe, Tiziana; Tilleczek, Kate; Wilson, Elizabeth; Lemieux, Sandy

    2006-01-01

    Context: There is insufficient literature documenting the mental health experiences and needs of rural communities, and a lack of focus on children in particular. This is of concern given that up to 20% of children and youth suffer from a diagnosable mental health problem. Purpose: This study examines issues of access to mental health care for…

  14. Rural Community-Based Tourism and its Impact on Ecological Consciousness, Environmental Stewardship and Social Structures

    DEFF Research Database (Denmark)

    Raftopoulos, Malayna

    2018-01-01

    Since rural community-based tourism (RCBT) emerged, it has been widely considered to be an effective means of promoting development and conserving natural resources. Through a political ecology approach, this article explores the potential of RCBT to foster long-term stewardship and transformations...

  15. Rural School In The Context Of Community-Led Local Development*

    Directory of Open Access Journals (Sweden)

    Hudečková H.

    2015-03-01

    Full Text Available The paper is based on the general concept of knowledge society and deals with regional development theories which emphasize local environment as an important part of rural development. The following two questions were studied: (1 What is the early experience of municipalities when establishing a Community School? (2 In which other municipalities would it be possible and appropriate to build such a school? For this purpose, both secondary and primary research methods were combined with data collection techniques – document study, observation, and questioning. Because the examined problem is set in the context of community-led local development (CLLD, violation of the ‘bottom-up’ approach principle is also highlighted. The paper presents the first experiences in the establishment of seven Community Schools within the Pilsen region and based on them also recommendations for the feasibility and suitability of establishing this type of school in other rural municipalities. The results show that the educational sector is not assisting in the modernization of rural schools with regard to community education and that the possibility of the contemporary and meaningful existence of schools in small rural municipalities remains ignored.

  16. Participatory Rural Appraisal as an Approach to Environmental Education in Urban Community Gardens.

    Science.gov (United States)

    Doyle, Rebekah; Krasny, Marianne

    2003-01-01

    Describes the Cornell University Garden Mosaics program in which youth learn about ethnic gardening practices in urban community gardens using research methods adapted from the Participatory Rural Appraisal (PRA). Conducts a study to determine whether youth could effectively facilitate PRA activities with gardeners and to document any social and…

  17. Districts on the Edge: The Impact of Urban Sprawl on a Rural Community.

    Science.gov (United States)

    Theobald, Paul

    1988-01-01

    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.…

  18. Patient safety problem identification and solution sharing among rural community pharmacists.

    Science.gov (United States)

    Galt, Kimberly A; Fuji, Kevin T; Faber, Jennifer

    2013-01-01

    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.

  19. Social entrepreneurship: A foundation for “creative capitalism” in rural African communities

    CSIR Research Space (South Africa)

    van Rensburg, JFJ

    2008-11-01

    Full Text Available The authors wish to share some of their current learning in the creation of social enterprises to act as primary support mechanisms for Infopreneurs (“creative capitalists”) in the rural African communities. The objective is to attract interested...

  20. Barriers Affecting Physical Activity in Rural Communities: Perceptions of Parents and Children

    Science.gov (United States)

    McWhinney, Sharon; McDonald, Andrea; Dawkins-Moultin, Lenna; Outley, Corliss; McKyer, E. Lisako; Thomas, Audrene

    2011-01-01

    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…

  1. Partnering with Communities to Address the Mental Health Needs of Rural Veterans

    Science.gov (United States)

    Kirchner, JoAnn E.; Farmer, Mary Sue; Shue, Valorie M.; Blevins, Dean; Sullivan, Greer

    2011-01-01

    Purpose: Many veterans who face mental illness and live in rural areas never obtain the mental health care they need. To address these needs, it is important to reach out to community stakeholders who are likely to have frequent interactions with veterans, particularly those returning from Operations Enduring and Iraqi Freedom (OEF/OIF). Methods:…

  2. The Internet & Regional Australia: How Rural Communities Can Address the Impact of the Internet.

    Science.gov (United States)

    Simpson, Rosie

    In the last decade, a technological revolution has touched all aspects of business and society in Australia, the Western world, and to a lesser extent, the developing world. This revolution has occurred against a backdrop of long-term fundamental changes in rural Australian communities. The decline in traditional agriculture's terms of trade and…

  3. Exploring Culturally Specific Drug Resistance Strategies of Hawaiian Youth in Rural Communities

    Science.gov (United States)

    Okamoto, Scott K.; Po'a-Kekuawela, Ka'ohinani; Chin, Coralee I. H.; Nebre, La Risa H.; Helm, Susana

    2010-01-01

    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…

  4. The College Transition for First-Year Students from Rural Oregon Communities

    Science.gov (United States)

    Ganss, Karen M.

    2016-01-01

    This study explores the lived experiences of 10 students entering college from rural Oregon communities. Using narrative inquiry, the author examines students' transition, common experiences, and enrollment barriers. Resulting themes include: (a) unexpected emotional and social transition, (b) motivations for enrolling, (c) lack of social and…

  5. Learning Innovative Maternal Instinct: Activity Designing Semantic Factors of Alcohol Modification in Rural Communities of Thailand

    Science.gov (United States)

    Yodmongkol, Pitipong; Jaimung, Thunyaporn; Chakpitak, Nopasit; Sureephong, Pradorn

    2014-01-01

    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…

  6. A Community Stakeholder Analysis of Drug Resistance Strategies of Rural Native Hawaiian Youth

    Science.gov (United States)

    Okamoto, Scott K.; Helm, Susana; Delp, Justin A.; Stone, Kristina; Dinson, Ay-Laina; Stetkiewicz, Jennifer

    2011-01-01

    This study examines and validates the drug resistance strategies identified by rural Hawaiian youth from prior research with a sample of community stakeholders on the Island of Hawai'i. One hundred thirty-eight stakeholders with a vested interest in reducing youth substance use (i.e., teachers, principals, social service agency providers, and…

  7. The Geography of Rape: Rape Victims in Urban and Rural Communities

    DEFF Research Database (Denmark)

    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...

  8. Pattern of Eye Diseases in Kaduna State – A rural community ...

    African Journals Online (AJOL)

    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 ...

  9. Tailoring Retention Theories to Meet the Needs of Rural Appalachian Community College Students

    Science.gov (United States)

    Hlinka, Karen R.

    2017-01-01

    Objective: Traditional-age students attending a rural community college in Kentucky's Appalachian region were interviewed, along with faculty members and administrators, to identify phenomena serving as sources of encouragement or as barriers to retention from the point of entry to the point of transfer. Method: Students' perspectives were…

  10. Extending connections between land and people digitally: designing with rural Herero communities in Namibia

    CSIR Research Space (South Africa)

    Bidwell, NJ

    2012-06-01

    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...

  11. Preparedness of South African deep rural SMMEs to deliver e-government services to local communities

    CSIR Research Space (South Africa)

    Dlodlo, N

    2009-10-01

    Full Text Available This paper reports on a research to assess the readiness of Small, Medium and Micro Enterprises (SMMEs) to deliver e-government services to deep rural communities through information dissemination by the SMMEs. This research was conducted as a case...

  12. Child gender preferences in an urban and rural community in Enugu ...

    African Journals Online (AJOL)

    Conclusion: Son preference exists in the rural and urban community in Enugu State however a balanced preference is also common especially in the urban area. Recommendation: Family education especially on gender equality and sensitivity was recommended. Keywords: Son preference, balanced preference, Urban, ...

  13. What explains the Rural-Urban Gap in Infant Mortality — Household or Community Characteristics?

    NARCIS (Netherlands)

    E. Van de Poel (Ellen); O.A. O'Donnell (Owen); E.K.A. van Doorslaer (Eddy)

    2007-01-01

    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

  14. Tourist preferences for ecotourism in rural communities adjacent to Kruger National Park: A choice experiment approach

    NARCIS (Netherlands)

    Chaminuka, P.; Groeneveld, R.A.; Selomane, A.O.; Ierland, van E.C.

    2012-01-01

    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

  15. Four Generations of Women's Educational Experience in a Rural Chinese Community

    Science.gov (United States)

    Huang, Haigen; Placier, Peggy

    2015-01-01

    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,…

  16. Project GRACE: a staged approach to development of a community-academic partnership to address HIV in rural African American communities.

    Science.gov (United States)

    Corbie-Smith, Giselle; Adimora, Adaora A; Youmans, Selena; Muhammad, Melvin; Blumenthal, Connie; Ellison, Arlinda; Akers, Aletha; Council, Barbara; Thigpen, Yolanda; Wynn, Mysha; Lloyd, Stacey W

    2011-03-01

    The HIV epidemic is a health crisis in rural African American communities in the Southeast United States; however, to date little attention has been paid to community-academic collaborations to address HIV in these communities. Interventions that use a community-based participatory research (CBPR) approach to address individual, social, and physical environmental factors have great potential for improving community health. Project GRACE (Growing, Reaching, Advocating for Change and Empowerment) uses a CBPR approach to develop culturally sensitive, feasible, and sustainable interventions to prevent the spread of HIV in rural African American communities. This article describes a staged approach to community-academic partnership: initial mobilization, establishment of organizational structure, capacity building for action, and planning for action. Strategies for engaging rural community members at each stage are discussed; challenges faced and lessons learned are also described. Careful attention to partnership development has resulted in a collaborative approach that has mutually benefited both the academic and community partners.

  17. Stated environmental preferences in a Romanian rural community

    OpenAIRE

    Toma, Luiza; Mathijs, Erik

    2004-01-01

    This article uses random utility theory to analyse the economic and environmental trade-offs at farm level in a Romanian rural area confronting water pollution on the basis of survey data. To underline the impact of socio-economic variables in the decision-making process at farm level as regards environmental choices, a binary logit model is estimated that includes socio-economic variables in addition to the attributes in the choice set. The study shows that heterogeneity in tastes is partial...

  18. Pattern and Trend of Substance Abuse in Eastern Rural Iran: A Household Survey in a Rural Community

    Directory of Open Access Journals (Sweden)

    Hasan Ziaaddini

    2013-01-01

    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.

  19. Nurses who work in rural and remote communities in Canada: a national survey.

    Science.gov (United States)

    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

    2017-05-23

    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

  20. The application of a biometric identification technique for linking community and hospital data in rural Ghana.

    Science.gov (United States)

    Odei-Lartey, Eliezer Ofori; Boateng, Dennis; Danso, Samuel; Kwarteng, Anthony; Abokyi, Livesy; Amenga-Etego, Seeba; Gyaase, Stephaney; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2016-01-01

    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.

  1. The Journey to Meet Emerging Community Benefit Requirements in a Rural Hospital: A Case Study

    Science.gov (United States)

    Sabin, Allison V; Levin, Pamela F

    2015-10-22

    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.

  2. Detecting the changes in rural communities in Taiwan by applying multiphase segmentation on FORMOSA-2 satellite imagery

    Science.gov (United States)

    Huang, Yishuo

    2015-09-01

    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

  3. Empowering rural communities to minimize wildlife related diseases ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-04-27

    Apr 27, 2016 ... ... of zoonotic diseases (those of animal origin) on animal and human ... turn trained other community members about disease management. ... portrays a burgeoning youth-owned business landscape in Africa, as millions of y.

  4. Uses, benefits and challenges of using rural community telecentres ...

    African Journals Online (AJOL)

    Journal of Development and Communication Studies ... The findings indicate that the users are improving their skills and knowledge, school performance, ... The community uses the telecentre to improve work related skills, keep in touch with ...

  5. Helping communities control leishmaniasis in rural Tunisia | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-05-05

    May 5, 2016 ... And with agricultural settlements spreading into areas that had been pastoral, ... factors, local farming practices, and the ecology of vector and host species. ... Involving urban communities in controlling dengue fever in Latin ...

  6. Cost-effectiveness of community screening for glaucoma in rural India: a decision analytical model.

    Science.gov (United States)

    John, D; Parikh, R

    2018-02-01

    Studies in several countries have demonstrated the cost-effectiveness of population-based screening for glaucoma when targeted at high-risk groups such as older adults and with familial history of disease. This study conducts a cost-effective analysis of a hypothetical community screening and subsequent treatment programme in comparison to opportunistic case finding for glaucoma in rural India. A hypothetical screening programme for both primary open-angle glaucoma and angle-closure disease was built for a population aged between 40 and 69 years in rural areas of India. A decision analytical model was built to model events, costs and treatment pathways with and without a hypothetical screening programme for glaucoma for a rural-based population aged between 40 and 69 years in India. The treatment pathway included both primary open-angle glaucoma and angle-closure disease. The data on costs of screening and treatment were provided by an administrator of a tertiary eye hospital in Eastern India. The probabilities for the screening and treatment pathway were derived from published literature and a glaucoma specialist. The glaucoma prevalence rates were adapted from the Chennai Glaucoma Study findings. An incremental cost-effectiveness ratio value of ₹7292.30 per quality-adjusted life-year was calculated for a community-screening programme for glaucoma in rural India. The community screening for glaucoma would treat an additional 2872 cases and prevent 2190 person-years of blindness over a 10-year period. Community screening for glaucoma in rural India appears to be cost-effective when judged by a ratio of willingness-to-pay thresholds as per WHO-CHOICE guidelines. For community screening to be cost-effective, adequate resources, such as trained medical personnel and equipment would need to be made available. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. Learning Preferences and Impacts of Education Programs in Dog Health Programs in Five Rural and Remote Australian Indigenous Communities

    Science.gov (United States)

    Constable, Sophie; Dixon, Roselyn; Dixon, Robert

    2011-01-01

    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…

  8. [Food insecurity in rural communities in Northeast Brazil: does belonging to a slave-descendent community make a difference?

    Science.gov (United States)

    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

    2017-06-01

    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.

  9. Stroke care challenges in rural India: Awareness of causes, preventive measures and treatment options of stroke among the rural communities

    Directory of Open Access Journals (Sweden)

    Kanaga Lakshmi

    2014-12-01

    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.

  10. Late-life depression in Rural China: do village infrastructure and availability of community resources matter?

    Science.gov (United States)

    Li, Lydia W; Liu, Jinyu; Zhang, Zhenmei; Xu, Hongwei

    2015-07-01

    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.

  11. Community perceptions of mental illness in rural Uganda: An analysis of existing challenges facing the Bwindi Mental Health Programme

    Science.gov (United States)

    2017-01-01

    Objectives To assess community perceptions of mental illness in the Bwindi Community Hospital (BCH) catchment area: to recognise beliefs about the causes and the treatments for mental illness. To provide community data to staff at BCH as they work to develop more effective community mental health programmes. Background A shortage of mental health providers in Uganda has prompted research into community-based task-sharing models for the provision of mental health services in underserved communities. Methods Six focus group discussions, with a total of 54 community members (50% male, n = 27; mean age + s.d. [39.9 + 10.9 years]) from the BCH catchment area, were conducted to assess community member and stakeholder perceptions of mental illness and belief in the feasibility of community-based programming. Qualitative study of data through thematic analysis was conducted to assess the presence of commonly occurring perceptions. Results Qualitative thematic analysis revealed two major themes: (1) belief that any given patient’s metal illness results from either an intrinsic or an extrinsic cause and (2) belief in a need to determine treatment of mental illness based on the believed cause. Conclusion As BCH designs community-based mental health services, our findings provide support for the need for further education of community members and training of community health workers to address and integrate the above-stated beliefs regarding mental illness. PMID:29041798

  12. Exploring the social relations of Roma employability: The case of rural segregated communities in Romania

    Directory of Open Access Journals (Sweden)

    Loreni Elena Baciu

    2016-04-01

    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.

  13. General surgery graduates may be ill prepared to enter rural or community surgical practice.

    Science.gov (United States)

    Gillman, Lawrence M; Vergis, Ashley

    2013-06-01

    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.

  14. WAYS FOR DEVELOPMENT OF RURAL COMMUNITIES IN VALCEA COUNTY

    Directory of Open Access Journals (Sweden)

    Remus STOIAN

    2014-12-01

    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.

  15. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China.

    Science.gov (United States)

    Li, Man; Zhong, Renyao; Zhu, Shanwen; Ramsay, Lauren C; Li, Fen; Coyte, Peter C

    2018-06-06

    Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1) explore regional differences in community living infrastructure; and (2) to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015)”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  16. Access to Community Living Infrastructure and Its Impact on the Establishment of Community-Based Day Care Centres for Seniors in Rural China

    Directory of Open Access Journals (Sweden)

    Man Li

    2018-06-01

    Full Text Available Community-based day care centres play an important role in service delivery for Chinese seniors. Little research has examined how community living infrastructure has influenced the establishment of these day care centres in rural communities. The purposes of this study were: (1 explore regional differences in community living infrastructure; and (2 to examine the impact of such infrastructure on the establishment of day care centres for Chinese seniors in rural communities. The data were derived from “The Fourth Sample Survey on the Living Conditions of Elderly People in Urban and Rural China (2015”. The establishment of at least one day care centre was the outcome of interest, which was dichotomized at the community level into the establishment of at least one day care centre or the absence of any day care centres. Logistic regression analysis was employed to examine the impact of various community living infrastructural characteristics on the establishment of day care centres. The results showed that of the 4522 rural communities surveyed in 2015, only 10.1% had established at least one day care centre. Community living infrastructural characteristics that were significantly associated with the establishment of day care centres were the availability of cement/asphalt roads, natural gas, tap drinking water, sewage systems, and centralized garbage disposal. Our findings suggest that the significant association between community-level characteristics, especially community living infrastructure, and the establishment of rural day care centre for seniors may inform policy decision making.

  17. The burden of hypertension and diabetes mellitus in rural communities in southern Nigeria.

    Science.gov (United States)

    Isara, Alphonsus Rukevwe; Okundia, Patrick Otamere

    2015-01-01

    The African region of the world is experiencing a double epidemic of both communicable and non-communicable diseases. The objective of the study was to determine the prevalence of hypertension and diabetes mellitus among adult residents of rural communities in southern Nigeria. A community based descriptive cross-sectional study. Adults aged 18 years and above residing in the rural communities who attended a free medical outreach programme were screened for hypertension and diabetes mellitus. Data were collected using a structured interviewer-administered questionnaire. Of the 845 participants, 349 (41.3%) were aged 50-69 years, 263 (31.1%) were males, and 305 (36.1%) were farmers. Overweight and obesity were found in 184 (21.8%) and 90 (10.6%) of them respectively. The overall prevalence of hypertension was 37.6% (males 43.7%, females 35.1%, p = 0.018) while that of diabetes mellitus was 4.6% (males 1.9%, females 5.8%, p = 0.012). Predictors of hypertension were age ≥ 40 years (OR = 5.04, CI: 2.99 - 8.48), overweight/obesity (OR = 1.56, CI: 1.15 - 2.13) while females are less likely to develop hypertension (OR = 0.72, CI: 0.53 - 0.98). The significant predictor of diabetes mellitus was overweight/obesity (OR = 3.53, CI: 1.78 - 6.98). The rising prevalence of hypertension and diabetes mellitus is assuming an epidemic level in rural communities in southern Nigeria. There is an urgent need for intensive health education and community surveillance programmes targeted at rural communities in order to achieve prevention and control of these non-communicable diseases in Nigeria.

  18. Thriving Together: Connecting Rural School Improvement and Community Development = Prosperando juntos: La conexion entre el mejoramiento de la escuela rural y el desarrollo comunitario.

    Science.gov (United States)

    Boethel, Martha

    Available in English or Spanish, this resource guide aims to help rural schools and communities learn ways of supporting each other so that both can thrive. Background information and basic tools are provided for starting a joint school-community development effort. Chapters contain: (1) outline of the guide and statement of beliefs about…

  19. Building Rural Communities through School-Based Agriculture Programs

    Science.gov (United States)

    Martin, Michael J.; Henry, Anna

    2012-01-01

    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…

  20. Indigenous knowledge of rural communities in Malawi on socio ...

    African Journals Online (AJOL)

    STORAGESEVER

    2008-07-18

    Jul 18, 2008 ... Available online at http://www.academicjournals.org/AJB ... considerably to livelihood as a food supplement and for income generation among local communities. However, U. .... the different forest reserves for consumption, marketing or both. ..... The Status of medicinal trees used in child healthcare in ten.

  1. The Colorado Gambling Boom: An Experiment in Rural Community Development.

    Science.gov (United States)

    Stokowski, Patricia A.

    1992-01-01

    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…

  2. Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research.

    Science.gov (United States)

    Cochran, Gerald T; Engel, Rafael J; Hruschak, Valerie J; Tarter, Ralph E

    2017-10-01

    Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids. Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse. We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse. A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse. Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.

  3. Community Leadership in Rural Tourism Development: A Tale of Two Ancient Chinese Villages

    Directory of Open Access Journals (Sweden)

    Keshuai Xu

    2017-12-01

    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.

  4. The financial and economic feasibility of rural household biodigesters for poor communities in South Africa.

    Science.gov (United States)

    Smith, Michael T; Goebel, Jessica Schroenn; Blignaut, James N

    2014-02-01

    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.

  5. Sustainable Community Sanitation for a Rural Hospital in Haiti

    Directory of Open Access Journals (Sweden)

    Jason Jawidzik

    2012-12-01

    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.

  6. Renewable energy projects to electrify rural communities in Cape Verde

    International Nuclear Information System (INIS)

    Ranaboldo, Matteo; Lega, Bruno Domenech; Ferrenbach, David Vilar; Ferrer-Martí, Laia; Moreno, Rafael Pastor; García-Villoria, Alberto

    2014-01-01

    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

  7. Understanding social capital and HIV risk in rural African American communities.

    Science.gov (United States)

    Cené, Crystal W; Akers, Aletha Y; Lloyd, Stacey W; Albritton, Tashuna; Powell Hammond, Wizdom; Corbie-Smith, Giselle

    2011-07-01

    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

  8. Community as classroom: teaching and learning public health in rural Appalachia.

    Science.gov (United States)

    Florence, James; Behringer, Bruce

    2011-01-01

    Traditional models for public health professional education tend to be didactic, with brief, discrete practica appended. National reports of both practitioners and academicians have called for more competency-driven, interdisciplinary-focused, community-based, service-oriented, and experientially-guided learning for students across the curriculum. East Tennessee State University began its own curricular revisioning in health professions education nearly 2 decades ago with a grant from the W.K. Kellogg Foundation, emphasizing competencies development through community-based learning in community-academic partnerships. This article describes 3 examples that grew from that initiative. In the first example, students in multiple classes delivered a longitudinal community-based employee wellness intervention for a rural county school district. BS public health students conducted needs assessments and prepared health education materials; MPH students conducted health assessments and worked with school wellness councils to deliver client-centered interventions; DrPH students supervised the project and provided feedback to the schools using participatory methods. In the second example, MPH students in a social-behavioral foundations course used experiential learning to investigate the region's elevated cancer mortality ranking. Following meetings with multiple community groups, students employed theoretical constructs to frame regional beliefs about cancer and presented findings to community leaders. One outcome was a 5-year community-based participatory research study of cancer in rural Appalachia. In the third example, MPH students in a health-consulting course assessed local African Americans' awareness of the university's health and education programs and perceptions of their community health issues. Students learned consultation methods by assisting at multiple regional African American community meetings to discover issues and interest that resulted in the

  9. [Adolescense pregnancy in a marginalized rural community in Mexico].

    Science.gov (United States)

    Jiménez-González, Alberto; Granados-Cosme, José Arturo; Rosales-Flores, Roselia Arminda

    2017-01-01

    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.

  10. Community health workers as cultural producers in addressing gender-based violence in rural South Africa.

    Science.gov (United States)

    de Lange, Naydene; Mitchell, Claudia

    2016-01-01

    South Africa has been experiencing an epidemic of gender-based violence (GBV) for a long time and in some rural communities health workers, who are trained to care for those infected with HIV, are positioned at the forefront of addressing this problem, often without the necessary support. In this article, we pose the question: How might cultural production through media making with community health workers (CHWs) contribute to taking action to address GBV and contribute to social change in a rural community? This qualitative participatory arts-based study with five female CHWs working from a clinic in a rural district of South Africa is positioned as critical research, using photographs in the production of media posters. We offer a close reading of the data and its production and discuss three data moments: CHWs drawing on insider cultural knowledge; CHWs constructing messages; and CHWs taking action. In our discussion, we take up the issue of cultural production and then offer concluding thoughts on 'beyond engagement' when the researchers leave the community.

  11. Living in a continuous traumatic reality: Impact on elderly persons residing in urban and rural communities.

    Science.gov (United States)

    Regev, Irit; Nuttman-Shwartz, Orit

    2016-01-01

    This study is an exploration of the contribution of exposure to the continuous threat of Qassam rocket attacks to PTSD among elderly residents of urban and rural communities. Specifically, we examined the contribution of sociodemographic variables, psychological resources, and perceived social support to PTSD, and whether this relationship is mediated by cognitive appraisals. The sample consisted of 298 residents of 2 different communities: urban (n = 190), and rural (n = 108). We examined the main research question by calculating the correlations of the sociodemographic variables, the psychological resource (self-esteem), social support, and cognitive appraisals with the dependent variable (PTSD). Our model explained the variance in PTSD (53% for urban residents, and 56% for rural residents). Higher levels of PTSD were found among the urban residents. Most of the predictors contributed to PTSD, but differences were found between each type of community with regard to the combination of components. Results indicated that the type of community is related degree of protection against stress-related triggers such as Qassam rockets. The psychological resource (self-esteem) and cognitive appraisal variables were found to be important for older people facing a continuous threat, and can serve as a basis for professional intervention. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. ‘It’s about the smoke, not the smoker’: messages that motivate rural communities to support smoke-free policies

    OpenAIRE

    Kostygina, Ganna; Hahn, Ellen J.; Rayens, Mary Kay

    2013-01-01

    Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were...

  13. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru.

    Science.gov (United States)

    Brown, Angela; Malca, Rosa; Zumaran, Adriana; Miranda, J Jaime

    2006-05-17

    To describe the profile of community health workers--health promoters, traditional birth attendants and traditional healers--in rural Quechua communities from Ayacucho, Peru. 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. 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. 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.

  14. On the front line of primary health care: the profile of community health workers in rural Quechua communities in Peru

    Directory of Open Access Journals (Sweden)

    Zumaran Adriana

    2006-05-01

    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.

  15. An approach for the evaluation of rural governance in Cameroon: are community forests really forests for the communities?

    Directory of Open Access Journals (Sweden)

    Hilaire NKENGFACK

    2009-01-01

    Full Text Available The aim of this paper is to evaluate the contribution of the traditionalexploitation of timber, in a community framework, to the respect of governanceprinciples in actions for the fight against poverty in some rural communities inCameroon. In 1990, the government of Cameroon adopted laws on the freedomof association that authorised teaming up for the search of possibilities for abetter economic welfare of populations. It is in line with this that in 1994, a newforest law which authorises willing communities to organise themselves andrequest the government to grant them a portion of the national forest of thepublic domain to be managed by them and for their personal interest. Also, andwith the help of the international community, Cameroon elaborated in 1998 itsfirst poverty reduction strategy paper that encouraged amongst others,community actions in the search of solutions to the economic crisis that strokethe country. Through the application of a logit model to the responses collectedthrough a survey carried out on a sample of 200 individuals of the East regionof Cameroon, it was noticed that timber exploitation in a community frameworkdoes not necessarily lead to the strengthening of the links of belonging to acommon community, and to the equitable redistribution of revenues from theexploitation of the community forest.

  16. The levels of Community Involvement in Health (CIH: a case of rural and urban communities in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    G.G. Mchunu

    2009-09-01

    Full Text Available The study aimed to describe the practice of community involvement in health programmes.The study therefore explored the nature and practice of community involvementin health programmes in the two communities in KwaZulu Natal. Thestudy was guided by the conceptual framework adapted from Amstein’s,( 1969 Ladderof Citizen Participation. This framework shows different levels and steps in communityparticipation. A case study method was used to conduct the study. The twocases were one urban based and one rural based community health centers in theIlembe health district, in Kwa Zulu Natal. A sample of 31 persons participated in thestudy. The sample comprised 8 registered nurses, 2 enrolled nurses 13 communitymembers and 8 community health workers. Data was collected using structured individualinterviews and focus group interviews, and was guided by the case protocol.Community involvement in health largely depended on the type of community, withrural community members being in charge of their health projects and urban communitymembers helping each other as neighbours in times of need.

  17. Rural Student Entrepreneurs: Linking Commerce and Community. (Benefits)[Squared]: The Exponential Results of Linking School Improvement and Community Development, Issue Number Three.

    Science.gov (United States)

    Boethel, Martha

    In many rural areas, both communities and schools are threatened by decreasing population and changing economic conditions. To boost both the local economy and student achievement, a growing number of rural schools are turning to entrepreneurial education. In school entrepreneurship programs, students create small businesses under the guidance of…

  18. Young adults’ perceptions of and affective bonds to a rural tourism community

    Directory of Open Access Journals (Sweden)

    Peter Möller

    2016-02-01

    Full Text Available Many rural areas, in Sweden and worldwide, experience population decline where the young leave for education and work in urban areas. Employment has declined in several rural industries, such as agriculture, forestry, and fishing, while growing in other industries are often located in urban areas. Politicians and organizations have put much hope in tourism as a tool of rural development, but can tourism help reverse the rural out-migration trend among young adults? This paper explores how tourism affects young inhabitants’ perceptions of and affective bonds to a rural area in Sweden, the ski resort of Sälen. Students from the 1993–1995 elementary school graduating classes were interviewed about their migration history, childhood, and view of and ties to Sälen. The respondents experience that tourism contributes to a more vital community incorporating influences from elsewhere, but without eliminating the positive aspects of rural life. The regular flow of people – tourists, seasonal workers, and entrepreneurs – passing through Sälen presents opportunities to extend one’s social network that are widely appreciated by respondents. The high in and out mobility constitutes a key part of Sälen’s character. Contributions from tourism – such as employment, entertainment, leisure, and opportunities to forge new social relationships – are available during the adult transition, the life phase when rural areas are often perceived as least attractive. Even though out-migration occurs in Sälen, and some respondents still find Sälen too small, tourism has clearly increased the available opportunities and contributed significantly to making Sälen more attractive to young adults.

  19. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

    Science.gov (United States)

    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

    2013-09-01

    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.

  20. Responding to rural social care needs: older people empowering themselves, others and their community.

    Science.gov (United States)

    Walsh, Kieran; O'Shea, Eamon

    2008-12-01

    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.

  1. Adaptation of intensive mental health intensive case management to rural communities in the Veterans Health Administration.

    Science.gov (United States)

    Mohamed, Somaia

    2013-03-01

    There has been increasing concern in recent years about the availability of mental health services for people with serious mental illness in rural areas. To meet these needs the Department of Veterans Affairs (VA) implemented the Rural Access Networks for Growth Enhancement (RANGE) program, in 2007, modeled on the Assertive Community Treatment (ACT) model. This study uses VA administrative data from the RANGE program (N = 343) to compare client characteristics at program entry, patterns of service delivery, and outcomes with those of Veterans who received services from the general VA ACT-like program (Mental Health Intensive Case Management (MHICM) (N = 3,077). Veterans in the rural program entered treatment with similar symptom severity, less likelihood of being diagnosed with schizophrenia and having had long-term hospitalization, but significantly higher suicidality index scores and greater likelihood of being dually diagnosed compared with those in the general program. RANGE Veterans live further away from their treatment teams but did not differ significantly in measures of face-to-face treatment intensity. Similar proportions of RANGE and MHICM Veterans were reported to have received rehabilitation services, crisis intervention and substance abuse treatment. The rural programs had higher scores on overall satisfaction with VA mental health care than general programs, slightly poorer outcomes on quality of life and on the suicidality index but no significant difference on other outcomes. These data demonstrate the clinical need, practical feasibility and potential effectiveness of providing intensive case management through small specialized case management teams in rural areas.

  2. Can E- Commerce Enable Marketing in an African Rural Women's Community Based Development Organization?

    Directory of Open Access Journals (Sweden)

    Jo Rhodes

    2003-01-01

    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.

  3. Continuing interprofessional education in geriatrics and gerontology in medically underserved areas.

    Science.gov (United States)

    Toner, John A; Ferguson, K Della; Sokal, Regina Davis

    2009-01-01

    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.

  4. Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

    NARCIS (Netherlands)

    Havenaar, J.M.; Geerlings, M.I.; Vivian, L.; Collinson, M.; Robertson, B.

    2008-01-01

    This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

  5. Common mental health problems in historically disadvantaged urban and rural communities in South Africa: prevalence and risk factors

    NARCIS (Netherlands)

    Havenaar, Juhan; Geerlings, Mirjan; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

    2007-01-01

    This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were

  6. Common mental health problems in historically disadvantaged urban and rural communities in South Africa : prevalence and risk factors

    NARCIS (Netherlands)

    Havenaar, Juhan M.; Geerlings, Mirjan I.; Vivian, Lauraine; Collinson, Marh; Robertson, Brian

    This paper reports on an epidemiological study of common mental health and substance abuse problems in a historically disadvantaged urban and rural community in South Africa. In the rural Limpopo Province of South Africa, and in a peri-urban township near Cape Town, self-report instruments were used

  7. Costs and outcome of assertive community treatment (ACT) in a rural area in Denmark

    DEFF Research Database (Denmark)

    Hastrup, Lene Halling; Aagaard, Jørgen

    2015-01-01

    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-experime......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...... only. Results: Seventy eight percent of the patients receiving ACT were in contact with psychiatric services at the 4-year follow-up, while 69% of the patients in the control group had contact with psychiatric services (P

  8. The community-level effects of women's education on reproductive behaviour in rural Ghana

    Directory of Open Access Journals (Sweden)

    Kofi D. Benefo

    2006-06-01

    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.

  9. The changing nature of nursing work in rural and small community hospitals.

    Science.gov (United States)

    Montour, Amy; Baumann, Andrea; Blythe, Jennifer; Hunsberger, Mabel

    2009-01-01

    The nursing literature includes descriptions of rural nursing workforces in Canada, the United States of America and Australia. However, inconsistent definitions of rural demography, diverse employment conditions and health care system reorganization make comparisons of these data difficult. In 2007, the Ministry of Health and Long-term Care in Ontario, Canada, transferred responsibility for decision-making and funding to 14 regional governing bodies known as Local Health Integration Networks (LHINs). Little is known about rural-urban variations in the nursing workforces in the LHINs because existing data repositories do not describe them. This study investigated the influence of demographic characteristics, provincial policies, organizational changes and emerging practice challenges on nursing work in a geographically unique rural region. The purpose was to describe the nature of nursing work from the perspective of rural nurse executives and frontline nurses. The study was conducted in 7 small rural and community hospitals in the Hamilton Niagara Haldimand Brant LHIN. Data collection occurred between August and November 2007. A qualitative descriptive study design was chosen to facilitate exploration of nursing in the rural setting. Study participants were identified through purposive snowball sampling. All nurses, nurse managers and nurse executives currently employed in the 7 study hospitals were eligible to participate. Data collection included the use of questionnaires and semi-structured interviews. Memos were also created to describe the relevance and applicability of concepts, categories and properties emerging from the data. Themes were compared across interviews to determine relevance and value. Twenty-one nurses from 7 different hospitals participated. The nurses reflect the aging trend in the provincial and regional workforces of Ontario. All study participants anticipate a substantial increase in retirements during the next decade, which will alter

  10. Community-Engaged Attribute Mapping: Exploring Resources and Readiness to Change the Rural Context for Obesity Prevention.

    Science.gov (United States)

    John, Deborah; Winfield, Tammy; Etuk, Lena; Hystad, Perry; Langellotto, Gail; Manore, Melinda; Gunter, Kathy

    2017-01-01

    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

  11. Insights into nasal carriage of Staphylococcus aureus in an urban and a rural community in Ghana

    DEFF Research Database (Denmark)

    Egyir, Beverly; Guardabassi, Luca; Esson, Joseph

    2014-01-01

    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...

  12. Dynamics of Community Participation, Student Achievement and School Management: The Case of Primary Schools in a Rural Area of Malawi

    Science.gov (United States)

    Taniguchi, Kyoko; Hirakawa, Yukiko

    2016-01-01

    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…

  13. Groundwater Exploration for Rural Communities in Ghana, West Africa

    Science.gov (United States)

    McKay, W. A.

    2001-05-01

    Exploration for potable water in developing countries continues to be a major activity, as there are more than one billion people without access to safe drinking water. Exploration for groundwater becomes more critical in regions where groundwater movement and occurrence is controlled by secondary features such as fractures and faults. Drilling success rates in such geological settings are generally very low, but can be improved by integrating geological, hydrogeological, aerial photo interpretation with land-based geophysical technology in the selection of drilling sites. To help alleviate water supply problems in West Africa, the Conrad N. Hilton Foundation and other donors, since 1990, have funded the World Vision Ghana Rural Water Project (GRWP) to drill wells for potable water supplies in the Greater Afram Plains (GAP) of Ghana. During the first two years of the program, drilling success rates using traditional methods ranged from 35 to 80 percent, depending on the area. The average drilling success rate for the program was approximately 50 percent. In an effort to increase the efficiency of drilling operations, the Desert Research Institute evaluated and developed techniques for application to well-siting strategies in the GAP area of Ghana. A critical project element was developing technical capabilities of in-country staff to independently implement the new strategies. Simple cost-benefit relationships were then used to evaluate the economic advantages of developing water resources using advanced siting methods. The application of advanced methods in the GAP area reveal an increase of 10 to 15 percent in the success rate over traditional methods. Aerial photography has been found to be the most useful of the imagery products covering the GAP area. An effective approach to geophysical exploration for groundwater has been the combined use of EM and resistivity methods. Economic analyses showed that the use of advanced methods is cost-effective when success

  14. Mental health literacy in rural Queensland: results of a community survey.

    Science.gov (United States)

    Bartlett, Helen; Travers, Catherine; Cartwright, Colleen; Smith, Norman

    2006-09-01

    The aim of this study was to assess the awareness of, and attitudes to, mental health issues in rural dwelling Queensland residents. A secondary objective was to provide baseline data of mental health literacy prior to the implementation of Australian Integrated Mental Health Initiative--a health promotion strategy aimed at improving the health outcomes of people with chronic or recurring mental disorders. In 2004 a random sample of 2% (2132) of the estimated adult population in each of eight towns in rural Queensland was sent a postal survey and invited to participate in the project. A series of questions were asked based on a vignette describing a person suffering major depression. In addition, questions assessed respondents' awareness and perceptions of community mental health agencies. Approximately one-third (36%) of those surveyed completed and returned the questionnaire. While a higher proportion of respondents (81%) correctly identified and labelled the problem in the vignette as depression than previously reported in Australian community surveys, the majority of respondents (66%) underestimated the prevalence of mental health problems in the community. Furthermore, a substantial number of respondents (37%) were unaware of agencies in their community to assist people with mental health issues while a majority of respondents (57.6%) considered that the services offered by those agencies were poor. While mental health literacy in rural Queensland appears to be comparable to other Australian regions, several gaps in knowledge were identified. This is in spite of recent widespread coverage of depression in the media and thus, there is a continuing need for mental health education in rural Queensland.

  15. Evaluation of Nutrition and Physical Activity Policies and Practices in Child Care Centers within Rural Communities.

    Science.gov (United States)

    Foster, Jaime S; Contreras, Dawn; Gold, Abby; Keim, Ann; Oscarson, Renee; Peters, Paula; Procter, Sandra; Remig, Valentina; Smathers, Carol; Mobley, Amy R

    2015-10-01

    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.

  16. Adiposity and Insulin Resistance in Children from a Rural Community in Mexico.

    Science.gov (United States)

    Barbosa-Cortes, Lourdes; Villasis-Keever, Miguel Angel; Del Prado-Manriquez, Martha; Lopez-Alarcon, Mardia

    2015-04-01

    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.

  17. Factors Associated with Insomnia among the Elderly in a Korean Rural Community

    OpenAIRE

    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

    2017-01-01

    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...

  18. An evaluation of a community pharmacy-based rural asthma management service.

    Science.gov (United States)

    Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol

    2008-04-01

    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.

  19. Obstetric referrals from a rural clinic to a community hospital in Honduras.

    Science.gov (United States)

    Josyula, Srirama; Taylor, Kathryn K; Murphy, Blair M; Rodas, Dairamise; Kamath-Rayne, Beena D

    2015-11-01

    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.

  20. 'It's about the smoke, not the smoker': messages that motivate rural communities to support smoke-free policies.

    Science.gov (United States)

    Kostygina, Ganna; Hahn, Ellen J; Rayens, Mary Kay

    2014-02-01

    Rural residents are exposed to sophisticated tobacco advertising and tobacco growing represents an economic mainstay in many rural communities. There is a need for effective health messages to counter the pro-tobacco culture in these communities. To determine relevant cultural themes and key message features that affect receptivity to pro-health advertisements among rural residents, 11 exploratory focus groups and surveys with community advocates (N = 82) in three rural Kentucky counties were conducted. Participants reviewed and rated a collection of print media advertisements and branding materials used by rural communities to promote smoke-free policies. Findings reveal that negative emotional tone, loss framing, appeals to religiosity, and shifting focus away from smokers are effective strategies with rural audiences. Potential pitfalls were identified. Attacks on smokers may not be a useful strategy. Health risk messages reinforced beliefs of secondhand smoke harm but some argued that the messages needed to appeal to smokers and emphasize health hazards to smokers, rather than to non-smokers only. Messages describing ineffectiveness of smoking sections were understood but participants felt they were only relevant for restaurants and not all public spaces. Emphasis on religiosity and social norms shows promise as a culturally sensitive approach to promoting smoke-free environments in rural communities.

  1. The Influence of Age and Gender on Skin-Associated Microbial Communities in Urban and Rural Human Populations.

    Directory of Open Access Journals (Sweden)

    Shi Ying

    Full Text Available Differences in the bacterial community structure associated with 7 skin sites in 71 healthy people over five days showed significant correlations with age, gender, physical skin parameters, and whether participants lived in urban or rural locations in the same city. While body site explained the majority of the variance in bacterial community structure, the composition of the skin-associated bacterial communities were predominantly influenced by whether the participants were living in an urban or rural environment, with a significantly greater relative abundance of Trabulsiella in urban populations. Adults maintained greater overall microbial diversity than adolescents or the elderly, while the intragroup variation among the elderly and rural populations was significantly greater. Skin-associated bacterial community structure and composition could predict whether a sample came from an urban or a rural resident ~5x greater than random.

  2. Conversations on telemental health: listening to remote and rural First Nations communities.

    Science.gov (United States)

    Gibson, Kerri L; Coulson, Heather; Miles, Roseanne; Kakekakekung, Christal; Daniels, Elizabeth; O'Donnell, Susan

    2011-01-01

    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

  3. Perception and Attitude of a Rural Community Regarding Adult Blindness in North Central Nigeria.

    Science.gov (United States)

    Olatunji, Victoria A; Adepoju, Feyi G; Owoeye, Joshua F A

    2015-01-01

    To determine the perception and attitudes of a rural community regarding the etiology, prevention, and treatment of blindness in adults. A cross-sectional, descriptive study was performed in a rural community in Kwara State, Nigeria using semi-structured questionnaire. All adults aged 40 years or older who were residents for a minimum of 6 months in the community were included. Data were collected on patient demographics, knowledge, attitude, perception, and use of the eye care facility. A total of 290 participants were interviewed. The male-to-female ratio was 1:2. Consumption of certain types of food was an important cause of blindness as perceived by 57.9% of the respondents, followed by supernatural forces (41.7%) and aging (19%). Sixty percent of respondents thought blindness could be prevented. Age (P = 0.04) and level of education (P =0.003) significantly affected the beliefs on the prevention of blindness. Most respondents (79.3%) preferred orthodox eye care, but only 65% would accept surgical intervention if required. The level of education significantly affected the acceptance of surgery (P = 0.04). Reasons for refusing surgery were, fear (64%), previous poor outcomes in acquaintances (31%), belief that surgery is not required (3%), and cost (2%). About 65% used one form of traditional eye medication or the other. Over half (56.6%) believed that spectacles could cure all causes of blindness. Of those who had ocular complaints, 57.1% used orthodox care without combining with either traditional or spiritual remedies. This rural Nigerian community had some beliefs that were consistent with modern knowledge. However, the overall knowledge, attitude, and perceptions of this community need to be redirected to favor the eradication of avoidable blindness. Although an eye care facility was available, use by the community was suboptimal. Age and the level of education affected their overall perception and attitudes.

  4. The application of a biometric identification technique for linking community and hospital data in rural Ghana

    Science.gov (United States)

    Odei-Lartey, Eliezer Ofori; Boateng, Dennis; Danso, Samuel; Kwarteng, Anthony; Abokyi, Livesy; Amenga-Etego, Seeba; Gyaase, Stephaney; Asante, Kwaku Poku; Owusu-Agyei, Seth

    2016-01-01

    Background 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. Objective Our goal was to assess the feasibility of using fingerprint identification to link community data and hospital data in a rural African setting. Design 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. Results 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. Conclusions 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. PMID:26993473

  5. The application of a biometric identification technique for linking community and hospital data in rural Ghana

    Directory of Open Access Journals (Sweden)

    Eliezer Ofori Odei-Lartey

    2016-03-01

    Full Text Available Background: 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. Objective: Our goal was to assess the feasibility of using fingerprint identification to link community data and hospital data in a rural African setting. Design: 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. Results: 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. Conclusions: 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.

  6. Stated preferences of doctors for choosing a job in rural areas of Peru: a discrete choice experiment.

    Directory of Open Access Journals (Sweden)

    J Jaime Miranda

    Full Text Available Doctors' scarcity in rural areas remains a serious problem in Latin America and Peru. Few studies have explored job preferences of doctors working in underserved areas. We aimed to investigate doctors' stated preferences for rural jobs.A labelled discrete choice experiment (DCE was performed in Ayacucho, an underserved department of Peru. Preferences were assessed for three locations: rural community, Ayacucho city (Ayacucho's capital and other provincial capital city. Policy simulations were run to assess the effect of job attributes on uptake of a rural post. Multiple conditional logistic regressions were used to assess the relative importance of job attributes and of individual characteristics. A total of 102 doctors participated. They were five times more likely to choose a job post in Ayacucho city over a rural community (OR 4.97, 95%CI 1.2; 20.54. Salary increases and bonus points for specialization acted as incentives to choose a rural area, while increase in the number of years needed to get a permanent post acted as a disincentive. Being male and working in a hospital reduced considerably chances of choosing a rural job, while not living with a partner increased them. Policy simulations showed that a package of 75% salary increase, getting a permanent contract after two years in rural settings, and getting bonus points for further specialisation increased rural job uptake from 21% to 77%. A package of 50% salary increase plus bonus points for further specialisation would also increase the rural uptake from 21% to 52%.Doctors are five times more likely to favour a job in urban areas over rural settings. This strong preference needs to be overcome by future policies aimed at improving the scarcity of rural doctors. Some incentives, alone or combined, seem feasible and sustainable, whilst others may pose a high fiscal burden.

  7. Community development: an important way for coordinating development of population and social economy in rural areas of China.

    Science.gov (United States)

    Li, J

    1995-01-01

    This article explains how community development is important to rural socioeconomic development in China. Almost all rural socioeconomic activities occur at the community level. Community development encourages voluntarism and self-development, which contribute to adoption of more modern ideas, morals, and values. Community development stimulates changes that favor decreased childbearing and a high quality of child rearing. The special features of Chinese rural communities are identified as underdevelopment, population pressure and resource degradation, collective entities, greater social cohesion, flexibility, affiliations as government units, and access to other useful community organizations. The development model for communities varied over time from an emphasis on family planning to a focus on women's development, poverty alleviation, or economic development. Well-developed communities focused on social security systems, service networks, or environmental protection. Community development is tied to economic development. The growth of collectives played an important role in community development. Women's active and extensive participation and leadership by other influential persons were important forces in community development. Women served as agents of change. Mass participation is now a key feature of community development. Former communes did not include the same level of voluntarism. Community development directly supports increased incomes for families, which decreases the emphasis on children as a source of income. The economic value of children is reduced when communities provide social security. The greater value placed on males is reduced when women's income is increased. Community development lowers the social value of children by improving people's quality of life and by creating a modern social environment.

  8. Program of active aging in a rural Mexican community: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Mendoza-Núñez Víctor

    2007-10-01

    Full Text Available 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 training program promoting gerontological development and health education. Participants in turn became coordinators of mutual-help groups (gerontological nucleus in Mexico. In-depth interviews were carried out to assess the empowerment after training for active aging. Results It was found that there was an increasing feeling of empowerment, creativity and self-fulfillment among participants. Among the main factors that positively influenced training of the elderly toward active aging were the teaching of gerontology topics themselves; besides, their motivation, the self-esteem, the increased undertaking of responsibility, the feeling of belonging to the group, and the sharing of information based on personal experience and on gerontological knowledge. Conclusion The main factors that contribute to empowerment of older adults in a rural Mexican community for participate in active aging programs are the training and teaching of gerontology topics themselves; besides, their interest, experience and involvement.

  9. Program of active aging in a rural Mexican community: a qualitative approach.

    Science.gov (United States)

    de la Luz Martínez-Maldonado, María; Correa-Muñoz, Elsa; Mendoza-Núñez, Víctor Manuel

    2007-10-03

    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. 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 training program promoting gerontological development and health education. Participants in turn became coordinators of mutual-help groups (gerontological nucleus) in Mexico. In-depth interviews were carried out to assess the empowerment after training for active aging. It was found that there was an increasing feeling of empowerment, creativity and self-fulfillment among participants. Among the main factors that positively influenced training of the elderly toward active aging were the teaching of gerontology topics themselves; besides, their motivation, the self-esteem, the increased undertaking of responsibility, the feeling of belonging to the group, and the sharing of information based on personal experience and on gerontological knowledge. The main factors that contribute to empowerment of older adults in a rural Mexican community for participate in active aging programs are the training and teaching of gerontology topics themselves; besides, their interest, experience and involvement.

  10. [Metabolic syndrome in adults from 20 to 40 years old in a rural Mexican community].

    Science.gov (United States)

    Echavarría-Pinto, Mauro; Hernández-Lomelí, Adrián; Alcocer-Gamba, Marco Antonio; Morales-Flores, Héctor; Vázquez-Mellado, Alberto

    2006-01-01

    Metabolic syndrome is the main health problem in Mexico. Its two principal complications (ischemic cardiopathy and type-2 diabetes) are the two main causes of death in Mexico since 2000. To describe the prevalence of the metabolic syndrome in adults from 20 to 40 years old in a Mexican rural community (Senegal de Palomas, San Juan del Río, Querétaro) using the National Cholesterol Education Program (NCEP III) definition. A descriptive study with a random sample was carried out. We present a univariate analysis with a 95% confidence interval. 73 cases were studied. The prevalence of the metabolic syndrome was 45.2% slightly higher in men (48.4%) than in women (42.8%). The prevalence of hypertension was 27.3%. The prevalence of obesity was 26.1% using the definition of the WHO and this prevalence rises up to 49.4% using the definition of the Mexican Official Norm. 90.5% of women and 93.5% of men had low HDLc. The prevalence of metabolic syndrome in adults from 20 to 40 years old in this Mexican rural community is much higher than the national mean for the same age cohort. The results show the necessity to increase the research of our rural communities in order to identify the possible causes to this problem and to create therapeutic programs for patients with metabolic syndrome.

  11. PRODUCTIVE ACTIVITIES IN RURAL SCHOOLS: A COMMUNITY MISSION OF THE EXECUTIVE

    Directory of Open Access Journals (Sweden)

    Lorena del Rosario Piñero

    2014-04-01

    Full Text Available The intention of the study consisted of valuing the productive activities for rural schools from the community mission that the executive exercises in the educational context of the Parish Ana Maria Campos, municipality Elevated place, condition Zulia. The study was considered to be descriptive, to such effects his basic action consisted of the valuation of elements considered like fundamental to identify the productive activities in rural schools from the community mission of the executive. The design of the investigation is not experimental, of field, transactional with a methodology qualitative and quantitative of dominant quantitative approach carried out in the educational context of the communities El Mecocal, El Crespo, El Rodeo, La Quebrada y el Kilometro 42. The population was constituted by teachers, parents and rural representatives to whom an instrument applied comprising questionnaire of 15 questions type Likert and 5 questions opened of triple version, validated in his content by 10 experts whose results were valued for categories and processed statistically across percentage tests. Between the conclusions there was demonstrated that the pedagogic practices are based basically on the approximation of executives and teachers by prevalence in knowing the expectations of learning of the pupils, the performance of the executives is estimated by good disposition by the teachers and the productive projects are realized across the education of the theoretical contents in the classroom of classes.

  12. Understanding Barriers and Facilitators to Healthy Eating and Active Living in Rural Communities

    Directory of Open Access Journals (Sweden)

    Rebecca Seguin

    2014-01-01

    Full Text Available Objective. Studies demonstrate that people’s food and physical activity (PA environments influence behavior, yet research examining this in rural communities is limited. Methods. Focus groups of 8–15 women were conducted in rural communities in seven US states. Questions were designed to identify factors within residents’ food and PA environments they felt helped or hindered them from eating healthfully and being physically active. Results. Participants were aged 30–84 years; mean (SD = 61 (14 (N=95. On average, communities had fewer than 5,000 residents. Limited time, social norms, and distances from or lack of exercise facilities were common PA barriers. Facilitators for PA included social support, dog walking, and availability of affordable facilities. Healthy eating barriers included the perception that healthy foods were too expensive; calorically dense large portion sizes served at family meals; and frequency of eating foods away from home, which were perceived as generally unhealthy. Healthy eating supports included culture/value around local food gathering (e.g., hunting and gardening and preservation (e.g., canning and smoking. Friends and family were frequently identified as key influencers of eating and PA behavior. Conclusions. Targeting both social and built environment factors, particularly those unique to rural locales, may enhance support for healthy eating and PA behavior change interventions.

  13. Attitude and Entrepreneurial Intention Among Rural Community: the Mediating Role of Entrepreneurial Opportunity Recognition

    Directory of Open Access Journals (Sweden)

    Dahalan Norziani

    2015-01-01

    Full Text Available Entrepreneurship has been well documented to have an economic and social implication for the nation to increase income. Most of developing countries give further consideration to include entrepreneurship as an agenda to help the poor to increase the living standard. In fact, entrepreneurship offers various business opportunities for rural communities to achieve better quality of life. However, the crucial part of doing business is to recognize business opportunity. Entrepreneurship and opportunity are two terms that complement each other. Opportunity recognition enables the entrepreneur to identify a good idea and transform it into a business concept. The purpose of this study is to examine the relationship between attitude (attitude toward money, attitude toward start-up and entrepreneurial intention. This paper also intends to understand the role of entrepreneurial opportunity recognition as a mediator between attitude and entrepreneurial intention. The aim of this research is to support training providers, to identify input for entrepreneurial training, specifically developing business concepts among rural community. From the practical perspective, it might help the government to understand the necessity to encourage entrepreneurial movement among rural community as to ensure business ideas flow. This research employed the quantitative method of data collection. The questionnaires were distributed to 500 local populations according to districts and villages. The findings of this study showed that both attitude (attitude toward money, attitude toward start-up influence entrepreneurial intention. The relationship between attitude toward start-up and entrepreneurial intention was mediated by opportunity recognition.

  14. Community Readiness for the Promotion of Physical Activity in Older Adults—A Cross-Sectional Comparison of Rural and Urban Communities

    Science.gov (United States)

    Brand, Tilman; Princk, Christina; Zeeb, Hajo

    2018-01-01

    Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3–5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): −0.02–0.59). The rural communities showed significantly higher CR scores in the ‘Knowledge of efforts’ dimension (0.70, 95% CI: 0.26–1.14) and in the ‘Knowledge of the issue’ (0.37, 95% CI: 0.04–0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels. PMID:29509675

  15. Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

    Science.gov (United States)

    Gansefort, Dirk; Brand, Tilman; Princk, Christina; Zeeb, Hajo

    2018-03-06

    Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

  16. Community involvement in obstetric emergency management in rural areas: a case of Rukungiri district, Western Uganda

    Directory of Open Access Journals (Sweden)

    Ogwang Simon

    2012-03-01

    Full Text Available Abstract Background Maternal mortality is a major public health problem worldwide especially in low income countries. Most causes of maternal deaths are due to direct obstetric complications. Maternal mortality ratio remains high in Rukungiri district, western Uganda estimated at 475 per 100,000 live births. The objectives were to identify types of community involvement and examine factors influencing the level of community involvement in the management of obstetric emergencies. Methods We conducted a descriptive study during 2nd to 28th February 2009 in rural Rukungiri district, western Uganda. A total of 448 heads of households, randomly selected from 6/11 (54.5% of sub-counties, 21/42 (50.0% parishes and 32/212 (15.1% villages (clusters, were interviewed. Data were analysed using STATA version 10.0. Results Community pre-emergency support interventions available included community awareness creation (sensitization while interventions undertaken when emergency had occurred included transportation and referring women to health facility. Community support programmes towards health care (obstetric emergencies included establishment of community savings and credit schemes, and insurance schemes. The factors associated with community involvement in obstetric emergency management were community members being employed (AOR = 1.91, 95% CI: 1.02 - 3.54 and rating the quality of maternal health care as good (AOR = 2.22, 95% CI: 1.19 - 4.14. Conclusions Types of community involvement in obstetric emergency management include practices and support programmes. Community involvement in obstetric emergency management is influenced by employment status and perceived quality of health care services. Policies to promote community networks and resource mobilization strategies for health care should be implemented. There is need for promotion of community support initiatives including health insurance schemes and self help associations; further community

  17. Impact on diarrhoeal illness of a community educational intervention to improve drinking water quality in rural communities in Puerto Rico

    Directory of Open Access Journals (Sweden)

    Ramírez Toro Graciela I

    2010-04-01

    Full Text Available Abstract Background Waterborne disease is a major risk for small water supplies in rural settings. This study was done to assess the impact of an educational intervention designed to improve water quality and estimate the contribution of water to the incidence of diarrhoeal disease in poor rural communities in Puerto Rico a two-part study was undertaken. Methods An educational intervention was delivered to communities relying on community water supplies. This intervention consisted of student operators and administrators supervising and assisting community members who voluntarily "operate" these systems. These voluntary operators had no previous training and were principally concerned with seeing that some water was delivered. The quality of that water was not something they either understood or addressed. The impact of this intervention was measured through water sampling for standard bacteriological indicators and a frank pathogen. In addition, face-to-face epidemiological studies designed to determine the base-line occurrence of diarrhoeal disease in the communities were conducted. Some 15 months after the intervention a further epidemiological study was conducted in both the intervention communities and in control communities that had not received any intervention. Results Diarrhoeal illness rates over a four week period prior to the intervention were 3.5%. Salmonella was isolated from all of 5 distributed samples prior to intervention and from only 2 of 12 samples after the intervention. In the 15 months follow-up study, illness rates were lower in the intervention compared to control communities (2.5% vs 3.6%% (RR = 0.70, 95%CI 0.43, 1.15, though this was not statistically significant. However, in the final Poisson regression model living in an intervention system (RR = 0.318; 95%CI 0.137 - 0.739 and owning a dog (RR = 0.597, 95%CI 0.145 - 0.962 was negatively associated with illness. Whilst size of system (RR = 1.006, 95%CI 1.001 - 1

  18. A national study on nurses' retention in healthcare facilities in underserved areas in Lebanon.

    Science.gov (United States)

    El-Jardali, Fadi; Alameddine, Mohamad; Jamal, Diana; Dimassi, Hani; Dumit, Nuhad Y; McEwen, Mary K; Jaafar, Maha; Murray, Susan F

    2013-09-30

    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

  19. Adapting participatory design to design information system with rural Ethiopian community

    DEFF Research Database (Denmark)

    Zewge, Amanuel; Dittrich, Yvonne; Bekele, Rahel

    2015-01-01

    Most of the Information and Communication Technology for Development initiatives introduced to communities in developing countries fails to deliver its promises due to the lack of intended beneficiary involvement. Participatory Design assumes to be effective as long as its nature of participations...... and methods are contextualized to a given settings. To this end, we discuss the implication of considering local (rural community) culture of participation practices, and propose a procedure to be followed in the early phases of information system development process. Finally we argue that, such adaption...... could advance the Participatory Action Research methodology....

  20. Stigmatization of people with mental illness among inhabitants of a rural community in northern Nigeria.

    Science.gov (United States)

    Audu, Ishaq A; Idris, Suleiman H; Olisah, Victor O; Sheikh, Taiwo L

    2013-02-01

    Despite the fact that mental illness is a common problem in society, people's perception of the mentally ill and community attitude towards them is still rather poor, making their rehabilitation and reintegration into society an uphill task. To examine the stigmatization of people with mental illness within a rural community and identify the socio-demographic variables involved. A cross-sectional descriptive study using a multi-stage random sampling technique to obtain data through an interviewer-administered questionnaire to 325 adult inhabitants of a rural community in Nigeria. The results showed widespread ignorance about causation, mode of transmission and remedies available for mental illness, with only 0.9% of respondents attributing mental illness to brain disease. The others attributed it to spiritual attack, punishment for evil doing and illicit psychoactive substance use, among other things. Negative views about the mentally ill were also widely expressed resulting in discriminatory practices. Stigmatization of people with mental illness is still rampant in our community. There is a need for adequate public education about the causes and mode of transmission of mental illness and the treatment options available in the community.

  1. Home is best: Why women in rural Zimbabwe deliver in the community.

    Science.gov (United States)

    Dodzo, Munyaradzi Kenneth; Mhloyi, Marvellous

    2017-01-01

    Maternal mortality in Zimbabwe has unprecedentedly risen over the last two and half decades although a decline has been noted recently. Many reasons have been advanced for the rising trend, including deliveries without skilled care, in places without appropriate or adequate facilities to handle complications. The recent decline has been attributed to health systems strengthening through a multi-donor pooled funding mechanism. On the other hand, the proportion of community deliveries has also been growing steadily over the years and in this study we investigate why. We used twelve (12) focus group discussions with child-bearing women and eight (8) key informant interviews (KIIs). Four (4) were traditional birth attendants and four (4) were spiritual birth attendants. A thematic approach was used to analyse the data in Ethnography software. The study shows that women prefer community deliveries due to perceived low economic, social and opportunity costs involved; pliant and flexible services offered; and diminishing quality and appeal of institutional maternity services. We conclude that rural women are very economic, logical and rational in making choices on place of delivery. Delivering in the community offers financial, social and opportunity advantages to disenfranchised women, particularly in remote rural areas. We recommend for increased awareness of the dangers of community deliveries; establishment of basic obstetric care facilities in the community and more efficient emergency referral systems. In the long-term, there should be a sustainable improvement of the public health delivery system to make it accessible, affordable and usable by the public.

  2. Towards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.

    Science.gov (United States)

    Pennington, Pamela Marie; Juárez, José Guillermo; Arrivillaga, Margarita Rivera; De Urioste-Stone, Sandra María; Doktor, Katherine; Bryan, Joe P; Escobar, Clara Yaseli; Cordón-Rosales, Celia

    2017-09-01

    Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9%) pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

  3. Towards Chagas disease elimination: Neonatal screening for congenital transmission in rural communities.

    Directory of Open Access Journals (Sweden)

    Pamela Marie Pennington

    2017-09-01

    Full Text Available Chagas disease is a neglected tropical disease that continues to affect populations living in extreme poverty in Latin America. After successful vector control programs, congenital transmission remains as a challenge to disease elimination. We used the PRECEDE-PROCEED planning model to develop strategies for neonatal screening of congenital Chagas disease in rural communities of Guatemala. These communities have persistent high triatomine infestations and low access to healthcare. We used mixed methods with multiple stakeholders to identify and address maternal-infant health behaviors through semi-structured interviews, participatory group meetings, archival reviews and a cross-sectional survey in high risk communities. From December 2015 to April 2016, we jointly developed a strategy to illustratively advertise newborn screening at the Health Center. The strategy included socioculturally appropriate promotional and educational material, in collaboration with midwives, nurses and nongovernmental organizations. By March 2016, eight of 228 (3.9% pregnant women had been diagnosed with T. cruzi at the Health Center. Up to this date, no neonatal screening had been performed. By August 2016, seven of eight newborns born to Chagas seropositive women had been parasitologically screened at the Health Center, according to international standards. Thus, we implemented a successful community-based neonatal screening strategy to promote congenital Chagas disease healthcare in a rural setting. The success of the health promotion strategies developed will depend on local access to maternal-infant services, integration with detection of other congenital diseases and reliance on community participation in problem and solution definition.

  4. What is safe and clean water in rural Bolivian communities? A preliminary investigation of heavy metal contamination in rural community water systems in the Bolivian Altiplano

    Science.gov (United States)

    Borella, M.; Guido, Z.; Borella, P.; Ketron, T.

    2009-12-01

    A proliferation of potable water systems utilizing groundwater is currently underway in the Lake Titicaca region of the Bolivian Altiplano. With the aid of national and international organizations, rural communities are developing groundwater sources because the region’s surface water is highly contaminated with waterborne pathogens—the primary factor contributing to high child mortality rates in developing nations. According to UNICEF, 86 percent of Bolivian families have access to “improved” water systems, which predominantly take the form of deep groundwater wells or contained natural springs. While the water systems have worked well to reduce pathogens in drinking water systems that cause illnesses such as dysentery, the water is rarely tested for heavy metal contamination, such as arsenic and lead. While bacteria analysis is essential, it is not the only component of healthy drinking water. Testing for heavy metals is especially important in the Bolivian Altiplano because abundant volcanic deposits and massive sulfide deposits suggest that in some areas it is likely that the water contains elevated concentrations of heavy metals. In this study, Terra Resource Development International, A California-based 502(c)3 nonprofit organization, partnered with Stanford University, the Technical University of Bolivia, and the Bolivian Geologic and Mining Survey to collect water samples in 36 rural community situated in four watersheds feeding into Lake Titicaca. Water was collected from shallow, hand dug wells, deep groundwater wells, springs, and small rivers in the Tiwanku, Laja, Batallas, Achacachi watersheds and were analyzed for inorganic contaminants. Samples were analyzed at Stanford’s Environmental Measurements Facility using the Inductively Coupled Plasma (ICP) Spectrometer for major ions and heavy metals. Results will help determine which, if any, community water systems are at risk of heavy metal contamination, where more comprehensive sampling is

  5. Promotion of breast feeding in the community: impact of health education programme in rural communities in Nigeria.

    Science.gov (United States)

    Davies-Adetugbo, A A

    1996-03-01

    Breast feeding has been recognized as a child survival strategy, while breast feeding programmes have been increasingly implemented in many communities. This study assesses the effectiveness of a breast feeding education programme launched through the primary health care programme in the rural communities of Nigeria. Late trimester pregnant women were enrolled into the study and given a questionnaire on knowledge, attitudes, and practices (KAP) about breast feeding. Women in the study group (n = 126) received breast feeding counselling before and after delivery, while those in control group (n = 130) did not receive any counselling. Both groups were monitored after delivery and followed with the KAP questionnaire. The results of the study showed marked improvements in the intervention group for colostrum feeding (p = 0.0000). Moreover, 31.6% of the mothers in the intervention group practised timely initiation of breast feeding compared to 5.6% of the controls, and the prevalence of exclusive breast feeding at 4 months was 39.8% in the intervention group compared to 13.9% for the controls. Multivariate analysis showed that the intervention was a powerful and the only significant predictor of the increase in breast feeding behaviours (p = 0.0000), and that an early initiation of breast feeding is a strong predictor of exclusive breast feeding at 4 months of age. It is concluded that breast feeding promotion in rural communities is feasible and can lead to behavioural changes.

  6. Community perceptions of a rural medical school: a pilot qualitative study

    Directory of Open Access Journals (Sweden)

    Nestel D

    2014-11-01

    Full Text Available Debra Nestel,1 Katherine Gray,1 Margaret Simmons,1 Shane A Pritchard,1 Rumana Islam,1 Wan Q Eng,1 Adrian Ng,1 Tim Dornan2 1Gippsland Medical School/School of Rural Health, Monash University, Clayton, Australia; 2School of Health Professions Education, Maastricht University, Maastricht, the Netherlands 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 involvement in medical curricula development, this study was designed to pilot an approach to exploring the perspectives of well members of the community in the transition of institutional policy on community engagement to one medical school. Methods: An advertisement in the local newspaper invited volunteers to participate in a telephone interview about the new medical school. An independent researcher external to the medical school conducted the interviews using a topic guide. Audio recordings were not made, but detailed notes including verbatim statements were recorded. At least two research team members analyzed interview records for emergent themes. Human research ethics approval was obtained. Results: Twelve interviews were conducted. Participants offered rich imaginings on the role of the school and expectations and opportunities for students. Most participants expressed strong and positive views, especially in addressing long-term health workforce issues. It was considered important that students live, mix, and study in the community. Some participants had very clear ideas about the need of the school to address specified needs, such as indigenous health, obesity, aging, drug and alcohol problems, teenage pregnancy, ethnic diversity, and working with people of low socioeconomic status. Conclusion: This study has initiated a dialogue with potential

  7. Sexual Practices That May Favor the Transmission of HIV in a Rural Community in Nigeria.

    Science.gov (United States)

    Ajuwon, A J; Oladepo, O; Adeniyi, J D; Ches, W R

    1993-01-01

    The Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) have been documented as a primarily urban phenomenon in Nigeria. The risk of spread to rural communities, where the largest portion of the population still lives, exists. This article presents a qualitative research study that was designed to explore sexual practices in a rural Nigerian community that held potential risk for introducing HIV into the community and for enabling HIV transmission should an infected person enters local sexual networks, in the small town of Ago-Are, Oyo State. Seven key informant interviews, in-depth interviews and observations with five commercial sex workers (CSWs), and focus group discussions (FGD) with married and single male and female residents were held. CSWs were found to be the most likely route whereby HIV could enter the community, both because of their own mobility, being resident in the community on average only nine months, and because of the mobility of their main clients, migrant farm laborers and commercial drivers. This did not preclude local patronage, which was more discrete. Another possible point of entry for HIV was through casual sexual relations during ceremonies, holidays and festivals, when towns' people working in the large urban centers came home. Within the community, extramarital sexual relations were posited as a likely route for spread within the community. The continued existence of a taboo against sexual intercourse while a mother is breastfeeding, frequent informal divorces and a tendency toward polygamy were identified by FGD members as factors that encourage extra-marital sex. The strong role that social and religious associations play in the community was identified as an ideal mechanism for health education to prevent HIV/AIDS.

  8. Infrastructural challenges to better health in maternity facilities in rural Kenya: community and healthworker perceptions.

    Science.gov (United States)

    Essendi, Hildah; Johnson, Fiifi Amoako; Madise, Nyovani; Matthews, Zoe; Falkingham, Jane; Bahaj, Abubakr S; James, Patrick; Blunden, Luke

    2015-11-09

    The efforts and commitments to accelerate progress towards the Millennium Development Goals for maternal and newborn health (MDGs 4 and 5) in low and middle income countries have focused primarily on providing key medical interventions at maternity facilities to save the lives of women at the time of childbirth, as well as their babies. However, in most rural communities in sub-Saharan, access to maternal and newborn care services is still limited and even where services are available they often lack the infrastructural prerequisites to function at the very basic level in providing essential routine health care services, let alone emergency care. Lists of essential interventions for normal and complicated childbirth, do not take into account these prerequisites, thus the needs of most health facilities in rural communities are ignored, although there is enough evidence that maternal and newborn deaths continue to remain unacceptably high in these areas. This study uses data gathered through qualitative interviews in Kitonyoni and Mwania sub-locations of Makueni County in Eastern Kenya to understand community and provider perceptions of the obstacles faced in providing and accessing maternal and newborn care at health facilities in their localities. The study finds that the community perceives various challenges, most of which are infrastructural, including lack of electricity, water and poor roads that adversely impact the provision and access to essential life-saving maternal and newborn care services in the two sub-locations. The findings and recommendations from this study are important for the attention of policy makers and programme managers in order to improve the state of lower-tier health facilities serving rural communities and to strengthen infrastructure with the aim of making basic routine and emergency obstetric and newborn care services more accessible.

  9. Nurses' experiences providing palliative care to individuals living in rural communities: aspects of the physical residential setting.

    Science.gov (United States)

    Kaasalainen, S; Brazil, K; Williams, A; Wilson, D; Willison, K; Marshall, D; Taniguchi, A; Phillips, C

    2014-01-01

    Efforts are needed to improve palliative care in rural communities, given the unique characteristics and inherent challenges with respect to working within the physical aspects of residential settings. Nurses who work in rural communities play a key role in the delivery of palliative care services. Hence, the purpose of this study was to explore nurses' experiences of providing palliative care in rural communities, with a particular focus on the impact of the physical residential setting. This study was grounded in a qualitative approach utilizing an exploratory descriptive design. Individual telephone interviews were conducted with 21 community nurses. Data were analyzed by thematic content analysis. Nurses described the characteristics of working in a rural community and how it influences their perception of their role, highlighting the strong sense of community that exists but how system changes over the past decade have changed the way they provide care. They also described the key role that they play, which was often termed a 'jack of all trades', but focused on providing emotional, physical, and spiritual care while trying to manage many challenges related to transitioning and working with other healthcare providers. Finally, nurses described how the challenges of working within the physical constraints of a rural residential setting impeded their care provision to clients who are dying in the community, specifically related to the long distances that they travel while dealing with bad weather. These study findings contribute to our understanding of the experiences of nurses working in rural communities in terms of the provision of palliative care and the influence of the physical residential setting that surrounds them. These findings are important since nurses play a major role in caring for community-dwelling clients who are dying, but they are confronted with many obstacles. As such, these results may help inform future decisions about how to best improve

  10. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2003-01-01

    .... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

  11. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Jr, Elton L

    2007-01-01

    .... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

  12. Community Hospital Telehealth Consortium

    National Research Council Canada - National Science Library

    Williams, Elton

    2004-01-01

    .... The central tenet of the CHTC project is the utilization of TeleHealth technology to improve and expand the opportunity for rural and urban underserved populations to receive quality, affordable health care...

  13. Community-Level Exposure to the Rural Mining Industry: The Potential Influence on Early Adolescent Alcohol and Tobacco Use.

    Science.gov (United States)

    Gay, Christopher; Clements-Nolle, Kristen; Packham, John; Ackerman, Gerald; Lensch, Taylor; Yang, Wei

    2018-01-31

    Rural youth have higher rates of alcohol and tobacco use compared to their urban counterparts. However, the economic dependence of rural communities may differentially influence risk behaviors. While research has shown that adults working in mining have elevated rates of alcohol and tobacco use, the influence of living in a mining community on early adolescent substance use is unknown. Using data from a representative sample of 4,535 middle school students in a state with heavy reliance on mining, we conducted weighted logistic regression to investigate whether community-level mining economic dependence influences rural-urban differences in adolescent alcohol and tobacco use. All models adjusted for sociodemographics, military family involvement, parental monitoring, and length of residence. Over one quarter of the sampled students lived in rural counties and approximately half of these counties met the USDA mining economic typology. After stratifying rural counties by mining and nonmining economic dependence, students in rural mining counties had significantly higher odds of all measures of alcohol use (AORs ranged from 1.83 to 3.99) and tobacco use (AORs ranged from 1.61 to 5.05) compared to students in urban counties. Only use of smokeless tobacco was higher among students in rural nonmining counties. Our findings demonstrate rural-urban disparities in adolescent substance use that are particularly pronounced among youth living in counties with economic dependence on mining. Future research on this subject should include a wider range of community-level factors that may have specific relevance in rural settings to inform the development of population-level interventions. © 2018 National Rural Health Association.

  14. Pharmacy and primary care perspectives on e-prescribing in a rural community: A focused ethnography.

    Science.gov (United States)

    Kooienga, Sarah; Singh, Reshmi L

    Electronic prescribing (ERx) is the ability for prescriber to send a digital prescription directly to a pharmacist through a dedicated secure network. A number of federally funded incentives such as the health information technology for economic and clinical health (HITECH) and Meaningful Use standards have led to ERx implementation. ERx is an integral part of primary care practice and today most community pharmacies are enabled to accept e-prescriptions. Little is known about the experience of rural pharmacists, primary care providers and patients regarding e-prescribing. This paper reports on the results of ERx from their perspectives. The findings are a portion of a larger qualitative descriptive study focused on the meaning of Meaningful Use in remote rural communities. One remote rural community in the Pacific Northwest was used for this research endeavor. Explore understandings of e-prescribing from both pharmacist and primary care provider perspective. Explore patients' understandings and experiences of e-prescribing. The conceptual model for this research was the Ecological Transactional Model. This model informed the research design, interview questions and analysis. A qualitative descriptive methodology - focused ethnography was used for this study. Six key informant interviews, 14 patient interviews and 15 hours of participant observation provided the data. Data analysis occurred collectively between a social pharmacy researcher, a primary care nurse practitioner-researcher and pharmacy graduate students. The research qualitatively identified contextual understandings and dimensions of ERx in this setting. Based on a focused ethnographic methodology, contextual understandings of rurality and role identity, both pharmacist and primary care provider, were explored. Perspectives on ERx of patients, clinic manager and RN staff were also elicited. Three dimensions of ERx were identified - technological, structural and communication. The structural

  15. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  16. Promoting and developing a trail network across suburban, rural, and urban communities.

    Science.gov (United States)

    Schasberger, Michele G; Hussa, Carol S; Polgar, Michael F; McMonagle, Julie A; Burke, Sharon J; Gegaris, Andrew J

    2009-12-01

    The Wyoming Valley Wellness Trails Partnership received an Active Living by Design grant late in 2003 for a project centered on a growing trail network linking urban, suburban, and rural communities in northeast Pennsylvania, a former coal region, in order to increase physical activity among residents. The partnership conducted research, collected information, created promotional documents, worked with partners on events and programs, and participated in trail planning. Local trail organizations continued planning and construction toward developing a trail network. Other partners spearheaded policy change in schools and worksites and worked toward downtown revitalization. The partnership assisted these efforts by providing a forum in which organizations could meet. The partnership became a central resource for information about local parks, trails, and outdoor recreational activities. The partnership increased awareness and use of recreational facilities. Trail partners constructed 22 miles of walking and biking trails. The partnership took advantage of an allied effort that created organizational capacity for wellness in schools and worksites. Messages promoting social and entertainment benefits of physical activity were more successful than those promoting health benefits. The existence of multiple small, independent trail organizations can help advance trail development through concurrent development efforts. Urban, suburban, and rural residents' conceptions of walkability may differ. Trails provide options for recreational and transportation-related physical activity across urban, suburban, and rural landscapes that are supported by all constituents. Trail builders can be strong allies in bringing active living to suburban and rural places.

  17. A community-based approach and its impact to sustainable rural water supply – A case of Kgotlopong ‘Mountain Water Harvesting’

    CSIR Research Space (South Africa)

    Maponya, G

    2013-07-01

    Full Text Available communities, especially in the remote rural areas, that face daunting challenges in accessing basic water. To address these challenges, other communities have developed community-based water supply initiatives. This paper takes a keen interest...

  18. Impact of religious faith & female literacy on fertility in a rural community of west Bengal

    Directory of Open Access Journals (Sweden)

    Mandal N

    2007-01-01

    Full Text Available Background : Role of different social factors on fertility control is evident from different studies. What is the impact of religious faith and female literacy on fertility? Objectives : To study the role of religious faith and female literacy on fertility regulation in a rural community of West Bengal. Methods : Cross Sectional Study at rural field practice area of Department of Community Medicine, NRS Medical College, Kolkata, based on interview of married women in reproductive age group. A total of 671 filled in schedules were analyzed by Epi info package. Results : Average number of pregnancies ever occurred among Muslim mothers (2.8 were higher in comparison with Hindu mothers (1.68. Regarding current fertility, live births in last 2 yrs was more among Muslim mothers (25.2% as compared with their counterparts among Hindu community (12.4%. In both the cases differences were found to be statistically significant. Female literacy was found to have no impact on fertility as a whole, but while stratified, its positive role was evident among Hindu mothers but not among Muslim mothers. Conclusions : Factors, which have made differences in fertility between two religious groups, should be properly assessed and duly addressed for better fertility control in the community.

  19. Associations between the social organization of communities and psychiatric disorders in rural Asia.

    Science.gov (United States)

    Axinn, William G; Ghimire, Dirgha J; Williams, Nathalie E; Scott, Kate M

    2015-10-01

    We provide rare evidence of factors producing psychiatric variation in a general population sample from rural South Asia. The setting is particularly useful for demonstrating that variations in the social organization of communities, often difficult to observe in rich countries, are associated with important variations in mental health. Clinically validated survey measures are used to document variation in psychiatric disorders among 401 adults. This sample is chosen from a systematic sample of the general population of rural Nepal, in a community-level-controlled comparison design. Multilevel logistic regression is used to estimate multivariate models of the association between community-level nonfamily social organization and individual-level psychiatric disorders. Schools, markets, health services and social support groups each substantially reduce the odds of depression, post-traumatic stress disorder (PTSD), intermittent explosive disorder and anxiety disorders. Associations between schools, health services and social support groups and depression are statistically significant and independent of each other. The association between access to markets and PTSD is statistically significant and independent of other social organization and support groups. Community integration of some nonfamily social organizations promotes mental health in ways that may go unobserved in settings with many such organizations. More research on the mechanisms producing these associations is likely to reveal potential avenues for public policy and programs to improve mental health in the general population.

  20. Community Participation and Barriers in Rural Tourism: A Case Study in Kiulu, Sabah

    Directory of Open Access Journals (Sweden)

    Velnisa Paimin N. F.

    2014-01-01

    Full Text Available The paper presents an investigation on local community participation and barriers in rural tourism. It identifies two sides of community participation in tourism as identified by Timothy [5], which are; the benefits point of view and from the decision making process perspective. It also identifies the communities’ barriers in engaging in tourism and uses Tosun’s [18] approach in examining the barriers. A total of eighty-three questionnaire forms were completed by respondents from seven villages in Kiulu, Sabah, Malaysia. Respondents involved in tourism were mainly engaged as river guides, homestay operators and Tagal participants. Their involvement in the decision making process were limited to attending meetings and giving ideas and opinions only. The main barriers to participate in tourism were related to their limited knowledge about tourism, lack of capital, unable to communicate well in English, lack of information about tourism development in Kiulu, and limited incentives or support from the government for tourism development. The findings have significant implication to community participation in tourism especially in rural settings. More efforts should be made to ensure many more communities participate in tourism so as to share the benefits of tourism.