WorldWideScience

Sample records for underserved rural families

  1. 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…

  2. 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…

  3. 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.

  4. Cancer Risk Assessment by Rural and Appalachian Family Medicine Physicians

    Science.gov (United States)

    Kelly, Kimberly M.; Love, Margaret M.; Pearce, Kevin A.; Porter, Kyle; Barron, Mary A.; Andrykowski, Michael

    2009-01-01

    Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region. Purpose: To examine primary care physicians' identification of hereditary cancers. Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United…

  5. 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 ...

  6. 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.

  7. 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...

  8. Personal values of family physicians, practice satisfaction, and service to the underserved.

    Science.gov (United States)

    Eliason, B C; Guse, C; Gottlieb, M S

    2000-03-01

    Personal values are defined as "desirable goals varying in importance that serve as guiding principles in people's lives," and have been shown to influence specialty choice and relate to practice satisfaction. We wished to examine further the relationship of personal values to practice satisfaction and also to a physician's willingness to care for the underserved. We also wished to study associations that might exist among personal values, practice satisfaction, and a variety of practice characteristics. We randomly surveyed a stratified probability sample of 1224 practicing family physicians about their personal values (using the Schwartz values questionnaire), practice satisfaction, practice location, breadth of practice, demographics, board certification status, teaching involvement, and the payor mix of the practice. Family physicians rated the benevolence (motivation to help those close to you) value type highest, and the ratings of the benevolence value type were positively associated with practice satisfaction (correlation coefficient = 0.14, P = .002). Those involved in teaching medical trainees were more satisfied than those who were not involved (P = .009). Some value-type ratings were found to be positively associated with caring for the underserved. Those whose practices consisted of more than 40% underserved (underserved defined as Medicare, Medicaid, and indigent populations) rated the tradition (motivation to maintain customs of traditional culture and religion) value type significantly higher (P = .02). Those whose practices consisted of more than 30% indigent care rated the universalism (motivation to enhance and protect the well-being of all people) value type significantly higher (P = .03). Family physicians who viewed benevolence as a guiding principle in their lives reported a higher level of professional satisfaction. Likewise, physicians involved in the teaching of medical trainees were more satisfied with their profession. Family physicians

  9. 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.

  10. Randomized Trial of a Family-based, Automated, Conversational Obesity Treatment Program for Underserved Populations

    Science.gov (United States)

    Wright, J. A.; Phillips, B.D.; Watson, B.L.; Newby, P.K.; Norman, G. J.; Adams, W.G.

    2013-01-01

    Objective To evaluate the acceptability and feasibility of a scalable obesity treatment program integrated with pediatric primary care and delivered using interactive voice technology (IVR) to families from underserved populations. Design and Methods Fifty parent-child dyads (child 9–12 yrs, BMI >95th percentile) were recruited from a pediatric primary care clinic and randomized to either an IVR or a wait-list control (WLC) group. The majority were lower-income, African-American (72%) families. Dyads received IVR calls for 12 weeks. Call content was informed by two evidenced-based interventions. Anthropometric and behavioral variables were assessed at baseline and 3 mo follow-up. Results Forty-three dyads completed the study. IVR parents ate 1 cup more fruit than WLC (p 75% agreed that the calls were useful, made for people like them, credible, and helped them eat healthy foods. Conclusion An obesity treatment program delivered via IVR may be an acceptable and feasible resource for families from underserved populations. PMID:23512915

  11. Associations between positive parenting practices and child externalizing behavior in underserved Latino immigrant families.

    Science.gov (United States)

    Holtrop, Kendal; McNeil Smith, Sharde'; Scott, Jenna C

    2015-06-01

    This study examined whether five specific parenting practices (i.e., monitoring, discipline, skill encouragement, problem solving, and positive involvement) were associated with reduced child externalizing behaviors among a sample of Latino immigrant families. It utilized baseline data from 83 Latino couples with children participating in a larger randomized controlled trial of a culturally adapted parenting intervention. Results reveal that monitoring, discipline, skill encouragement, and problem solving each made independent contributions to the prediction of child externalizing behavior, although not all in the expected direction. Further analyses examining mothers and fathers separately suggest that mother-reported monitoring and father-reported discipline practices uniquely contributed to these findings. These results may have important implications for prevention and clinical intervention efforts with Latino immigrant families, including the cultural adaptation and implementation of parenting interventions with this underserved population. © 2014 Family Process Institute.

  12. Collaboration with pharmacy services in a family practice for the medically underserved

    Directory of Open Access Journals (Sweden)

    Campbell K

    2009-12-01

    Full Text Available Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed.Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twenty-two patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages.Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for

  13. 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.

  14. Dermatologic care in the homeless and underserved populations: observations from the Venice Family Clinic.

    Science.gov (United States)

    Grossberg, Anna L; Carranza, Dafnis; Lamp, Karen; Chiu, Melvin W; Lee, Catherine; Craft, Noah

    2012-01-01

    Dermatologic care in the homeless and impoverished urban underserved populations is rarely described despite the wide prevalence of skin concerns in this population. Because the homeless population may be subject to increased sun exposure compared to the nonhomeless population, they also may be at increased risk for skin cancer. We sought to describe the spectrum of dermatologic diseases seen in a free clinic in Venice, California--the Venice Family Clinic (VFC)--as well as the differences in diagnoses between the homeless and nonhomeless patients seen at this clinic. A retrospective chart review was performed of dermatology patients (N = 82) seen at VFC throughout the 2006 calendar year. The homeless population (n = 22) was found to have more diagnoses of malignant/premalignant growths (25% [16/64] of all homeless diagnoses) compared to their nonhomeless (n = 60) counterparts (6.1% [8/132] of all nonhomeless diagnoses; P < .0001). This difference was sustained when ethnicity was controlled, with 29.6% [16/54] of diagnoses in the homeless white group consisting of malignant/ premalignant growths compared to 8.9% [4/45] of diagnoses in the nonhomeless white cohort (P < .005). Homeless patients may have a higher incidence of skin cancers and precancerous skin lesions due to increased sun exposure and/or limited access to dermatologic care.

  15. Maternity and family leave policies in rural family practices.

    Science.gov (United States)

    Mainguy, S; Crouse, B J

    1998-09-01

    To help recruit and retain physicians, especially women, rural family practice groups need to establish policies regarding maternity and other family leaves. Also important are policies regarding paternity leave, adoptive leave, and leave to care for elderly parents. We surveyed members of the American Academy of Family Physicians in rural practice in 1995 to assess the prevalence of leave policies, the degree to which physicians are taking family leave, and the characteristics of ideal policies. Currently, both men and women physicians are taking family leaves of absence, which indicates a need for leave policies. Furthermore, a lack of family leave policies may deter women from entering rural practice.

  16. 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.

  17. 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.

  18. 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

  19. A Tobacco Cessation Intervention with Rural, Medically Underserved, Blue-collar Employees: A Quasiexperimental Study

    Directory of Open Access Journals (Sweden)

    Telisa Stewart

    2016-12-01

    Conclusion: Participants at the intervention worksite increased their knowledge regarding the dangers of tobacco use and secondhand smoke exposure. Among current tobacco users, the intervention appeared to increase family rules regarding secondhand smoke exposure in their homes and vehicles.

  20. CURRENT TRENDS OF ROMANIAN RURAL FAMILY

    Directory of Open Access Journals (Sweden)

    Adina IORGA

    2013-01-01

    Full Text Available The profound changes experienced by the Romanian society had a profound social impact on the structure and functions of the rural family. The paper aims to highlight the main trends recorded using a number of indicators: ruralization rate, birth rate, infant mortality rate, percentage of children born outside marriage, fertility rate, percentage of population aged 65 and over. Statistics from censuses and statistical yearbooks were processed to identify the trends of the Romanian rural family: changes in reproductive behavior, increased aging, declining birth rates.

  1. Rural Health, Center of Excellence for Remote and Medically Under-Served Areas (CERMUSA). Addendum

    Science.gov (United States)

    2010-07-01

    Plaque *c. Pulpitis or an abscess d. Gingivitis 4. Pulp necrosis can be defined as: a. A viral infection in the gums *b. Death of the pulp...families. Available data indicate higher incidences of breast and prostate cancer affecting U.S. military versus the general population (Zhu et al...Meyerowitz, B. E., et al. (2006). Fatigue in long-term breast carcinoma survivors: A longitudinal investigation. Cancer, 106(4), 751-758. Courneya, K

  2. 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

  3. 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

  4. 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.

  5. Family Reunions: Broadened Kinship, Celebrated Rurality

    Directory of Open Access Journals (Sweden)

    Renata Menasche

    2014-12-01

    Full Text Available This articletakes family reunions held among peasants as a focus of study. During these events,keycultural categories come to light from which the analyzed group builds up ideas about kinship and also the relations that are implied in it. We observe that, in these cases, there are also indications of specific elements through which people express a valorization of rurality. To carry out this study, we collected data as part of an ethnographic research project conducted at a family reunion and in a rural community settled by German descendent immigrants, located in Rio Grande do Sul, southern Brazil

  6. Digital divide and information needs for improving family support among the poor and underserved.

    Science.gov (United States)

    Collins, Sarah A; Yoon, Sunmoo; Rockoff, Maxine L; Nocenti, David; Bakken, Suzanne

    2016-03-01

    Despite of its emotional benefits, communication with family members who live abroad can present a large financial burden for low-income foreign-born individuals. The aims of this study were (1) to explore the current technologies available for low-cost communication with family living abroad and (2) to assess the level of awareness and use of low-cost technologies for family communication as well as related information needs among low-income foreign-born individuals. This mixed-methods study included an environmental scan, survey, and focus groups with low-income foreign-born individuals living in East Harlem in New York City. Low-income individuals who have family members living abroad face financial stress with complicated technology choices for communication with family living abroad and they have many information needs. They would welcome interactive and convenient educational tools that (1) build skills for utilization of various technologies and (2) provide decision support to simplify choosing among the vast array of available communication options. © The Author(s) 2014.

  7. 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.

  8. Pathways to rural family practice at Memorial University of Newfoundland.

    Science.gov (United States)

    Rourke, James; O'Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle

    2018-03-01

    To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Analysis of anonymized secondary data. Canada. Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). National effect was measured by the proportion of MUN's family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN's MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN's 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Memorial's comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN's MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial's 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of

  9. Factors affecting frequency of communication about family health history with family members and doctors in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Goodman, Melody; Pandya, Chintan; Garg, Priyanka; Stafford, Jewel; Lachance, Christina

    2012-08-01

    Family history contributes to risk for many common chronic diseases. Little research has investigated patient factors affecting communication of this information. 1061 adult community health center patients were surveyed. We examined factors related to frequency of discussions about family health history (FHH) with family members and doctors. Patients who talked frequently with family members about FHH were more likely to report a family history of cancer (p =.012) and heart disease (p history of heart disease (p = .011), meet physical activity recommendations (p = .022), seek health information frequently in newspapers (p history of some diseases, those not meeting physical activity recommendations, and those who do not frequently seek health information may not have ongoing FHH discussions. Interventions are needed to encourage providers to update patients' family histories systematically and assist patients in initiating FHH conversations in order to use this information for disease prevention and control. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  10. Attitude of Rural Youths towards Family Farming in Dass, Bauchi ...

    African Journals Online (AJOL)

    Attitude of Rural Youths towards Family Farming in Dass, Bauchi State, Nigeria and the ... Majority were males (88 %), single (51 %), literate (99 %) and had rural ... most of them (78 %) said was learned through parents (non-formal sources).

  11. 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...

  12. 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…

  13. 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.

  14. Attitude of Women towards Family Planning in Selected Rural ...

    African Journals Online (AJOL)

    ... the desired attitudinal and behavioral changes towards family planning is yet to be ... from selected rural areas in Ibadan towards family planning using the Health ... The study revealed that the socio-economic status of mothers significantly ...

  15. Parent behavior and child weight status among a diverse group of underserved rural families

    Science.gov (United States)

    The purpose of this study was threefold: to investigate the association between three parenting behaviors (parenting style, feeding style, and feeding practices); to evaluate whether these behaviors were associated with child weight; and to determine whether style (parenting and feeding) moderated t...

  16. 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...

  17. 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.

  18. Food insecurity and physical activity insecurity among rural Oregon families

    Directory of Open Access Journals (Sweden)

    Katherine B. Gunter

    2017-12-01

    Full Text Available Among rural families, rates of both child obesity and household food insecurity (FI are higher compared to non-rural families. These disparities result from a complex interplay of social and environmental conditions that influence behavior. The Transtheoretical Model suggests individual readiness to change underlies success in modifying obesity-preventing behaviors; however, whether an association between readiness to change obesity-related behaviors and FI status among rural families exists is unknown. We examined the association between readiness to change family-level nutrition and physical activity (PA behaviors that predict child obesity and family FI status within a sample of rural families to better understand these relationships. Families (n=144 were recruited from six rural Oregon communities in 2013. Families completed a FI screener and the Family Stage of Change Survey (FSOC, a measure of readiness to change family-level nutrition and PA behaviors associated with obesity. Demographic differences by FI status were explored, and regression was applied to examine relationships between FI and FSOC scores, adjusting for relevant covariates. Among FI families (40.2%, more were non-white (77.8% vs. 22.2%; p=0.036 and had lower adult education (30.4% vs. 11.8% with >high school degree; p=0.015 compared to non-FI families. After adjusting for education, race, ethnicity, and eligibility for federal meal programs, readiness to provide opportunities for PA was lower among FI families (p=0.002. These data highlight a need to further investigate how food insecurity and low readiness to provide PA opportunities, i.e. “physical activity insecurity” may be contributing to the higher obesity rates observed among rural children and families. Keywords: Food insecurity, Physical activity, Rural, Childhood obesity

  19. Impact of the rural pipeline in medical education: practice locations of recently graduated family physicians in Ontario.

    Science.gov (United States)

    Wenghofer, Elizabeth F; Hogenbirk, John C; Timony, Patrick E

    2017-02-20

    The "rural pipeline" suggests that students educated in rural, or other underserviced areas, are more likely to establish practices in such locations. It is upon this concept that the Northern Ontario School of Medicine (NOSM) was founded. Our analysis answers the following question: Are physicians who were educated at NOSM more likely to practice in rural and northern Ontario compared with physicians who were educated at other Canadian medical schools? We used data from the College of Physicians and Surgeons of Ontario. We compared practice locations of certified Ontario family physicians who had graduated from NOSM vs. other Canadian medical schools in 2009 or later. We categorized the physicians according to where they completed their undergraduate (UG) and postgraduate (PG) training, either at NOSM or elsewhere. We used logistic regression models to determine if the location of UG and PG training was associated with rural or northern Ontario practice location. Of the 535 physicians examined, 67 had completed UG and/or PG medical education at NOSM. Over two thirds of physicians with any NOSM education were practicing in northern areas and 25.4% were practicing in rural areas of Ontario compared with those having no NOSM education, with 4.3 and 10.3% in northern and rural areas, respectively. Physicians who graduated from NOSM-UG were more likely to have practices located in rural Ontario (OR = 2.57; p = 0.014) whereas NOSM-PG physicians were more likely to have practices in northern Ontario (OR = 57.88; p education was associated with an increased likelihood of practicing in rural (NOSM-UG) and northern (NOSM-PG) Ontario.

  20. Planning a Family: Priorities and Concerns in Rural Tanzania ...

    African Journals Online (AJOL)

    Planning a Family: Priorities and Concerns in Rural Tanzania. T Marchant, AK Mushi, R Nathan, O Mukasa, S Abdulla, C Lengeler, JRM Armstrong Schellenberg. Abstract. A fertility survey using qualitative and quantitative techniques described a high fertility setting (TFR 5.8) in southern Tanzania where family planning use ...

  1. Better Together: Expanding Rural Partnerships to Support Families

    Science.gov (United States)

    Shaklee, Harriet; Bigbee, Jeri; Wall, Misty

    2012-01-01

    Chronic shortages of health, social service, and mental health professionals in rural areas necessitate creative partnerships in support of families. Cooperative extension professionals in Family and Consumer Sciences and community health nurses, who can bring critical skills to human services teams, are introduced as trusted professionals in…

  2. [Effect of development of rural commodity economy on family planning].

    Science.gov (United States)

    Chen, X

    1986-05-01

    The paper discusses the effects of the changes of rural income level on family planning practice based a survey of 200 rural families in a affluent vegetable producing area of suburban Beijing. In 1984, 99.7% of child birth followed the local birth planning, and 99.1% of families with one child received One Child Certificates. The annual per capita income of the 200 families was 1,092 yuan (1 US$ = 3.7 yuan) in 1984 even higher than the community average. The number of children was negatively associated with the per capita income and per capita consumption except families with 4 children, most of whom have grown up. The rural mechanization in the community has greatly increased the need for skills and technology rather than strong laborers. The provision of community welfare programs and the increased living standard changed the value of children and also changed people's perception in favor of gender equality. Among families with 1 or 2 children, most preferred to have girls. And among families with more children, the preferred family size is smaller than the actual size, which shows a tendency towards favoring a small family. Among 1 child families, 58.7% considered 1 boy and 1 girl to be ideal, and 37.7% was happy with the only child. As the community becomes richer, both the community and individual families increased their investment in education. The spending on education per child was over 2 times as high in 1 child families than the families with more children. The educational status of parents is positively associated with the exception of children's future education and current spending on education. The concern of parents over children's education is an important factor in improving the quality of labor force. Women of higher education status are more acceptable to contraception and family planning policy. The relatively high level of education of the community has been conducive to it fertility decline.

  3. Single-Parent Families in Rural Communities

    Science.gov (United States)

    Lewis, Ken

    1978-01-01

    Presenting national statistics on single-parent families, this article illustrates the need for serious study of this phenomenon, suggesting that changing divorce laws, increased single-parent adoptions, and an increase in the number of supportive services for single-parent families are contingencies having significant bearing upon the…

  4. The experience of rural families in the face of cancer.

    Science.gov (United States)

    Girardon-Perlini, Nara Marilene Oliveira; Ângelo, Margareth

    2017-01-01

    To understand the meanings of cancer within the experience of rural families and how such meanings influence family dynamics. Qualitative study guided by Symbolic Interactionism as a theoretical framework and Grounded Theory as a methodological framework. Six rural families (18 participants) undergoing the experience of having a relative with cancer participated in the interview. Constant comparative analysis of data allowed the elaboration of an explanatory substantive theory, defined by the main category Caregiving to support the family world, which represents the family's symbolic actions and strategies to reconcile care for the patient and care for family life. Throughout the experience, rural families seek to preserve the interconnected symbolic elements that provide support for the family world: family unit, land, work and care. Compreender os significados do câncer presentes na experiência de famílias rurais e como esses significados influenciam a dinâmica familiar. Estudo qualitativo orientado pelo Interacionismo Simbólico como referencial teórico e pela Teoria Fundamentada nos Dados como referencial metodológico. Participaram, por meio de entrevista, seis famílias rurais (18 participantes) que estavam vivendo a experiência de ter um familiar com câncer. A análise comparativa constante dos dados permitiu a elaboração de uma teoria substantiva explicativa da experiência, definida pela categoria central Cuidando para manter o mundo da família amparado, que representa as ações e estratégias simbólicas da família visando a conciliar o cuidado do familiar doente e o cuidado da vida familiar. Ao longo da experiência, a família rural procura preservar os elementos simbólicos que, conectados, constituem o amparo do mundo da família: a unidade familiar, a terra, o trabalho e o cuidado.

  5. Rural Family Physicians Are Twice as Likely to Use Telehealth as Urban Family Physicians.

    Science.gov (United States)

    Jetty, Anuradha; Moore, Miranda A; Coffman, Megan; Petterson, Stephen; Bazemore, Andrew

    2018-04-01

    Telehealth has the potential to reduce health inequities and improve health outcomes among rural populations through increased access to physicians, specialists, and reduced travel time for patients. Although rural telehealth services have expanded in several specialized areas, little is known about the attitudes, beliefs, and uptake of telehealth use in rural American primary care. This study characterizes the differences between rural and urban family physicians (FPs), their perceptions of telehealth use, and barriers to further adoption. Nationally representative randomly sampled survey of 5,000 FPs. Among the 31.3% of survey recipients who completed the survey, 83% practiced in urban areas and 17% in rural locations. Rural FPs were twice as likely to use telehealth as urban FPs (22% vs. 10%). Logistic regressions showed rural FPs had greater odds of reporting telehealth use to connect their patients to specialists and to care for their patients. Rural FPs were less likely to identify liability concerns as a barrier to using telehealth. Telemedicine allows rural patients to see specialists without leaving their communities and permits rural FPs to take advantage of specialist expertise, expand their scope of practice, and reduce the feeling of isolation experienced by rural physicians. Efforts to raise awareness of current payment policies for telehealth services, addressing the limitations of current reimbursement policies and state regulations, and creating new avenues for telehealth reimbursement and technological investments are critical to increasing primary care physician use of telehealth services.

  6. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  7. Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan.

    Science.gov (United States)

    Broughton, Edward Ivor; Hameed, Waqas; Gul, Xaher; Sarfraz, Shabnum; Baig, Imam Yar; Villanueva, Monica

    2017-01-01

    This study reports on the effectiveness and efficiency from the program funder's perspective of the Suraj Social Franchise (SSF) voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016. A decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs) to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program. A total of 168,206 married women of reproductive age (MWRA) received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient). The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62-5.31). The result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.

  8. Husband and Wife Interaction and Family Regulation in Rural Uruguay.

    Science.gov (United States)

    De Winter, A. M.

    Decision-making and family planning were studied in the rural city of Durazno, Uruguay, by means of answers to questions by both husbands and wives. A sample size of 268 couples in which at least one partner was between 21 and 50 years of age was used. Data were collected by means of a pretested and precoded interview schedule. Major conclusions…

  9. The Role of Family Background for Earnings in Rural China

    DEFF Research Database (Denmark)

    Eriksson, Tor Viking; Qiang, Zhang Ying

    This paper provides estimates of brother income correlations for rural China. Brother correlations are a parsimonious measure of the importance of family and community background as determinants of individuals' economic status. We find internationally high levels of income similarity for brothers...

  10. Assessing predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan: results of a cross-sectional baseline survey.

    Science.gov (United States)

    Azmat, Syed Khurram; Ali, Moazzam; Ishaque, Muhammad; Mustafa, Ghulam; Hameed, Waqas; Khan, Omar Farooq; Abbas, Ghazunfer; Temmerman, Marleen; Munroe, Erik

    2015-03-28

    Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed. A cross-sectional baseline household survey was conducted with randomly selected 3,998 married women of reproductive age (MWRA) in the Chakwal, Mianwali, and Bhakkar districts of Punjab. The data were analyzed on SPSS 17.0 using simple descriptive and logistic regression. Most of the women had low socio-economic status and were younger than 30 years of age. Four-fifths of the women consulted private sector health facilities for reproductive health services; proximity, availability of services, and good reputation of the provider were the main predicators for choosing the facilities. Husbands were reported as the key decision maker regarding health-seeking and family planning uptake. Overall, the current contraceptive use ranged from 17% to 21% across the districts: condoms and female sterilization were widely used methods. Woman's age, husband's education, wealth quintiles, spousal communication, location of last delivery, and favorable attitude toward contraception have an association with current contraceptive use. Unmet need for contraception was 40.6%, 36.6%, and 31.9% in Chakwal, Mianwali, and Bhakkar, respectively. Notably, more than one fifth of the women across the districts expressed willingness to use quality, affordable long-term family planning services in the future. The baseline results highlight the need for quality, affordable long-term family planning

  11. 78 FR 36520 - U.S. Department of Agriculture Multi-Family Housing Section 515-Underserved Counties and Colonias...

    Science.gov (United States)

    2013-06-18

    ...-Discrimination Statement The U.S. Department of Agriculture (USDA) prohibits discrimination against its customers..., gender identity, religion, reprisal, and where applicable, political beliefs, marital status, familial or... activities.) If you wish to file a Civil Rights program complaint of discrimination, complete the USDA...

  12. Racial and Gender Differences in the Diets of Rural Youth and Their Mothers

    Science.gov (United States)

    Stanton, Cassandra A.; Fries, Elizabeth A.; Danish, Steven J.

    2003-01-01

    Objective: To examine mother-child dietary concordance that may contribute to healthy eating practices critical to cancer prevention in underserved rural families. Methods: A brief food frequency questionnaire was administered to 404 sixth-graders and their mothers in rural Virginia and New York. Results: Significant dietary fat concordance rates…

  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. Son preference in rural China: patrilineal families and socioeconomic change.

    Science.gov (United States)

    Murphy, Rachel; Tao, Ran; Lu, Xi

    2011-01-01

    This article draws on a survey conducted in six provinces in summer 2008 to investigate the determinants of son preference in rural China. The analysis confirms the conventional wisdom that son preference is embedded within patrilineal family structures and practices. We extend our analysis by exploring specific aspects of variation within patrilineal family culture. We find that the patrilineal group (clan) composition of villages and family participation in practices such as building ancestral halls and updating genealogies significantly influence son preference. Yet even though son preference is embedded within patrilineal family culture, our analysis suggests that over time the attenuation of son preference is likely. This is because determinants associated with socioeconomic change—for instance, higher levels of education, direct exposure to official policy education materials, higher income (a proxy for rural industrialization), and agricultural mechanization—all attenuate son preference. Being younger and female are also associated with weaker son preference, and both characteristics are likely to interact with education and industrialization to further dilute son preference in the longer term. Nevertheless, our findings suggest that concerted efforts are needed to ameliorate institutional discrimination against rural people in welfare provisioning and in labor markets, and to promote multiple dimensions of gender equality, including in land rights, wage rates, and education.

  15. Children Education Investment of Rural Families in Hechuan District of Chongqing Municipality

    Institute of Scientific and Technical Information of China (English)

    Xiaoling SONG; Dan YANG; Xiaohong SONG

    2015-01-01

    Taking 20 relative poor families in Hechuan District of Chongqing Municipality as survey samples,taking 275 households of rural families selected by stratified sampling method as research objects,and taking family education investment behavior of this rural area as research content,this paper studied current situations of rural family education investment behavior in Hechuan District,difference in investment behavior and related influence factors. It is intended to provide references for family education investment of rural areas in Hechuan District and even Chongqing Municipality,and promote development of rural education undertaking in China.

  16. Examining Empowerment, Family-School Partnerships, and Advocacy among Rural and Urban Latino Families of Children with Disabilities

    Science.gov (United States)

    Burke, Meghan M.

    2017-01-01

    Latino students and their families are the fastest growing minority group in the country, yet it is unclear whether rural (vs. urban) Latino families of students with disabilities have different needs. In this pilot study, 65 Latino family members of students with disabilities (15 rural; 50 urban) responded to a questionnaire about empowerment,…

  17. Family planning and fertility decline in rural Iran: the impact of rural health clinics.

    Science.gov (United States)

    Salehi-Isfahani, Djavad; Abbasi-Shavazi, M Jalal; Hosseini-Chavoshi, Meimanat

    2010-09-01

    During the first few years of the Islamic Revolution of 1979, and aided by pro-natal government policies, Iranian fertility was on the rise. In a reversal of its population policy, in 1989, the government launched an ambitious and innovative family planning program aimed at rural families. By 2005, the program had covered more than 90% of the rural population and the average number of births per rural woman had declined to replacement level from about 8 births in the mid 1980s. In this paper, we evaluate the impact of a particular feature of the program - health houses - on rural fertility, taking advantage of the variation in the timing of their construction across the country. We use three different methods to obtain a range of estimates for the impact of health houses on village-level fertility: difference-in-differences (DID), matching DID, and length of exposure. We find estimates of impact ranging from 4 to 20% of the decline in fertility during 1986-1996. (c) 2010 John Wiley & Sons, Ltd.

  18. Family caregivers in rural Uganda: the hidden reality.

    Science.gov (United States)

    Kipp, Walter; Tindyebwa, Denis; Rubaale, Tom; Karamagi, Ednah; Bajenja, Ellen

    2007-01-01

    We conducted 16 in-depth interviews with family caregivers of AIDS patients in three rural districts in western Uganda. They were selected from a client visitation list of the home-based care program for AIDS patients, based on volunteer participation. Family caregivers reported huge problems associated with providing the necessary psychological, social, and economic care. They also said that the physical and emotional demands of caregiving are overwhelming daily challenges. Most support to AIDS patients provided by family, friends, and the churches. The study highlights the great burden of caregivers, in sub-Saharan Africa who most often are elderly women and young girls. This study examine, the burden and related health issues of family caregivers, primarily women, for AIDS patients in Uganda. It was part of a broad research project using qualitative methods on family caregiving in the home environment in sub-Saharan Africa. As the requirements for family care giving are often overwhelming for women under the conditions as they exist in Uganda and in other developing countries, it constitutes a gender issue of great importance that has not been appreciated fully in the international literature. Family caregiving is also of international relevance, as HIV/AIDS is a global pandemic of previously unknown proportions. In many poor countries, family caregiving is the most common and often the only care that AIDS patients receive, because clinic-based care often is not available close to home or is not affordable. Therefore, family caregiver support programs to alleviate this burden are essential for all those countries where HIV/AIDS is prevalent. Family caregiver burden encompasses medical, social, and economic issues at the household level, which requires an interdisciplinary approach in order to fully understand and appreciate the different dimensions of the family caregiver burden and its negative impact on the lives of so many women in so many countries.

  19. 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.

  20. 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.

  1. Cultivating men's interest in family planning in rural El Salvador.

    Science.gov (United States)

    Lundgren, Rebecka I; Gribble, James N; Greene, Margaret E; Emrick, Gail E; de Monroy, Margarita

    2005-09-01

    A pilot project in rural El Salvador tested the integration of family planning into a water and sanitation program as a strategy for increasing male involvement in family planning decison making and use. The organizations involved posited that integrating family planning into a resource management and community development project would facilitate male involvement by diffusing information, by referring men and women to services, and by expanding method choice to include the new Standard Days Method through networks established around issues men cared about and were already involved in. This article examines data from a community-based household survey to assess the impact of the intervention and finds significant changes in contraceptive knowledge, attitudes, and behavior from baseline to endline. Because the differences between baseline and endline are greater than the differences between participants and nonparticipants at endline, the study demonstrates the power of informal networks for spreading information.

  2. Cost-Effectiveness of a Family Planning Voucher Program in Rural Pakistan

    Directory of Open Access Journals (Sweden)

    Edward Ivor Broughton

    2017-09-01

    Full Text Available IntroductionThis study reports on the effectiveness and efficiency from the program funder’s perspective of the Suraj Social Franchise (SSF voucher program in which private health-care providers in remote rural areas were identified, trained, upgraded, and certified to deliver family planning services to underserved women of reproductive age in 29 districts of Sindh and 3 districts of Punjab province, Pakistan between October 2013 and June 2016.MethodA decision tree compared the cost of implementing SSF to the program funder and its effects of providing additional couple years of protection (CYPs to targeted women, compared to business-as-usual. Costs included vouchers given to women to receive a free contraceptive method of their choice from the SSF provider. The vouchers were then reimbursed to the SSF provider by the program.ResultsA total of 168,206 married women of reproductive age (MWRA received SSF vouchers between October 2013 and June 2016, costing $3,278,000 ($19.50/recipient. The average effectiveness of the program per voucher recipient was an additional 1.66 CYPs, giving an incremental cost-effectiveness of the program of $4.28 per CYP compared to not having the program (95% CI: $3.62–5.31.ConclusionThe result compares favorably to other interventions with similar objectives and appears affordable for the Pakistan national health-care system. It is therefore recommended to help address the unmet need for contraception among MWRA in these areas of Pakistan and is worthy of trial implementation in the country more widely.

  3. Risk projection and the fertility of rural families.

    Science.gov (United States)

    Song, R

    1991-01-01

    The author comments on the theories and empirical evidence which aid in understanding the determinants of the reproductive behavior of farmers in China. The issues are defined, and discussion expands on the needs for a specific number of children in rural versus urban areas, M. Cain's risk insurance hypothesis, the importance of modes of production for the farm family, the farmer's security versus risks, and the balance between risk projection and the maximization of interest. The significance of risk projection is presented as are the implications for policy making. Neither theory of farmer's reproductive behavior, 1) the economic cost and benefit theory or 2) the need for labor theory is considered suitable. The idea that benefits exceed the costs of rearing children cannot justify the repeated cycle of poverty among farmers with many children. The Hubei Province, Danjiankou City, study which estimates rearing costs of 3360 yuan/child benefits of 305 yuan/year to the parents in old age is considered incorrect. The second theory agrees that children are needed for production but recognized surplus labor and does not account for the fact that the more children, the poorer the family. Micro demographic theories identify factors affecting demographic behavior, the extent to which factors affect fertility, and the interrelatedness of factors. The rural family feels jeopardized with one child, and the lowest tolerable number of children is 2-3 in rural areas. Manual labor is the basis of the traditional peasant economy. In this economy, loss of income is a threat whether due to crop failure, weather changes, or market changes. Payment occurs at the end of the year only. Child health is a risk due to poor nutrition and poor health facilities. Following a one-child policy might jeopardize perpetuation of the family line and provision for parents by sons. Urban risks are different. Rural families limit risk by keeping material resources, enlarging and strengthening the

  4. Differential Adjustment Among Rural Adolescents Exposed to Family Violence

    Science.gov (United States)

    Sianko, Natallia; Hedge, Jasmine M.; McDonell, James R.

    2016-01-01

    This study examines differences in psychological adjustment in a sample of rural adolescents who have been exposed to family violence. Self-report questionnaires were administered to 580 adolescents and their primary caregivers. The results revealed that over two thirds of the study participants (68.8%) had been exposed to violence in their families. As hypothesized, cluster analysis identified several profiles among adolescents, distinguished by their psychological and emotional functioning: well adjusted (46.2%), moderately adjusted (44.3%), and struggling (9.5%). Discriminant function analysis confirmed the groupings and revealed that family functioning was among the most influential factors explaining adjustment differences. Multivariate analyses of variance (MANOVAs) further showed that adolescents from each of the three adjustment profiles reported significantly different levels of family social support, parental involvement, and perceived neighborhood safety. Overall, the results confirm heterogeneity of adolescent adaptation in the aftermath of family violence and provide insights into family and neighborhood factors that account for variability in adolescents’ reactions to violence. Implications for future research and practical interventions are discussed. PMID:27106255

  5. Differential Adjustment Among Rural Adolescents Exposed to Family Violence.

    Science.gov (United States)

    Sianko, Natallia; Hedge, Jasmine M; McDonell, James R

    2016-04-22

    This study examines differences in psychological adjustment in a sample of rural adolescents who have been exposed to family violence. Self-report questionnaires were administered to 580 adolescents and their primary caregivers. The results revealed that over two thirds of the study participants (68.8%) had been exposed to violence in their families. As hypothesized, cluster analysis identified several profiles among adolescents, distinguished by their psychological and emotional functioning: well adjusted (46.2%), moderately adjusted (44.3%), and struggling (9.5%). Discriminant function analysis confirmed the groupings and revealed that family functioning was among the most influential factors explaining adjustment differences. Multivariate analyses of variance (MANOVAs) further showed that adolescents from each of the three adjustment profiles reported significantly different levels of family social support, parental involvement, and perceived neighborhood safety. Overall, the results confirm heterogeneity of adolescent adaptation in the aftermath of family violence and provide insights into family and neighborhood factors that account for variability in adolescents' reactions to violence. Implications for future research and practical interventions are discussed. © The Author(s) 2016.

  6. Corporal punishment in rural Colombian families: prevalence, family structure and socio-demographic variables.

    Science.gov (United States)

    González, Martha Rocío; Trujillo, Angela; Pereda, Noemí

    2014-05-01

    To reveal the prevalence of corporal punishment in a rural area of Colombia and its correlates to family structure and other socio-demographic variables. A survey about childrearing and childcare was developed for this study, including a specific question about corporal punishment that was developed based on the Conflict Tactics Scale (CTS). Family structure was categorized as follows, based on previous literature: 'nuclear family,' 'single parent' family, 'extended family,' 'simultaneous family' and 'composed family.' Forty-one percent of the parents surveyed admitted they had used corporal punishment of their children as a disciplinary strategy. The type of family structure, the number of children living at home, the age of the children, the gender of the parent who answered the survey, and the age and gender of the partner were significant predictors of corporal punishment. Family structure is an important variable in the understanding of corporal punishment, especially in regard to nuclear families that have a large number of children and parents who started their parental role early in life. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. My Future, My Family, My Freedom: Meanings of Schooling for Poor, Rural Chinese Youth

    Science.gov (United States)

    Xiang, Xin

    2018-01-01

    In this article, Xin Xiang investigates what dushu, or "schooling," means for rural senior secondary school students in a high-poverty county in southwestern China. With the persistence of China's rural-urban education inequality and alarming reports about secondary school dropout rates, rural students' and their families' attitudes…

  8. The Role of Responses to Experiences of Rural Population Decline in the Social Capital of Families

    NARCIS (Netherlands)

    Elshof, Hans; Bailey, Ajay

    2015-01-01

    Population decline in rural areas has an impact on rural villages. This research investigates to what extent families with children in rural villages experience consequences of population decline, in which ways they respond to these experiences, and how that plays a role in their individual social

  9. Who steers the ship? Rural family physicians' views on collaborative care models for patients with dementia.

    Science.gov (United States)

    Kosteniuk, Julie; Morgan, Debra; Innes, Anthea; Keady, John; Stewart, Norma; D'Arcy, Carl; Kirk, Andrew

    2014-01-01

    Little is known about the views of rural family physicians (FPs) regarding collaborative care models for patients with dementia. The study aims were to explore FPs' views regarding this issue, their role in providing dementia care, and the implications of providing dementia care in a rural setting. This study employed an exploratory qualitative design with a sample of 15 FPs. All rural FPs indicated acceptance of collaborative models. The main disadvantages of practicing rural were accessing urban-based health care and related services and a shortage of local health care resources. The primary benefit of practicing rural was FPs' social proximity to patients, families, and some health care workers. Rural FPs provided care for patients with dementia that took into account the emotional and practical needs of caregivers and families. FPs described positive and negative implications of rural dementia care, and all were receptive to models of care that included other health care professionals.

  10. Social Work Practice in a Rural Health Care Setting: Farm Families.

    Science.gov (United States)

    Durham, Judith A.; Miah, M. Mizanur Rahman

    1993-01-01

    Literature review addresses the status of farm families; farm stresses and their effects; dysfunctional family relationships; and the unique attitudes, behaviors, and perceptions of rural culture toward social service intervention. By implementing coordinated service programs and initiating new legislation that addresses rural health care issues,…

  11. Achieving success with family planning in rural Afghanistan.

    Science.gov (United States)

    Huber, Douglas; Saeedi, Nika; Samadi, Abdul Khalil

    2010-03-01

    Afghan women have one of the world's highest lifetime risks of maternal death. Years of conflict have devastated the country's health infrastructure. Total fertility was one of the world's highest, contraceptive use was low and there were no Afghan models of success for family planning. We worked closely with communities, providing information about the safety and non-harmful side-effects of contraceptives and improving access to injectable contraceptives, pills and condoms. Regular interaction with community leaders, mullahs (religious leaders), clinicians, community health workers and couples led to culturally acceptable innovations. A positive view of birth spacing was created by the messages that contraceptive use is 300 times safer than pregnancy in Afghanistan and that the Quran (the holy book of Islam) promotes two years of breastfeeding. Community health workers initiated the use of injectable contraceptives for the first time. The non-for-profit organization, Management Sciences for Health, Afghan nongovernmental organizations and the Ministry of Public Health implemented the Accelerating Contraceptive Use project in three rural areas with different ethnic populations. The contraceptive prevalence rate increased by 24-27% in 8 months in the project areas. Men supported modern contraceptives once they understood contraceptive safety, effectiveness and non-harmful side-effects. Injectable contraceptives contributed most to increases in contraceptive use. Community health workers can rapidly increase contraceptive use in rural areas when given responsibility and guidance. Project innovations were adopted as best practices for national scale-up.

  12. 77 FR 42230 - Grants for the Rural Veterans Coordination Pilot (RVCP)

    Science.gov (United States)

    2012-07-18

    ... opportunity for the grantee to respond before making any final decision to recover the funds. The grantee... families who are making the transition from military service to civilian life in rural or underserved... information. Section 506 offers no specialized meaning of the term, and therefore, we believe it is rational...

  13. 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.

  14. Women and family poultry production in rural Africa.

    Science.gov (United States)

    Gueye, E H

    2000-02-01

    Poultry production has existed for many generations in Africa, and almost every village household keeps chickens. The rural family poultry (RFP) are generally raised in free-range and/or backyard systems, which are traditional extensive husbandry systems. The development of an intensive poultry production has been the goal of the African government over the years. Despite efforts aiming for such goal, RFP is still very important in African countries that are both poor and net importers of food. It is a valuable asset because it can contribute significantly in alleviating poverty, securing food supply, and promoting gender equality. In view of this, interventions to improve RFP production systems should take into account the sociocultural issues, specifically gender-based aspects. It is noted that such interventions might, in addition to food security and poverty alleviation, also serve to promote gender equality. RFP development programs should be more women-friendly in order to facilitate women's participation, as RFP production in the region is generally a woman's business. Moreover, efforts to empower village women has to be envisaged cautiously as there is a serious risk of men taking over once the poultry sector becomes more profitable.

  15. 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...

  16. Bridging the Rural-Urban Literacy Gap in China: A Mediation Analysis of Family Effects

    Science.gov (United States)

    Wang, Jingying; Li, Hui; Wang, Dan

    2018-01-01

    This study examines the effects of family involvement on the literacy gap between rural and urban Chinese primary students via mediation analysis. Altogether, 1080 students in Grades 1, 3, and 5 were randomly sampled from three urban and three rural primary schools from Shandong and Guizhou Provinces, representing eastern and western China,…

  17. Circuits of Education, Rural Gentrification, and Family Migration from the Global City

    Science.gov (United States)

    Smith, Darren P.; Higley, Rebecca

    2012-01-01

    Although there is recurring empirical evidence of gentrifier families with young children, the importance of education-related factors in the migration and residential decision-making of rural gentrifiers have yet to be fully examined. Using the case study of Cranbrook, Kent, processes of education-led rural gentrification are revealed that are…

  18. Insecure Land Rights, Obstacles to Family Farming, and the Weakness of Protest in Rural Russia

    NARCIS (Netherlands)

    Visser, A.

    2010-01-01

    After short-lived growth in the early 1990s, Russia’s private family farming sector has been characterized by stagnation, while ownership of former collective and state farms is increasingly concentrated in the hands of the rural elite. This accumulation turns the rural dwellers, who (formally) had

  19. Women in rural family medicine: a qualitative exploration of practice attributes that promote physician satisfaction.

    Science.gov (United States)

    Hustedde, Carol; Paladine, Heather; Wendling, Andrea; Prasad, Rupa; Sola, Orlando; Bjorkman, Sarah; Phillips, Julie

    2018-04-01

    The USA needs more rural physicians. Although women represent half of all US trained medical students, the rural physician workforce has remained predominantly male. Insight is needed into what makes rural practice attractive for women and which practice characteristics allow women physicians to practice successfully in rural areas. This study's purpose was to examine aspects of the practice environment that impact women physicians' professional satisfaction and commitment to rural medicine. Twenty-five women family physicians practicing in rural areas of the USA were interviewed by phone using a semi-structured format. Transcribed interviews were analyzed using an immersion and crystallization approach. Emergent themes were identified, coded, and discussed until team consensus was attained. Interviews continued until saturation of themes was reached. Three themes emerged from the data, in relationship to practice and employment attributes that contribute to US women physicians' professional satisfaction and willingness to remain in a rural setting: professional relationships, practice characteristics, and support during times of transition. Participants placed high importance on professional relationships, both within and outside of their rural practice. Rural women physicians enjoyed practicing an expanded scope of care, valued loan repayment opportunities, and appreciated supportive practice partners. Importantly, women physicians who found themselves struggling to maintain rural careers often had experienced difficulty during times of practice transition, including maternity leaves. Understanding practice attributes valued by successful rural women family physicians in the USA will help rural health systems, practices, and physicians-in-training to develop and evaluate opportunities that will best contribute to successful rural practice. Supporting women physicians during periods of practice transition may improve retention.

  20. Motivations for childbearing and fertility behavior among urban and rural families of Iran.

    Science.gov (United States)

    Hekmat, F; Kabacoff, R I; Klein, H E

    1983-01-01

    A sample of 384 husbands and wives were randomly selected and interviewed to investigate the implication of fertility norms and motivations for childbearing on fertility and family planning behavior among Iranian families in urban and rural areas of Iran, after the Islamic Revolution of 1979. The term "fertility behavior" refers to actual family size, which is defined as number of children the respondent has living at the time of the interview. "Family planning behavior" refers to the duration of time that the subject has used any birth control method(s). Rural families demonstrated larger actual and ideal family sizes than urban families. The rural sample had a median actual family size of 3.5 children and a median ideal family size of 4.7 children. For the urban sample these figures were 2.2 and 2.3, respectively. The median number of years married was 12.33 for rural and 13.91 for urban respondents. Urban respondents tended to emphasize the psychological and emotional benefits and liabilities associated with having children while rural respondents tended to emphasize both economic and security related motivations. Both groups endorsed infant mortality as a motivation for having more children. Male and female respondents were remarkably similar in their endorsed motivations. There was a significant positive correlation between desired and ideal family size. The correlations among ideal/desired family size and practicing birth control methods were the same and significant at the .001 level. The relationship between motivations for childbearing and years of practicing birth control methods was also significant at the .001 level. Stepwise regression analyses were performed to examine the important predictors of fertility and family planning behavior. For both actual family size and years on birth control, males and females were very similar in terms of predictor importance. Those respondents with less education and large ideal family size tended to have larger

  1. Trickling Down: Are Rural and Rural Poor Family Incomes Responsive to Regional Economic Growth? Institute for Research on Poverty, Discussion Papers No. 210-74.

    Science.gov (United States)

    Weber, Bruce A.

    The past decade has seen a number of studies of how the poverty incidence (the percentage of families below the poverty line) of certain demographic groups changes in response to economic growth. The question of whether regional economic growth trickles down to rural and rural poor families was examined by statistically estimating the relationship…

  2. Rural Women Family Physicians: Strategies for Successful Work-Life Balance.

    Science.gov (United States)

    Phillips, Julie; Hustedde, Carol; Bjorkman, Sarah; Prasad, Rupa; Sola, Orlando; Wendling, Andrea; Bjorkman, Kurt; Paladine, Heather

    2016-05-01

    Women family physicians experience challenges in maintaining work-life balance while practicing in rural communities. We sought to better understand the personal and professional strategies that enable women in rural family medicine to balance work and personal demands and achieve long-term career satisfaction. Women family physicians practicing in rural communities in the United States were interviewed using a semistructured format. Interviews were recorded, professionally transcribed, and analyzed using an immersion and crystallization approach, followed by detailed coding of emergent themes. The 25 participants described a set of strategies that facilitated successful work-life balance. First, they used reduced or flexible work hours to help achieve balance with personal roles. Second, many had supportive relationships with spouses and partners, parents, or other members of the community, which facilitated their ability to be readily available to their patients. Third, participants maintained clear boundaries around their work lives, which helped them to have adequate time for parenting, recreation, and rest. Women family physicians can build successful careers in rural communities, but supportive employers, relationships, and patient approaches provide a foundation for this success. Educators, employers, communities, and policymakers can adapt their practices to help women family physicians thrive in rural communities. © 2016 Annals of Family Medicine, Inc.

  3. The Family Home Environment, Food Insecurity, and Body Mass Index in Rural Children

    Science.gov (United States)

    Jackson, Jennifer A.; Smit, Ellen; Branscum, Adam; Gunter, Katherine; Harvey, Marie; Manore, Melinda M.; John, Deborah

    2017-01-01

    Background. Family homes are a key setting for developing lifelong eating and physical activity habits, yet little is known about how family home nutrition and physical activity (FNPA) environments influence food insecurity (FI) and childhood obesity, particularly in rural settings. Aims. This study examined associations among FNPA, FI, and body…

  4. Family planning practices of rural community dwellers in cross River ...

    African Journals Online (AJOL)

    Results: Fifty (17.2%) respondents were using at least one family planning method. One hundred and ninety-eight (68.3%) respondents had used at least one family planning method at some point in time. Reasons given for not using any family planning method included “Family planning is against my religious beliefs” ...

  5. 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.

  6. Human Capital of Family and Social Mobility in Rural Areas-Evidence from China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jin-hua; YU Mei-lian; WU Fang-wei; CHEN Wei

    2013-01-01

    This research focuses on the impact of family’s human capital on social mobility in China’s rural community. Empirical research is conducted based on data from surveying a typical rural community in the past 20 yr. The study indicates that social mobility in rural area is active in the past 20 yr, and the human capital of family, represented by primary labor’s education level, has played an essential role in mobility of low social class. Meanwhile, socio-economic development and the change of supply and demand in labor market dims the signaling role of degree education, but the impact of occupational training is increasingly remarkable. Therefore, the change from sole degree education to multi-leveled education including occupational education and training is a main way for China’s rural families in low class to realize social mobility.

  7. 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.

  8. Life Satisfaction among Young Adults from Rural Families.

    Science.gov (United States)

    Wilson, Stephan M.; Peterson, Gary W.

    1988-01-01

    Examined possible predictors of life satisfaction among 322 low-income young adults from rural Appalachia. Both objective and subjective conditions of life were predictors of life satisfaction: financial resources, self-esteem, and proximity to childhood home were positive predictors; frustrations about limited job opportunities and community size…

  9. Rural Issues for Children and Families Affected by Epilepsy.

    Science.gov (United States)

    Ellis, Gail Johnston

    Epilepsy affects approximately one percent of the population, with most cases having onset during childhood. School personnel can best incorporate the child with epilepsy into the classroom and provide support for families by becoming familiar with the types of seizure disorders, the issues that epilepsy presents for children and families, and the…

  10. Women, microcredit and family planning practices: a case study from rural Ghana.

    Science.gov (United States)

    Norwood, Carolette

    2011-01-01

    This paper examines the influence of informal banking club participation on family planning practices in rural Ghana. Research from Asia suggests that family planning practices are improved by club participation. This study examines this thesis in an African context, using rural Ghana as a case study. A sample of 204 women (19 years and older) was drawn from Abokobi village, Ghana. Multivariate analyses of direct, mediating and moderating effects of women’s demographic background characteristics, membership status and length, and women’s empowerment status as predictors of family planning practices are assessed. Findings suggest that club membership and membership length is not associated with family planning practices; however, age, education level, number of children and empowerment status are.

  11. Strategies for Estonian rural family enterprises. Eesti maapiirkonna pereettevõtete strateegia

    Directory of Open Access Journals (Sweden)

    Maret Kirsipuu

    2013-01-01

    Full Text Available The paper seeks to analyse family businesses in rural areas, family business strategies and re-registration of sole proprietors with the Centre of Registers and Information Systems (hereinafter Commercial Register in 2009, and to provide an overview of entrepreneurship policies targeted at Estonian rural businesses. Layoffs have increased the number of unemployed; some of those who have lost employment opt for social assistance benefits, but some others decide to become entrepreneurs. Many enterprising people in Estonia have set up a family enterprise, mainly in the sphere of services, agriculture and tourism. The Estonian entrepreneurship policy supports enterprising people and approves of entrepreneurship as a promoter of national economic development. One of the most positive qualities of family enterprises is their short decision-making chain, which ensures rapid implementation of the strategy.

  12. 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…

  13. Effects of rural-urban youth migration on farm families in Benue state, Nigeria

    Directory of Open Access Journals (Sweden)

    E.N. Mbah

    2016-06-01

    Full Text Available The study was assessed to determine the effects of rural-urban youth migration on farm families in Benue state, Nigeria during November 2014 to June 2015. Interview schedule was used to collect data from a sample of 80 respondents. Data were analyzed using frequency, percentage, mean scores and standard deviation. Results indicate that majority (76.3% of the respondents were males, middle aged and married. Major causes of rural-urban youth migration indicated by the respondents include inadequate employment opportunities in rural areas (M=3.6, search for better education (M=3.5, inadequate social infrastructure such as schools (M=3.4, poor medical care services in rural areas (M=3.4, looking for money through labour (M=3.4, apprenticeship programme (M=3.2, etc. Findings of the study also indicate that reduction of agricultural labour force (M=3.5, low agricultural productivity (M=3.3, high cost of labour (M= 3.3, reduction on demand for locally grown foods (M=2.9, decrease in dependency ratio in the rural areas (M=2.7, reduction on number of mouths to feed (M=2.7, among others were major effects of rural-urban youth migration among farm families. The study recommends that Nigerian government should provide adequate physical and social infrastructure in rural areas in order to encourage youths to remain in agriculture, reduce rural-urban youth migration as well as sustain agriculture for enhanced food security.

  14. Prevalence of Low Calorie Intake by Rural Families in Palpa District of Nepal

    Directory of Open Access Journals (Sweden)

    Madhusudhan Ghimire

    2013-12-01

    Full Text Available Background: Healthy population is indispensable for national development. Adequate food intake by people is the key determinant to keep up their health. Malnutrition nevertheless remains pervasive in developing countries, undermining people’s health, productivity, and often their survival. Food insecurity and hunger remain persistent in Nepal. Prevalence of low calories intake by rural family is widespread throughout the country population. Mainly marginalized communities, ethnic group with poor economic status, traditional societies and lower cast people are exposed to food defi cit. Objective: to investigate the prevalence of low calories intake by rural families and its associated determinants in Palpa district. Materials and methods: The cross-sectional study was designed to achieve objective of the research. A random sample of 339 families was selected from rural areas (DUMRE, DAMKADA, GORKHEKOT and TELGHA villages of this district. Data were analyzed by using the SPSS software for Windows (version 16.0. Results: The existence of inadequate food calorie intake among rural families was most common. Most of them were malnourished. Conclusion: low calorie intake by ethnic group was considerably higher than other groups in community.

  15. Maternal Resources, Parenting Practices, and Child Competence in Rural, Single-Parent African American Families.

    Science.gov (United States)

    Brody, Gene H.; Flor, Douglas L.

    1998-01-01

    Tested a model linking maternal/family characteristics to child cognitive and psychosocial competence in African-American 6- to 9-year olds in rural single-mother-headed households. Found that maternal education, religiosity, and financial resources were linked with parenting style, mother-child relationship, and maternal school involvement.…

  16. analysis of poverty status of rural farm families in akwa ibom state

    African Journals Online (AJOL)

    PROF. BARTH EKWEME

    This study was conducted to provide empirical evidence of the effect of farming on the poverty status of rural farm families in Uyo, Akwa ... Reducing poverty in developing economies is a ... is one of the poorest among the poor countries of the.

  17. Ideal family size in a rural Tswana population | De Villiers | South ...

    African Journals Online (AJOL)

    A questionnaire was used to discover what 350 rural Tswanas believed the ideal number of children to be; results were tabulated according to age and sex. It appears· that older people tend to want more children and, more surprisingly, that men and women agree on the ideal number of children in a family; this is contrary to ...

  18. Digital Storytelling in Adult Education and Family Literacy: A Case Study from Rural Ireland

    Science.gov (United States)

    Prins, Esther

    2017-01-01

    Previous research on digital storytelling (DST) has focused chiefly on children and youth, but we know little about how it is used in non-formal adult education. This article analyzes a DST class in rural Ireland, which was organized by a family literacy program and offered for parents at an elementary school. Data sources included fieldnotes,…

  19. Monetary Value of a Prescription Assistance Program Service in a Rural Family Medicine Clinic

    Science.gov (United States)

    Whitley, Heather P.

    2011-01-01

    Purpose: To quantify the monetary value of medications provided to rural Alabamians through provision of pharmaceutical manufacturer-sponsored prescription assistance programs (PAPs) provided by a clinical pharmacist in a private Black Belt family medicine clinic during 2007 and 2008. Methods: Patients struggling to afford prescription medications…

  20. Measuring financial protection for health in families with chronic conditions in Rural China.

    Science.gov (United States)

    Jiang, Chunhong; Ma, Jingdong; Zhang, Xiang; Luo, Wujin

    2012-11-16

    As the world's largest developing country, China has entered into the epidemiological phase characterized by high life expectancy and high morbidity and mortality from chronic diseases. Cardiovascular diseases, chronic obstructive pulmonary diseases, and malignant tumors have become the leading causes of death since the 1990s. Constant payments for maintaining the health status of a family member who has chronic diseases could exhaust household resources, undermining fiscal support for other necessities and eventually resulting in poverty. The purpose of this study is to probe to what degree health expenditure for chronic diseases can impoverish rural families and whether the New Cooperative Medical Scheme can effectively protect families with chronic patients against catastrophic health expenditures. We used data from the 4th National Health Services Survey conducted in July 2008 in China. The rural sample we included in the analysis comprised 39,054 households. We used both households suffering from medical impoverishment and households with catastrophic health expenditures to compare the financial protection for families having a chronic patient with different insurance coverage statuses. We used a logistic regression model to estimate the impact of different benefit packages on health financial protection for families having a chronic patient. An additional 10.53% of the families with a chronic patient were impoverished because of healthcare expenditure, which is more than twice the proportion in families without a chronic patient. There is a higher catastrophic health expenditure incidence in the families with a chronic patient. The results of logistic regression show that simply adding extra benefits did not reduce the financial risks. There is a lack of effective financial protection for healthcare expenditures for families with a chronic patient in rural China, even though there is a high coverage rate with the New Cooperative Medical Schemes. Given the

  1. The role of a family for internal dose formation in rural community

    International Nuclear Information System (INIS)

    Vlasova, N.V.; Rozhko, A.V.; Stavrov, V.V.

    2008-01-01

    Full text: Despite correct evaluation of agricultural land contamination of a settlement and the activity of foodstuffs, it is impossible to explain dose formation in rural community. And without this knowledge it is impossible to estimate correctly decision-making. The dose formation research was provided earlier in rural community based on the concept describing that the individual with his personal characteristics, social and economic statuses during his practical activity interacting with the contaminated environment, actively contributes to dose formation. Such approach only partly allows revealing dose formation mechanisms though there are some unclear issues: for example, high doses at some children. At the same time children, as well as all residents are the members of families. Direct consumption of food stuffs is provided within a family. It is preceded with the formation of psycho-emotional perception of radiation danger factor. There have been used the data of internal doses of the inhabitants obtained by the results of WBC-measurements. Simultaneously with performing of WBC measurements by interviewing of adult members of a family there was revealed the frequency of visits to forest and consumption rate of its 'gifts'. The method of a family analysis of internal dose formation is the classification of families by set of the informative attributes describing dose formation in a family such as an average internal dose at a member of a family; family total dose; the description of a family 'contact' with a forest; the number of family members; the number of children in a family; average age and the educational level of adult members of a family; gender and occupation of the head of a family; age and education of the head of a family. As a result of multivariate classification of families in the settlement there was obtained 10 different classes providing complete imagination about a variety of families' types. The average doses in classes essentially

  2. The Impact of Desired Family Size Upon Family Planning Practices in Rural East Pakistan

    Science.gov (United States)

    Mosena, Patricia Wimberley

    1971-01-01

    Results indicated that women whose desired family size is equal to or less than their actual family size have significantly greater frequencies practicing family planning than women whose desired size exceeds their actual size. (Author)

  3. An Examination of Family Physicians Plan Implementation in Rural ...

    African Journals Online (AJOL)

    Background: Family physician plan (FPP) and referral system (RS) is one of the major plans in Iran's health system with the aim of increasing the accountability in the health market, enhancing the public's access to the health services, lowering the unnecessary costs and equitable distribution of health across the society.

  4. The Synergy of Family and Neighborhood on Rural Dating Violence Victimization.

    Science.gov (United States)

    Foshee, Vangie A; Chang, Ling-Yin; McNaughton Reyes, H Luz; Chen, May S; Ennett, Susan T

    2015-09-01

    Rural adolescents are at high risk for dating violence victimization (DVV), which has serious negative consequences. Understanding more about the conditions that increase DVV risk for rural adolescents is needed to inform prevention efforts. In response to calls for examining the influence of upper levels of the social ecology on adolescent dating violence, this study examined whether associations between the family context and physical DVV were conditioned by the characteristics of the neighborhoods in which the family resided. Data were from a multi-wave longitudinal study of 3,236 rural adolescents nested in 65 block groups, which defined neighborhoods. Data were collected between 2003 and 2005. Multilevel growth curve modeling was conducted in 2014 to test hypothesized synergistic effects of the family and neighborhood on trajectories of physical DVV from grade 8 to 12. Low parental closeness was a DVV risk in residentially stable (pFamily aggression was a DVV risk, regardless of neighborhood characteristics (p=0.001). Low parental monitoring and rule setting were not DVV risks and their effects were not moderated by neighborhood characteristics. Neighborhood ethnic heterogeneity was significantly (pviolence were not associated with DVV. None of the effects varied by sex of the adolescent, across time (grade), or by the combination of sex and time. Findings demonstrate the importance of considering the family and neighborhood, and particularly their synergistic effects in efforts to prevent adolescent DVV. Copyright © 2015 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  5. Family planning among women in urban and rural areas in Serbia

    Directory of Open Access Journals (Sweden)

    Antić Ljiljana

    2013-01-01

    Full Text Available Introduction. Family planning is an important aspect of population policy at the state level, because the demographic trends in Serbia are very unfavorable. Objective. The objective of this study was to examine the differences in family planning between the women in rural and urban areas of Serbia. Methods. This study represents the secondary analysis of the National Health Survey of the population in Serbia from 2006, which was conducted as a cross sectional study, on a representative sample of the population. Results. The respondents who used condoms as a method of contraception, were often younger, better educated, had better financial status, lived in Vojvodina, and had no children. Conclusion. Our study showed that there were differences in terms of family planning between the women of urban and rural areas, however, these differences could be explained by differences in age and education. [Projekat Ministarstva nauke Republike Srbije, br. 175025: National Health Survey of the Population of Serbia

  6. 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

  7. 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.

  8. Determinants of family planning service uptake and use of contraceptives among postpartum women in rural Uganda.

    Science.gov (United States)

    Sileo, Katelyn M; Wanyenze, Rhoda K; Lule, Haruna; Kiene, Susan M

    2015-12-01

    Uganda has one of the highest unmet needs for family planning globally, which is associated with negative health outcomes for women and population-level public health implications. The present cross-sectional study identified factors influencing family planning service uptake and contraceptive use among postpartum women in rural Uganda. Participants were 258 women who attended antenatal care at a rural Ugandan hospital. We used logistic regression models in SPSS to identify determinants of family planning service uptake and contraceptive use postpartum. Statistically significant predictors of uptake of family planning services included: education (AOR = 3.03, 95 % CI 1.57-5.83), prior use of contraceptives (AOR = 7.15, 95 % CI 1.58-32.37), partner communication about contraceptives (AOR = 1.80, 95 % CI 1.36-2.37), and perceived need of contraceptives (AOR = 2.57, 95 % CI 1.09-6.08). Statistically significant predictors of contraceptive use since delivery included: education (AOR = 2.04, 95 % CI 1.05-3.95), prior use of contraceptives (AOR = 10.79, 95 % CI 1.40-83.06), and partner communication about contraceptives (AOR = 1.81, 95 % CI 1.34-2.44). Education, partner communication, and perceived need of family planning are key determinants of postpartum family planning service uptake and contraceptive use, and should be considered in antenatal and postnatal family planning counseling.

  9. Rural end-of-life care from the experiences and perspectives of patients and family caregivers: A systematic literature review.

    Science.gov (United States)

    Rainsford, Suzanne; MacLeod, Roderick D; Glasgow, Nicholas J; Phillips, Christine B; Wiles, Robert B; Wilson, Donna M

    2017-12-01

    End-of-life care must be relevant to the dying person and their family caregiver regardless of where they live. Rural areas are distinct and need special consideration. Gaining end-of-life care experiences and perspectives of rural patients and their family caregivers is needed to ensure optimal rural care. To describe end-of-life care experiences and perspectives of rural patients and their family caregivers, to identify facilitators and barriers to receiving end-of-life care in rural/remote settings and to describe the influence of rural place and culture on end-of-life care experiences. A systematic literature review utilising the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four databases (PubMed, CINAHL, Scopus and Web of Science) were searched in January 2016, using a date filter of January 2006 through January 2016; handsearching of included article references and six relevant journals; one author contacted; pre-defined search terms and inclusion criteria; and quality assessment by at least two authors. A total of 27 articles (22 rural/remote studies) from developed and developing countries were included, reporting rural end-of-life care experiences and perspectives of patients and family caregivers. Greatest needs were informational (developed countries) and medications (developing countries). Influence of rural location included distances, inaccessibility to end-of-life care services, strong community support and importance of home and 'country'. Articulation of the rural voice is increasing; however, there still remain limited published rural studies reporting on patient and family caregivers' experiences and perspectives on rural end-of-life care. Further research is encouraged, especially through national and international collaborative work.

  10. Normative influence and desired family size among young people in rural Egypt.

    Science.gov (United States)

    Harbour, Catherine

    2011-06-01

    Research has identified the lack of acceptance of a two-child-family norm as the biggest obstacle to achieving replacement-level fertility in Egypt. This analysis examines norms about desired family size for 1,366 males and 1,367 females aged 15-24 in 2004 in rural Minya governorate. Two-level random-effects multivariate logistic regression models, stratified by sex and grouped by neighborhood, are used to assess normative influence at the household and neighborhood levels, controlling for individual- and household-level covariates. In the final model, young males in neighborhoods where more people desire a small family are 33 percent more likely to desire a small family than are young males in other neighborhoods. Young females in households with one or more adults preferring a small family are 78 percent more likely to desire a small family, and young females in households with one or more young people who prefer a small family are 37 percent more likely to desire a small family themselves, compared with those living with adults or with young people, respectively, who do not prefer a small family. Programs aiming to reduce fertility should be aware of gender differences in the sources of normative influence on desired family size.

  11. Governance in agribusiness organizations: challenges in the management of rural family firms

    Directory of Open Access Journals (Sweden)

    Cláudio Pinheiro Machado Filho

    Full Text Available Abstract The rural production in Brazil has experienced a significant competitive impact with the stabilization of the economy promoted by the Real Plan in 1994. Indeed, the Brazilian agriculture has achieved efficiency gains in terms of technology, economies of scale and general modernization of the activity in the field. In this context, the professional management of rural production evolved. However, the governance process does not evolve in the same dimension, and the “governance risk” is still poorly addressed in the rural environment, which often limits the potential of operations. In this study, we sought to deepen the understanding of the factors that impact the implementation of governance practices in rural properties in Brazil. Based on a convenience and non-probability sample, this study seeks to understand the evolution of the governance process on farms and its correlation with the management practices. This study found a correlation between the existence of some formal management processes (for example, strategic planning and more robust accounting systems and advances in the governance mechanisms and processes, such as the establishment of a board of directors, clearer rules regarding the separation between corporate and family assets and more transparency in income statements. This study also found a lack of clarity in the separation of return on capital (dividend and compensation for work (compensation for services provided for partners, heirs and other family members. In summary, we concluded that there is the adoption of some governance mechanisms in the rural sector, but they are still poorly developed among rural producers, hence the need to stimulate them.

  12. Patient, staff, and clinician perspectives on implementing electronic communications in an interdisciplinary rural family health practice.

    Science.gov (United States)

    Chang, Feng; Paramsothy, Thivaher; Roche, Matthew; Gupta, Nishi S

    2017-03-01

    Aim To conduct an environmental scan of a rural primary care clinic to assess the feasibility of implementing an e-communications system between patients and clinic staff. Increasing demands on healthcare require greater efficiencies in communications and services, particularly in rural areas. E-communications may improve clinic efficiency and delivery of healthcare but raises concerns about patient privacy and data security. We conducted an environmental scan at one family health team clinic, a high-volume interdisciplinary primary care practice in rural southwestern Ontario, Canada, to determine the feasibility of implementing an e-communications system between its patients and staff. A total of 28 qualitative interviews were conducted (with six physicians, four phone nurses, four physicians' nurses, five receptionists, one business office attendant, five patients, and three pharmacists who provide care to the clinic's patients) along with quantitative surveys of 131 clinic patients. Findings Patients reported using the internet regularly for multiple purposes. Patients indicated they would use email to communicate with their family doctor for prescription refills (65% of respondents), appointment booking (63%), obtaining lab results (60%), and education (50%). Clinic staff expressed concerns about patient confidentiality and data security, the timeliness, complexity and responsibility of responses, and increased workload. Clinic staff members are willing to use an e-communications system but clear guidelines are needed for successful adoption and to maintain privacy of patient health data. E-communications might improve access to and quality of care in rural primary care practices.

  13. Determinants of unmet need for family planning in rural Burkina Faso: a multilevel logistic regression analysis.

    Science.gov (United States)

    Wulifan, Joseph K; Jahn, Albrecht; Hien, Hervé; Ilboudo, Patrick Christian; Meda, Nicolas; Robyn, Paul Jacob; Saidou Hamadou, T; Haidara, Ousmane; De Allegri, Manuela

    2017-12-19

    Unmet need for family planning has implications for women and their families, such as unsafe abortion, physical abuse, and poor maternal health. Contraceptive knowledge has increased across low-income settings, yet unmet need remains high with little information on the factors explaining it. This study assessed factors associated with unmet need among pregnant women in rural Burkina Faso. We collected data on pregnant women through a population-based survey conducted in 24 rural districts between October 2013 and March 2014. Multivariate multilevel logistic regression was used to assess the association between unmet need for family planning and a selection of relevant demand- and supply-side factors. Of the 1309 pregnant women covered in the survey, 239 (18.26%) reported experiencing unmet need for family planning. Pregnant women with more than three living children [OR = 1.80; 95% CI (1.11-2.91)], those with a child younger than 1 year [OR = 1.75; 95% CI (1.04-2.97)], pregnant women whose partners disapproves contraceptive use [OR = 1.51; 95% CI (1.03-2.21)] and women who desired fewer children compared to their partners preferred number of children [OR = 1.907; 95% CI (1.361-2.672)] were significantly more likely to experience unmet need for family planning, while health staff training in family planning logistics management (OR = 0.46; 95% CI (0.24-0.73)] was associated with a lower probability of experiencing unmet need for family planning. Findings suggest the need to strengthen family planning interventions in Burkina Faso to ensure greater uptake of contraceptive use and thus reduce unmet need for family planning.

  14. Decline of traditional family system and reproductive behaviour in rural Bangladesh.

    Science.gov (United States)

    Sarker, P C

    1993-01-01

    This paper is based on data taken from the study entitled Social Structure and Fertility Behavior in a Rural Community of Bangladesh. The field-work was carried out during 1985-86 in Kamnagar, a village in the north-eastern corner of Rajshahi metropolitan city, with a total population of 884. 54.4% of the villagers had no education. Basic information was collected from every household by questionnaires interviewing the head of the household. In the 2nd phase questionnaires were administered to 140 eligible husbands and 140 wives separately to collect information on fertility behavior. 56.8% of the families were nuclear. 12.1% of the families were supplementary nuclear, with parents and their unmarried children including 1 or more additional members. 24.9% of the families were joint, in which related males belonging to 2 or 3 generations lived together with their dependents. 6.2% of the families were extended. As far as the authority structure was concerned, 68.1% of the families were patriarchal, 9.9% of the families were matriarchal, and 22% of the families were egalitarian. The egalitarian authority system is increasing with the spread of female literacy, economic activities outside the home, and women's mobility. Couples in nuclear families are more free to decide on the number of children, birth spacing, and adoption of contraception than those in joint, extended, and supplementary nuclear families with patriarchal and matriarchal authority structures. In nuclear families with an egalitarian authority structure, husband-wife communication can help decide about the number of children wanted, the acceptance of contraceptives, and child spacing. Nuclear families favor lower fertility than supplementary nuclear, joint, and extended families with a patriarchal or matriarchal authority structure. The number of traditional joint and extended families is on the decline with the trend to nuclear families as a result of the increasing landlessness in rural Bangladesh

  15. Factors affecting the cultural competence of visiting nurses for rural multicultural family support in South Korea.

    Science.gov (United States)

    Suk, Min Hyun; Oh, Won-Oak; Im, YeoJin

    2018-01-01

    With the recent growth of multicultural families in the Korean society, the importance of the role of qualified visiting nurses in the delivery of culturally sensitive health care has grown dramatically. As the primary health care provider for multicultural families enrolled in public community-based health care centers, the cultural competence of visiting nurses is an essential qualification for the provision of quality health care for multicultural families, especially in rural areas. Cultural competence of visiting nurses is based on their cultural awareness and empathetic attitude toward multicultural families. This study aimed to examine the levels of cultural competence, empowerment, and empathy in visiting nurses, and to verify the factors that affect the cultural competence of visiting nurses working with rural multicultural families in South Korea. Employing a cross-sectional descriptive study design, data from 143 visiting nurses working in rural areas were obtained. Data collection took place between November 2011 and August 2012. The measurement tools included the modified Korean version of the Cultural Awareness Scale, the Text of Items Measuring Empowerment, and the Interpersonal Reactivity Index to measure the level of empathy of visiting nurses. Analyses included descriptive statistics, a t-test, an ANOVA, a Pearson correlation coefficient analysis, and a multiple linear regression analysis. The cultural competence score of the visiting nurses was 3.07 on a 5-point Likert scale (SD = 0.30). The multiple regression analysis revealed that the cultural competence of visiting nurses was significantly influenced by experience of cultural education, empathy, and scores on the meaning subscale of the empowerment tool (R 2  = 10.2%). Institutional support to enhance visiting nurses' empowerment by assuring the significance of their job and specific strategies to enhance their empathy would be helpful to improve the cultural competence of visiting

  16. Parental encouragement of initiative-taking and adjustment in Chinese children from rural, urban, and urbanized families.

    Science.gov (United States)

    Chen, Xinyin; Li, Dan

    2012-12-01

    Due to the requirements of the competitive, market-oriented urban society, parents in urban and urbanized families are more likely than parents in rural families to encourage initiative-taking in child rearing in China. The socialization experiences of children from different types of families may be related to their adjustment. This study examined parental socialization attitudes, social and school adjustment, and their relations in Chinese children from rural, urban, and urbanized families. Participants were elementary school students (N = 1,033; M age = 11 years) and their parents in China. Data were obtained from parental reports, peer evaluations, teacher ratings, and school records. A multivariate analysis of variance revealed that parents in urban and urbanized families had higher scores than parents in rural families on encouragement of initiative-taking. Urban children, particularly girls, were more sociable, obtained higher social status, and had fewer school problems than their rural counterparts. Children from urbanized families were different from rural children and similar to urban children in social and school adjustment. Moreover, multigroup invariance tests showed that parental encouragement of initiative-taking was associated more strongly with children's sociable-assertive behavior and social standing in the urban and urbanized groups than in the rural group. The results indicate that particular socialization attitudes may vary in their adaptive value in child development as a function of specific social and cultural requirements in changing societies. PsycINFO Database Record (c) 2012 APA, all rights reserved.

  17. Child health, nutrition and family size: a comparative study of rural and urban children.

    Science.gov (United States)

    Balderama-guzman, V

    1978-01-01

    771 children from Baras, Rizal, and Pasay City, Philippines were studied. House interviews of mothers using precoded questionnaires were conducted and the children were given a complete physical examination. The study objectives were to compare the health and nutritional status of children in a rural and an urban area in greater Manila and to determine how family size affects the nutritional status of children 3 years and younger. The following were among the study results: 1) the weight curves of both urban and rural groups were similar until age 4-1/2 years, but beyond this age the mean weight curve of the rural group exceeded that of the urban group; 2) urban children between ages 1-5 enjoyed a height advantage; 3) there was a positive correlation between malnutrition and excessive family size; 4) the high prevalence of malnutrition among children 1-4 years of age was due to food deprivation because of poverty, parental ignorance, inappropriate folklores, oversized families, high episodes of illnesses, and inadequate medical care; and 5) dietary assessment of both groups showed the inadequacy of the quality and quantity of basic nutrients and elements needed for growth, development, and repair of tissues.

  18. Rural families' interpretations of experiencing unexpected transition in the wake of a natural disaster.

    Science.gov (United States)

    Fernandes, Gisele Cristina Manfrini; Boehs, Astrid Eggert; Denham, Sharon A; Nitschke, Rosane Gonçalves; Martini, Jussara Gue

    2017-02-13

    Natural disasters affect populations in various parts of the world. The impacts of disasters can cause many problems to the health of people and disruption to family life, potentially leading to an unexpected transition. The objective of this paper is to present the unexpected transitional experiences of rural families following a natural disaster. A multiple case study of six families was conducted with children and adolescents in a rural area affected by a 2008 disaster in southern Brazil. For data collection, we used participant observation, narrative interviews, genograms, ecomaps and an instrument called calendar routine. The analysis of the data resulted in different family interpretations about the changes resulting from the storm and compared life before and after the disaster. The loss of homes and loved ones, migration, unemployment, and losses from the farm were the main changes associated with new development tasks. The experiences of family transition after the disaster revealed that losses influenced social lives, daily routines and the preservation of cultural values.

  19. Rural families' interpretations of experiencing unexpected transition in the wake of a natural disaster

    Directory of Open Access Journals (Sweden)

    Gisele Cristina Manfrini Fernandes

    Full Text Available Abstract: Natural disasters affect populations in various parts of the world. The impacts of disasters can cause many problems to the health of people and disruption to family life, potentially leading to an unexpected transition. The objective of this paper is to present the unexpected transitional experiences of rural families following a natural disaster. A multiple case study of six families was conducted with children and adolescents in a rural area affected by a 2008 disaster in southern Brazil. For data collection, we used participant observation, narrative interviews, genograms, ecomaps and an instrument called calendar routine. The analysis of the data resulted in different family interpretations about the changes resulting from the storm and compared life before and after the disaster. The loss of homes and loved ones, migration, unemployment, and losses from the farm were the main changes associated with new development tasks. The experiences of family transition after the disaster revealed that losses influenced social lives, daily routines and the preservation of cultural values.

  20. The influence of neighbors' family size preference on progression to high parity births in rural Nepal.

    Science.gov (United States)

    Jennings, Elyse A; Barber, Jennifer S

    2013-03-01

    Large families can have a negative impact on the health and well-being of women, children, and their communities. Seventy-three percent of the individuals in our rural Nepalese sample report that two children is their ideal number, yet about half of the married women continue childbearing after their second child. Using longitudinal data from the Chitwan Valley Family Study, we explore the influence of women's and neighbors' family size preferences on women's progression to high parity births, comparing this influence across two cohorts. We find that neighbors' family size preferences influence women's fertility, that older cohorts of women are more influenced by their neighbors' preferences than are younger cohorts of women, and that the influence of neighbors' preferences is independent of women's own preferences. © 2013 The Population Council, Inc.

  1. Maternal mental health and the persistence of food insecurity in poor rural families.

    Science.gov (United States)

    Lent, Megan D; Petrovic, Lindsay E; Swanson, Josephine A; Olson, Christine M

    2009-08-01

    Little is known about the causal relationship between and the mechanisms linking depression and food insecurity. Our purpose was to examine these knowledge gaps. Chi-squared analysis of longitudinal data from 29 rural upstate New York families followed for three years and qualitative analysis of interviews were used to identify associations and mechanisms. Depressive symptoms (p=.009) and poor mental health (p=.01) in mothers limited the likelihood families would leave food insecurity. This relationship was mediated through limiting the employment of adult family members and operated in three ways: preventing the depressed household member from working, preventing a different household member from working, and limiting access to childcare for depressed children so adults could work. Poor mental health is associated with keeping families food-insecure by limiting their employment. High-quality, accessible mental health care is needed for poverty-associated food insecurity to be alleviated.

  2. The progress of family health nursing in remote and rural Scotland.

    Science.gov (United States)

    Macduff, Colin

    2005-12-01

    Since 2001 the World Health Organization Europe's family health nurse (FHN) role has been developing in remote and rural areas of Scotland. In 2003, an independent evaluation identified a need for facilitation of the FHN role and family-health orientated approaches with local primary health care teams. The Scottish Executive Health Department appointed three part-time, regionally-based family health practice development facilitators (FHPDFs) in December 2003 to work over an 18-month period. This article presents findings from a small study which sought these FHPDFs' judgements on individual FHN autonomy and supportive colleague action at 24 sites where FHNs were practising. These judgements reveal a picture of mixed progress that is consistent with findings from other related research. This collective overview is presented in the form of a new typology and the resultant implications for future development of family health nursing are discussed.

  3. Family trauma through generations: incest and domestic violence in rural Sweden in the nineteenth century.

    Science.gov (United States)

    Drugge, Ulf

    2008-10-01

    Two generations of a family who lived in mid-nineteenth rural Sweden are described. Domestic violence was a common feature in the first generation family. The salient feature there was undoubtedly the incestuous father-daughter relationships. The way incest appeared in Sweden about 150 years ago, the role of local authorities, and the serious consequences to those victimized is analyzed with reference to both the cultural context of that time and to modern theories of incest. Seemingly puzzling violence committed by a second generation family member is related to the domestic violence in the previous generation. Due to the extraordinary character of the incest cases and the specific church council sessions in which the incest case was treated, aspects of family life normally hidden behind curtains of conventions were made public. Reaction patterns drawn from this case indicate a patriarchal system of oppression and badly-directed considerations.

  4. Underserved Areas and Pediatric Resident Characteristics: Is There Reason for Optimism?

    Science.gov (United States)

    Laraque-Arena, Danielle; Frintner, Mary Pat; Cull, William L

    2016-01-01

    To examine whether resident characteristics and experiences are related to practice in underserved areas. Cross-sectional survey of a national random sample of pediatric residents (n = 1000) and additional sample of minority residents (n = 223) who were graduating in 2009 was conducted. Using weighted logistic regression, we examined relationships between resident characteristics (background, values, residency experiences, and practice goals) and reported 1) expectation to practice in underserved area and 2) postresidency position in underserved area. Response rate was 57%. Forty-one percent of the residents reported that they had an expectation of practicing in an underserved area. Of those who had already accepted postresidency positions, 38% reported positions in underserved areas. Service obligation in exchange for loans/scholarships and primary care/academic pediatrics practice goals were the strongest predictors of expectation of practicing in underserved areas (respectively, adjusted odds ratio 4.74, 95% confidence interval 1.87-12.01; adjusted odds ratio 3.48, 95% confidence interval 1.99-6.10). Other significant predictors include hospitalist practice goals, primary care practice goals, importance of racial/ethnic diversity of patient population in residency selection, early plan (before medical school) to care for underserved families, mother with a graduate or medical degree, and higher score on the Universalism value scale. Service obligation and primary care/academic pediatrics practice goal were also the strongest predictors for taking a postresidency job in underserved area. Trainee characteristics such as service obligations, values of humanism, and desire to serve underserved populations offer the hope that policies and public funding can be directed to support physicians with these characteristics to redress the maldistribution of physicians caring for children. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All

  5. Family planning practices of rural community dwellers in cross River State, Nigeria.

    Science.gov (United States)

    Etokidem, A J; Ndifon, W; Etowa, J; Asuquo, E F

    2017-06-01

    Nigeria is the most populous nation in Africa and the seventh most populous in the world. Despite a high fertility rate of 5.5 per woman and a high population growth rate of 3.2%, Nigeria's contraceptive prevalence is 15%, which is one of the lowest in the world. The objective of this study was to determine the knowledge of family planning and family planning preferences and practices of rural community women in Cross River State of Nigeria. This was a cross-sectional study involving 291 rural women. Convenience sampling method was used. The women were assembled in a hall and a semi-structured questionnaire was administered to every consenting woman until the sample size was attained. Data obtained from the study were analyzed using the Statistical Package for the Social Sciences version 20 and presented in tables as frequencies and percentages as well as figures. Association between categorical variables was explored using chi-square test. Binary logistic regression was also performed to determine predictors of use of at least one family planning method at some point in time. Fifty (17.2%) respondents were using at least one family planning method. One hundred and ninety-eight (68.3%) respondents had used at least one family planning method at some point in time. Reasons given for not using any family planning method included "Family planning is against my religious beliefs" (56%); "it is against our culture" (43.8%); "I need more children" (64.9%); "my partner would not agree" (35.3%); "family planning does not work" (42.9%); "it reduces sexual enjoyment" (76%); and "it promotes unfaithfulness/infidelity" (59%). Binary logistic regression conducted to predict the use of at least one family planning method at some point in time using some independent variables showed that who makes the decision regarding family planning use was the strongest predictor of family planning use (OR = 0.567; 95% CI = 0.391-0.821). This suggests that family planning uptake is more

  6. Mental Health of Children Living in Foster Families in Rural Rwanda: The Role of HIV and the Family Environment.

    Science.gov (United States)

    Nduwimana, Estella; Mukunzi, Sylvere; Ng, Lauren C; Kirk, Catherine M; Bizimana, Justin I; Betancourt, Theresa S

    2017-06-01

    Fostering children is common in sub-Saharan Africa, but few studies examine these children's mental health needs. This study investigated the impact of living in a foster family on the mental health of HIV-positive, HIV-affected and HIV-unaffected children (n = 681 aged 10-17) in rural Rwanda. Regression analyses assessed the impact of living in a foster family on mental health, parenting, and daily hardships; multiple mediation analyses assessed whether family factors mediated the association between foster status and mental health. HIV-positive children were eight times more likely to live in foster families than HIV-unaffected children. Being HIV-affected was predictive of depression and irritability symptoms after controlling for family factors. Controlling for HIV-status, foster children had more symptoms of depression, anxiety, and irritability than non-fostered children. Positive parenting fully mediated the association between foster status and mental health. Mental health and parenting interventions for foster children and HIV-affected children may improve child outcomes.

  7. Household food insecurity and dietary patterns in rural and urban American Indian families with young children.

    Science.gov (United States)

    Tomayko, Emily J; Mosso, Kathryn L; Cronin, Kate A; Carmichael, Lakeesha; Kim, KyungMann; Parker, Tassy; Yaroch, Amy L; Adams, Alexandra K

    2017-06-30

    High food insecurity has been demonstrated in rural American Indian households, but little is known about American Indian families in urban settings or the association of food insecurity with diet for these families. The purpose of this study was to examine the prevalence of food insecurity in American Indian households by urban-rural status, correlates of food insecurity in these households, and the relationship between food insecurity and diet in these households. Dyads consisting of an adult caregiver and a child (2-5 years old) from the same household in five urban and rural American Indian communities were included. Demographic information was collected, and food insecurity was assessed using two validated items from the USDA Household Food Security Survey. Factors associated with food insecurity were examined using logistic regression. Child and adult diets were assessed using food screeners. Coping strategies were assessed through focus group discussions. These cross-sectional baseline data were collected from 2/2013 through 4/2015 for the Healthy Children, Strong Families 2 randomized controlled trial of a healthy lifestyles intervention for American Indian families. A high prevalence of food insecurity was determined (61%) and was associated with American Indian ethnicity, lower educational level, single adult households, WIC participation, and urban settings (p = 0.05). Food insecure adults had significantly lower intake of vegetables (p insecure children had significantly higher intakes of fried potatoes (p insecurity. The prevalence of food insecurity in American Indian households in our sample is extremely high, and geographic designation may be an important contributing factor. Moreover, food insecurity had a significant negative influence on dietary intake for families. Understanding strategies employed by households may help inform future interventions to address food insecurity. ( NCT01776255 ). Registered: January 16, 2013. Date of enrollment

  8. Social franchising and vouchers to promote long-term methods of family planning in rural Pakistan: a qualitative stocktaking with stakeholders.

    Science.gov (United States)

    Azmat, Syed Khurram; Mustafa, Ghulam; Hameed, Waqas; Asghar, Jamshaid; Ahmed, Aftab; Shaikh, Babar T

    2013-04-01

    The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes the perspectives of Suraj clients, field workers mobilization (FWMs), and providers on various components of the Suraj model. A qualitative exploratory study was conducted in six randomly selected intervention districts in the Sindh and Punjab provinces. Data were collected using focus group discussions (FGDs) with clients and in-depth interviews (IDIs) with providers and FWMs. Data were manually analyzed using constant comparison and the thematic analysis approach. Clients showed positive attitudes towards modern contraceptive methods and identified Suraj FWMs and signboards as sources of information. Almost all clients reported IUCDs as effective methods as they have manageable side effects and require fewer visits to clinics. They spoke highly of voucher schemes as these enabled them to avail free IUCD services. Clients also appreciated many components of Suraj clinics, including cleanliness, privacy, confidentiality, the sterilization of instruments, and courteous Suraj providers and FWMs. Most Suraj providers said that IUCD insertion and infection-prevention training enhanced their ability to provide IUCD services and increased their standing in local communities. They reported that the role of FWMs was crucial in mobilizing the community and increasing their FP clientele. The FWMs said that attitudes

  9. Investigating performance of rural family physicians in Fars province working as part of Family Physician Program

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    Mansour Kashfi

    2016-09-01

    Full Text Available Background & Objective: Health family physician program is a complete system which eliminates the bewilderment of people and increases the satisfaction with health services as its most important results in medical care. The aim of this study was to evaluate the performance of family physicians and their strengths and weaknesses. Material & Methods: In this study, 52 family physicians were chosen via Random Stratified Sampling to participate in the study. A questionnaire titled “Performance of Family Physicians” with 5 domains of management, performance, contract guidelines, community involvement and results was used to collect data. Data were analyzed using SPSS-19 via t-test, ANOVA, Pearson correlation coefficient, and non-parametric tests. Results: Among the 52 studied family physicians, 56.9% were female and 43.1% were male. The lowest and the highest scores were obtained for the community involvement and results, respectively. Based on the results of this study, there were significant relationships among most of the domains. However, there was no significant correlation between the gender and different domains. Conclusion: In order to solve the problems of family physician program and improve the quality of services, more researches should be carried out soon to determine the types and causes of referring to the family physicians. Accordingly, appropriate interventions should be implemented to reduce the burden of visits and improve the quality of health services by guiding the society towards the prevention measures.

  10. Information sharing with rural family caregivers during care transitions of hip fracture patients

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    Jacobi Elliott

    2014-06-01

    Full Text Available Introduction: Following hip fracture surgery, patients often experience multiple transitions through different care settings, with resultant challenges to the quality and continuity of patient care. Family caregivers can play a key role in these transitions, but are often poorly engaged in the process. We aimed to: (1 examine the characteristics of the family caregivers’ experience of communication and information sharing and (2 identify facilitators and barriers of effective information sharing among patients, family caregivers and health care providers. Methods: Using an ethnographic approach, we followed 11 post-surgical hip fracture patients through subsequent care transitions in rural Ontario; in-depth interviews were conducted with patients, family caregivers (n = 8 and health care providers (n = 24. Results: Priority areas for improved information sharing relate to trust and respect, involvement, and information needs and expectations; facilitators and barriers included prior health care experience, trusting relationships and the rural setting. Conclusion: As with knowledge translation, effective strategies to improve information sharing and care continuity for older patients with chronic illness may be those that involve active facilitation of an on-going partnership that respects the knowledge of all those involved.

  11. Information sharing with rural family caregivers during care transitions of hip fracture patients

    Directory of Open Access Journals (Sweden)

    Jacobi Elliott

    2014-06-01

    Full Text Available Introduction: Following hip fracture surgery, patients often experience multiple transitions through different care settings, with resultant challenges to the quality and continuity of patient care. Family caregivers can play a key role in these transitions, but are often poorly engaged in the process. We aimed to: (1 examine the characteristics of the family caregivers’ experience of communication and information sharing and (2 identify facilitators and barriers of effective information sharing among patients, family caregivers and health care providers.Methods: Using an ethnographic approach, we followed 11 post-surgical hip fracture patients through subsequent care transitions in rural Ontario; in-depth interviews were conducted with patients, family caregivers (n = 8 and health care providers (n = 24.Results: Priority areas for improved information sharing relate to trust and respect, involvement, and information needs and expectations; facilitators and barriers included prior health care experience, trusting relationships and the rural setting.Conclusion: As with knowledge translation, effective strategies to improve information sharing and care continuity for older patients with chronic illness may be those that involve active facilitation of an on-going partnership that respects the knowledge of all those involved.

  12. Analysis on Imbalance of Family Intergenerational Exchange in China Rural Area

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    Liguo Liu

    2014-04-01

    Full Text Available In China rural area, intergenerational exchange on supporting each other between parents and offspring is uneven. Parents pay much more than the return they’ll get when they’re old, which mainly relates to the utilities of children. In countryside, the utilities of children (especially sons manifest in following aspects: continuing the family line, emotional comfort, laborer and supporting for old age. To some extent, these factors influence the rural intergenerational injustice respectively and together. From the prospective of trend of social and economic development, the caring of the retired will be taken by social insurance system; the intergeneration exchange on supporting each other between parents and offspring will no longer be a social issue, but in the vast rural areas, the influence of traditional culture family lineage is still powerful. The need of caring of the old becomes so weak that emotional effect becomes much more urgent. The weak status of the old generation bring the fathers’ generation in a weak social status, which seriously affect the living conditions of the old generations. Therefore, when focusing the caring issue in the country, besides that we should ensure the old be cared materially, what matters most is keep the balance between the exchanging two sides

  13. Commercial Television Exposure, Fast Food Toy Collecting, and Family Visits to Fast Food Restaurants among Families Living in Rural Communities.

    Science.gov (United States)

    Emond, Jennifer A; Bernhardt, Amy M; Gilbert-Diamond, Diane; Li, Zhigang; Sargent, James D

    2016-01-01

    To assess the associations between children's exposure to television (TV) networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants. One hundred parents of children 3-7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's TV viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association. Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (aOR 2.84 for each 1-unit increase in the child's commercial TV viewing scale, P restaurants. Child desire for toy premiums may be a mediating factor. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Adoption Of Small Family Norms In A Rural Community Of West Bengal

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    Biswas A.K

    1994-01-01

    Full Text Available Research Questions: 1. To what extent do rural eligible couples accept the small family norm? 2. What are the factors which influence the adoption of small family norm by these couples? Objectives: 1. To determine the extent of adoption of small norm among family planning service acceptors (2 To identify factors influencing adoption of small family norm. Study Design: Cross sectional Study Setting: 2 villages- a PHC village and one 5 kms away of Block Sonarpur. Participants: 312 eligible couples of these villages. Study Variables: Socio â€" economics status, literacy of the wives, type of family, religion, number of children, type of family planning method. Outcome Variables: Prevalence of contraceptive method use, reasons for not using family planning methods. Statistical Analysis: Proportions Results : The prevalence of contraceptive use was 44.9% but the Effective Couple Protection Rate was only 20.5% and the Crude Birth Rate was still high (35/1000. This was because 40% of the couples had more then 2 children and of them 38% were still exposed to the risk of conception. Muslim couples had a lower contraceptive acceptance rate than Hindu couples. The more literate the wife, the greater the acceptance of the small family norm. Male preference pressure from elders and fear about contraception were the main reasons for non acceptance of family planning methods: The health teams were the main source of information to these couples. Recommendations: There is an urgent need to increase the emphasis on the 2 child family norm. The IEC activities of the health team should be strengthened.

  15. A Comparison Study of Single-Parent Families Living on Remote, Rural Islands and in Urban Settings in Japan.

    Science.gov (United States)

    Hiratani, Yuko; Hohashi, Naohiro

    2016-06-01

    Nursing interventions that aim to enhance the family environment are necessary to help single-parent families with children to improve family functioning. The cultural and social factors that are unique to Japan's remote islands should be considered to assess the influence of this unique setting on family functioning. The objectives of this study were to evaluate the family functioning of child-rearing single-parent families living in different environments and to investigate the association between family demographics and family functioning. A self-administered questionnaire, the Japanese version of the Survey of Family Environment, was used to evaluate the sufficiency of family functioning. The participants were families with children enrolled in nurseries and kindergartens who were either living in remote, rural islands or in an urban city on the mainland in Japan. Family functioning was significantly higher for single-parent families living on the islands than for those living in the city in terms of media use, participation in community activities, and the collaboration of family members in child-rearing. Family functioning of single-parent families correlated significantly with household income, the parent's gender, family members' health, and family life cycle. Single-parent families living on Japanese offshore islands maintained family functioning through mutual support and the effective use of information technology. Nevertheless, single-parent families require additional support to improve their healthcare and financial situations.

  16. Household food insecurity and dietary patterns in rural and urban American Indian families with young children

    Directory of Open Access Journals (Sweden)

    Emily J. Tomayko

    2017-06-01

    Full Text Available Abstract Background High food insecurity has been demonstrated in rural American Indian households, but little is known about American Indian families in urban settings or the association of food insecurity with diet for these families. The purpose of this study was to examine the prevalence of food insecurity in American Indian households by urban-rural status, correlates of food insecurity in these households, and the relationship between food insecurity and diet in these households. Methods Dyads consisting of an adult caregiver and a child (2–5 years old from the same household in five urban and rural American Indian communities were included. Demographic information was collected, and food insecurity was assessed using two validated items from the USDA Household Food Security Survey. Factors associated with food insecurity were examined using logistic regression. Child and adult diets were assessed using food screeners. Coping strategies were assessed through focus group discussions. These cross-sectional baseline data were collected from 2/2013 through 4/2015 for the Healthy Children, Strong Families 2 randomized controlled trial of a healthy lifestyles intervention for American Indian families. Results A high prevalence of food insecurity was determined (61% and was associated with American Indian ethnicity, lower educational level, single adult households, WIC participation, and urban settings (p = 0.05. Food insecure adults had significantly lower intake of vegetables (p < 0.05 and higher intakes of fruit juice (<0.001, other sugar-sweetened beverages (p < 0.05, and fried potatoes (p < 0.001 than food secure adults. Food insecure children had significantly higher intakes of fried potatoes (p < 0.05, soda (p = 0.01, and sports drinks (p < 0.05. Focus group participants indicated different strategies were used by urban and rural households to address food insecurity. Conclusions The prevalence of food insecurity in

  17. Reproductive Health of Women in Rural Areas of East Azerbaijan – Iran, before and after Implementation of rural Family Physician Program: an Ecologic Study

    Science.gov (United States)

    Alizadeh, Mahasti; Jabbari Birami, Hossein; Moradi, Siavash

    2015-01-01

    Introduction: Implementation of rural family physician program in Iran in 2005 has been evaluated and shown that this program has been led to some improvements in health indicators. In this study, some reproductive health (RH) indicators were compared before and after implementation of this program in rural areas of East Azerbaijan, Iran. Methods: In this ecologic- time trend study, the data of 191075 births of rural women of East Azerbaijan from 2001 to 2010 was extracted from vital horoscope (ZIJ) and used for calculation of 20 important RH indicators. The paired t-test and correlation analysis wear used for data analysis. Results: Some indicators such as adolescent marriage rate, adolescent birth and over 35 year olds birth rate were increased after rural family physician program implementation in 2005. Also stillbirth rate and unsafe delivery were decreased during this period. There was a significant correlation between increasing adolescent birth rate and increasing low birth weight deliveries (r= 0.911, P= 0.031) and also between increasing over 35 year olds birth rate and increasing neonatal mortality rate in term of prematurity and congenital malformations (r= 0.912, P= 0.031) after program implementation. Conclusion: Perinatal care and safe delivery even for pregnancies outside the typical child-bearing ages are promoting after implementation of rural family physician program in East Azerbaijan. Also decreasing unsafe delivery and stillbirth rate can be considered as achievements of running this program in this province. PMID:26744731

  18. Reproductive Health of Women in Rural Areas of East Azerbaijan – Iran, before and after Implementation of rural Family Physician Program: an Ecologic Study

    Directory of Open Access Journals (Sweden)

    Mahasti Alizadeh

    2015-12-01

    Full Text Available Introduction: Implementation of rural family physician program in Iran in 2005 has been evaluated and shown that this program has been led to some improvements in health indicators. In this study, some reproductive health (RH indicators were compared before and after implementation of this program in rural areas of East Azerbaijan, Iran. Methods: In this ecologic- time trend study, the data of 191075 births of rural women of East Azerbaijan from 2001 to 2010 was extracted from vital horoscope (ZIJ and used for calculation of 20 important RH indicators. The paired t-test and correlation analysis wear used for data analysis. Results: Some indicators such as adolescent marriage rate, adolescent birth and over 35 year olds birth rate were increased after rural family physician program implementation in 2005. Also stillbirth rate and unsafe delivery were decreased during this period. There was a significant correlation between increasing adolescent birth rate and increasing low birth weight deliveries (r= 0.911, P= 0.031 and also between increasing over 35 year olds birth rate and increasing neonatal mortality rate in term of prematurity and congenital malformations (r= 0.912, P= 0.031 after program implementation. Conclusion: Perinatal care and safe delivery even for pregnancies outside the typical child-bearing ages are promoting after implementation of rural family physician program in East Azerbaijan. Also decreasing unsafe delivery and stillbirth rate can be considered as achievements of running this program in this province.

  19. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA.

    Science.gov (United States)

    Ouma, S; Turyasima, M; Acca, H; Nabbale, F; Obita, K O; Rama, M; Adong, C C; Openy, A; Beatrice, M O; Odongo-Aginya, E I; Awor, S

    Uganda's rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. To determine obstacles to family planning use among rural women in Northern Uganda. A descriptive cross-sectional analytical study. Atiak Health Centre IV, Amuru District, rural Northern Uganda. Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders' involvement in family planning programme. In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family planning and thus reduce the rapid population growth and poverty.

  20. OBSTACLES TO FAMILY PLANNING USE AMONG RURAL WOMEN IN ATIAK HEALTH CENTER IV, AMURU DISTRICT, NORTHERN UGANDA

    Science.gov (United States)

    Ouma, S.; Turyasima, M.; Acca, H.; Nabbale, F.; Obita, K. O.; Rama, M.; Adong, C. C.; Openy, A.; Beatrice, M. O.; Odongo-Aginya, E. I.; Awor, S.

    2016-01-01

    Background Uganda’s rapid population growth (3.2%) since 1948 has placed more demands on health sector and lowered living standard of Ugandans resulting into 49% of people living in acute poverty especially in post conflict Northern Uganda. The population rise was due to low use of contraceptive methods (21% in rural areas and 43% in urban areas) and coupled with high unmet need for family planning (41%). This indicated poor access to reproductive health services. Effective use of family planning could reduce the rapid population growth. Objective To determine obstacles to family planning use among rural women in Northern Uganda. Design A descriptive cross-sectional analytical study. Setting Atiak Health Centre IV, Amuru District, rural Northern Uganda. Subjects Four hundred and twenty four females of reproductive ages were selected from both Inpatient and Outpatient Departments of Atiak Health Centre IV. Results There was high level of awareness 418 (98.6%), positive attitude 333 (78.6%) and fair level of utilisation 230 (54.2%) of family planning. However, significant obstacles to family planning usage included; long distance to Health facility, unavailability of preferred contraceptive methods, absenteeism of family planning providers, high cost of managing side effects, desire for big family size, children dying less than five years old, husbands forbidding women from using family planning and lack of community leaders’ involvement in family planning programme. Conclusions In spites of the high level of awareness, positive attitude, and free family planning services, there were obstacles that hindered family planning usage among these rural women. However, taking services close to people, reducing number of children dying before their fifth birthday, educating men about family planning, making sure family planning providers and methods are available, reducing cost of managing side effects and involving community leaders will improve utilisation of family

  1. Family Planning Practice Among Rural Reproductive-Age Married Women in Myanmar.

    Science.gov (United States)

    Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai

    2016-05-01

    A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. © 2016 APJPH.

  2. Development of a New South Dakota Rural Family Medicine Residency Program.

    Science.gov (United States)

    Heisler, Jean; Huber, Thomas; Huntington, Mark K

    2017-11-01

    The healthcare workforce is a priority in South Dakota. It has been estimated that 8,000 additional healthcare workers beyond those in practice in 2010 will be needed by 2020. In 2016, the South Dakota Department of Health included in its budget funds for the development of a new Rural Family Medicine Residency Training Program as one of the steps toward addressing the physician component of these workforce needs. This new program has just received its accreditation and is recruiting the inaugural class of resident physicians for the spring of 2018. This article provides a concise overview of the program's initial development. Copyright© South Dakota State Medical Association.

  3. Understanding the strategies employed to cope with increased numbers of AIDS-orphaned children in families in rural settings: a case of Mbeya Rural District, Tanzania.

    Science.gov (United States)

    Fauk, Nelsensius Klau; Mwakinyali, Silivano Edson; Putra, Sukma; Mwanri, Lillian

    2017-02-07

    The purpose of this study was to understand the strategies employed by families that adopt Acquired Immune Deficiency Syndrome (AIDS)-orphaned children (Adoptive families) for coping with and mitigating the impact of AIDS in Mbeya Rural District, Tanzania. High numbers of AIDS-orphaned children aged below 18 years in Mbeya Region have led to increasing the burden of families caring for them. Understanding the coping strategies and impact mitigation activities employed by adoptive families is important in order to develop programmes to help them. This study employed a qualitative method for data collection (one-on-one in-depth interviews). The respondents included 12 male and 8 female heads of families that provide essential care for AIDS-orphaned children in Mbeya Rural District in Tanzania. The framework approach was used to analyse the data that were collected from 15 July to 15 August 2010. The study findings revealed that adoptive families faced several challenges including financial constraints due to increased needs for basic essentials such as health care expenses, school fees and food. Further impacts on adoptive families included shortage of work opportunities and limited time to address these challenges. To mitigate these challenges, adoptive families employed a range of coping strategies including selling family assets and renting out parts of cultivable land for extra cash. Task reallocation which involved the AIDS-orphaned children entering the labour force was also employed as a strategy to mitigate challenges and involved de-enrolling of children from schools so they could take part in income-generating activities in order to earn supplementary family income. The creation of additional income-generating activities such as poultry farming were other coping mechanisms employed, and these received support from both non-governmental organisations (NGOs) and governmental organisations, including the Isangati Agricultural Development Organization (local

  4. [How to carry out work on family planning after adopting production responsibility systems in rural areas].

    Science.gov (United States)

    Xiao, S H

    1982-05-29

    After the Third Meeting of the Eleventh People's Congress, the entire responsibility for agricultural production was transferred to a lower level. Peasants in various areas have adopted the so called production responsibility system, and the phenomenon of an increased population rate has also appeared in some areas. In this article, the author discusses how to solve these problems created by the new situation. The 1st step is try to control population growth through socialist propaganda education, administrative measures, economic incentives and punishments, and family planning work. The 2nd step is to popularize the practice of having only 1 child per household in the rural areas. The 2nd and 3rd child in each family should be controlled and prohibited. This policy formulated by the Central Government should be carried out thoroughly. Families which follow the policy and have only 1 child should be encouraged with economic rewards, and those families which have 2 or more children should be punished economically. The 3rd step is to establish a national work team to be in charge of family planning and birth control. There should be an ideological unity among the nation's leadership. Party members and cadres should establish themselves as good examples for the people so that the population control work may become successful.

  5. Family life course transitions and rural household economy during China's market reform.

    Science.gov (United States)

    Chen, Feinian; Korinek, Kim

    2010-11-01

    This article investigates the effect of family life course transitions on labor allocation strategies in rural Chinese households. We highlight three types of economic activity that involve reallocation of household labor oriented toward a more diversified, nonfarm rural economy: involvement in wage employment, household entrepreneurship, and/or multiple activities that span economic sectors. With the use of data from the China Health and Nutrition Survey (CHNS 1997, 2000, and 2004), our longitudinal analyses of rural household economic activity point to the significance of household demography, life course transitions, and local economic structures as factors facilitating household labor reallocation. First, as expected, a relatively youthful household structure is conducive to innovative economic behavior. Second, household entrances and exits are significant, but their impacts are not equal. Life events such as births, deaths, marriage, or leaving home for school or employment affect household economy in distinctive ways. Finally, the reallocations of household labor undertaken by households are shaped by local economic structures: in particular, the extent of village-level entrepreneurial activity, off-farm employment, and out-migration.

  6. Benefits of family planning: an assessment of women's knowledge in rural Western Kenya.

    Science.gov (United States)

    Mutombo, Namuunda; Bakibinga, Pauline; Mukiira, Carol; Kamande, Eva

    2014-03-18

    The last two decades have seen an increase in literature reporting an increase in knowledge and use of contraceptives among individuals and couples in Kenya, as in the rest of Africa, but there is a dearth of information regarding knowledge about benefits of family planning (FP) in Kenya. To assess the factors associated with knowledge about the benefits of FP for women and children, among women in rural Western Kenya. Data are drawn from the Packard Western Kenya Project Baseline Survey, which collected data from rural women (aged 15-49 years). Ordinal regression was used on 923 women to determine levels of knowledge and associated factors regarding benefits of FP. Women in rural Western Kenya have low levels of knowledge about benefits of FP and are more knowledgeable about benefits for the mother rather than for the child. Only age, spousal communication and type of contraceptive method used are significant. Women's level of knowledge about benefits of FP is quite low and may be one of the reasons why fertility is still high in Western Kenya. Therefore, FP programmes need to focus on increasing women's knowledge about the benefits of FP in this region.

  7. Family sources of educational gender inequality in rural china: A critical assessment.

    Science.gov (United States)

    Hannum, Emily; Kong, Peggy; Zhang, Yuping

    2009-09-01

    In this paper, we investigate the gender gap in education in rural northwest China. We first discuss parental perceptions of abilities and appropriate roles for girls and boys; parental concerns about old-age support; and parental perceptions of different labor market outcomes for girls' and boys' education. We then investigate gender disparities in investments in children, children's performance at school, and children's subsequent attainment. We analyze a survey of 9-12-year-old children and their families conducted in rural Gansu Province in the year 2000, along with follow-up information about subsequent educational attainment collected 7 years later. We complement our main analysis with two illustrative case studies of rural families drawn from 11 months of fieldwork conducted in rural Gansu between 2003 and 2005 by the second author.In 2000, most mothers expressed egalitarian views about girls' and boys' rights and abilities, in the abstract. However, the vast majority of mothers still expected to rely on sons for old-age support, and nearly one in five mothers interviewed agreed with the traditional saying, "Sending girls to school is useless since they will get married and leave home." Compared to boys, girls faced somewhat lower (though still very high) maternal educational expectations and a greater likelihood of being called on for household chores than boys. However, there was little evidence of a gender gap in economic investments in education. Girls rivaled or outperformed boys in academic performance and engagement. Seven years later, boys had attained just about a third of a year more schooling than girls-a quite modest advantage that could not be fully explained by early parental attitudes and investments, or student performance or engagement. Fieldwork confirmed that parents of sons and daughters tended to have high aspirations for their children. Parents sometimes viewed boys as having greater aptitude, but tended to view girls as having more

  8. Development and Validation of a Gender Ideology Scale for Family Planning Services in Rural China

    Science.gov (United States)

    Yang, Xueyan; Li, Shuzhuo; Feldman, Marcus W.

    2013-01-01

    The objectives of this study are to develop a scale of gender role ideology appropriate for assessing Quality of Care in family planning services for rural China. Literature review, focus-group discussions and in-depth interviews with service providers and clients from two counties in eastern and western China, as well as experts’ assessments, were used to develop a scale for family planning services. Psychometric methodologies were applied to samples of 601 service clients and 541 service providers from a survey in a district in central China to validate its internal consistency, reliability, and construct validity with realistic and strategic dimensions. This scale is found to be reliable and valid, and has prospects for application both academically and practically in the field. PMID:23573222

  9. Geographical Mobility, Income, Life Satisfaction and Family Size Preferences: An Empirical Study on Rural Households in Shaanxi and Henan Provinces in China.

    Science.gov (United States)

    Chen, Jiangsheng; Yang, Hong

    Employing data from the China rural-urban mobility survey conducted in 2010, this study investigates the influence of family demographic characteristics on the income, life satisfaction, and potential for rural-urban mobility at the rural household level of two provinces of China: Shaanxi and Henan. A larger labor force in a rural household was found to reduce a family's ability or inclination to move to a city. The findings reveal that family size negatively affects the average income per family member and reduces the marginal income of the labor force and that minor children can improve the life satisfaction of family members. We conclude that a larger family size does not translate to more benefits for a rural household. Family size preference is found to be a reflection of parents' concerns about elderly care and is deemed to be unfavorable for urbanization in P. R. China.

  10. 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.

  11. Values transferred and cherished by mothers in the rural families in the Polish Second Republic

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    ANNA JÓZEFOWICZ

    2017-10-01

    Full Text Available In the Polish Second Republic, so in the country rebom afiter one hundred twenty three years of captivity, the role of a woman as a woman-mother, was significantly emphasized. Press, literature, researchers have proved that safety and order in the whole country depend on safety and order in individual families. The key notion became: „from education of a mother to education of a child”. While analyzing sources such as newspapers, magazines, diaries, guidebooks, I noticed the following values for which mothers in rural families were held to be responsible: 1 ,value of work connected with obligation in farm and household, so role of mother asahousewife; 2.the value of the family as a community and the mother's role in it. Mother was the first protector, tutor, patron of a child. Mother took care of child and other members in the family, she helped them, she guaranteed the positive atmosphere at home, took care of safety in a wide context. It was significant that mother appealed in the process of socialization to common traditions and experiences; 3.value of education and social consciousness, so the role of the mother in shaping social consciousness; 4.patriotic value, so the role of the mother in shaping patriotic attitude

  12. 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

  13. Family effects on the rurality of GP's work location: a longitudinal panel study.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J; O'Sullivan, Belinda G

    2017-10-19

    Reduced opportunities for children's schooling and spouse's/partner's employment are identified internationally as key barriers to general practitioners (GPs) working rurally. This paper aims to measure longitudinal associations between the rurality of GP work location and having (i) school-aged children and (ii) a spouse/partner in the workforce. Participants included 4377 GPs responding to at least two consecutive annual surveys of the Medicine in Australia: Balancing Employment and Life (MABEL) national longitudinal study between 2008 and 2014. The main outcome, GP work location, was categorised by remoteness and population size. Five sequential binary school-age groupings were defined according to whether a GP had no children, only preschool children (aged 0-4 years), at least one primary-school child (aged 5-11 years), at least one child in secondary school (aged 12-18 years), and all children older than secondary school (aged ≥ 19). Partner in the workforce was defined by whether a GP had a partner who was either currently working or looking for work, or not. Separate generalised estimating equation models, which aggregated consecutive annual observations per GP, tested associations between work location and (i) educational stages and (ii) partner employment, after adjusting for key covariates. Male GPs with children in secondary school were significantly less likely to work rurally (inclusive of > 50 000 regional centres through to the smallest rural towns of locations were not significantly associated with the educational stage of their children. Having a partner in the workforce was not associated with work location for male GPs, whereas female GPs with a partner in the workforce were significantly less likely to work in smaller rural/remote communities (location is related to key family needs which differ according to GP gender and educational stages of children. Such non-professional factors are likely to be dynamic across the GP's lifespan and

  14. Educational Outcomes across the Generational and Gender Divide: The Rural Family Habitus of Pakistani Families Living in Poverty

    Science.gov (United States)

    Arnot, Madeleine; Naveed, Arif

    2014-01-01

    Education for all as a global agenda has particular repercussions for those living in rural poverty. By adopting a Bourdieusian framework to analyse interview data collected from fathers, mothers, sons and daughters in 10 rural Punjabi households, we expose the intersections of education, gender, poverty and rurality. The concept of a "rural…

  15. 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

  16. Impact of an in-built monitoring system on family planning performance in rural Bangladesh

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    Ashraf Ali

    2007-06-01

    Full Text Available Abstract Background During 1982–1992, the Maternal and Child Health Family Planning (MCH-FP Extension Project (Rural of International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B, in partnership with the Ministry of Health and Family Welfare (MoHFW of the Government of Bangladesh (GoB, implemented a series of interventions in Sirajganj Sadar sub-district of Sirajganj district. These interventions were aimed at improving the planning mechanisms and for reviewing the problem-solving processes to build an effective monitoring system of the interventions at the local level of the overall system of the MOHFW, GoB. Methods The interventions included development and testing of innovative solutions in service-delivery, provision of door-step injectables, and strengthening of the management information system (MIS. The impact of an in-built monitoring system on the overall performance was assessed during the period from June 1995 to December 1996, after the withdrawal of the interventions in 1992. Results The results of the assessment showed that Family Welfare Assistants (FWAs increased household-visits within the last two months, and there was a higher use of service-delivery points even after the withdrawal of the interventions. The results of the cluster surveys, conducted in 1996, showed that the selected indicators of health and family-planning services were higher than those reported by the Bangladesh Demographic and Health Survey (BDHS 1996–1997. During June 1995-December, 1996, the contraceptive prevalence rate (CPR increased by 13 percentage points (i.e. from 40% to 53%. Compared to the national CPR (49%, this increase was statistically significant (p Conclusion The in-built monitoring systems, including effective MIS, accompanied by rapid assessments and review of performance by the programme managers, have potentials to improve family planning performance in low-performing areas.

  17. Admission Factors Predicting Family Medicine Specialty Choice: A Literature Review and Exploratory Study among Students in the Rural Medical Scholars Program

    Science.gov (United States)

    Avery, Daniel M., Jr.; Wheat, John R.; Leeper, James D.; McKnight, Jerry T.; Ballard, Brent G.; Chen, Jia

    2012-01-01

    Purpose: The Rural Medical Scholars Program (RMSP) was created to increase production of rural family physicians in Alabama. Literature review reveals reasons medical students choose careers in family medicine, and these reasons can be categorized into domains that medical schools can address through admission, curriculum, and structural…

  18. Cultural health beliefs in a rural family practice: a Malaysian perspective.

    Science.gov (United States)

    Ariff, Kamil M; Beng, Khoo S

    2006-02-01

    Understanding the sociocultural dimension of a patient's health beliefs is critical to a successful clinical encounter. Malaysia with its multi-ethnic population of Malay, Chinese and Indian still uses many forms of traditional health care in spite of a remarkably modern rural health service. The objective of this paper is discuss traditional health care in the context of some of the cultural aspects of health beliefs, perceptions and practices in the different ethnic groups of the author's rural family practices. This helps to promote communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoids cultural blind spots and unnecessary medical testing and leads to better adherence to treatment by patients. Includes traditional practices of 'hot and cold', notions of Yin-Yang and Ayurveda, cultural healing, alternative medicine, cultural perception of body structures and cultural practices in the context of women's health. Modern and traditional medical systems are potentially complementary rather than antagonistic. Ethnic and cultural considerations can be integrated further into the modern health delivery system to improve care and health outcomes.

  19. The effect of economic factors on families calorie demand in rural

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    hossein ebadipour

    2016-11-01

    The quantity of the received calories by families is one of the important debates in public and development economic context. This is an attractive subject for government officials and policy makers in different countries. In the current paper, the impacts of households' income shocks, price and food commodity subsidies on the quantity of the received amount of calories in the rural parts of Iran are studied. For this purpose, we used time series data of 1961-2011 in the vector auto-regressive (VAR model. The results indicated that the impact period of the applied shock on the quantity of paid subsidies to agricultural sector is shorter than the period of price and income shocks. Besides, the most sensitivity of calorie demand is related to the income factor. According to the research findings, we can conclude that for creating food security, we should create economic stability in the market and consider the final effect of changes in nutrition pattern when determining the policies regarding market regulation, subsidies and taxation regardless of income growth that affect rural households and will have a serious negative impact on calories.

  20. Systemic approach in rural administration: Study of the family production unit

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    Adilson R. Paz Stamberg

    2015-06-01

    Full Text Available This paper focuses on understanding the rationality of production management and available resources in agricultural production unit (UPA, identifying its main technical and socioeconomic characteristics in order to make a diagnosis to subsidize the rural manager in decision making.This study was part of the extension project approved in the Institutional Incentive Extension Program of the Farroupilha Federal Institute (Brazil, prioritizing as object of study a family UPA in the municipality of Santo Antônio das Missões/RS/Brazil, being conducted between October-November 2014.As methodological procedure a survey was done with qualitative and quantitative data, such as natural resources, utilized agricultural area, herd, plant, machinery and equipment, availability of labor force and yields of the various cultivation subsystems, breeding and processing. This data was organized in a spreadsheet, which identifies the adopted production system and its main technical and socioeconomic characteristics. As proposed, technical and managerial intervention in the production system, proposed strategically to enhance milk production opposed to the soybean production, considering its high contribution in relation to the value added per unit area.Key Words: Rural Administration - Production management - Systemic approach.

  1. Are the cause(s) responsible for urban-rural differences in schizophrenia risk rooted in families or individuals?

    DEFF Research Database (Denmark)

    Pedersen, Carsten Bøcker; Mortensen, Preben Bo

    2006-01-01

    Many studies have identified urban-rural differences in schizophrenia risk. Hypothetical underlying cause(s) may include toxic exposures, diet, infections, and selective migration. The authors investigated whether the underlying cause(s) responsible for the urban-rural differences were rooted...... evaluated whether the nearest older sibling's place of birth had an independent effect on schizophrenia risk. If the cause(s) responsible for the urban-rural differences are rooted in individuals only, the nearest older sibling's place of birth should have no independent effect. In this analysis....... Some of the cause(s) responsible for the urban-rural differences in schizophrenia risk are rooted in families, but some might also be rooted in individuals....

  2. The long-term demographic role of community-based family planning in rural Bangladesh.

    Science.gov (United States)

    Phillips, J F; Hossain, M B; Arends-Kuenning, M

    1996-01-01

    Experimental studies demonstrating the effectiveness of nonclinical distribution of contraceptives are typically conducted in settings where contraceptive use is low and unmet need is extensive. Determining the long-term role of active outreach programs after initial demand is met represents an increasingly important policy issue in Asia, where contraceptive prevalence is high and fixed service points are conveniently available. This article examines the long-term rationale for household family planning in Bangladesh-where growing use of contraceptives, rapid fertility decline, and normative change in reproductive preferences are in progress, bringing into question the rationale for large-scale deployment of paid outreach workers. Longitudinal data are analyzed that record outreach encounters and contraceptive use dynamics in a large rural population. Findings demonstrate that outreach has a continuing impact on program effectiveness, even after a decade of household visitation. The policy implications of this finding are reviewed.

  3. Child development in rural China: children left behind by their migrant parents and children of nonmigrant families.

    Science.gov (United States)

    Wen, Ming; Lin, Danhua

    2012-01-01

    Using recent cross-sectional data of rural children aged from 8 to 18 in Hunan Province of China, this article examines psychological, behavioral, and educational outcomes and the psychosocial contexts of these outcomes among children left behind by one or both of their rural-to-urban migrant parents compared to those living in nonmigrant families. The results showed that left-behind children were disadvantaged in health behavior and school engagement but not in perceived satisfaction. The child's psychosocial environment, captured by family socioeconomic status, socializing processes, peer and school support, and psychological traits, were associated with, to varying extent, child developmental outcomes in rural China. These influences largely remain constant for the sampled children regardless of their parents' migrant status. © 2011 The Authors. Child Development © 2011 Society for Research in Child Development, Inc.

  4. The garden dying: Commoditization of agriculture and changes in practices of self-consumption among rural families of southern gaucho

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    Flávio Sacco dos Anjos

    2009-12-01

    Full Text Available The article is based on qualitative research carried out in the southern extreme of the Rio Grande do Sul state and explores the transformations on the practices of self-consumption production in the context of familiar agriculture, essentially, under the impacts of the process of commoditization of agriculture and the rural life. The self-consumption practices present a cultural matrix among rural families, in spite of the symbolic value attributed to products generated within the very rural establishment, as compared to the ones which are acquired externally in usual commerce or from other units of production. The field-work was performed within thirty family agricultural establishments whose main commercial activity lies on the milk, peach and tobacco production. The authors discuss the impacts of the commoditization of agriculture on the practical of self-consumption production.

  5. Rural Latinos' mental wellbeing: a mixed-methods pilot study of family, environment and social isolation factors.

    Science.gov (United States)

    Stacciarini, Jeanne-Marie R; Smith, Rebekah; Garvan, Cynthia Wilson; Wiens, Brenda; Cottler, Linda B

    2015-05-01

    Upon immigration to the rural areas in the US, Latino families may experience cultural, geographic, linguistic and social isolation, which can detrimentally affect their wellbeing by acting as chronic stressors. Using a community engagement approach, this is a pilot mixed-method study with an embedded design using concurrent qualitative and quantitative data. The purpose of this study is to evaluate family and social environments in terms of protective factors and modifiable risks associated with mental well-being in Latino immigrants living in rural areas of Florida. Latino immigrant mother and adolescent dyads were interviewed by using in-depth ethnographic semistructured interviews and subsequent quantitative assessments, including a demographic questionnaire and three structured instruments: the Family Environment Scale Real Form, the SF-12v2™ Health Survey and the short version (eight items) of PROMIS Health Organization Social Isolation. This mixed-method pilot study highlighted how family, rural, and social environments can protect or impair wellbeing in rural Latino immigrant mother and adolescent dyads.

  6. The Influence of Family on Educational and Occupational Achievement of Adolescents in Rural Low-Income Areas: An Ecological Perspective.

    Science.gov (United States)

    Schiamberg, Lawrence B.; Chin, Chong-Hee

    Focusing on the family as a context for the development of life plans by youth, this report summarizes findings of a 14-year longitudinal study on the educational and occupational life plans and achievement of youth in rural low-income areas in six southeastern states. Specific attention is given to (1) how parental educational and occupational…

  7. Are Mothers Really "Gatekeepers" of Children?: Rural Mothers' Perceptions of Nonresident Fathers' Involvement in Low-Income Families

    Science.gov (United States)

    Sano, Yoshie; Richards, Leslie N.; Zvonkovic, Anisa M.

    2008-01-01

    Guided by symbolic interactionism, this qualitative study based on interviews with 83 rural mothers investigated mothers' perceptions of nonresident fathers' involvement in low-income families. Contrary to some fathers' claims that mothers "gatekeep" their access to children, the majority of mothers in our study wanted increased father…

  8. The quality assessment of family physician service in rural regions, Northeast of Iran in 2012.

    Science.gov (United States)

    Vafaee-Najar, Ali; Nejatzadegan, Zohreh; Pourtaleb, Arefeh; Kaffashi, Shahnaz; Vejdani, Marjan; Molavi-Taleghani, Yasamin; Ebrahimipour, Hosein

    2014-04-01

    Following the implementation of family physician plan in rural areas, the quantity of provided services has been increased, but what leads on the next topic is the improvement in expected quality of service, as well. The present study aims at determining the gap between patients' expectation and perception from the quality of services provided by family physicians during the spring and summer of 2012. This was a cross-sectional study in which 480 patients who referred to family physician centers were selected with clustering and simple randomized method. Data were collected through SERVQUAL standard questionnaire and were analyzed with descriptive statistics, using statistical T-test, Kruskal-Wallis, and Wilcoxon signed-rank tests by SPSS 16 at a significance level of 0.05. The difference between the mean scores of expectation and perception was about -0.93, which is considered as statistically significant difference (P≤ 0.05). Also, the differences in five dimensions of quality were as follows: tangible -1.10, reliability -0.87, responsiveness -1.06, assurance -0.83, and empathy -0.82. Findings showed that there was a significant difference between expectation and perception in five concepts of the provided services (P≤ 0.05). There was a gap between the ideal situation and the current situation of family physician quality of services. Our suggestion is maintaining a strong focus on patients, creating a medical practice that would exceed patients' expectations, providing high-quality healthcare services, and realizing the continuous improvement of all processes. In both tangible and responsive, the gap was greater than the other dimensions. It is recommended that more attention should be paid to the physical appearance of the health center environment and the availability of staff and employees.

  9. The Family Life Project: an epidemiological and developmental study of young children living in poor rural communities.

    Science.gov (United States)

    Vernon-Feagans, Lynne; Cox, Martha

    2013-10-01

    About 20% of children in the United States have been reported to live in rural communities, with child poverty rates higher and geographic isolation from resources greater than in urban communities. There have been surprisingly few studies of children living in rural communities, especially poor rural communities. The Family Life Project helped fill this gap by using an epidemiological design to recruit and study a representative sample of every baby born to a mother who resided in one of six poor rural counties over a 1-year period, oversampling for poverty and African American. 1,292 children were followed from birth to 36 months of age. This monograph described these children and used a cumulative risk model to examine the relation between social risk and children's executive functioning, language development, and behavioral competence at 36 months. Using both the Family Process Model of development and the Family Investment Model of development, observed parenting was examined over time in relation to child functioning at 36 months. Different aspects of observed parenting were examined as mediators/moderators of risk in predicting child outcomes. Results suggested that cumulative risk was important in predicting all three major domains of child outcomes and that positive and negative parenting and maternal language complexity were mediators of these relations. Maternal positive parenting was found to be a buffer for the most risky families in predicting behavioral competence. In a final model using both family process and investment measures, there was evidence of mediation but with little evidence of the specificity of parenting for particular outcomes. Discussion focused on the importance of cumulative risk and parenting in understanding child competence in rural poverty and the implications for possible intervention strategies that might be effective in maximizing the early development of these children.

  10. Nine years of publications on strengths and weaknesses of Family Physician Program in rural area of Iran: A systematic review

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    Saber Azami-Aghdash

    2016-12-01

    Full Text Available Introduction: One of the most important duties of a family physician is to provide primary health care. This is completely considered in the Family Physician Program for a target population. The aim of this study was to systematically review the Family Physician and Referral System strength and weakness in rural area of Iran. Methods: In this systematic review, Scientific Information Database (SID, Science Direct, and PubMed databases were searched and Google search engine was employed using key words such as family medicine, family physician, and referral system for the period of January 2005 to June 2013, both in English and Persian. For identifying duplicated references, Endnote Software was used and for summarizing results of fully assessed articles extraction table was employed. Results: Strengths and weaknesses of Family Physician Program and referral system in rural areas of Iran were extracted from 28 studies. In total, 115 weaknesses (3.96 per study and 103 strengths (3.55 per study were obtained. Content analysis was used and 218 items were summarized into 29 items. Strengths of Family Physician Program were: access of villagers to health services, filling health document for clients, improving services for pregnant mothers, and family planning; while its obvious weaknesses included repeated unnecessary referral of clients as well as lack of providing job stability. Conclusion: Results of studies conducted in Iran showed that Family Physician and Referral System in rural area of Iran could not be successful enough and has many shortcomings. Therefore, a growing body of effective changes must be made for a better performance and to obtain better outcomes.

  11. Does rural generalist focused medical school and family medicine training make a difference? Memorial University of Newfoundland outcomes.

    Science.gov (United States)

    Rourke, James; Asghari, Shabnam; Hurley, Oliver; Ravalia, Mohamed; Jong, Michael; Graham, Wendy; Parsons, Wanda; Duggan, Norah; O'Keefe, Danielle; Moffatt, Scott; Stringer, Katherine; Sturge Sparkes, Carolyn; Hippe, Janelle; Harris Walsh, Kristin; McKay, Donald; Samarasena, Asoka

    2018-03-01

    Rural recruitment and retention of physicians is a global issue. The Faculty of Medicine at Memorial University of Newfoundland, Canada, was established as a rural-focused medical school with a social accountability mandate that aimed to meet the healthcare needs of a sparse population distributed over a large landmass as well as the needs of other rural and remote areas of Canada. This study aimed to assess whether Memorial medical degree (MD) and postgraduate (PG) programs were effective at producing physicians for their province and rural physicians for Canada compared with other Canadian medical schools. This retrospective cohort study included medical school graduates who completed their PG training between 2004 and 2013 in Canada. Practice locations of study subjects were georeferenced and assigned to three geographic classes: Large Urban; Small City/Town; and Rural. Analyses were performed at two levels. (1) Provincial level analysis compared Memorial PG graduates practicing where they received their MD and/or PG training with other medical schools who are the only medical school in their province (n=4). (2) National-level analysis compared Memorial PG graduates practicing in rural Canada with all other Canadian medical schools (n=16). Descriptive and bivariate analyses were performed. Overall, 18 766 physicians practicing in Canada completed Canadian PG training (2004-2013), and of those, 8091 (43%) completed Family Medicine (FM) training. Of all physicians completing Canadian PG training, 1254 (7%) physicians were practicing rurally and of those, 1076 were family physicians. There were 379 Memorial PG graduates and of those, 208 (55%) completed FM training and 72 (19%) were practicing rurally, and of those practicing rurally, 56 were family physicians. At the national level, the percentage of all Memorial PG graduates (19.0%) and FM PG graduates (26.9%) practicing rurally was significantly better than the national average for PG (6.4%, p<0.000) and FM (12

  12. "The Kids Still Come First": Creating Family Stability during Partnership Instability in Rural, Low-Income Families

    Science.gov (United States)

    Sano, Yoshie; Manoogian, Margaret M.; Ontai, Lenna L.

    2012-01-01

    This qualitative study examined the nature of partnerships among 28 rural low-income mothers who experienced partnership transitions across three waves of annual interviews. Guided by "lens of uncertainty" and "boundary ambiguity theory," the authors specifically explored (a) how low-income mothers in rural communities experience partnership…

  13. Domestic and environmental factors of chikungunya-affected families in Thiruvananthapuram (Rural district of Kerala, India

    Directory of Open Access Journals (Sweden)

    T S Anish

    2011-01-01

    Full Text Available Background: The world is experiencing a pandemic of chikungunya which has swept across Indian Ocean and the Indian subcontinent. Kerala the southernmost state of India was affected by the chikungunya epidemic twice, first in 2006 and then in 2007. Kerala has got geography and climate which are highly favorable for the breeding of Aedes albopictus, the suspected vector. Aim: The aim of the study was to highlight the various domestic and environmental factors of the families affected by chikungunya in 2007 in Thiruvananthapuram district (rural of Kerala. Settings and design: This is a cross-sectional survey conducted in Thiruvananthapuram (rural district during November 2007. Materials and Methods : Samples were selected from field area under three Primary Health Centers. These areas represent the three terrains of the district namely the highland, midland, and lowland. The sample size was estimated to be 134 houses from each study area. The field area of health workers was selected as clusters and six subcenters from each primary health center were randomly selected (lot method. Results and Conclusions: The proportion of population affected by chikungunya fever is 39.9% (38.9-40.9%. The investigators observed water holding containers in the peri-domestic area of 95.6% of the houses. According to regression (binary logistic analysis, the area of residence [adjusted odds ratio (OR = 8.01 (6.06-14.60], residing in a non-remote area [adjusted OR=0.25 (0.16-0.38], perceived mosquito menace [adjusted OR=3.07 (2.31-4.64], and containers/tires outside the house [adjusted OR=5.61 (2.74-27.58] were the independent predictors of the occurrence of chikungunya in households.

  14. Young People's Preferences for Family Planning Service Providers in Rural Malawi: A Discrete Choice Experiment.

    Directory of Open Access Journals (Sweden)

    Christine Michaels-Igbokwe

    Full Text Available To quantify the impact of service provider characteristics on young people's choice of family planning (FP service provider in rural Malawi in order to identify strategies for increasing access and uptake of FP among youth.A discrete choice experiment was developed to assess the relative impact of service characteristics on preferences for FP service providers among young people (aged 15-24. Four alternative providers were included (government facility, private facility, outreach and community based distribution of FP and described by six attributes (the distance between participants' home and the service delivery point, frequency of service delivery, waiting time at the facility, service providers' attitude, availability of FP commodities and price. A random parameters logit model was used to estimate preferences for service providers and the likely uptake of services following the expansion of outreach and community based distribution (CBDA services. In the choice experiment young people were twice as likely to choose a friendly provider (government service odds ratio [OR] = 2.45, p<0.01; private service OR = 1.99, p<0.01; CBDA OR = 1.88, p<0.01 and more than two to three times more likely to choose a provider with an adequate supply of FP commodities (government service OR = 2.48, p<0.01; private service OR = 2.33, p<0.01; CBDA = 3.85, p<0.01. Uptake of community based services was greater than facility based services across a variety of simulated service scenarios indicating that such services may be an effective means of expanding access for youth in rural areas and an important tool for increasing service uptake among youth.Ensuring that services are acceptable to young people may require additional training for service providers in order to ensure that all providers are friendly and non-judgemental when dealing with younger clients and to ensure that supplies are consistently available.

  15. Importance of cattle breeding in the nourishment safety of families in the rural area of Paipa, Boyaca

    Directory of Open Access Journals (Sweden)

    Diana Milena Soler Fonseca

    2011-05-01

    Full Text Available In the rural municipality of Paipa, Boyaca many families rely on cattle breeding to obtain from this activity, suficient income and resources to meet their basic needs, however little is known about the true role of this species in the nourishment safety of rural families in the municipality of Paipa in Boyacá, for that reason, this study aimed to analyze the importance of general breeding cattle in the nourishment safety of thirty peasant families in the municipality of Paipa, Boyacá and get to know the social and cultural roles that are generated by this livestock activity. The obtained result was that the cale are raised as a second choice in the pursuit of economic resources, after the birds. In cattle production an average of  five animals per farm are raised, the widely used breeds are the Normando, Holstein and crosses between them; milk production dominates with an average yield of 150 liters/week per family; income and costs production depend on the number of cattle raised, the gained income is used to purchase food for home, but savings are not encouraged; the consumption of dairy products is very low and beef cattle is not consumed within the household; animals management is in charge of all family members (both genders. In general, cattle farming make interesting economic contributions to the countryside families, but these revenues are used to purchase food of high nutritional value, also a2ecting the nourishment safety of the studied families.

  16. Eating breakfast together as a family: mealtime experiences and associations with dietary intake among adolescents in rural Minnesota, USA.

    Science.gov (United States)

    Larson, Nicole; Wang, Qi; Berge, Jerica M; Shanafelt, Amy; Nanney, Marilyn S

    2016-06-01

    Although existing evidence links breakfast frequency to better dietary quality, little is known specifically in regard to the benefits associated with eating breakfast together with one's family. The present study describes the prevalence and experience of having family meals at breakfast among rural families and examines associations between meal frequency and adolescent diet quality. Data were drawn from Project BreakFAST, a group-randomized trial aimed at increasing school breakfast participation in rural Minnesota high schools, USA. Linear mixed models were used to examine associations between student reports of family breakfast frequency and Healthy Eating Index 2010 (HEI-2010) scores while accounting for clustering within schools, demographics and household food security. Adolescent students from sixteen schools completed online surveys, height and weight measurements, and dietary recalls at baseline in 2012-2014. The sample included 827 adolescents (55·1 % girls) in grades 9-10 who reported eating breakfast on at most three days per school week. On average, adolescents reported eating breakfast with their family 1·3 (sd 1·9) times in the past week. Family breakfast meals occurred most frequently in the homes of adolescents who reported a race other than white (P=0·002) or Hispanic ethnicity (P=0·02). Family breakfast frequency was directly associated with adolescent involvement in preparing breakfast meals (Pfood patterns at breakfast. Additional research is needed to better inform and evaluate strategies.

  17. Older family carers in rural areas: experiences from using caregiver support services based on Information and Communication Technology (ICT).

    Science.gov (United States)

    Blusi, Madeleine; Asplund, Kenneth; Jong, Mats

    2013-09-01

    The aim of this intervention study was to illuminate the meaning of ICT-based caregiver support as experienced by older family carers living in vast rural areas, caring for a spouse at home. In order to access, the support service participants were provided with a computer and high speed Internet in their homes. Semi structured webcam-interviews were carried out with 31 family carers. A strategy for webcam interviewing was developed to ensure quality and create a comfortable interview situation for the family carers. Interviews were analysed using content analyses, resulting in the themes: Adopting new technology with help from others and Regaining social inclusion . The results indicate that ICT-based support can be valuable for older family carers in rural areas as it contributes to improve quality in daily life in a number of ways. In order to fully experience the benefits, family carers need to be frequent users of the provided support. Adequate training and encouragement from others were essential in motivating family carers to use the support service. Access to Internet and webcamera contributed to reducing loneliness and isolation, strengthening relationships with relatives living far away and enabled access to services no longer available in the area. Use of the ICT-service had a positive influence on the relationship between the older carer and adult grandchildren. It also contributed to carer competence and promote feelings of regaining independence and a societal role.

  18. 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.

  19. Telemed: Ehealth applications applied to underserved areas in Latin America

    International Nuclear Information System (INIS)

    Sachpazidis, Ilias; Ohl, Roland; Binotto, Alecio Pedro Delazari; Torres, Marcio Soares; Messina, Luiz Ary; Sales, Alexandre; Gomes, Ricardo; Sakas, Georgios

    2006-01-01

    Access to medical care is sometimes very difficult to be reached from people living in rural and underserved areas. This problem is very well known in rural areas in Brazil. Citizens have no access to health care. They have to travel hundreds of kilometres to receive medical care. In this paper, we will propose a medical network based on state-of-the-art medical imaging application that addresses the problems of providing health care from a distance. Additionally, we are going to show preliminarily results of the first year of the system deployment and utilization in undeserved regions in Brazil. The total number of patients submitted to ultrasound examinations, during the 10 months of projects' medical trials, is 321. The exams have begun with the elderly people (hypertension and diabetes cases) with 90% above 50-years-old. Fifty-four percent were male and 46% were female. From those exams, 67 exams (21%) needed a second medical opinion and were transmitted to Santa Casa hospital in Porto Alegre, Brazil, one of the referral medical centres. From those second opinions of Santa Casa, 12 exams had to be repeated since the acquired images were not sufficient to give a correct diagnosis. The Lagoa Tres Cantos medical doctor performed also preventive exams with patients who had not presented any symptoms (70%)

  20. Telemed: Ehealth applications applied to underserved areas in Latin America

    Energy Technology Data Exchange (ETDEWEB)

    Sachpazidis, Ilias [Fraunhofer Institute for Computer Graphics, Fraunhoferstr. 5, D-64283, Darmstadt (Germany)]. E-mail: Ilias.Sachpazidis@igd.fraunhofer.de; Ohl, Roland [MedCom Gesellschaft fuer medizinische Bildverarbeitung mbH, Rundeturmstr. 12, D-64283, Darmstadt (Germany); Binotto, Alecio Pedro Delazari [Centro de Excelencia em Tecnologias Avancadas Av. Assis Brasil, 8450, 91, 140-000 Porto Alegre (Brazil); Torres, Marcio Soares [Centro de Excelencia em Tecnologias Avancadas Av. Assis Brasil, 8450, 91, 140-000 Porto Alegre (Brazil); Messina, Luiz Ary [Messina Informatica e Comercio Ltda., Rua Castelo Branco 330, 29100-040 Praia da Costa, Vila Velha (Brazil); Sales, Alexandre [Fundacao de Apoio ao Hospital Universitario da UFES-Fahucam, Av. Marechal Campos 1355, 29042-715 Santos Dumont, Vitoria (Brazil); Gomes, Ricardo [Complexo Hospitalar Santa Casa de Porto Alegre Rua Prof. Annes Dias 285, Porto Alegre (Brazil); Sakas, Georgios [Fraunhofer Institute for Computer Graphics, Fraunhoferstr. 5, D-64283, Darmstadt (Germany)

    2006-12-20

    Access to medical care is sometimes very difficult to be reached from people living in rural and underserved areas. This problem is very well known in rural areas in Brazil. Citizens have no access to health care. They have to travel hundreds of kilometres to receive medical care. In this paper, we will propose a medical network based on state-of-the-art medical imaging application that addresses the problems of providing health care from a distance. Additionally, we are going to show preliminarily results of the first year of the system deployment and utilization in undeserved regions in Brazil. The total number of patients submitted to ultrasound examinations, during the 10 months of projects' medical trials, is 321. The exams have begun with the elderly people (hypertension and diabetes cases) with 90% above 50-years-old. Fifty-four percent were male and 46% were female. From those exams, 67 exams (21%) needed a second medical opinion and were transmitted to Santa Casa hospital in Porto Alegre, Brazil, one of the referral medical centres. From those second opinions of Santa Casa, 12 exams had to be repeated since the acquired images were not sufficient to give a correct diagnosis. The Lagoa Tres Cantos medical doctor performed also preventive exams with patients who had not presented any symptoms (70%)

  1. Challenges Addressing Unmet Need for Contraception: Voices of Family Planning Service Providers in Rural Tanzania.

    Science.gov (United States)

    Baraka, Jitihada; Rusibamayila, Asinath; Kalolella, Admirabilis; Baynes, Colin

    2015-12-01

    Provider perspectives have been overlooked in efforts to address the challenges of unmet need for family planning (FP). This qualitative study was undertaken in Tanzania, using 22 key informant interviews and 4 focus group discussions. The research documents perceptions of healthcare managers and providers in a rural district on the barriers to meeting latent demand for contraception. Social-ecological theory is used to interpret the findings, illustrating how service capability is determined by the social, structural and organizational environment. Providers' efforts to address unmet need for FP services are constrained by unstable reproductive preferences, low educational attainment, and misconceptions about contraceptive side effects. Societal and organizational factors--such as gender dynamics, economic conditions, religious and cultural norms, and supply chain bottlenecks, respectively--also contribute to an adverse environment for meeting needs for care. Challenges that healthcare providers face interact and produce an effect which hinders efforts to address unmet need. Interventions to address this are not sufficient unless the supply of services is combined with systems strengthening and social engagement strategies in a way that reflects the multi-layered, social institutional problems.

  2. The impact of family transitions on child fostering in rural Malawi.

    Science.gov (United States)

    Grant, Monica J; Yeatman, Sara

    2014-02-01

    Despite the frequency of divorce and remarriage across much of sub-Saharan Africa, little is known about what these events mean for the living arrangements of children. We use longitudinal data from rural Malawi to examine the effects of family transitions on the prevalence and incidence of child fostering, or children residing apart from their living parents. We find that between 7 % and 15 % of children aged 3-14 are out-fostered over the two-year intersurvey period. Although divorce appears to be a significant driver of child fostering in the cross-sectional analysis, it is not significantly associated with the incidence of out-fostering. In contrast, maternal remarriage has both a lagged and an immediate effect on the incidence of out-fostering. Furthermore, the likelihood of out-fostering is even higher among children whose mother remarried and had a new child during the intersurvey period. Using longitudinal data collected from living mothers rather than from children's current foster homes offers new insights into the reasons children are sent to live with others besides their parents.

  3. Grandparent-grandchild family capital and self-rated health of older rural Chinese adults: the role of the grandparent-parent relationship.

    Science.gov (United States)

    Lou, Vivian W Q; Lu, Nan; Xu, Ling; Chi, Iris

    2013-07-01

    This study tested the relationship between grandparent-grandchild family capital and self-rated health of older rural Chinese adults and the mediating role of the grandparent-parent relationship in terms of grandparent-grandchild family capital and self-rated health. Data were derived from a random sample of 1,027 adults aged 60 and older who were interviewed in the rural Chaohu region in 2009. Structural equation modeling was used to examine the direct effect of grandparent-grandchild family capital in terms of relations with the first child's family on self-rated health among respondents, as well as the mediating effect of the grandparent-parent relationship. The results showed the direct effect of grandparent-grandchild family capital on self-rated health of older rural Chinese adults. The grandparent-parent relationship had a partial mediation effect on the relationship between grandparent-grandchild family capital and self-rated health of respondents. Grandparent-grandchild family capital had a unique direct effect on the self-rated health of older rural Chinese adults, enriching our theoretical understanding of sources of family capital and their impacts in a collectivist cultural context that emphasizes intergenerational interaction and exchange. The findings also highlighted the mediation effects of grandparent-parent relationships on the relationship between grandparent-grandchild family capital and self-rated health of older rural Chinese adults, supporting the "grandchild-as-linkage" hypothesis in understanding the social determination of self-rated health in China.

  4. Rural food insecurity: When cooking skills, homegrown food, and perseverance aren't enough to feed a family.

    Science.gov (United States)

    Buck-McFadyen, Ellen V

    2015-03-12

    More than 1 in 10 Canadians experience food insecurity, and a growing number of families rely on food banks each month. This ethnographic study aimed to give voice to rural families about their experiences with food insecurity while situating the findings within the broader social, political and economic context. Semi-structured interviews were conducted with women who had children living at home, and interviewer observations within the food bank were recorded as field notes. Content analysis was combined with the constant comparison method of data analysis to identify common themes regarding the experience of living with food insecurity and the influence of public policy. Seven female participants described the emotional toll that food insecurity had on their well-being and relationships, with stress and depression common to many women. Strategies used to stretch resources included cooking from scratch, growing produce, stocking up on sale items, hunting and fishing, and paying half-bills. Many participants described going without food so that their children could eat first, and three participants went without prescription medications. Rurality and social programs were identified as both supports and barriers to overcoming food insecurity. Participants in this study were highly skilled in attempting to feed their families with limited resources, although this proved inadequate to overcome their food insecurity. This highlights the need for policy initiatives to address the root causes of food insecurity and health inequities, including access to rural employment and high-quality child care, drug benefits and guaranteed annual income programs.

  5. City mouse, country mouse: a mixed-methods evaluation of perceived communication barriers between rural family physicians and urban consultants in Newfoundland and Labrador, Canada.

    Science.gov (United States)

    Renouf, Tia; Alani, Sabrina; Whalen, Desmond; Harty, Chris; Pollard, Megan; Morrison, Megan; Coombs-Thorne, Heidi; Dubrowski, Adam

    2016-05-06

    To examine perceived communication barriers between urban consultants and rural family physicians practising routine and emergency care in remote subarctic Newfoundland and Labrador (NL). This study used a mixed-methods design. Quantitative and qualitative data were collected through exploratory surveys, comprised of closed and open-ended questions. The quantitative data was analysed using comparative statistical analyses, and a thematic analysis was applied to the qualitative data. 52 self-identified rural family physicians and 23 urban consultants were recruited via email. Rural participants were also recruited at the Family Medicine Rural Preceptor meetings in St John's, NL. Rural family physicians and urban consultants in NL completed a survey assessing perceived barriers to effective communication. Data confirmed that both groups perceived communication difficulties with one another; with 23.1% rural and 27.8% urban, rating the difficulties as frequent (p=0.935); 71.2% rural and 72.2% urban as sometimes (p=0.825); 5.8% rural and 0% urban acknowledged never perceiving difficulties (p=0.714). Overall, 87.1% of participants indicated that perceived communication difficulties impacted patient care. Primary trends that emerged as perceived barriers for rural physicians were time constraints and misunderstanding of site limitations. Urban consultants' perceived barriers were inadequate patient information and lack of native language skills. Barriers to effective communication are perceived between rural family physicians and urban consultants in NL. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. In search of attachment: a qualitative study of chronically ill women transitioning between family physicians in rural Ontario, Canada.

    Science.gov (United States)

    Randall, Ellen; Crooks, Valorie A; Goldsmith, Laurie J

    2012-12-23

    Most Canadians receive basic health services from a family physician and these physicians are particularly critical in the management of chronic disease. Canada, however, has an endemic shortage of family physicians. Physician shortages and turnover are particularly acute in rural regions, leaving their residents at risk of needing to transition between family physicians. The knowledge base about how patients manage transitioning in a climate of scarcity remains nascent. The purpose of this study is to explore the experience of transitioning for chronically ill, rurally situated Canadian women to provide insight into if and how the system supports transitioning patients and to identify opportunities for enhancing that support. Chronically ill women managing rheumatic diseases residing in two rural counties in the province of Ontario were recruited to participate in face-to-face, semi-structured interviews. Interview transcripts were analysed thematically to identify emergent themes associated with the transitioning experience. Seventeen women participated in this study. Ten had experienced transitioning and four with long-standing family physicians anticipated doing so soon. The remaining three expressed concerns about transitioning. Thematic analysis revealed the presence of a transitioning trajectory with three phases. The detachment phase focused on activities related to the termination of a physician-patient relationship, including haphazard notification tactics and the absence of referrals to replacement physicians. For those unable to immediately find a new doctor, there was a phase of unattachment during which patients had to improvise ways to receive care from alternative providers or walk-in clinics. The final phase, attachment, was characterized by acceptance into the practice of a new family physician. Participants often found transitioning challenging, largely due to perceived gaps in support from the health care system. Barriers to a smooth transition

  7. The perception of crime from Albanian families that come from rural areas (Case study in the city of Durres

    Directory of Open Access Journals (Sweden)

    Marjeta Milloshi

    2015-07-01

    Full Text Available Crime in the family constitutes one of the major concerns of recent years in Albania. Violence in Albanian families remains unnoticed and is not declared by the majority of those affected. The worst is that there are deep rural areas where violence is accepted as normal within a family. Many studies have come to the conclusion that women who have higher education tend to be better prepared to cope with domestic disputes and solve the problems with communication, so are less likely to be victims of physical violence. The economic, cultural, emotional and social factors are sources that generate violence or crime within the family. The transition from a totalitarian to a democratic society brought not only functional changes, but also differences in their implementation. This was accompanied by misunderstandings of the individual crisis and human rights. This misunderstanding is often associated with deviant behavior or by criminal acts. Poverty, unemployment, jealousy, alcohol and drugs are some of the main reasons that cause domestic violence. Albania has long been considered a patriarchal society where men have more rights than women. This difference has led to a situation where husbands continue to see themselves as more superior, and tend to violate their women or children. In recent years poverty has even increased bringing domestic violence to alarming levels. But besides the major problem of growing violence within the family, the biggest problem is the failure of declaration, because of the mentality, shame, lack of trust in government bodies etc. This problem is even greater in rural areas, where there is a lack of police structures, while NGOs cannot cover the whole country. This study was concentrated in the city of Durres, where 600 surveys were undertaken to people of different ages. This paper is focused in the way of how domestic violence is seen by citizens of the city of Durres and those coming from rural areas.

  8. Rural Students in a Chinese Top-Tier University: Family Background, School Effects, and Academic Performance

    Science.gov (United States)

    Postiglione, Gerard A.; Ailei, Xie; Jung, Jisun; Yanbi, Hong

    2017-01-01

    New preferential policies in China promise to increase the number of rural students entering top-tier universities, where there is a wider path to a higher social status. While a substantial body of literature has investigated rural students' trajectories to university, there is a dearth of systematic empirical studies on the academic success of…

  9. Family Size and Rural Poverty -in the Kwahu South District in Ghana ...

    African Journals Online (AJOL)

    Rural Poverty is one of the greatest social problems confronting the world today. The problem is more pronounced in the developing countries. Ghana is no exception to this global problem of rural poverty. Ghana as a nation has adopted a lot of measures to address poverty. From the early 1980's to 2002, the country has ...

  10. Factors influencing the intention of women in rural Ghana to adopt postpartum family planning.

    Science.gov (United States)

    Eliason, Sebastian; Baiden, Frank; Quansah-Asare, Gloria; Graham-Hayfron, Yvonne; Bonsu, Derek; Phillips, James; Awusabo-Asare, Kofi

    2013-07-22

    Uptake of postpartum family planning (PPFP) remains low in sub-Saharan Africa and very little is known about how pregnant women arrive at their decisions to adopt PPFP. This information is needed to guide the development of interventions to promote PPFP. We conducted a survey among pregnant women attending antenatal clinics in a rural district in Ghana. We used univariate and multivariate logistic regression analysis to explore how knowledge of various family planning (FP) methods, past experience with their use and the acceptability of PPFP to male partners and close relations influenced the intention of pregnant women to adopt PPFP. We interviewed 1914 pregnant women in four health facilities. About 84% considered PPFP acceptable, and 70% intended to adopt a method. The most preferred methods were injectables (31.5%), exclusive breastfeeding (16.7%), and oral contraceptive pills (14.8%). Women whose first choice of PPFP method were injectables were more likely to be women who had had past experience with its use (O.R = 2.07, 95% C.I. 1.50-2.87). Acceptability of PPFP by the pregnant woman (O.R. = 3.21, 1.64-6.26), perception of partner acceptability (O.R. = 3.20, 1.94-5.48), having had prior experience with the use of injectables (O.R. = 3.72, 2.61-5.30) were the strongest predictors of the intention to adopt PPFP. Conversely women who knew about the diaphragm (O.R. = 0.59, 0.38-0.93) and those who had past experience with IUD use (O.R. = 0.13, 0.05-0.38) were less likely to want to adopt PPFP. Acceptability of PPFP to the pregnant woman, male partner approval, and past experience with the use of injectables are important factors in the PPFP decisions of women in this population. Antenatal and early postnatal care need to be adapted to take these factors into consideration.

  11. 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.

  12. Community based study on married couples' family planning knowledge, attitude and practice in rural and urban Gambia.

    Science.gov (United States)

    Jammeh, Sulayman S S; Liu, Chieh-Yu; Cheng, Su-Fen; Lee-Hsieh, Jane

    2014-06-01

    Family planning services have been free of charge and available in all the health facilities in the Gambia since 1975 yet contraceptive prevalence is only 17.5% and even 6% in some areas. Since the last census in 2003, there existed no available data on married couples' contraception status. To explore married couples' family planning knowledge, attitudes, and practices in rural and urban Gambia and to analyze what factors may affect such knowledge, attitudes and practices. Quantitative cross-sectional study design was used. Through convenience sampling, 176 men and 235 women representing a total of 176 couples participated. A structured questionnaire was used for data collection. The mean scores of the married couples family planning knowledge, attitudes, and practices were 19.00 ± 6.11(ranging from 0 to 64), 6.90 ± 3.08 (0 to 14) and 4.69 ± 3.3 (0 to 19) respectively. Urban residents had higher scores on family planning practice than rural residents (pfamily planning knowledge, attitude and practice in Gambia", as well as suggesting broader health intervention programs in health education and promotion.

  13. Analysing the relationship between family planning workers' contact and contraceptive switching in rural Bangladesh using multilevel modelling.

    Science.gov (United States)

    Hossain, Mian B

    2005-09-01

    With a population of over 131 million and a fertility rate of 29.9 per 1000, population growth constitutes a primary threat to continued economic growth and development in Bangladesh. One strategy that has been used to cease further increases in fertility in Bangladesh involves using family planning outreach workers who travel throughout rural and urban areas educating women regarding contraceptive alternatives. This study uses a longitudinal database to assess the impact of family planning outreach workers' contact upon contraceptive switching and upon the risk of an unintended pregnancy. Using longitudinal data on contraceptive use from the Operations Research Project (ORP) of the International Centre for Diarrhoeal Disease Research (ICDDR,B) in Bangladesh, multiple decrement life table analysis and multilevel, discrete-time competing risk hazards models were used to estimate the cumulative probabilities of switching to an alternative form of contraceptive use after a woman engaged in a discussion with an outreach worker. After controlling for the effects of socio-demographic and economic characteristics, the analysis revealed that family planning outreach workers' contact with women significantly decreases the risk of transitioning to the non-use of contraceptives. This contact also reduces the risk of an unintended pregnancy. Family planning workers' contact with women is associated with the increased risk of a woman switching from one modern method to another modern method. The study results indicate that side-effects and other method-related reasons are the two primary reasons for contraceptive discontinuation in rural Bangladesh.

  14. Impact of Potential Accreditation and Certification in Family Medicine Maternity Care.

    Science.gov (United States)

    Eden, Aimee R; Peterson, Lars E

    2017-01-01

    Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ). In 2014 and 2015, the authors conducted semi-structured interviews with 51 key stakeholders in family medicine maternity care. Transcribed interviews were coded using an iterative process to identify themes and patterns until saturation was reached. Participants generally supported both maternity care fellowship accreditation and a CAQ and recognized multiple advantages such as legitimization of training. Many had concerns about potential negative unintended consequences such as a loss of curricular flexibility; however, most felt that these could be mediated. Only a few did not support one or both aspects of formalization. Most participants interviewed support formalizing maternity care fellowship training in family medicine through accreditation and a subsequent CAQ, if implemented with attention to minimizing the potential negative consequences. Such formalization would recognize the advanced skill and training of family physicians practicing advanced maternity care and could address some access issues to essential maternity care services for rural and other underserved populations.

  15. Structural Quality and Utilization of Outpatient Curative Care Under Family Medicine Scheme in Rural Area of Mazandaran– Iran

    Directory of Open Access Journals (Sweden)

    Samad Rouhani

    2013-09-01

    Full Text Available Background & purpose: Since 2005, a reform known as Rural Insurance and Family Medicine Scheme has introduced to primary health care network in Iran in rural areas and small towns. The content of the reform implies a substantial change in those aspects of health centers that mainly could be categorized as structural quality. Although, this is the requirement of all health care providers, they are not identical in those items. In this article, we have tried to report the relation between structural quality of health centers and utilization of curative care in Mazandran province. Materials & Methods: This was a cross-sectional study conducted in 2013. Secondary and routinely collected data was used to answer the research questions. The source of original data was provincial health authority’s data set. A check list containing pre-identified variables was used to extract the data. Using SPSS software package, regression analysis was run to measure the role of different independent variable on dependent variable. Results: There were 215 rural health centers affiliated to 16 cities or small towns that the reform has taken place. The outreach area population of these health centers was 1ˏ330ˏ212 of which 834ˏ189 (62.71% were covered by rural insurance solely. Health centers are not identical in terms of the characteristics of health centers and their utilization. Among the variables with significant impact on the utilization of outpatient care, except for number of physician in each health centre and existence of state owned pharmacy that were found in some health centers, the rest of variables had significant positive impact on the demand for physician visit. Conclusion: Structural quality has significant impact on the utilization of curative care of primary healthcare units at rural area in Iran. The reform seems well targeted the quality improvement and utilization of effective primary health care.

  16. Chlamydia trachomatis and Neisseria gonorrhoeae in asymptomatic family planning patients in rural New Mexico.

    OpenAIRE

    Bell, T A; Ebenezer, M R

    1989-01-01

    We tested 98 asymptomatic women seen in state-funded contraception clinics in rural New Mexico. A fluorescein-conjugated monoclonal antibody stain revealed Chlamydia trachomatis infection in 25% of asymptomatic unmarried women and 3% of married women (P = .03). Neisseria gonorrhoeae was detected in only one woman. As in urban clinics providing contraception, the prevalence of gonorrhea is rare in rural New Mexico, but chlamydial infections are common in young unmarried women.

  17. The Current Situation of Hypertension among Rural Minimal Assurance Family Participants in Liaoning (China): A Cross-Sectional Study.

    Science.gov (United States)

    Chen, Yintao; Yu, Shasha; Chen, Shuang; Guo, Xiaofan; Li, Yuan; Li, Zhao; Sun, Yingxian

    2016-12-02

    In China, the prevalence of hypertension is increasing and is showing an epidemic accelerating trend. However, there is a lack of studies reporting the hypertension status of rural residents with minimum living allowances. We performed a cross-sectional study including 11,435 (5285 men and 6150 women) from the general population aged ≥35 years in the Liaoning Province of China from 2012 to 2013, of which 1258 (11.0%) participants came from minimal assurance families. Anthropometric measurements, laboratory examinations and self-reported lifestyle factor information were collected by trained personnel. Multivariate logistic regression was used to detect the association between socioeconomic status (SES) and the risk of hypertension. We found that the prevalence of hypertension was as high as 61.9% in participants from minimal assurance families and the odd ratio for hypertension was 1.32 (95% CI: 1.15-1.52). The awareness, treatment, and control rates among treated hypertensive participants did not increase with higher level of income and education. In the total sample, the lower income levels increased the risk for hypertension, but education didn't show a significant association with hypertension. Thus, there is a severe hypertension situation in the Liaoning rural population of minimal assurance families, which need more attention and prevention and control measures for hypertension.

  18. Diet and Obesity Issues in the Underserved.

    Science.gov (United States)

    Mejia de Grubb, Maria C; Levine, Robert S; Zoorob, Roger J

    2017-03-01

    The goal of this article is to inform new directions for addressing inequalities associated with obesity by reviewing current issues about diet and obesity among socioeconomically vulnerable and underserved populations. It highlights recent interventions in selected high-risk populations, as well as gaps in the knowledge base. It identifies future directions in policy and programmatic interventions to expand the role of primary care providers, with an emphasis on those aimed at preventing obesity and promoting healthy weight. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Re-Presenting Slavery: Underserved Questions in Museum Collections

    Science.gov (United States)

    Levenson, Cyra

    2014-01-01

    This article looks at the notion of what, not who, is underserved in museum education. The importance of looking through, in, and from objects in order to uncover underserved questions and themes is vital. A willingness to consider new ways to approach collections and display is necessary to have a dialogue with our audiences about how museums can…

  20. Commercial TV exposure, fast-food toy collecting and family visits to fast food restaurants among families living in rural communities

    Science.gov (United States)

    Emond, Jennifer A.; Bernhardt, Amy M.; Gilbert-Diamond, Diane; Li, Zhigang; Sargent, James D.

    2015-01-01

    Objective To assess the associations between children's exposure to TV networks that aired child-directed advertisements for children's fast food meals with the collection of fast food meal toy premiums and frequency of family visits to those restaurants. Study design One hundred parents of children 3–7 years old were recruited from a rural pediatrics clinic during 2011; families receiving Medicaid were oversampled. Parents reported the child's television viewing habits and family visit frequency to the fast food restaurants participating in child-directed TV marketing at the time, and their child's requests for visits to and the collecting of toy premiums from those restaurants. Logistic regression models assessed adjusted associations between a child's TV viewing with more frequent restaurant visits (≥monthly in this population). Structural equation modeling assessed if child requests or toy collecting mediated that association. Results Thirty-seven percent of parents reported ≥monthly visits to the select fast food restaurants. Among children, 54% requested visits to and 29% collected toys from those restaurants. Greater child commercial TV viewing was significantly associated with more frequent family visits to those fast food restaurants (adjusted odds ratio 2.84 for each one-unit increase in the child's commercial TV viewing scale, prestaurants. Child desire for toy premiums may be a mediating factor. PMID:26526362

  1. Dementia diagnosis and post-diagnostic support in Scottish rural communities: experiences of people with dementia and their families.

    Science.gov (United States)

    Innes, Anthea; Szymczynska, Paulina; Stark, Cameron

    2014-03-01

    This paper explores the reported difficulties and satisfactions with diagnostic processes and post-diagnostic support offered to people with dementia and their families living in the largest remote and rural region in Scotland. A consultation with 18 participants, six people with dementia and 12 family members, was held using semi-structured interviews between September and November 2010. Three points in the diagnostic process were explored: events and experiences pre-diagnosis; the experience of the diagnostic process; and post-diagnostic support. Experiences of people with dementia and their carers varied at all three points in the diagnostic process. Participant experiences in this study suggest greater efforts are required to meet Government diagnosis targets and that post-diagnostic support needs to be developed and monitored to ensure that once a diagnosis is given people are well-supported. Without post-diagnostic provision Government targets for diagnosis are just that, quota targets, rather than a means to improve service experiences.

  2. SOCIO-DEMOGRAPHIC FACTORS INFLUENCING FAMILY SIZE AMONG RURAL POPULATION OF DISTRICT NAINITAL, UTTARAKHAND

    Directory of Open Access Journals (Sweden)

    Sanjay Pandey

    2012-12-01

    Full Text Available Background: India is the second most populous country in the world. A decline in its population growth rate has been shown amounting to during the last decades. The decline in the family size is important step towards population stabilization for our country. The status of family size is related to various demographic, socio-economic, cultural factors and attitude towards use of family planning methods. Objective: To assess the relationship of family size with socio-economic factors and effect of contraceptive use. Methodology: A cross sectional house to house survey to know the family size and socio-demographic was conducted in the adopted villages of field practice area. The study subjects are the married women of reproductive age group (15-49 years. Results: About half (44.9% of respondents were aged more than 35 years and only (0.9% were < 19 years. The family size in our study was 2.55. About 54.5% of respondents have family size d" 2. About two-third of families (65% with size less than or equals to two were of nuclear type. Education level of family has significant relationship with small family size. About 90% of the respondents and their spouse of family size two or less were literate. A significant association was found between occupation of the spouse and family size. The spouses of the respondents with family size more than two were mainly engaged in agriculture (29.7% and as labourer (38.5%. Among the families with family size of more than two, majority were from middle (81% and lower (14.9% class. There is no significant effect of use of contraceptives on the family size.

  3. SOCIO-DEMOGRAPHIC FACTORS INFLUENCING FAMILY SIZE AMONG RURAL POPULATION OF DISTRICT NAINITAL, UTTARAKHAND

    Directory of Open Access Journals (Sweden)

    Sanjay Pandey

    2013-01-01

    Full Text Available Background: India is the second most populous country in the world. A decline in its population growth rate has been shown amounting to during the last decades. The decline in the family size is important step towards population stabilization for our country. The status of family size is related to various demographic, socio-economic, cultural factors and attitude towards use of family planning methods. Objective: To assess the relationship of family size with socio-economic factors and effect of contraceptive use. Methodology: A cross sectional house to house survey to know the family size and socio-demographic was conducted in the adopted villages of field practice area. The study subjects are the married women of reproductive age group (15-49 years. Results: About half (44.9% of respondents were aged more than 35 years and only (0.9% were < 19 years. The family size in our study was 2.55. About 54.5% of respondents have family size d" 2. About two-third of families (65% with size less than or equals to two were of nuclear type. Education level of family has significant relationship with small family size. About 90% of the respondents and their spouse of family size two or less were literate. A significant association was found between occupation of the spouse and family size. The spouses of the respondents with family size more than two were mainly engaged in agriculture (29.7% and as labourer (38.5%. Among the families with family size of more than two, majority were from middle (81% and lower (14.9% class. There is no significant effect of use of contraceptives on the family size.

  4. Navigating the digital divide: A systematic review of eHealth literacy in underserved populations in the United States.

    Science.gov (United States)

    Chesser, Amy; Burke, Anne; Reyes, Jared; Rohrberg, Tessa

    2016-01-01

    eHealth provides an important mechanism to connect medically underserved populations with health information, but little is known about gaps in eHealth literacy research in underserved adult populations within the U.S. Between June and July 2013, three systematic literature reviews of five databases were conducted and a subsequent hand search was completed. Identified literature was screened and studies meeting exclusion and inclusion criteria were synthesized and analyzed for common themes. Of the 221 articles critically appraised, 15 met these criteria. Thirty-five of these studies were excluded due to international origin. Of the articles meeting the inclusion criteria, underserved populations assessed included immigrant women, the elderly, low-income, the un- and underemployed, and African-American and Hispanic populations. eHealth literacy assessments utilized included one or two item screeners, the eHEALS scale, health information competence and cognitive task analysis. Factors examined in relation to eHealth literacy included age, experience, overall health literacy, education, income and culture. The majority did not assess the impact of locality and those that did were predominately urban. These data suggest that there is a gap in the literature regarding eHealth literacy knowledge for underserved populations, and specifically those in rural locations, within the U.S.

  5. Family-centred care for families living with cystic fibrosis in a rural setting: A qualitative study.

    Science.gov (United States)

    Jessup, Melanie; Smyth, Wendy; Abernethy, Gail; Shields, Linda; Douglas, Tonia

    2018-02-01

    To explore experiences of family-centred care among parents of children with cystic fibrosis living far from tertiary treatment centres and to understand what such distances mean to their care. Australia is a large continent. However, many families with a child with cystic fibrosis live in regional areas, often thousands of kilometres away from the primary treatment centres located in Australia's coastal capital cities. A qualitative, phenomenological design using a Van Manen () approach. Individual, semi-structured interviews were conducted with parents (n = 7) of a child with cystic fibrosis who lived in regional Australia. Thematic content data analysis was used. The essence of the participants' experience was their seeking certainty and continuity in the changeable realm of cystic fibrosis while negotiating a collaborative approach to their child's care. Five core themes and two subthemes were identified: "Daily care: a family affair," including the subtheme "Accessing expert care"; "Family-centred care: seeking inclusion"; "Control versus collaboration: seeking mutual trust," with the subtheme "The team who grows with you"; "Future projections"; and "The CF circle." Some concerns are not unlike those of their city counterparts, but can be intensified by their sense of distance and isolation. Insight into this unique milieu from the parents' perspective is requisite so that care is appropriate to such a challenging environment and incorporates the whole family. © 2017 John Wiley & Sons Ltd.

  6. Self-Esteem of Rural Teens: Results for Three Family Types.

    Science.gov (United States)

    Hall, Anita M.; Rowe, George P.

    1991-01-01

    A total of 108 (of 200) adolescents completed the Coopersmith Self-Esteem Inventory and family characteristics questionnaire. Results showed that it is not the structure of the family but the degree of discord within the family that influences self-esteem. (Author/JOW)

  7. An intergenerational study of perceptions of changes in active free play among families from rural areas of Western Canada.

    Science.gov (United States)

    Holt, Nicholas L; Neely, Kacey C; Spence, John C; Carson, Valerie; Pynn, Shannon R; Boyd, Kassi A; Ingstrup, Meghan; Robinson, Zac

    2016-08-19

    Children's engagement in active free play has declined across recent generations. Therefore, the purpose of this study was to examine perceptions of intergenerational changes in active free play among families from rural areas. We addressed two research questions: (1) How has active free play changed across three generations? (2) What suggestions do participants have for reviving active free play? Data were collected via 49 individual interviews with members of 16 families (15 grandparents, 16 parents, and 18 children) residing in rural areas/small towns in the Province of Alberta (Canada). Interview recordings were transcribed verbatim and subjected to thematic analysis guided by an ecological framework of active free play. Factors that depicted the changing nature of active free play were coded in the themes of less imagination/more technology, safety concerns, surveillance, other children to play with, purposeful physical activity, play spaces/organized activities, and the good parenting ideal. Suggestions for reviving active free play were coded in the themes of enhance facilities to keep kids entertained, provide more opportunities for supervised play, create more community events, and decrease use of technology. These results reinforce the need to consider multiple levels of social ecology in the study of active free play, and highlight the importance of community-based initiatives to revive active free play in ways that are consistent with contemporary notions of good parenting.

  8. An intergenerational study of perceptions of changes in active free play among families from rural areas of Western Canada

    Directory of Open Access Journals (Sweden)

    Nicholas L. Holt

    2016-08-01

    Full Text Available Abstract Background Children’s engagement in active free play has declined across recent generations. Therefore, the purpose of this study was to examine perceptions of intergenerational changes in active free play among families from rural areas. We addressed two research questions: (1 How has active free play changed across three generations? (2 What suggestions do participants have for reviving active free play? Methods Data were collected via 49 individual interviews with members of 16 families (15 grandparents, 16 parents, and 18 children residing in rural areas/small towns in the Province of Alberta (Canada. Interview recordings were transcribed verbatim and subjected to thematic analysis guided by an ecological framework of active free play. Results Factors that depicted the changing nature of active free play were coded in the themes of less imagination/more technology, safety concerns, surveillance, other children to play with, purposeful physical activity, play spaces/organized activities, and the good parenting ideal. Suggestions for reviving active free play were coded in the themes of enhance facilities to keep kids entertained, provide more opportunities for supervised play, create more community events, and decrease use of technology. Conclusions These results reinforce the need to consider multiple levels of social ecology in the study of active free play, and highlight the importance of community-based initiatives to revive active free play in ways that are consistent with contemporary notions of good parenting.

  9. 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…

  10. Family Income and Early Achievement across the Urban-Rural Continuum

    Science.gov (United States)

    Miller, Portia; Votruba-Drzal, Elizabeth; Setodji, Claude Messan

    2013-01-01

    Rural and suburban children account for the majority of poor children in the United States. Yet, most research examining poverty's associations with child development is focused on urban samples. Using nationally representative data from the Early Childhood Longitudinal Study, Birth Cohort (N ˜ 6,600), this study examines whether the form and…

  11. Family Sources of Educational Gender Inequality in Rural China: A Critical Assessment

    Science.gov (United States)

    Hannum, Emily; Kong, Peggy; Zhang, Yuping

    2009-01-01

    In this paper, we investigate the gender gap in education in rural northwest China. We first discuss parental perceptions of abilities and appropriate roles for girls and boys; parental concerns about old-age support; and parental perceptions of different labor market outcomes for girls' and boys' education. We then investigate gender disparities…

  12. Parent Socialization, Family Economic Well-Being, and Toddlers' Cognitive Development in Rural Paraguay

    Science.gov (United States)

    Austin, Ann M. Berghout; Blevins-Knabe, Belinda; de Aquino, Cyle Nielsen; de Burro, Elizabeth Urbieta; Park, Kyung-Eun; Bayley, Bruce; Christensen, Matthew; Leavitt, Spencer; Merrill, Junius; Taylor, Denise; George, Anne Thomas

    2006-01-01

    This study examined the specific factors relative to healthy socialization and economic well-being that predicted toddler mental development in rural Paraguay. Thirty toddlers and their primary caregivers were assessed using the Bayley Scales of Infant Development-II (BSID-II), the Home Observation for Measurement of the Environment (HOME) to…

  13. 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

  14. Knowledge and use of modern family planning methods by rural women in Zambia

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    C. Mubita-Ngoma

    2010-09-01

    Full Text Available The main aim of the study was to determine knowledge and use of modem contractive methods among reproductive age group rural women in Zambia. The study is a descriptive cross-sectional study of 105 randomly selected rural women. Data was collected using semi-structured interview schedule and analyzed using EPI Info version 6 statistical packages. The findings revealed that 63% of the respondents were within the age group 21-35 years, 65% were married and 64% were peasant farmers. 90% of the respondents had heard about modem contraceptives and their main source of information was the Health worker (62%. 76% of the respondents stated that modem contraceptive methods could be obtained from public health facilities. 56% of the respondents were currently using modem contraceptive methods and 46% were not using modem contraceptive methods. Reasons for non use of contraceptive methods were religious beliefs (50%, partner disapproval (30% and side effects (20%. The results showed a relationship between educational level and use of contraceptives (Chi-square 7.83, df = 3, P < 0.05 and spouse approval or support of contractive methods and use of contraceptive (Chisquare 5.9, df = 2, P < 0.05. Therefore, efforts to promote modem contraceptive use among the rural women should be intensified to overcome barriers to contraceptive use and should involve men.

  15. Pediatric Diabetes Telemedicine Program Improves Access to Care for Rural Families: Role of APRNs.

    Science.gov (United States)

    Smith, Nancy Marie; Satyshur, Rosemarie DiMauro

    2016-01-01

    Type 1 diabetes mellitus has increased in children by 23% from 2001 to 2009. Rural communities additionally have increased disparities related to access barriers and a large minority population with poorer overall health. Research evidence supports telemedicine as an effective alternative to bring preventive diabetes care to remote areas. This article presents an overview of the leadership role of advanced practice registered nurses (APRNs) with the implementation and evaluation of a pediatric diabetes telemedicine program at a rural pediatric outpatient specialty clinic in partnership with a tertiary center telemedicine network. The telemedicine program quality improvement (QI) project explored caregiver satisfaction with a convenience sample of caregivers (N = 14) using a nine-item Telemedicine Diabetes Caregiver Satisfaction Survey (TDCSS), with responses ranging from 1 = strongly disagree to 5 = strongly agree. Findings indicate caregivers were highly satisfied with communication/ privacy (M = 4.8), access to care (M = 4.1), and quality of services (M = 5.0). The multidisciplinary collaborative teamwork, continuous QI, and dependable technology were integral to the quality of the telemedicine clinical initiative. APRNs provided technology expertise, interdisciplinary collaboration leadership, care coordination, and advocacy for policy changes. Results demonstrate that telemedicine and APRN leadership can help implement innovative programs into rural communities to improve access to care, healthcare cost, and outcomes.

  16. 5 CFR 894.801 - Will benefits be available in underserved areas?

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 2 2010-01-01 2010-01-01 false Will benefits be available in underserved... Underserved Areas § 894.801 Will benefits be available in underserved areas? (a) Dental and vision plans under FEDVIP will include underserved areas in their service areas and provide benefits to enrollees in...

  17. Access to Money and Relation to Women's Use of Family Planning Methods Among Young Married Women in Rural India.

    Science.gov (United States)

    Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

    2016-06-01

    Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women's access to and decision-making power related to family planning (FP). Women's access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women's status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women's social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n = 855), crude and adjusted regression was used to assess women's access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59 %) was associated with condom and other contraceptive use (AORs ranged 1.5-1.8). These findings remained significant after adjusting for women's FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women's ability to obtain FP methods, even in contexts where social norms to support women's power in FP decision-making may not be readily adopted.

  18. Web usability testing with a Hispanic medically underserved population.

    Science.gov (United States)

    Moore, Mary; Bias, Randolph G; Prentice, Katherine; Fletcher, Robin; Vaughn, Terry

    2009-04-01

    Skilled website developers value usability testing to assure user needs are met. When the target audience differs substantially from the developers, it becomes essential to tailor both design and evaluation methods. In this study, researchers carried out a multifaceted usability evaluation of a website (Healthy Texas) designed for Hispanic audiences with lower computer literacy and lower health literacy. METHODS INCLUDED: (1) heuristic evaluation by a usability engineer, (2) remote end-user testing using WebEx software; and (3) face-to-face testing in a community center where use of the website was likely. Researchers found standard usability testing methods needed to be modified to provide interpreters, increased flexibility for time on task, presence of a trusted intermediary such as a librarian, and accommodation for family members who accompanied participants. Participants offered recommendations for website redesign, including simplified language, engaging and relevant graphics, culturally relevant examples, and clear navigation. User-centered design is especially important when website developers are not representative of the target audience. Failure to conduct appropriate usability testing with a representative audience can substantially reduce use and value of the website. This thorough course of usability testing identified improvements that benefit all users but become crucial when trying to reach an underserved audience.

  19. Distance is no hurdle: Reforming the family violence exception to better protect immigrant women in rural, regional and remote communities

    Directory of Open Access Journals (Sweden)

    Khanh Hoang

    2015-01-01

    Full Text Available After careful consideration consistent with COPE guidelines, the editorial staff has concluded that there is no case of plagiarism associated with this article. (10th August, 2016 The editors have received allegations that the paper references arguments and evidence without attribution to pre-existing literature, and that it exhibits stylistic similarities to other sources on the same topic. The editors are currently conducting an investigation under the Committee on Publication Ethics (COPE guidelines to confirm or refute the allegations. (29th June, 2016 This article considers the impact of migration laws on immigrant women in rural, regional and remote communities (RRR communities who are victims of family violence. The Migration Regulations 1994 (Cth (‘the Regulations’ includes a ‘family violence exception’ that allows for the grant of permanent residency to women who hold a temporary partner visa in circumstances where the relationship with the Australian sponsor has broken down due to family violence. However, the Regulations impose strict procedural and evidentiary requirements for making a family violence claim. These laws disproportionately impact those in RRR communities by failing to account for their isolation, lack of access to services and particular vulnerabilities. As a result, immigrant women in RRR communities are restricted in their ability to access the family violence exception. This article calls for reform of the Regulations to address the locational disadvantages faced by immigrant women in RRR communities. Building on the work of the Australian Law Reform Commission, it argues for the repeal of the provisions governing evidentiary requirements for ‘non-judicially determined’ claims of family violence. In its place, it is suggested that there should be no restrictions on the types of evidence that can be provided. In addition, all non-judicially determined family violence claims would be referred to an

  20. Household and familial resemblance in risk factors for type 2 diabetes and related cardiometabolic diseases in rural Uganda

    DEFF Research Database (Denmark)

    Nielsen, Jannie; Bahendeka, Silver K.; Whyte, Susan R.

    2017-01-01

    prevention and screening, we investigated the resemblance of T2D risk factors at household level and by type of familial dyadic relationship in a rural Ugandan community. Methods: This cross-sectional household-based study included 437 individuals ≥13 years of age from 90 rural households in south......-western Uganda. Resemblance in glycosylated haemoglobin (HbA1c), anthropometry, blood pressure, fitness status and sitting time were analysed using a general mixed model with random effects (by household or dyad) to calculate household intraclass correlation coefficients (ICCs) and dyadic regression coefficients...... (ICC=0.24), HbA1c (ICC=0.18) and systolic blood pressure (ICC=0.11). Regarding dyadic resemblance, the highest standardised regression coefficient was seen in fitness status for spouses (0.54, 95% CI 0.32 to 0.76), parent–offspring (0.41, 95% CI 0.28 0.54) and siblings (0.41, 95% CI 0.25 to 0...

  1. Relationships between family physicians’ referral for palliative radiotherapy, knowledge of indications for radiotherapy, and prior training: a survey of rural and urban family physicians

    Directory of Open Access Journals (Sweden)

    Olson Robert A

    2012-05-01

    Full Text Available Abstract Background The primary objective of this research was to assess the relationship between FPs’ knowledge of palliative radiotherapy (RT and referral for palliative RT. Methods 1001 surveys were sent to FPs who work in urban, suburban, and rural practices. Respondents were tested on their knowledge of palliative radiotherapy effectiveness and asked to report their self-assessed knowledge. Results The response rate was 33%. FPs mean score testing their knowledge of palliative radiotherapy effectiveness was 68% (SD = 26%. The majority of FPs correctly identified that painful bone metastases (91%, airway obstruction (77%, painful local disease (85%, brain metastases (76% and spinal cord compression (79% can be effectively treated with RT, though few were aware that hemoptysis (42% and hematuria (31% can be effectively treated. There was a linear relationship between increasing involvement in palliative care and both self-assessed (p  Conclusions Self-assessed and tested knowledge of palliative RT is positively associated with referral for palliative RT. Since palliative RT is underutilized, further research is needed to assess whether family physician educational interventions improve palliative RT referrals. The current study suggests that studies could target family physicians already in practice, with educational interventions focusing on hemostatic and other less commonly known indications for palliative RT.

  2. Effects of a psychological skills training programme for underserved ...

    African Journals Online (AJOL)

    Effects of a psychological skills training programme for underserved rugby ... The development of psychological skills is an important, but often neglected part of ... Repeated measures two-way ANOVAs revealed significant main time effects, ...

  3. The Impact of Family Setting and Local Opportunities on Leaving Home and Migration Destinations of Rural Youths, The Netherlands 1860-1940

    Directory of Open Access Journals (Sweden)

    Bastian Mönkediek

    2015-11-01

    Full Text Available In this article we aim to study how Dutch children’s individual destinies result from the complex interplay of family setting and local conditions in a rural environment. We focus on their final move from the parental home, and we will analyse not only timing and incidence of leaving, but also the destinations. To do this, we propose a multi-level competing risk analysis of migration destinations. We focus on two groups: the children of farmers and those of rural workers. Dutch farmers and workers differ in the type of family economy in which children were integrated, and contrasting them will allow us to explain the speed, the directions, and the individual and family backgrounds of the process of leaving agriculture. We make use of the Historical Sample of the Netherlands to analyse last migrations of 8,338 children of farmers and rural workers. As we cover the entire country, we can study the full impact of regional differences on type of agriculture and inheritance, in combination with the family composition. Our results indicate significant effects of specialised versus traditional, mixed farming on the migration behaviour of farmers’ and rural workers’ children, as well as the importance of the number of siblings of the same sex and birth order. The variations in the effects of the sibship among regions with different agricultural systems demonstrate the importance of gender-specific divisions of labour on leaving home.

  4. The Impact of Family Setting and Local Opportunities on Leaving Home and Migration Destinations of Rural Youths, The Netherlands 1860-1940

    NARCIS (Netherlands)

    Mönkediek, Bastian; Kok, Jan; Mandemakers, Kees

    2016-01-01

    In this article we aim to study how Dutch children’s individual destinies result from the complex interplay of family setting and local conditions in a rural environment. We focus on their final move from the parental home, and we will analyse not only timing and incidence of leaving, but also the

  5. Rural environmental planning in a family farm: education, extension and sustainability

    Directory of Open Access Journals (Sweden)

    Dayana Almeida

    Full Text Available ABSTRACT: Developing research, teaching and extension in university programs is fundamental to capacitate professionals for the challenging endeavors. Considering the importance of these three university functions as relevant learning practices, the objective of this study was to analyze qualitatively the development of teaching project proposals associated with extension activities, directed to the rural environmental planning in an Agricultural Production Unit, in order to identify the issues and their degree of applicability. Twenty project proposals were developed in the "Rural Environmental Planning" course to plan an Agricultural Production Unit, which were subsequently evaluated by the farmer. This discipline is part of the Bachelor's degree course in Environmental Management and Analysis of the Universidade Federal de São Carlos. The projects followed qualitative research methods using the systemic and participatory approach. At the end of the process the farmer answered an evaluation matrix of the projects. Development of the projects was particularly important for the students and for their knowledge on the various topics covered, which also resulted in factual improvement perspectives in the Agricultural Production Unit. Construction of knowledge was participatory and integrated between the students and farmer.

  6. Health beliefs of school-age rural children in podoconiosis-affected families: A qualitative study in Southern Ethiopia.

    Directory of Open Access Journals (Sweden)

    Abebayehu Tora

    2017-05-01

    Full Text Available Several studies have suggested investigation of health beliefs in children to be an important pre-condition for primary prevention of disease. However, little effort has been made to understand these in the context of podoconiosis. This study therefore aimed to explore the health beliefs of school-age rural children in podoconiosis-affected families.A cross sectional qualitative study was conducted in March 2016 in Wolaita Zone, Southern Ethiopia. Data were collected through in-depth individual interviews (IDIs and focus group discussions (FGDs, with a total of one hundred seventeen 9 to15-year-old children recruited from podoconiosis affected families. The study revealed various misconceptions regarding risk factors for podoconiosis. Most children believed barefoot exposure to dew, worms, snake bite, frog urine, other forms of poison, and contact with affected people to be major causes of the disease. Their knowledge about the role of heredity and that of long term barefoot exposure to irritant mineral particles was also weak. Though most participants correctly appraised their susceptibility to podoconiosis in relation to regular use of footwear and foot hygiene, others based their risk perceptions on factors they think beyond their control. They described several barriers to preventive behaviour, including uncomfortable footwear, shortage and poor adaptability of footwear for farm activities and sports, and shortage of soap for washing. Children also perceived low self-efficacy to practice preventive behaviour in spite of the barriers.Health education interventions may enhance school-age children's health literacy and be translated to preventive action. Overcoming practical challenges such as shortage of footwear and other hygiene facilities requires other forms of interventions such as livelihood strengthening activities. Linking podoconiosis-affected families with local governmental or non-governmental organizations providing socio

  7. Relationship of body mass index and psychosocial factors on physical activity in underserved adolescent boys and girls.

    Science.gov (United States)

    Kitzman-Ulrich, Heather; Wilson, Dawn K; Van Horn, M Lee; Lawman, Hannah G

    2010-09-01

    Previous research indicates that body mass index (BMI) and sex are important factors in understanding physical activity (PA) levels. The present study examined the influence of BMI on psychosocial variables (self-efficacy, social support) and PA in underserved (ethnic minority, low income) boys in comparison with girls. Participants (N = 669; 56% girls; 74% African American) were recruited from the "Active by Choice Today" trial. BMI ʐ score was calculated from objectively collected height and weight data, and PA was assessed with 7-day accelerometry estimates. Self-report questionnaires were used to measure self-efficacy and social support (family, peers) for PA. A 3-way interaction between BMI z score, sex, and family support on PA was shown such that family support was positively associated with PA in normal-weight but not overweight or obese boys, and was not associated with PA in girls. Self-efficacy had the largest effect size related to PA in comparison with the other psychosocial variables studied. Self-efficacy was found to be an important variable related to PA in underserved youth. Future studies should evaluate possible barriers to PA in girls, and overweight youth, to provide more effective family support strategies for underserved adolescents' PA. (PsycINFO Database Record (c) 2010 APA, all rights reserved).

  8. Family planning in a rural setting in Uganda, the USHAPE initiative.

    Science.gov (United States)

    Clark, Emily; Goodhart, Clare

    2016-01-01

    The total fertility rate in Uganda is 5.9 children per woman, and women admit to having nearly two more children than they actually want. The maternal mortality rate remains stubbornly high. Family planning saves lives. It prevents maternal deaths by delaying motherhood, helping women limit their family size and avoid unwanted pregnancies. It also reduces infant mortality. USHAPE (Ugandan Sexual Health and Pastoral Education) is an initiative run in conjunction with the Royal College of General Practitioners in south-west Uganda. USHAPE aims to disseminate positive messages about modern contraception in an attempt to dispel fears and misconceptions and address the high rate of unmet need. The aim was to determine the rate of unmet need for family planning among women of reproductive age in the population local of Kisiizi hospital and to use the successful USHAPE model to train health workers to address this need. 100 patients were screened in the outpatient department to determine the level of unmet need by asking 2 questions. Level 1 training aims enhance every staff member's knowledge, so that the responsibility for family planning is adopted by the whole institution. Level 2 trains clinicians to become full family planning providers, with the necessary communication, educational and practical skills. The screening for unmet need for contraception revealed that 51% have an unmet need, which is higher than the national average of 38%. Sixty-eight members of staff at Kisiizi trained to a basic level and a further 32 staff have been trained to Level 2 higher level. The USHAPE approach has begun to tackle some of the barriers to accessing family planning, but there are further areas which need development. Our cascade model of training, involves training Ugandan USHAPE trainers with the aim of future scale up and long-term development.

  9. Individual aspiration or family survival: rural-urban female migration in Malaysia.

    Science.gov (United States)

    Kusago, T

    1998-01-01

    "This paper analyzes the determinants of female migration to export processing zones (EPZs) in Malaysia. A comparison of the individual and household migration models reveals interesting and important contrasting results. First, the role played by the expected net income gains is opposite in the two models: negative in the individual model, positive in the household model. Second, family migration experience is significant in the individual model but not in the household model. Third, attitudes matter to the household decision on a daughter's migration but not in the individual model. These contrasting results suggest that explaining the daughter's migration decision may require more than separation of the individual motives and familial needs." excerpt

  10. Family studies of somatic and functional characteristics in the polish rural population

    Directory of Open Access Journals (Sweden)

    T Wieczorek

    2010-09-01

    Full Text Available In the present investigation we were trying to determine the genetic and environmental conditioning of the chosen somatic and functional traits in Polish rural population during ontogenesis. In order to find out interactions between environmental and genetic conditions of the studied traits, classical methods of quantitative features were applied: correlation coefficients corrected by assortative mating in the chosen types of heritability were evaluated on their base, heritability coefficients of analyzed features were assessed. The biggest stability of the correlation coefficients was observed for the length-parameters. We did not noticed stronger genetic control of functional features in men. Mean-strong genetic control among analyzed traits was observed in: reaction time, space orientation and static strength expressed as relative and absolute strength.

  11. Why do women not adhere to advice on maternal referral in rural Tanzania? Narratives of women and their family members.

    Science.gov (United States)

    Pembe, Andrea B; Mbekenga, Columba K; Olsson, Pia; Darj, Elisabeth

    2017-01-01

    In most low-income countries, many women with high-risk pregnancies and complications do not reach the referral hospitals despite the provision of referral advice. To explore how antenatal maternal referral advice is understood and handled in a rural Tanzanian community. Individual in-depth interviews were conducted with six women who did not go to hospital and 13 people who were involved in the referral advice. Narrative analysis was used to describe and create meanings out of the decision-making process. In all interviews, not following the referral advice was greatly influenced by close family members. Three main traits of how referral advice was understood emerged: convinced referral is not necessary, accepting referral advice but delayed by others, and passive and moving with the wind. The main reasons given for declining the referral advice included discrediting midwives' advice, citing previous successful deliveries despite referral advice; being afraid of undergoing surgery; lack of support for care of siblings at home; and high costs incurred during referral. Declining maternal referral advice centred around the pregnant women's position and their dependence on the family members around them, with a decreased ability to show autonomy. If they were socially and economically empowered, women could positively influence decision making during maternal referrals.

  12. [Is Work in Older Age Healthy? Findings from Family Run Businesses Using the Example of Bavarian Rural Economics].

    Science.gov (United States)

    Hetzel, C; Holzer, M; Allinger, F; Watzele, R; Hörmann, G; Weber, A

    2016-05-01

    Working in second half of life is individually and socially important. The aim of this study is to multidimensionally evaluate the subjective health situation of older people, in particular those beyond the legal age of retirement who are working or assisting in family run businesses, using the example of Bavarian rural economics. A 3 stage random sample stratified proportionally to regional population numbers was selected for a cross-sectional questionnaire survey (personal delivery, postal return n=3 176, 39.1%). Sample results can be generalised (men 59.8%, at least 65 years old 60.8%, smallest/small enterprises 61.8%). Life satisfaction is similar to that of the German age cohort population. In comparison to commercial and technical fields, physic and psychological complaints are lower and work pleasure is much higher. Health indicators are not dependent on enterprise structures, but on age and gender - on age partly non-linearly. Our results indicate that working in older age can be a source of subjective health. Process of family business succession may effect health. RESULTS might be applicable to other structurally similar agriculture regions and to craft sector. They promote individual confrontation with and social debate on a positive image of old age and aging. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Rural Hispanic populations at risk in developing diabetes: sociocultural and familial challenges in promoting a healthy diet.

    Science.gov (United States)

    Heuman, Amy N; Scholl, Juliann C; Wilkinson, Kenton

    2013-01-01

    Type II diabetes affects Hispanic populations disproportionately and is the fifth leading cause of death for Hispanic people in the United States ( Smith & Barnett, 2005 ). Risk of diabetes is of great concern throughout the United States and is clearly of epidemic proportions for regions such as the Southwest and Texas where the primary minority populations are Mexican American. We conducted four focus groups with a total of 49 Hispanic participants (23 adults and 26 adolescents) from rural West Texas communities to gain insights about participants' eating habits, knowledge of diabetes, and potential barriers to preventive care. From the data, we identified a three-tiered predisposition or vulnerability to diabetes-heredity; preferences for unhealthy, culturally based food; and temptations from U.S. mainstream fast food culture. These vulnerabilities added to the sociocultural concerns that participants identified-importance of parental and familial modeling; challenges to healthy eating based on a culturally based diet and mainstream fast food culture; and a lack of support from the larger sociocultural networks such as teachers, community leaders, and the media. From these data, we have a better understanding of familial and sociocultural factors that need to be addressed in the development of preventive public awareness and educational plans. We outline implications for practitioners and educators from an integrated cultural biomedical approach.

  14. Epilepsy and its effects on children and families in rural Uganda

    African Journals Online (AJOL)

    EB

    2013-09-03

    Sep 3, 2013 ... about the wider family and social consequences of. (untreated) ... deficit, learning difficulty as perceived by parents, plus disruption of ... disabled children in Rukungiri district of Western. Uganda ... had, in some cases, led to withdrawal from school. ..... per annum spent dealing with 'moderate' seizures.

  15. Poverty, Residential Mobility, and Persistence across Urban and Rural Family Literacy Programs in Pennsylvania

    Science.gov (United States)

    Schafft, Kai A.; Prins, Esther S.

    2009-01-01

    This study investigates how poverty and residential mobility affect adult persistence and participation in family literacy (FL) programs. Combining data from interviews with directors and participants from a sample of FL sites in Pennsylvania, this study examines (a) the perceptions of practitioners and adult learners regarding the role of…

  16. Family Involvement in Creative Teaching Practices for All in Small Rural Schools

    Science.gov (United States)

    Vigo Arrazola, Begoña; Soriano Bozalongo, Juana

    2015-01-01

    Parental involvement is interpreted as a key form of support that can contribute to the establishment of inclusive practices in schools, but this can be difficult in sparsely populated areas. Using ethnographic methods of participant observation, informal conversations and document analysis, this article therefore focuses on family involvement…

  17. Family Care of People with Intellectual Disability in Rural China: A Magnified Responsibility

    Science.gov (United States)

    Pan, Lu; Ye, Jingzhong

    2015-01-01

    Background: Welfare for the disabled is becoming an important issue in China and care for people with intellectual disability is challenging because of the inadequacies in formal support and the social service system. Material and Method: Based on ethnographic research in two villages in North China, this paper analyses the dilemmas of family care…

  18. Influence of Parental Education and Family Income on Children's Education in Rural Uganda

    Science.gov (United States)

    Drajea, Alice J.; O'Sullivan, Carmel

    2014-01-01

    This article investigates the effect of parents' literacy levels and family income in Uganda on the quality and nature of parents' involvement in their children's primary education. A mixed-methods study with an ethnographic element was employed to explore the views and opinions of 21 participants through a qualitative approach. Methods for data…

  19. Development and pilot evaluation of novel genetic educational materials designed for an underserved patient population.

    Science.gov (United States)

    Lubitz, Rebecca Jean; Komaromy, Miriam; Crawford, Beth; Beattie, Mary; Lee, Robin; Luce, Judith; Ziegler, John

    2007-01-01

    Genetic counseling for BRCA1 and BRCA2 mutations involves teaching about hereditary cancer, genetics and risk, subjects that are difficult to grasp and are routinely misunderstood. Supported by a grant from the Avon Foundation, the UCSF Cancer Risk Program started the first genetic testing and counseling service for a population of traditionally underserved women of varied ethnic and social backgrounds at the San Francisco General Hospital (SFGH). Informed by educational theory and clinical experience, we devised and piloted two simplified explanations of heredity and genetic risk, with the aim of uncovering how to best communicate genetics and risk to this underserved population. A "conventional" version comprised pictures of genes, pedigrees, and quantitative representations of risk. A "colloquial" pictorial version used an analogy of the "information book" of genes, family stories and vignettes, and visual representations of risk, without using scientific words such as genes or chromosomes. A verbal narrative accompanied each picture. We presented these modules to four focus groups of five to eight women recruited from the SFGH Family Practice Clinic. Overall, women preferred a picture-based approach and commented that additional text would have been distracting. The majority of women preferred the colloquial version because it was easier to understand and better conveyed a sense of comfort and hope. We conclude that simplicity, analogies, and familiarity support comprehension while vignettes, family stories, and photos of real people provide comfort and hope. These elements may promote understanding of complex scientific topics in healthcare, particularly when communicating with patients who come from disadvantaged backgrounds.

  20. Sharing Gravity's Microscope: Star Formation and Galaxy Evolution for Underserved Arizonans

    Science.gov (United States)

    Knierman, Karen A.; Monkiewicz, Jacqueline A.; Bowman, Catherine DD; Taylor, Wendy

    2016-01-01

    Learning science in a community is important for children of all levels and especially for many underserved populations. This project combines HST research of galaxy evolution using gravitationally lensed galaxies with hands-on activities and the Starlab portable planetarium to link astronomy with families, teachers, and students. To explore galaxy evolution, new activities were developed and evaluated using novel evaluation techniques. A new set of galaxy classification cards enable inquiry-based learning about galaxy ages, evolution, and gravitational lensing. Activities using new cylinder overlays for the Starlab transparent cylinder will enable the detailed examination of star formation and galaxy evolution as seen from the viewpoint inside of different types of galaxies. These activities were presented in several Arizona venues that enable family and student participation including ASU Earth and Space Open House, Arizona Museum of Natural History Homeschooling Events, on the Salt River Pima-Maricopa Indian Community, and inner city Phoenix schools serving mainly Hispanic populations. Additional events targeted underserved families at the Phoenix Zoo, in Navajo County, and for the Pascua Yaqui Tribe. After evaluation, the activities and materials will also be shared with local teachers and nationally.

  1. 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.

  2. Strengthening government health and family planning programs: findings from an action research project in rural Bangladesh.

    Science.gov (United States)

    Simmons, R; Phillips, J F; Rahman, M

    1984-01-01

    An ongoing study at the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) is based on the premise that public sector health and family planning programs can be improved through an assessment of the dysfunctional aspects of their operations, the development of problem-solving capabilities, and the transfer of strategies successfully tested in a small-scale pilot project. This paper reports findings from a field trial implemented in a subunit of the project area at an early stage of the project. Operational barriers to public sector program implementation are discussed with regard to the quantity of work, the quality of work, supplies and facilities, integration of health and family planning, and leadership, supervision, and decision making. Initial results of the ICDDR,B intervention on these managerial processes are also indicated.

  3. Mothers’ and Fathers’ Sensitivity and Children's Cognitive Development in Low-Income, Rural Families

    Science.gov (United States)

    Mills-Koonce, W. Roger; Willoughby, Michael T.; Zvara, Bharathi; Barnett, Melissa; Gustafsson, Hanna; Cox, Martha J

    2015-01-01

    This study examines associations between maternal and paternal sensitive parenting and child cognitive development across the first 3 years of life using longitudinal data from 630 families with co-residing biological mothers and fathers. Sensitive parenting was measured by observational coding of parent-child interactions and child cognitive development was assessed with the Bayley Scales of Infant Development and the Wechsler Preschool and Primary Scales of Intelligence. There were multiple direct and indirect associations between parenting and cognitive development across mothers and fathers, suggesting primary effects, carry-forward effects, spillover effects across parents, and transactional effects across parents and children. Associations between parenting and cognitive development were statistically consistent across mothers and fathers, and the cumulative effects of early parenting on later cognitive development were comparable to the effects of later parenting on later cognitive development. As interpreted through a family systems framework, findings suggest additive and interdependent effects across parents and children. PMID:25954057

  4. Relationships between family physicians’ referral for palliative radiotherapy, knowledge of indications for radiotherapy, and prior training: a survey of rural and urban family physicians

    International Nuclear Information System (INIS)

    Olson, Robert A; Lengoc, Sonca; Tyldesley, Scott; French, John; McGahan, Colleen; Soo, Jenny

    2012-01-01

    The primary objective of this research was to assess the relationship between FPs’ knowledge of palliative radiotherapy (RT) and referral for palliative RT. 1001 surveys were sent to FPs who work in urban, suburban, and rural practices. Respondents were tested on their knowledge of palliative radiotherapy effectiveness and asked to report their self-assessed knowledge. The response rate was 33%. FPs mean score testing their knowledge of palliative radiotherapy effectiveness was 68% (SD = 26%). The majority of FPs correctly identified that painful bone metastases (91%), airway obstruction (77%), painful local disease (85%), brain metastases (76%) and spinal cord compression (79%) can be effectively treated with RT, though few were aware that hemoptysis (42%) and hematuria (31%) can be effectively treated. There was a linear relationship between increasing involvement in palliative care and both self-assessed (p < 0.001) and tested (p = 0.02) knowledge. FPs had higher mean knowledge scores if they received post-MD training in palliative care (12% higher; p < 0.001) or radiotherapy (15% higher; p = 0.002). There was a strong relationship between FPs referral for palliative radiotherapy and both self-assessed knowledge (p < 0.001) and tested knowledge (p = 0.01). Self-assessed and tested knowledge of palliative RT is positively associated with referral for palliative RT. Since palliative RT is underutilized, further research is needed to assess whether family physician educational interventions improve palliative RT referrals. The current study suggests that studies could target family physicians already in practice, with educational interventions focusing on hemostatic and other less commonly known indications for palliative RT

  5. Social aspect of the functioning of family and women in rural environmen

    Directory of Open Access Journals (Sweden)

    KRZYSZTOF ZAJDEL

    2017-10-01

    Full Text Available The woman's part is subject of my study and the country family in Poland in period of alternatively. Yet to recent, country family more considerably often than municipal she was numerous, and so with many children and many generations. She was perceived as more durable, less subject on divorces and separations. Beyond this nation in the country more seldom than they in city live in informal relationships, extramarital. It was can so – peaceably with social picture – at least in this field recognise the occupants of village not only za more tradycjonalnych, but and more moral. First of all however living in the country men be perceived by Poles' totality as more religious than occupants cities and it turns out, that they are tray really. Village – as educational environment; differentiation as place to life shows considerable, work and education in dependence from regional arrangement, national, continental. Despite many the times the affirmed strong standardizing in frames of processes of urbanization influences ( the municipal examples of life many country environments kept its specific of educational influences still. The guilds of social distinction, economic the and cultural village the children are the essential determinants of conditions of education and the youth

  6. Farmers or rural workers? A current social characterization of rural families of Atamisqui Department, Santiago del Estero ¿Campesinos o asalariados rurales? Una caracterización social actual de las familias rurales del Departamento de Atamisqui, Santiago del Estero

    Directory of Open Access Journals (Sweden)

    Agustina Desalvo

    2011-01-01

    Full Text Available It is often said that Santiago del Estero concentrates a large number of farmers. In this paper, we present a first approach to the subject in order to begin to demystify the idea. To do this, we use data obtained from the Familiar Characterization Form prepared by PROINDER in 2009 - implemented by the Secretariat for Family Agriculture and Rural Development, Delegation Santiago del Estero- and interviews conducted in villages of Atamisqui department in April 2010. The form used allows us, among other things, measure the weight that have different sources of income in total household income. This, together with the evidence gathered in interviews, allows us to know how live analyzed families. It notes that the most important support comes from the seasonal employee working developed in different rural activities (though especially in the deflowering of corn and harvesting blueberries and various transfers (pensions, social benefits, remittances. These data would indicate, in this particular case, that the subject usually characterized as farmer hides, in reality, the atamisqueña rural working class.Suele afirmarse que Santiago del Estero concentra un elevado número de campesinos. En este artículo presentamos una primera aproximación al tema con el propósito de comenzar a desmitificar dicha idea. Para ello, recurrimos a datos arrojados por el Formulario de Caracterización Familiar del PROINDER, año 2009 -ejecutado desde la Subsecretaría de Desarrollo Rural y Agricultura Familiar de Santiago del Estero- y entrevistas realizadas en parajes rurales del departamento de Atamisqui en abril del 2010. El Formulario utilizado nos permite, entre otras cosas, mensurar el peso que las distintas fuentes de ingreso tienen en el total del ingreso familiar. Esto, junto a los testimonios recogidos en las entrevistas, nos permite conocer de qué viven las familias analizadas. Se observa que el sustento más importante proviene del trabajo estacional

  7. Association of impairments of older persons with caregiver burden among family caregivers: Findings from rural South India.

    Science.gov (United States)

    Ajay, Shweta; Kasthuri, Arvind; Kiran, Pretesh; Malhotra, Rahul

    In India, owing to cultural norms and a lack of formal long-term care facilities, responsibility for care of the older person falls primarily on the family. Based on the stress process model, we assessed the association of type and number of impairments of older persons (∼primary stressors) with caregiver burden among their family caregivers in rural South India. All impaired older persons (aged ≥60, with impairment in activities of daily living (ADL) or cognition or vision or hearing) residing in 8 villages in Bangalore district, Karnataka, India, and their primary informal caregivers were interviewed. Caregiver burden was measured using the Zarit Burden Interview (ZBI; higher score indicating greater perceived burden). Linear regression models, adjusting for background characteristics of older persons and caregivers, assessed the association of type of impairment (physical [Yes/No], cognitive [Yes/No], vision [Yes/No] and hearing [Yes/No]) and number (1 or 2 or 3 or 4) of older person impairments with caregiver burden. A total of 140 caregivers, caring for 149 older persons, were interviewed. The mean (standard deviation) ZBI score was 21.2 (12.9). Of the various older person impairments, ZBI score was associated only with physical impairment (β=6.6; 95% CI: 2.1-11.1). Relative to caregivers of older person with one impairment, those caring for an older person with all 4 impairments had significantly higher ZBI score (β=13.9; CI: 2.5-25.4). Caregivers of older persons with multiple impairments, especially physical impairment, are vulnerable. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. Care-seeking patterns among families that experienced under-five child mortality in rural Rwanda.

    Science.gov (United States)

    Kagabo, Daniel M; Kirk, Catherine M; Bakundukize, Benjamin; Hedt-Gauthier, Bethany L; Gupta, Neil; Hirschhorn, Lisa R; Ingabire, Willy C; Rouleau, Dominique; Nkikabahizi, Fulgence; Mugeni, Catherine; Sayinzoga, Felix; Amoroso, Cheryl L

    2018-01-01

    Over half of under-five deaths occur in sub-Saharan Africa and appropriate, timely, quality care is critical for saving children's lives. This study describes the context surrounding children's deaths from the time the illness was first noticed, through the care-seeking patterns leading up to the child's death, and identifies factors associated with care-seeking for these children in rural Rwanda. Secondary analysis of a verbal and social autopsy study of caregivers who reported the death of a child between March 2013 to February 2014 that occurred after discharge from the child's birth facility in southern Kayonza and Kirehe districts in Rwanda. Bivariate analyses using Fisher's exact tests were conducted to identify child, caregiver, and household factors associated with care-seeking from the formal health system (i.e., community health worker or health facility). Factors significant at α = 0.10 significance level were considered for backwards stepwise multivariate logistic regression, stopping when remaining factors were significantly associated with care-seeking at α = 0.05 significance level. Among the 516 eligible deaths among children under-five, 22.7% (n = 117) did not seek care from the health system. For those who did, the most common first point of contact was community health workers (45.8%). In multivariate logistic regression, higher maternal education (OR = 3.36, 95% CI: 1.89, 5.98), having diarrhea (OR = 4.21, 95%CI: 1.95, 9.07) or fever (OR = 2.03, 95%CI: 1.11, 3.72), full household insurance coverage (3.48, 95%CI: 1.79, 6.76), and longer duration of illness (OR = 22.19, 95%CI: 8.88, 55.48) were significantly associated with formal care-seeking. Interventions such as community health workers and insurance promote access to care, however a gap remains as many children had no contact with the health system prior to death and those who sought formal care still died. Further efforts are needed to respond to urgent cases in communities and further

  9. 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...

  10. Understanding Family Migration in Rural South Africa: Exploring Children's Inclusion in the Destination Households of Migrant Parents.

    Science.gov (United States)

    Bennett, Rachel; Hosegood, Victoria; Newell, Marie-Louise; McGrath, Nuala

    2015-05-01

    Despite the removal of restrictions on movement and increasing female participation in migration, only a minority of migrant parents in South Africa include their children in their destination household. Quantitative analyses of the circumstances in which children accompany a migrant parent have been limited by the lack of available data that document family arrangements from the perspective of more than one household. This paper uses data about members of rural households in a demographic surveillance population in KwaZulu-Natal and a linked sample survey of adult migrants to examine factors associated with children's inclusion in the destination household of migrant parents, analyse the timing and sequence of children's moves to parental destination households, and describe the composition of parental origin and destination households. The findings confirm that in contemporary South Africa, only a small percentage (14%) of migrants' children who are members of the parental origin household are also members of the parental destination household. Membership of the parental destination household is associated with parental characteristics and the child's age, but not measures of socio-economic status, and children most commonly migrate several years after their migrant parent. Children included in the destination household of migrant fathers frequently live in small households, which also include their mother, whereas children included in the destination household of migrant mothers live in larger households. This study contributes to understanding the contexts of children's inclusion in parental destination households in South Africa and demonstrates the potential of data collected in migrants' origin and destination households.

  11. The role of tradition in mulitigeneration rural families in Małopolska Rola tradycji w wielopokoleniowych rodzinach wiejskich w Małopolsce

    Directory of Open Access Journals (Sweden)

    Magdalena Kowalska

    2008-06-01

    Full Text Available Research was carried out in 2006 in three gminas (administrative boroughs of the Małopolska Province – Dębno, Wieliczka, and Zabierzów. 40 multigeneration rural families were selected in each gmina. Interviews were conducted with them on the basis of a questionnaire made up of three parts focused on the representatives of three genera-tions: grandparents, parents, and grandchildren. 360 people were surveyed in total. The results of the research, which are presented here, will try to provide an answer to the ques-tion of how critical a role tradition plays in the life of multigeneration rural families, and also to what extent they cherish the customs and habits which they have inherited from previous generations.

  12. 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.

  13. Productive inclusion, family livestock situation of rural women of brazil without poverty program in a municipality of the rs - context a little-known reality

    Directory of Open Access Journals (Sweden)

    Marta Julia Marques Lopes

    2018-01-01

    Full Text Available The aim of this article is to describe and analyze sociodemographic characteristics of rural women working in family livestock, inserted in Brazil without Poverty Plan in Encruzilhada do Sul. This type of work is culturally defined as masculine as well, the question is how women in it operate. In Rio Grande do Sul, the southern half has in beef cattle the main productive activity which alludes to a supposed production homogeneity. This condition challenges and boost research that shows the multiplicity of experiences of livestock rural families. Thus, the motivation of this article also is based on the problem of discussion little debated on family livestock, for example, the sexual division of labor and women's participation in the activity. So it was found the presence of women in family livestock and their inclusion in the Brazil without Poverty Program. The information analyzed shows that 92.31% of ownership in the program are women, 6.59% of men and 1.10% for both. This reality leads the female role of idea in action, however it is necessary to consider other issues that contribute to other explanatory possibilities of this condition. The trajectory and the sexual division of labor "earmarking" women to the most precarious jobs, it may be a potential answer. Thus, the recognition of women's work is hindered in social practices and intra-family and sexual division of labor is reaffirmed by the notions of what is "man of affairs and women's things". The issues that emerge interrelate livestock, poverty and gender, since most of the families of the Brazil without Poverty is also included in the livestock. We question the extent to which livestock is male activity and poverty would be a "parameter" to characterize rural activities, including livestock, as female?

  14. THE EFFECTS OF WORKPLACE SOCIAL SUPPORT ON WORK-FAMILY CONFLICT (CASE STUDY: RURAL WATER AND WASTEWATER COMPANY EMPLOYEES KERMANSHAH, IRAN)

    OpenAIRE

    Sobhani Aliasgar

    2017-01-01

    The main objective of the current study is to investigate the relationship between workplace social support and work-family conflict among employees who were married, living with a partner, or had at least one child or dependent living at home and worked a minimum of 20 h/week in Rural Water and Wastewater Company employees Kermanshah, Iran. The relation between workplace social support and work–family conflict (WFC) was examined using a two-dimensional measure of WFC and both global and sum...

  15. A comparative study of factors influencing decisions on desired family size among married men and women in Bokkos, a rural local government area in Plateau state.

    Science.gov (United States)

    Kahansim, Makshwar L; Hadejia, Idris S; Sambo, Mohammed N

    2013-03-01

    The total fertility rate of Nigerian women has remained high at 5.7. This is even higher for women in rural areas. Men and women in rural areas desire more children than those in urban areas. This study was aimed at describing and comparing the factors that influence family size decisions among men and women in Bokkos, a rural Local Government Area in Plateau state, Nigeria. A cross sectional descriptive comparative study was used. Data was collected using structured interviewer administered questionnaires. Seventy two percent of women and 83.6% of men who desire to have 1-4 children had at least a secondary school education. Close to seventy percent of both men and women would have fewer children if they are certain of their survival to adulthood. Over 50% of the respondents believe that the husbands should have the final say on family size decisions. Preference for male children influences decisions on family size among men and women in the study population.

  16. The emergence of the work class "family farmer" as individuals with rights in the path of the Brazilian rural syndicalism A emergência dos "agricultores familiares" como sujeitos de direitos na trajetória do sindicalismo rural brasileiro

    Directory of Open Access Journals (Sweden)

    Everton Lazzaretti Picolotto

    2009-01-01

    Full Text Available The process of the family farmers' recognition as individuals with rights demonstrates having their first roots, in spite of being recent, if compared to the history of the Brazilian rural syndicalism, still in the constitution of the labor-syndical legislation in 1930. Therefore, seeking to explore that process the present paper has as objective to analyze the family farmers' emergence as individuals of rights in the contemporary Brazilian society, analyzing the processes of formation of the rural syndicalism and the expansion of the labor law for the rural workers as a form of accomplishment of a "regulated citizenship" until the decade of 1970; the urge to the official syndicalism, the structuring of a "new syndicalism" and the new social actors' appearance in the field, which made possible the enlargement of the citizenship spaces in the period of re-democratization in Brazil; the "crisis" of the new syndicalism, the creation of new syndical structures "apart" of the official structure (syndicalism of the family agriculture and the emergency of the "family farmers" as subject of rights in the recent periodO processo de reconhecimento dos agricultores familiares como sujeitos de direitos apesar de ser recente quando pensado a partir da trajetória do sindicalismo rural brasileiro demonstra ter suas primeiras raízes ainda na constituição da legislação trabalhista-sindical dos anos de 1930. Visando explorar esse processo o artigo tem por objetivo analisar a emergência dos agricultores familiares como sujeitos de direitos na sociedade brasileira contemporânea. Analisa-se os processos de formação do sindicalismo rural e de expansão da legislação trabalhista para os trabalhadores rurais como forma de realização de uma "cidadania regulada" até a década de 1970; o questionamento do sindicalismo oficial, a estruturação de um "novo sindicalismo" e a emergência de novos atores sociais no campo, que possibilitaram a ampliação dos

  17. Why factors rooted in the family may solely explain the urban-rural differences in schizophrenia risk estimates

    DEFF Research Database (Denmark)

    Pedersen, Carsten Bøcker; Mortensen, Preben Bo

    2006-01-01

    Many studies have identified urban-rural differences in schizophrenia risk. The underlying cause(s) may hypothetically include toxic exposures, diet, infections, and selective migration. In a recent study, we concluded that some of the cause(s) responsible for the urban-rural differences...... explain the urban-rural differences. Although other potential explanations for these differences exist, we focus on this hypothesis as it has not previously been discussed in detail. To determine the cause(s) responsible for the urban-rural differences, we need direct measurements of genetic and....../or environmental factors related to urban life...

  18. 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.

  19. The Online-Counseling Debate: A View toward the Underserved

    Science.gov (United States)

    Sanchez-Page, Delida

    2005-01-01

    This article responds to some important issues that Mallen, Vogel, Rochlen, and Day raise in "Online Counseling: Reviewing the Literature from a Counseling Psychology Framework." This reaction reviews the appropriateness of online counseling for underserved populations. The author provides suggestions for better serving historically undeserved…

  20. 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.

  1. 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.

  2. Formal, Nonformal, and Informal Learning in Rural India: The Case of Fishing Families on the Chilika Lagoon

    Science.gov (United States)

    Pilz, Matthias; Wilmshöfer, Simon

    2015-01-01

    The vast majority--70%--of the Indian population lives in rural areas. They are far removed from India's image as a society with an emerging middle class and well-regarded schools. This research focuses on education and opportunities for skill development for this rural population. The researchers investigated the area around the Chilika Lagoon, a…

  3. Assessing Family Planning Service Quality And User Experiences In Social Franchising Programme - Case Studies From Two Rural Districts In Pakistan.

    Science.gov (United States)

    Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Awan, Muhammad Ali

    2018-01-01

    Studies have documented the impact of quality family planning services on improved contraceptive uptake and continuation, however, relatively little is known about their quality of service provision especially in the context of social franchising. This study examined the quality of clinical services and user experiences among two models in franchised service providers in rural Pakistan. This facility-based assessment was carried out during May-June 2015 at the 20 randomly selected social franchise providers from Chakwal and Faisalabad. In our case, a franchise health facility was a private clinic (mostly) run by a single provider, supported by an assistant. Within the selected health facilities, a total 39 user-provider interactions were observed and same users were interviewed separately. Most of the health facilities were in the private sector. Comparatively, service providers at Greenstar Social Marketing/Population Services International (GSM/PSI) model franchised facilities had higher number of rooms and staff employed, with more providers' ownership. Quality of service indices showed high scores for both Marie Stopes Society (MSS) and GSM/PSI franchised providers. MSS franchised providers demonstrated comparative edge in terms of clinical governance, better method mix and they were more user-focused, while PSI providers offered broader range of non-FP services. Quality of counselling services were similar among both models. Service providers performed well on all indicators of interpersonal care however overall low scores were noted in technical care. For both models, service providers attained an average score of 6.7 (out of the maximum value of 8) on waste disposal mechanism, supplies 12.5 (out of the maximum value of 15), user-centred facility 2.7 (out of the maximum value of 4), and clinical governance 6.5 (out of the maximum value of 11) and respecting clients' privacy. The exit interviews yielded high user satisfaction in both service models. The

  4. Patient-family EoL communication and its predictors: Reports from caregivers of Latino patients in the rural U.S.-Mexico border region.

    Science.gov (United States)

    Ko, Eunjeong; Lee, Jaehoon; Ramirez, Carlos; Lopez, Denicka; Martinez, Stephanie

    2017-10-26

    Family caregivers play an important role in end-of-life (EoL) decision making when the patient is unable to make his/her own decisions. While communication about EoL care between patients and family is perhaps a first step toward advance care planning (ACP)/EoL decisions, not every culture puts great value on open communication about this topic. The aims of the present study were to explore EoL communication and the aspects of communication among caregivers of Latino patients in the rural United States (U.S.)-Mexico border region. This study analyzed data from a hospice needs assessment collected from 189 family caregivers of Latino patients at a home health agency in a rural U.S.-Mexico border region. Bivariate tests and logistic regression were used to address our aims. About half of the family caregivers (n = 96, 50.8%) reported to have ever engaged in EoL discussion with patients. Significant predictors of EoL discussion included life-sustaining treatment preference (odds ratio [OR] = 0.44, p EoL communication. Also, caregivers who worried that physicians might want to stop treatments (i.e., "pull the plug") too soon were less likely to do so. Conversely, caregivers who had knowledge about ADs were more likely to engage in EoL communication. EoL communication is a complex process influenced by individual, social, and cultural values and the beliefs of both the patient and his/her family. Inclusion of family caregivers in the ACP process and facilitating culturally tailored EoL communication between patients and family caregivers is important.

  5. Multicultural Milky Way: Ethnoastronomy and Planetarium Shows for Under-served Arizonans

    Science.gov (United States)

    Knierman, Karen

    2018-01-01

    The astronomy outreach initiative, Multicultural Milky Way, partners the School of Earth and Space Exploration (SESE) at Arizona State University (ASU) with under-served populations in Arizona in learning about our Milky Way and other galaxies. Arizona is home to many diverse populations with rich cultural histories such as Mayan, Navajo, and Apache. Linking astronomy practiced by one’s indigenous culture to that of Western astronomy may increase the interest in science. Through multicultural planetarium shows and associated hands-on activities, under-served students and families will learn how the Milky Way is represented in different cultures and about the science of galaxies. New planetarium shows using the Mesa Community College (MCC) Digital Planetarium and STARLAB portable planetarium explore how the Milky Way is interpreted in different cultures. STARLAB shows and associated new hands-on activities have been featured during school visits, teacher trainings, and Community Astronomy Nights around Arizona. For authentic assessment, evaluation techniques and procedures were developed.

  6. Simulation and optimization study on a solar space heating system combined with a low temperature ASHP for single family rural residential houses in Beijing

    DEFF Research Database (Denmark)

    Deng, Jie; Tian, Zhiyong; Fan, Jianhua

    2016-01-01

    A pilot project of the solar water heating system combined with a low temperature air source heat pump (ASHP) unit was established in 2014 in a detached residential house in the rural region of Beijing, in order to investigate the system application prospect for single family houses via system...... optimization design and economic analysis. The established system was comprised of the glass heat-pipe based evacuated tube solar collectors with a gross area of 18.8 m2 and an ASHP with a stated heating power of 8 kW for the space heating of a single family rural house of 81.4 m2. The dynamic thermal...... with good building insulation were undertaken to figure out the system economical efficiency in the rural regions of Beijing. The results show that the payback periods of the solar space heating system combined with the ASHP with the collector areas 15.04-22.56 m2 are 17.3-22.4 years for the established...

  7. A "Medical Mission" at Home: The Needs of Rural America in Terms of Otolaryngology Care

    Science.gov (United States)

    Winters, Ryan; Pou, Anna; Friedlander, Paul

    2011-01-01

    Objectives: Describe the population, Medicaid, uninsured, and otolaryngology practice demographics for 7 representative rural Southeastern states, and propose academic-affiliated outreach clinics as a service to help meet the specialty care needs of an underserved rural population, based on the "medical mission" model employed in…

  8. 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.

  9. CHARM, a gender equity and family planning intervention for men and couples in rural India: protocol for the cluster randomized controlled trial evaluation.

    Science.gov (United States)

    Yore, Jennifer; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusadana; Nair, Saritha; Silverman, Jay; Saggurti, Niranjan; Balaiah, Donta; Raj, Anita

    2016-02-20

    Globally, 41% of all pregnancies are unintended, increasing risk for unsafe abortion, miscarriage and maternal and child morbidities and mortality. One in four pregnancies in India (3.3 million pregnancies, annually) are unintended; 2/3 of these occur in the context of no modern contraceptive use. In addition, no contraceptive use until desired number and sex composition of children is achieved remains a norm in India. Research shows that globally and in India, the youngest and most newly married wives are least likely to use contraception and most likely to report husband's exclusive family planning decision-making control, suggesting that male engagement and family planning support is important for this group. Thus, the Counseling Husbands to Achieve Reproductive Health and Marital Equity (CHARM) intervention was developed in recognition of the need for more male engagement family planning models that include gender equity counseling and focus on spacing contraception use in rural India. For this study, a multi-session intervention delivered to men but inclusive of their wives was developed and evaluated as a two-armed cluster randomized controlled design study conducted across 50 mapped clusters in rural Maharashtra, India. Eligible rural young husbands and their wives (N = 1081) participated in a three session gender-equity focused family planning program delivered to the men (Sessions 1 and 2) and their wives (Session 3) by village health providers in rural India. Survey assessments were conducted at baseline and 9&18 month follow-ups with eligible men and their wives, and pregnancy tests were obtained from wives at baseline and 18-month follow-up. Additional in-depth understanding of how intervention impact occurred was assessed via in-depth interviews at 18 month follow-up with VHPs and a subsample of couples (n = 50, 2 couples per intervention cluster). Process evaluation was conducted to collect feedback from husbands, wives, and VHPs on program

  10. T@lemed: Ehealth applications applied to underserved areas in Latin America

    Science.gov (United States)

    Sachpazidis, Ilias; Ohl, Roland; Binotto, Alécio Pedro Delazari; Torres, Márcio Soares; Messina, Luiz Ary; Sales, Alexandre; Gomes, Ricardo; Sakas, Georgios

    2006-12-01

    Access to medical care is sometimes very difficult to be reached from people living in rural and underserved areas. This problem is very well known in rural areas in Brazil. Citizens have no access to health care. They have to travel hundreds of kilometres to receive medical care. In this paper, we will propose a medical network based on state-of-the-art medical imaging application that addresses the problems of providing health care from a distance. Additionally, we are going to show preliminarily results of the first year of the system deployment and utilization in undeserved regions in Brazil. The total number of patients submitted to ultrasound examinations, during the 10 months of projects' medical trials, is 321. The exams have begun with the elderly people (hypertension and diabetes cases) with 90% above 50-years-old. Fifty-four percent were male and 46% were female. From those exams, 67 exams (21%) needed a second medical opinion and were transmitted to Santa Casa hospital in Porto Alegre, Brazil, one of the referral medical centres. From those second opinions of Santa Casa, 12 exams had to be repeated since the acquired images were not sufficient to give a correct diagnosis. The Lagoa Tres Cantos medical doctor performed also preventive exams with patients who had not presented any symptoms (70%).

  11. Agricultura familiar, multifuncionalidade da agricultura e ruralidade: interfaces de uma realidade complexa Family farming, multifunctionality of agriculture and rurality: interfaces of a complex reality

    Directory of Open Access Journals (Sweden)

    Regina Aparecida Leite de Camargo

    2012-09-01

    Full Text Available Nas últimas décadas, assistimos à revitalização do debate em torno da agricultura familiar pela incorporação das discussões sobre as múltiplas funções da agricultura num rural que não pode mais ser visto como domínio exclusivo da atividade agrícola e dos agricultores. No contexto brasileiro, acreditamos que essa discussão deva ser permeada pela análise de como processos diferenciados de distribuição fundiária e desenvolvimento econômico e o tipo de agricultura resultante geram ruralidades específicas com características como, no caso da agricultura familiar, a manutenção de práticas sociais e de trabalho marcadas pelas relações de parentesco e vizinhança presentes numa sociedade de interconhecimento. Partindo desse princípio, este trabalho analisa a agricultura familiar de um bairro rural do município de Ouro Fino - MG, sua herança histórica e sua participação na criação de uma paisagem natural e humana que muito contribui para a atratividade da região.The last decades witnessed the revitalization of the debate around family farming with the addition of discussions regarding the multiple functions of agriculture, given the fact that rural areas are longer devoted exclusively to agricultural activities. In the Brazilian context, we believed that this debate must be permeated by analyses of how differentiated processes of land distribution and economic development, and the resulting types of agriculture, generate specific ruralities with characteristics such as, in the case of family farming, the maintenance of social and work practices marked by the relations among relatives and neighbours. It is in this light that this research analyses family agriculture in a rural area of Ouro Fino-MG, its historical heritage, and its participation in the creation of a physical and human landscape that greatly contributes to the attractiveness of the region.

  12. Recent abuse from in-laws and associations with adverse experiences during the crisis among rural Ivorian women: extended families as part of the ecological model.

    Science.gov (United States)

    Falb, Kathryn L; Annan, Jeannie; Hossain, Mazeda; Topolska, Monika; Kpebo, Denise; Gupta, Jhumka

    2013-01-01

    Violence against women in the aftermath of conflict represents a growing area of concern. However, little is known about violence perpetrated by a woman's in-laws and how these experiences may be related to adverse experiences during a crisis. Therefore, guided by the ecological model, the objectives of the following analysis were to (1) document adverse experiences during the crisis among rural Ivorian women and (2) investigate the association between such experiences and abuse perpetrated by partners' extended families, among a sample of women residing in rural Côte d'Ivoire. Utilising data from a baseline survey conducted in 2010, we generated descriptive statistics and used generalised estimating equations to assess the relationships of interest. Women whose family was victimised during the crisis had 1.7 times the odds of reporting past-year in-law abuse compared to those women whose families did not experience such adversity (95% CI: 1.1-2.4), and women who experienced a personal form of adversity had twice the odds of reporting past-year in-law abuse compared to women who did not report victimisation (95% CI: 1.2-3.2). Being forced to flee was not statistically associated with in-law abuse. Findings underscore the importance of addressing in-law abuse in order to promote women's health in post-conflict settings.

  13. Unmet Needs of Family Planning Among Women: A Cross-Sectional Study in a Rural Area of Kanchipuram District, Tamil Nadu, South India.

    Science.gov (United States)

    Vishnu Prasad, R; Venkatachalam, J; Singh, Zile

    2016-10-01

    Global contraceptive usage was 63.3 % in 2010 which was 9 % more than that in 1990. NFHS-III 2005-2006 revealed that the contraceptive prevalence rate was 56 % while in the past decade it was 48 %. In India, female sterilization is the most commonly preferred method of contraception accounting for 76 %, while in Tamil Nadu it was 90 %. Thus, this study aims at measuring the prevalence of unmet needs of family planning and its determinants in a rural area of Kancheepuram district, Tamil Nadu. The study was carried out as a community-based cross-sectional study in Chunambed panchayat, a rural area in Kanchipuram District, Tamil Nadu, India, among 505 women of age group 15-49 years. Cluster random sampling was done to select the households to include in the study. In every household, all the available and eligible women were explained about the study and recruited after obtaining informed consent. Chi-square test was applied for finding the difference in proportion, and p value <0.05 was considered statistically significant. The prevalence of unmet need for family planning in our study population was nearly 31 %; it was even more for younger age groups and for the women whose family size was less. 51.7 % of the participants were currently using a contraceptive measure and very few of their partners used contraception. Government health facilities were the major source of contraceptive service and majority of our participants were well aware about the various contraceptive methods. Unmet needs of family planning were high in our study population, and the knowledge about the contraceptive use and family planning was found to be fairly adequate.

  14. 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.

  15. Complementary and alternative medicine use by visitors to rural Japanese family medicine clinics: results from the international complementary and alternative medicine survey.

    Science.gov (United States)

    Shumer, Gregory; Warber, Sara; Motohara, Satoko; Yajima, Ayaka; Plegue, Melissa; Bialko, Matthew; Iida, Tomoko; Sano, Kiyoshi; Amenomori, Masaki; Tsuda, Tsukasa; Fetters, Michael D

    2014-09-25

    There is growing interest in the use of complementary and alternative medicine (CAM) throughout the world, however previous research done in Japan has focused primarily on CAM use in major cities. The purpose of this study was to develop and distribute a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q) to assess the use of CAM among people who visit rural Japanese family medicine clinics. Using a Japanese version of the International Complementary and Alternative Medicine Questionnaire (I-CAM-Q), a cross-sectional survey was conducted in three rural family medicine clinics. All patients and those accompanying patients who met inclusion criteria were eligible to participate. Data were entered into SPSS Statistics and analyzed for use by age, gender, and location. Of the 519 respondents who participated in the project, 415 participants reported CAM use in the past 12 months (80.0%). When prayer is excluded, the prevalence of CAM use drops to 77.3% in the past year, or 403 respondents. The most common forms of CAM used by respondents were pain relief pads (n = 170, 32.8%), herbal medicines/supplements (n = 167, 32.2%), and massage by self or family (n = 166, 32.0%). Female respondents, individuals with higher levels of education, and those with poorer overall health status were more likely to use CAM than respondents without these characteristics. Only 22.8% of CAM therapies used were reported to physicians by survey participants. These data indicate that CAM use in rural Japan is common. The results are consistent with previous studies that show that Japanese individuals are more interested in forms of CAM such as pain relief pads and massage, than in mind-body forms of CAM like relaxation and meditation. Due to the high utilization of certain CAM practices, and given that most CAM users do not disclose their CAM use to their doctors, we conclude that physicians in rural Japan would benefit by asking about CAM use

  16. Rural Resilience: Youth "Making a Life" in Regions of High Unemployment.

    Science.gov (United States)

    Abbott-Chapman, Joan

    2001-01-01

    In rural Australia, education beyond year 10 involves leaving home. Rural families may influence young people to stay home. Family influence and culture should not always be considered a deficit, for the family provides support when jobs are scarce. Rural families' social capital and rural resilience should be considered in developing rural school…

  17. Pobreza e desigualdade de renda entre famílias da zona rural de Mato Grosso de 2004 a 2006 Poverty and income inequality among families in rural areas of Mato Grosso from 2004 to 2006

    Directory of Open Access Journals (Sweden)

    Benedito Dias Pereira

    2010-12-01

    Full Text Available Investigou-se a desigualdade da distribuição de renda e a pobreza das famílias residentes nas áreas rurais de Mato Grosso em 2004 e 2006, com base nos microdados da PNAD (IBGE. Em especial, o coeficiente de Gini foi decomposto por fonte de renda, para se identificar a contribuição relativa de determinada fonte de renda na desigualdade da renda total. Dentre os principais resultados encontrados, verificou-se que há elevada desigualdade na distribuição de renda entre as famílias rurais mato-grossenses, que a renda das atividades agrícolas contribui para aumentar essa desigualdade e que essa renda se constitui em variável importante e estratégica para a economia do Estado. Os indicadores também sugerem que houve incremento da pobreza entre as famílias rurais do Estado entre 2004 e 2006.Investigates on income distribution inequality and poverty of families living in rural areas of Mato Grosso in 2004 and 2006, based on the microdata of PNAD (IBGE. In particular, the Gini coefficient was broken by source of income to identify the relative contribution of a particular source of income inequality in total income. Among the key findings, it appears that there is high inequality in the income distribution among households in Mato Grosso, that the agriculture income contributes to increasing inequality and that this income is one important and strategic variable for the economy of the state. The indicators also suggest that there was an increase in poverty among rural families of the state between 2004 and 2006.

  18. Evaluation of the Program in Medical Education for the Urban Underserved (PRIME-US) at the UC Berkeley-UCSF Joint Medical Program (JMP): The First 4 Years.

    Science.gov (United States)

    Sokal-Gutierrez, Karen; Ivey, Susan L; Garcia, Roxanna M; Azzam, Amin

    2015-01-01

    Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities. The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school. This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley-UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed. Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities

  19. 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.

  20. Remote care of a patient with stroke in rural Trinidad: use of telemedicine to optimise global neurological care.

    Science.gov (United States)

    Reyes, Antonio Jose; Ramcharan, Kanterpersad

    2016-08-02

    We report a patient driven home care system that successfully assisted 24/7 with the management of a 68-year-old woman after a stroke-a global illness. The patient's caregiver and physician used computer devices, smartphones and internet access for information exchange. Patient, caregiver, family and physician satisfaction, coupled with outcome and cost were indictors of quality of care. The novelty of this basic model of teleneurology is characterised by implementing a patient/caregiver driven system designed to improve access to cost-efficient neurological care, which has potential for use in primary, secondary and tertiary levels of healthcare in rural and underserved regions of the world. We suggest involvement of healthcare stakeholders in teleneurology to address this global problem of limited access to neurological care. This model can facilitate the management of neurological diseases, impact on outcome, reduce frequency of consultations and hospitalisations, facilitate teaching of healthcare workers and promote research. 2016 BMJ Publishing Group Ltd.

  1. Why do women not adhere to advice on maternal referral in rural Tanzania? Narratives of women and their family members

    OpenAIRE

    Pembe, Andrea B.; Mbekenga, Columba K.; Olsson, Pia; Darj, Elisabeth

    2017-01-01

    ABSTRACT Background: In most low-income countries, many women with high-risk pregnancies and complications do not reach the referral hospitals despite the provision of referral advice. Objective: To explore how antenatal maternal referral advice is understood and handled in a rural Tanzanian community. Methods: Individual in-depth interviews were conducted with six women who did not go to hospital and 13 people who were involved in the referral advice. Narrative analysis was used to describe ...

  2. Rural eHealth nutrition education for limited-income families: an iterative and user-centered design approach.

    Science.gov (United States)

    Atkinson, Nancy L; Saperstein, Sandra L; Desmond, Sharon M; Gold, Robert S; Billing, Amy S; Tian, Jing

    2009-06-22

    Adult women living in rural areas have high rates of obesity. Although rural populations have been deemed hard to reach, Internet-based programming is becoming a viable strategy as rural Internet access increases. However, when people are able to get online, they may not find information designed for them and their needs, especially harder to reach populations. This results in a "content gap" for many users. User-centered design is a methodology that can be used to create appropriate online materials. This research was conducted to apply a user-centered approach to the design and development of a health promotion website for low-income mothers living in rural Maryland. Three iterative rounds of concept testing were conducted to (1) identify the name and content needs of the site and assess concerns about registering on a health-related website; (2) determine the tone and look of the website and confirm content and functionality; and (3) determine usability and acceptability. The first two rounds involved focus group and small group discussions, and the third round involved usability testing with individual women as they used the prototype system. The formative research revealed that women with limited incomes were enthusiastic about a website providing nutrition and physical activity information targeted to their incomes and tailored to their personal goals and needs. Other priority content areas identified were budgeting, local resources and information, and content that could be used with their children. Women were able to use the prototype system effectively. This research demonstrated that user-centered design strategies can help close the "content gap" for at-risk audiences.

  3. 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

  4. 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

  5. International Comparisons in Underserved Health: Issues, Policies, Needs and Projections.

    Science.gov (United States)

    Hutchinson, Paul; Morelli, Vincent

    2017-03-01

    Health care globally has made great strides; for example, there are lower rates of infant and maternal mortality. Increased incomes have led to lower rates of diseases accompanying poverty and hunger. There has been a shift away from the infectious diseases so deadly in developing nations toward first-world conditions. This article presents health care statistics across age groups and geographic areas to help the primary care physician understand these changes. There is a special focus on underserved populations. New technologies in health and health care spending internationally are addressed, emphasizing universal health care. The article concludes with recommendations for the future. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Time trends and determinants of completed family size in a rural community from the Basque area of Spain (1800-1969).

    Science.gov (United States)

    Alfonso-Sánchez, Miguel A; Peña, José A; Calderón, Rosario

    2003-10-01

    The focus of this work is the analysis of changes in completed family size and possible determinants of that size over time, in an attempt to characterize the evolution of reproductive patterns during the demographic transition. With this purpose in mind, time trends are studied in relation to the mean number of live births per family (as an indirect measure of fertility), using family reconstitution techniques to trace the reproductive history of each married woman. The population surveyed is a Spanish rural community called Lanciego, located at the southern end of the province of Alava (Basque Country). A total of 24,510 parish records of baptisms, marriages and burials made between 1800 and 1969 were examined to obtain the demographic data set. For each reconstituted family, the variables included in the study were the number of live births per family or family size (FAMS), year of marriage (YEAR), age at marriage of both partners (AMAN, AWOM), wife's age at the end of marriage (WEND), duration of marriage (MARD), age at first maternity (A1CH), length of reproductive span (REPS) and number of children dying before their first anniversary (MINF). Through a principal component analysis, three factors were found that explained more than 75% of the total variance. Association of variables in factors I and III was particularly useful in characterizing the variability of mean family size in pre-transitional, transitional and post-transitional cohorts. During demographic transition, a decreasing trend is observed in the variables FAMS, REPS and MINF, while variables AWOM, AMAN, WEND and A1CH show a tendency to increase over the 20th century. Results obtained by multiple regression analysis confirm that the best predictors of family size (dependent variable) were REPS and MINF, which between them explained over 85% of the total variation in FAMS (R2 = 0.853). In Lanciego, birth control seems to be present on the evidence of an increase in age at first maternity and a

  7. 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.

  8. Knowledge, attitude and practice of family planning methods among the rural females of Bagbahara block Mahasamund district in Chhattishgarh State, India

    Directory of Open Access Journals (Sweden)

    Mohammad Jawed Quereishi

    2017-01-01

    Full Text Available Background If many women in Chhattisgarh are not using family planning, it is not due to a lack of knowledge. Knowledge of contraception is nearly universal; 98 percent of currently married women know at least one modern family planning method. Women are most familiar with female sterilization (97 percent, followed by male sterilization (86 percent, the pill (68 percent, the condom (55 percent, and the IUD (40 percent. About two out of every five women (43 percent have knowledge of at least one traditional method. Yet only 45 percent of married women in Chhattisgarh are currently using some method of contraception, about the same as in Madhya Pradesh (44 percent but less than the national average (48 percent. Contraceptive prevalence in Chhattisgarh is considerably higher in urban areas (59 percent than in rural areas (42 percent. Objectives To assess the knowledge, attitude and practice of family planning methods, and factors that could affect their use, among the rural females of reproductive age group (15-49 years. Methods A total of 326 females of reproductive age group (15-49years from the rural areas of Bagbahara block of Mahasamund district in Chhattisgarh state were selected randomly and interviewed with the help of semi-structured interview schedule, which consists of demographic data, questions related to knowledge, attitude and practice of different contraceptive methods and factors affecting the use of these methods. Results Most of the respondents (79% were aware of at least one contraceptive method. The most common source of information on contraception was Health staffs (46%, followed by ASHA (Mitanin workers (42.5%, media (7.5% and relatives/friends (4%. Knowledge of non-contraceptive benefits of family planning methods was claimed by only 19% of the respondents, while knowledge about various adverse effects was reported by 32% of the respondents. About 62% of respondents showed favourable attitude towards family planning methods

  9. Access to Money and Relation to Women’s Use of Family Planning Methods among Young Married Women in Rural India

    Science.gov (United States)

    Reed, Elizabeth; Donta, Balaiah; Dasgupta, Anindita; Ghule, Mohan; Battala, Madhusudana; Nair, Saritha; Silverman, Jay; Jadhav, Arun; Palaye, Prajakta; Saggurti, Niranjan; Raj, Anita

    2016-01-01

    Objectives The social positioning (i.e. social status and autonomy) of women in the household facilitates women’s access to and decision-making power related to family planning (FP). Women’s access to spending money, which may be an indicator of greater social positioning in the household, may also be greater among women who engage in income generating activities for their families, regardless of women’s status in the household. However, in both scenarios, access to money may independently afford greater opportunity to obtain family planning services among women. This study seeks to assess whether access to money is associated with FP outcomes independently of women’s social positioning in their households. Methods Using survey data from married couples in rural Maharashtra, India (n=855), crude and adjusted regression was used to assess women’s access to their own spending money in relation to past 3 month use of condoms and other forms of contraceptives (pills, injectables, intrauterine device). Results Access to money (59%) was associated with condom and other contraceptive use (AORs ranged: 1.5 – 1.8). These findings remained significant after adjusting for women’s FP decision-making power in the household and mobility to seek FP services. Conclusion While preliminary, findings suggest that access to money may increase women’s ability to obtain FP methods, even in contexts where social norms to support women’s power in FP decision-making may not be readily adopted. PMID:26971270

  10. Telemedicine as a tool to provide family conferences and palliative care consultations in critically ill patients at rural health care institutions: a pilot study.

    Science.gov (United States)

    Menon, Prema R; Stapleton, Renee D; McVeigh, Ursula; Rabinowitz, Terry

    2015-06-01

    Many critically ill patients who transfer from rural hospitals to tertiary care centers (TCCs) have poor prognoses, and family members are unable to discuss patient prognosis and goals of care with TCC providers until after transfer. Our TCC conducted teleconferences prior to transfer to facilitate early family discussions. We conducted a retrospective review of these telemedicine family conferences among critically ill patients requested for transfer which occurred from December 2008 to December 2009 at our TCC. Outcomes for each patient and detailed descriptions of the conference content were obtained. We also assessed limitations and attitudes and satisfaction with this intervention among clinicians. During the 12-month period, 12 telemedicine consultations were performed. Of these patients, 10 (83%) died in the 30 days following the request for transfer. After the telemedicine consultation, 8 (67%) patients were transferred to our TCC from their respective hospitals, while 4 (33%) patients continued care at their regional hospital and did not transfer. Of the patients who transferred to TCC, 7 (88% of those transferred) returned to their community after a stay at the TCC. This study demonstrates that palliative care consultations can be provided via telemedicine for critically ill patients and that adequate preparation and technical expertise are essential. Although this study is limited by the nature of the retrospective review, it is evident that more research is needed to further assess its applicability, utility, and acceptability. © The Author(s) 2014.

  11. HEROs: Design of a Mixed-Methods Formative Research Phase for an Ecocultural Intervention to Promote Healthy Eating and Activity Behaviors in Rural Families With Preschoolers.

    Science.gov (United States)

    Bellows, Laura L; McCloskey, Morgan; Clark, Lauren; Thompson, Darcy A; Bekelman, Traci A; Chamberlin, Barbara; Johnson, Susan L

    2018-04-10

    To describe the mixed-methods formative research phase in the development of the Healthy Environments Study (HEROs), a technology-based, interactive family intervention to promote healthy eating and activity behaviors for young children in the home environment. A mixed-method iterative approach, using ecocultural theory as a framework, will guide the development of both quantitative and qualitative formative research assessments. Rural eastern Colorado. Low-income families (n = 200) with preschool-aged children enrolled at 6 Head Start/preschool centers. Quantitative and qualitative methodologies will garner insights into 4 key topic areas: (1) food behaviors and environments (Remote Food Photography Method, parent focus group, and survey), (2) physical activity behaviors and environments (parent interview and survey), (3) mobile device use (parent survey and interview), and (4) daily life (ecocultural family interview and teacher/staff group discussions). Results will be interpreted in combination to allow for a holistic understanding of participant behaviors, beliefs, attitudes and values related to each of the 4 topic areas. Collectively, outcomes will provide a comprehensive picture of preschoolers' daily life and inform intervention design and strategies to enhance preschoolers' eating and activity behaviors in the home environment. Copyright © 2018 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. 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.

  14. Physical Activity in an Underserved Population: Identifying Technology Preferences.

    Science.gov (United States)

    Medairos, Robert; Kang, Vicky; Aboubakare, Carissa; Kramer, Matthew; Dugan, Sheila Ann

    2017-01-01

    This study aims to identify patterns of use and preferences related to technology platforms that could support physical activity (PA) programs in an underserved population. A 29-item questionnaire was administered at 5 health and wellness sites targeting low income communities in Chicago. Frequency tables were generated for Internet, cell phone, and social media use and preferences. Chi-squared analysis was used to evaluate differences across age and income groups. A total of 291 individuals participated and were predominantly female (69.0%). Majority reported incomes less than $30,000 (72.9%) and identified as African American/Black/Caribbean (49.3%) or Mexican/Mexican American (34.3%). Most participants regularly used smartphones (63.2%) and the Internet (75.9%). Respondents frequently used Facebook (84.8%), and less commonly used Instagram (43.6%), and Twitter (20.0%). Free Internet-based exercise programs were the most preferred method to increase PA levels (31.6%), while some respondents (21.0%) thought none of the surveyed technology applications would help. Cell phone, Internet, and social media use is common among the surveyed underserved population. Technology preferences to increase PA levels varied, with a considerable number of respondents not preferring the surveyed technology platforms. Creating educational opportunities to increase awareness may maximize the effectiveness of technology-based PA interventions.

  15. Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2-8 Years in Rural and Urban Areas - United States, 2011-2012.

    Science.gov (United States)

    Robinson, Lara R; Holbrook, Joseph R; Bitsko, Rebecca H; Hartwig, Sophie A; Kaminski, Jennifer W; Ghandour, Reem M; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A

    2017-03-17

    Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. 2011-2012. The National Survey of Children's Health (NSCH) is a cross-sectional, random-digit-dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged health and well-being, health care access, and family and community characteristics. Using data from the 2011-2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2-8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2-8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas (18.6%) than in urban areas (15.2%). In urban and the majority of rural

  16. Differences in Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders Among Children Aged 2–8 Years in Rural and Urban Areas — United States, 2011–2012

    Science.gov (United States)

    Holbrook, Joseph R.; Bitsko, Rebecca H.; Hartwig, Sophie A.; Kaminski, Jennifer W.; Ghandour, Reem M.; Peacock, Georgina; Heggs, Akilah; Boyle, Coleen A.

    2017-01-01

    Problem/Condition Mental, behavioral, and developmental disorders (MBDDs) begin in early childhood and often affect lifelong health and well-being. Persons who live in rural areas report more health-related disparities than those in urban areas, including poorer health, more health risk behaviors, and less access to health resources. Reporting Period 2011–2012. Description of System The National Survey of Children’s Health (NSCH) is a cross-sectional, random-digit–dial telephone survey of parents or guardians that collects information on noninstitutionalized children aged health and well-being, health care access, and family and community characteristics. Using data from the 2011–2012 NSCH, this report examines variations in health care, family, and community factors among children aged 2–8 years with and without MBDDs in rural and urban settings. Restricting the data to U.S. children aged 2–8 years with valid responses for child age and sex, each MBDD, and zip code resulted in an analytic sample of 34,535 children; MBDD diagnosis was determined by parent report and was not validated with health care providers or medical records. Results A higher percentage of all children in small rural and large rural areas compared with all children in urban areas had parents who reported experiencing financial difficulties (i.e., difficulties meeting basic needs such as food and housing). Children in all rural areas more often lacked amenities and lived in a neighborhood in poor condition. However, a lower percentage of children in small rural and isolated areas had parents who reported living in an unsafe neighborhood, and children in isolated areas less often lived in a neighborhood lacking social support, less often lacked a medical home, and less often had a parent with fair or poor mental health. Across rural subtypes, approximately one in six young children had a parent-reported MBDD diagnosis. A higher prevalence was found among children in small rural areas

  17. The harmony of family and the silence of women: sexual attitudes and practices among rural married women in northern Viet Nam.

    Science.gov (United States)

    Ha, Vu Song

    2008-06-01

    Women in Viet Nam have long had to face various sexual and reproductive health problems, ranging from abortion to reproductive tract infections (RTIs) and sexual coercion. These issues have increasingly been addressed by scholars in the fields of public health and social sciences through sexual and reproductive health research and in other ways. Despite this, there remains a lack of in-depth information on attitudes and practices regarding sex and sexuality of Vietnamese women today. This paper in part responds to the knowledge gap by reporting on findings from qualitative research on sexual attitudes and practices among rural married women in a Northern rural community, measured against the broader social and cultural context. Twenty-five women in total were interviewed; and two focus group discussions were conducted. The findings show that women generally believe that men are (or should be) the initiators in sexual relations. Many women feel reluctant to refuse sex to their husbands or communicate openly about sex and sexuality. However, this paper also demonstrates that women are not totally passive in sexual relations. Women in this study used a range of strategies to negotiate their sexual life, and sometimes 'silence' is used as a form of agency in order to maintain harmony and happiness within the family.

  18. Sleep duration of underserved minority children in a cross-sectional study

    Science.gov (United States)

    Short sleep duration has been shown to associate with increased risk of obesity. Childhood obesity is more prevalent among underserved minority children. The study measured the sleep duration of underserved minority children living in a large US urban environment using accelerometry and its relation...

  19. 77 FR 43127 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2013

    Science.gov (United States)

    2012-07-23

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the States that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

  20. 78 FR 50119 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2014

    Science.gov (United States)

    2013-08-16

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... determination of the states that qualify as Medically Underserved Areas under the Federal Employees Health... law that mandates special consideration for enrollees of certain FEHB plans who receive covered health...

  1. 76 FR 31998 - Federal Employees Health Benefits Program: Medically Underserved Areas for 2012

    Science.gov (United States)

    2011-06-02

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program: Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2012. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

  2. 75 FR 32972 - Federal Employees Health Benefits Program; Medically Underserved Areas for 2011

    Science.gov (United States)

    2010-06-10

    ... OFFICE OF PERSONNEL MANAGEMENT Federal Employees Health Benefits Program; Medically Underserved... Underserved Areas under the Federal Employees Health Benefits (FEHB) Program for calendar year 2011. This is... certain FEHB plans who receive covered health services in States with critical shortages of primary care...

  3. Socio-culturele structuur en innovatie : een structuur-vergelijkend onderzoek naar adoptie van family planning in de periode 1969 - 1973 door Sundanese echtparen in twee rurale gemeenschappen op West-Java

    NARCIS (Netherlands)

    Norren, van B.

    1985-01-01

    This publication contains a comparative study of socio- cultural influences on the process of family planning adoption during the period 1969-1973 in two rural communities in the regency of Bandung, West Java, Indonesia. One community, to be called Cianyar, is a ward in an agrarian village, while

  4. 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.

  5. Family economic strengthening and mental health functioning of caregivers for AIDS-affected children in rural Uganda

    Science.gov (United States)

    Wang, Julia Shu-Huah; Ssewamala, Fred M.; Han, Chang-Keun

    2015-01-01

    In sub-Saharan Africa, many extended families assume the role of caregivers for children orphaned by AIDS (AIDS-affected children). The economic and psychological stress ensued from caregiving duties often predispose caregivers to poor mental health outcomes. Yet, very few studies exist on effective interventions to support these caregivers. Using data from a randomized controlled trial called Suubi-Maka (N = 346), this paper examines whether a family economic strengthening intervention among families caring for AIDS-affected children (ages 12–14) in Uganda would improve the primary caregivers’ mental health functioning. The Suubi-Maka study comprised of a control condition (n = 167) receiving usual care for AIDS-affected children, and a treatment condition (n = 179) receiving a family economic strengthening intervention, including matched savings accounts, and financial planning and management training to incentivize families to save money for education and/or family-level income generating projects. This paper uses data from baseline/pre-intervention (wave 1) interviews with caregivers and 12-month post-intervention initiation (wave 2). The caregiver’s mental health measure adapted from previous studies in sub- Saharan Africa had an internal consistency of .88 at wave 1 and .90 at wave 2. At baseline, the two study groups did not significantly differ on caregiver’s mental health functioning. However, at 12-month follow-up, multiple regression analysis located significant differences between the two study groups on mental health functioning. Specifically, following the intervention, caregivers in the treatment condition reported positive improvements on their mental health functioning, especially in the symptom areas of obsession–compulsion, interpersonal sensitivity, hostility, and psychoticism. Findings point to a need for programs and policies aimed at supporting caregivers of AIDS-affected children to begin to consider incorporating family

  6. Teaching the content in context: Preparing "highly qualified" and "high quality" teachers for instruction in underserved secondary science classrooms

    Science.gov (United States)

    Tolbert, Sara E.

    2011-12-01

    This dissertation research project presents the results of a longitudinal study that investigates the knowledge, beliefs, and practices of 13 preservice secondary science teachers participating in a science teacher credentialing/Masters program designed to integrate issues of equity and diversity throughout coursework and seminars. Results are presented in the form of three papers: The first paper describes changes in preservice teacher knowledge about contextualization in science instruction, where contextualization is defined as facilitating authentic connections between science learning and relevant personal, social, cultural, ecological, and political contexts of students in diverse secondary classrooms; the second paper relates changes in the self-efficacy and content-specific beliefs about science, science teaching, diversity, and diversity in science instruction; and the final paper communicates the experiences and abilities of four "social justice advocates" learning to contextualize science instruction in underserved secondary placement classrooms. Results indicate that secondary student teachers developed more sophisticated understandings of how to contextualize science instruction with a focus on promoting community engagement and social/environmental activism in underserved classrooms and how to integrate science content and diversity instruction through student-centered inquiry activities. Although most of the science teacher candidates developed more positive beliefs about teaching science in underrepresented classrooms, many teacher candidates still attributed their minority students' underperformance and a (perceived) lack of interest in school to family and cultural values. The "social justice advocates" in this study were able to successfully contextualize science instruction to varying degrees in underserved placement classrooms, though the most significant limitations on their practice were the contextual factors of their student teaching

  7. The Role of Parenting Practices in the Home Environment among Underserved Youth.

    Science.gov (United States)

    Conlon, Beth A; McGinn, Aileen P; Lounsbury, David W; Diamantis, Pamela M; Groisman-Perelstein, Adriana E; Wylie-Rosett, Judith; Isasi, Carmen R

    2015-08-01

    The home environment, which includes parenting practices, is an important setting in which children develop their health behaviors. We examined the role of parenting practices in the home environment among underserved youth. We examined baseline data of a family-focused pediatric obesity intervention. Parenting practices (monitoring, discipline, limit setting of soda/snacks [SS] and screen media [SM], pressure to eat, and reinforcement) and availability of fruits/vegetables (FV) and sugar-sweetened beverages (SSBs), family meals, television (TV) watching during meals, TVs in the home, owning active video games/sports equipment, and household food security were assessed in 301 parent/caregivers of overweight/obese children (ages 7-12 years; BMI≥85th percentile). Associations were evaluated using Spearman's rank correlation coefficients and logistic regression models adjusted for potential confounders. Parents/caregivers (ages 22-67 years) were largely Hispanic/Latino (74.1%), female (92.4%), and reported high levels of limit setting SS and low levels of pressure to eat. Parent age, gender, country of birth, and years living in the United States accounted for differences among several parenting practices. Adjusted logistic regression models identified several statistically significant associations, including: Monitoring was positively associated with availability FV (odds ratio [OR]=2.19; 95% confidence interval [CI], 1.25, 3.82); limit setting SS was inversely associated with availability of SSBs (OR=0.40; 95% CI, 0.21, 0.75); and limit setting SM was inversely associated with TV viewing during family meals (OR=0.51; 95% CI, 0.31, 0.85). Nearly 40% of our population was food insecure, and food insecurity was positively associated with pressure to eat (OR=1.77; 95% CI, 1.01, 3.15). Parenting practices play an important role in the home environment, and longitudinal studies are needed to examine these associations in the context of family-focused pediatric obesity

  8. Report on a Program Evaluation of a Telephone Assisted Parenting Support Service for Families Living in Isolated Rural Areas.

    Science.gov (United States)

    Cann, Warren; Rogers, Helen; Worley, Greg

    2003-01-01

    This brief report evaluates a pilot project to deliver a telephone supported, self-directed parenting program to isolated families. The aim of the project was to promote the competence and confidence of parents experiencing early difficulties. Significant improvements were noted in child behavior, parenting style, parental depression, anxiety, and…

  9. Recruiting Underserved Mothers to Medical Research: Findings from North Carolina

    Science.gov (United States)

    Spears, Chaya R.; Sandberg, Joanne C.; O’Neill, Jenna L.; Grzywacz, Joseph G.; Howard, Timothy D.; Feldman, Steven R.; Arcury, Thomas A.

    2014-01-01

    Representative samples are required for ethical, valid, and useful health research. Yet, recruiting participants, especially from historically underserved communities, can be challenging. This paper presents findings from in-depth interviews with 40 mothers about factors that might influence their willingness to participate or allow their children to participate in medical research. Saliency analysis organizes the findings. Frequent and important salient themes about research participation included concerns that it might cause participants harm, hope that participants might gain a health benefit, and recognition that time and transportation resources could limit participation. Ultimately, we propose that a theoretical model, such as the Theory of Planned Behavior (TPB), will facilitate more systematic evaluation of effective methods for recruitment and retention of participants in medical research. Future research should explore the utility of such a model for development of effective recruitment and retention strategies. PMID:24185171

  10. HealthATM: personal health cyberinfrastructure for underserved populations.

    Science.gov (United States)

    Botts, Nathan E; Horan, Thomas A; Thoms, Brian P

    2011-05-01

    There is an opportunity for personal health record (PHR) systems to play a vital role in fostering health self-management within underserved populations. If properly designed and promoted, it is possible that patients will use PHRs to become more empowered in taking an active role toward managing their health needs. This research examines the potential of a cyberinfrastructure-based PHR to encourage patient activation in health care, while also having population health implications. A multi-phased, iterative research approach was used to design and evaluate a PHR system called HealthATM, which utilizes services from a cloud computing environment. These services were integrated into an ATM-style interface aimed at providing a broad range of health consumers with the ability to manage health conditions and encourage accomplishment of health goals. Evaluation of the PHR included 115 patients who were clients of several free clinics in Los Angeles County. The majority of patients perceived ease of use (74%) and confidence (73%) in using the HealthATM system, and thought they would like to use it frequently (73%). Patients also indicated a belief in being responsible for their own health. However, fewer felt as though they were able to maintain necessary life changes to improve their health. Findings from the field tests suggest that PHRs can be a beneficial health management tool for underserved populations. In order for these types of tools to be effective within safety-net communities, they must be technically accessible and provide meaningful opportunities to increase patient engagement in their health care. Copyright © 2011. Published by Elsevier Inc.

  11. Enrolling Minority and Underserved Populations in Cancer Clinical Research.

    Science.gov (United States)

    Wallington, Sherrie F; Dash, Chiranjeev; Sheppard, Vanessa B; Goode, Tawara D; Oppong, Bridget A; Dodson, Everett E; Hamilton, Rhonda N; Adams-Campbell, Lucile L

    2016-01-01

    Research suggests that community involvement is integral to solving public health problems, including involvement in clinical trials-a gold standard. Significant racial/ethnic disparities exist in the accrual of participants for clinical trials. Location and cultural aspects of clinical trials influence recruitment and accrual to clinical trials. It is increasingly necessary to be aware of defining characteristics, such as location and culture of the populations from which research participants are enrolled. Little research has examined the effect of location and cultural competency in adapting clinical trial research for minority and underserved communities on accrual for clinical trials. Utilizing embedded community academic sites, the authors applied cultural competency frameworks to adapt clinical trial research in order to increase minority participation in nontherapeutic cancer clinical trials. This strategy resulted in successful accrual of participants to new clinical research trials, specifically targeting participation from minority and underserved communities in metropolitan Washington, DC. From 2012 to 2014, a total of 559 participants enrolled across six nontherapeutic clinical trials, representing a 62% increase in the enrollment of blacks in clinical research. Embedding cancer prevention programs and research in the community was shown to be yet another important strategy in the arsenal of approaches that can potentially enhance clinical research enrollment and capacity. The analyses showed that the capacity to acquire cultural knowledge about patients-their physical locales, cultural values, and environments in which they live-is essential to recruiting culturally and ethnically diverse population samples. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  12. A National Longitudinal Survey of Medical Students' Intentions to Practice Among the Underserved.

    Science.gov (United States)

    O'Connell, Thomas F; Ham, Sandra A; Hart, Theodore G; Curlin, Farr A; Yoon, John D

    2018-01-01

    To explore students' intentions to practice in medically underserved areas. In January 2011, 960 third-year medical students from 24 MD-granting U.S. medical schools were invited to participate in a survey on their intention to practice in a medically underserved area. A follow-up survey was sent to participants in September 2011. Covariates included student demographics, medical school characteristics, environmental exposures, work experiences, sense of calling, and religious characteristics. Adjusted response rates were 564/919 (61.4%, first survey) and 474/564 (84.0%, follow-up survey). Among fourth-year medical students, an estimated 34.3% had an intention to practice among the underserved. In multivariate logistic regression modeling, predictors for intentions to practice among the underserved included growing up in an underserved setting (odds ratio [OR] range: 2.96-4.81), very strong sense of calling (OR range: 1.86-3.89), and high medical school social mission score (in fourth year: OR = 2.34 [95% confidence interval (CI), 1.31-4.21]). International experience was associated with favorable change of mind in the fourth year (OR = 2.86 [95% CI, 1.13-7.24]). High intrinsic religiosity was associated with intentions to practice primary care in underserved settings (in fourth year: OR = 2.29 [95% CI = 1.13-4.64]). Growing up in medically underserved settings, work experience in religiously affiliated organizations, very strong sense of calling, and high medical school social mission score were associated with intentions to practice in underserved areas. Lack of formative educational experiences may dissuade students from considering underserved practice.

  13. Effects of Recruiting Midwives into a Family Physician Program on Women's Awareness and Preference for Mode of Delivery and Caesarean Section Rates in Rural Areas of Kurdistan.

    Science.gov (United States)

    Hajizadeh, Shayesteh; Tehrani, Fahimeh Ramezani; Simbar, Masoumeh; Farzadfar, Farshad

    2016-01-01

    The accepted rate rate of caesarean section is 15%. It is expected that an increase in the density of midwives in the family physician program lead to a decrease in this indicator. This study aimed to compare the rates of caesarean section and women's awareness and preference for mode of delivery before and after the implementation of the family physician program in health centres with and without an increase in midwives density. In this cross-sectional study, using multistage cluster sampling method a total of 668 mothers with two-month-old children were selected from among all mothers with two-month-old children who were living in rural areas of Kurdistan province. Using the difference-in-differences model and Matchit statistical model, the factors associated with caesarean section rates and women's awareness and preference for mode of delivery were compared in centres with and without an increase in midwives density after the implementation of the family physician program. To compare the changes before and after the program, we used the data collected from the same number of women in 2005 as the baseline. After adjusting for baseline data collected in 2005, the resutls showed no significant change in caesarean section rates and women's awareness and preference for mode of delivery in the centres with and without an increase in midwives density after the implementation of the family physician program. The Matchit model showed a significant mean increase 14%(0.03-0.25) in women's awareness of the benefits of natural childbirth between 2005 and 2013 in health centres where the density of midwives increased compared with health centres where it did not. The difference-in-differences model showed that the odds ratio of women's preference for caesarean section decreased by 41% among participants who were aware of the benefits of natural childbirth, (OR = 0.59, 95% CI: (0.22-0.85); P>0.001). The results of this study showed that an increase in the density of midwives

  14. Mobile Phones and Mental Well-Being: Initial Evidence Suggesting the Importance of Staying Connected to Family in Rural, Remote Communities in Uganda.

    Directory of Open Access Journals (Sweden)

    Amber L Pearson

    Full Text Available Due to the ubiquity of mobile phones around the globe, studies are beginning to analyze their influence on health. Prior work from developed countries highlights negative mental health outcomes related to overuse of mobile phones. However, there is little work on mental health impacts of mobile phone use or ownership in developing countries. This is an important gap to address because there are likely variations in mental health impacts of mobile phones between developing and developed countries, due to cultural nuances to phone use and distinct variations in financial models for obtaining mobile phone access in developing countries. To address this gap, this study analyzes survey data from 92 households in sparse, rural villages in Uganda to test two hypotheses about mobile phone ownership and mental health in a developing country context: (i Mobile phone ownership is higher among more privileged groups, compared to less privileged groups (ie, wealth and ethnicity; and (ii mobile phone ownership is positively associated with a culturally-relevant indicator of mental health, 'feelings of peace'. Results indicate that households with mobile phones had higher levels of wealth on average, yet no significant differences were detected by ethnicity. As hypothesized, mobile phone ownership was associated with increased mental well-being for persons without family nearby (in the District (p = 0.038 after adjusting for wealth, ethnicity and amount of land for crops and land for grazing. Mobile phone ownership was not significantly associated with increased mental well-being for persons with family nearby. These findings are consistent with studies of mobile phone use in other sub-Saharan African countries which find that phones are important tools for social connection and are thus beneficial for maintaining family ties. One might infer then that this increased feeling of mental well-being for persons located farther from family stems from the ability to

  15. Mobile Phones and Mental Well-Being: Initial Evidence Suggesting the Importance of Staying Connected to Family in Rural, Remote Communities in Uganda.

    Science.gov (United States)

    Pearson, Amber L; Mack, Elizabeth; Namanya, Judith

    2017-01-01

    Due to the ubiquity of mobile phones around the globe, studies are beginning to analyze their influence on health. Prior work from developed countries highlights negative mental health outcomes related to overuse of mobile phones. However, there is little work on mental health impacts of mobile phone use or ownership in developing countries. This is an important gap to address because there are likely variations in mental health impacts of mobile phones between developing and developed countries, due to cultural nuances to phone use and distinct variations in financial models for obtaining mobile phone access in developing countries. To address this gap, this study analyzes survey data from 92 households in sparse, rural villages in Uganda to test two hypotheses about mobile phone ownership and mental health in a developing country context: (i) Mobile phone ownership is higher among more privileged groups, compared to less privileged groups (ie, wealth and ethnicity); and (ii) mobile phone ownership is positively associated with a culturally-relevant indicator of mental health, 'feelings of peace'. Results indicate that households with mobile phones had higher levels of wealth on average, yet no significant differences were detected by ethnicity. As hypothesized, mobile phone ownership was associated with increased mental well-being for persons without family nearby (in the District) (p = 0.038) after adjusting for wealth, ethnicity and amount of land for crops and land for grazing. Mobile phone ownership was not significantly associated with increased mental well-being for persons with family nearby. These findings are consistent with studies of mobile phone use in other sub-Saharan African countries which find that phones are important tools for social connection and are thus beneficial for maintaining family ties. One might infer then that this increased feeling of mental well-being for persons located farther from family stems from the ability to maintain

  16. Pathways out of poverty in lagging regions: evidence from rural western China

    NARCIS (Netherlands)

    Christiaensen, L.; Pan, L.; Wang, S.G.

    2013-01-01

    How to reduce poverty in lagging regions remains much debated and underserved with solid empirical evidence. This study illustrates an empirical methodology to analyze the pathways households followed out of poverty and to explore their potential in the future using 20002004 rural household panel

  17. HPV Vaccine Acceptance in a Clinic-Based Sample of Women in the Rural South

    Science.gov (United States)

    Brandt, Heather M.; Sharpe, Patricia A.; McCree, Donna H.; Wright, Marcie S.; Davis, Jennifer; Hutto, Brent E.

    2009-01-01

    Background: Human papillomavirus (HPV) is a very common sexually transmitted infection linked to cervical disease. Vaccines for some types of HPV were in development at the time of the study. Purpose: The study examined HPV vaccine acceptability among underserved women in a rural region of the southeastern U.S. with high rates of cervical cancer…

  18. Underserved parents, underserved youth: Considering foster parent willingness to foster substance-using adolescents

    Science.gov (United States)

    Meyers, Kathleen; Kaynak, Övgü; Clements, Irene; Bresani, Elena; White, Tammy

    2014-01-01

    Adolescents involved with foster care are five times more likely to receive a drug dependence diagnosis when compared to adolescents in the general population. Prior research has shown that substance use is often hidden from providers, negating any chance for treatment and almost guaranteeing poor post-foster care outcomes. There are virtually no studies that examine the willingness (and its determinants) to foster youth with substance abuse problems. The current study conducted a nationally-distributed survey of 752 currently licensed foster care parents that assessed willingness to foster youth overall and by type of drug used, and possible correlates of this decision (e.g., home factors, system factors, and individual foster parent factors such as ratings of perceived difficulty in fostering this population). Overall, willingness to foster a youth involved with alcohol and other drugs (AOD) was contingent upon the types of drugs used. The odds that a parent would foster an AOD-involved youth were significantly increased by being licensed as a treatment foster home, having fostered an AOD-involved youth in the past, having AOD-specific training and past agency-support when needed, and self-efficacy with respect to positive impact. Surprisingly, when religion played a large part in the decision to foster any child, the odds of willingness to foster an AOD-involved youth dropped significantly. These results suggest that a large proportion of AOD-involved youth who find themselves in the foster care system will not have foster families willing to parent them, thereby forcing placement into a variety of congregate care facilities (e.g., residential treatment facilities, group homes). Specific ways in which the system can address these issues to improve placement and permanency efforts is provided. PMID:25878368

  19. Cardiovascular risk in minority and underserved women in Appalachian Tennessee: a descriptive study.

    Science.gov (United States)

    Pearson, Tamera Lea

    2010-04-01

    The purposes of this study were to translate current knowledge regarding cardiovascular risk factors, screening, and prevention to a disparate population of women and to ascertain the cardiovascular health status and risk factors in a sample of minority and underserved Appalachian women. Demographic data were collected from a voluntary sample of women from a disparate population living in Appalachian Tennessee. A coronary risk profile recorded family health history, personal health history, and lifestyle habits affecting risk for cardiovascular disease. Physiologic measurements included body mass index, blood pressure, fasting glucose, cholesterol levels, ankle brachial index, and carotid artery stenosis. Women in Appalachia Tennessee from a disparate population have high risks for heart disease and stroke. This is a critical time to address any modifiable risk factors and aggressively treat underlying cardiovascular diseases such as hypertension and hypercholesterolemia. Nurse practitioners (NPs) often provide primary care to women who may not be aware of their cardiovascular risks or actual disease. NPs can ensure that their practice incorporates primary and secondary cardiovascular prevention through screening, individual health education, and aggressive evidence-based treatment plans for women.

  20. Underserved Pregnant and Postpartum Women's Access and Use of Their Health Records.

    Science.gov (United States)

    Guo, Yuqing; Hildebrand, Janet; Rousseau, Julie; Brown, Brandon; Pimentel, Pamela; Olshansky, Ellen

    The purpose of this study was to examine knowledge of and experiences with use of their electronic health record (EHR) among mostly Hispanic women during pregnancy and postpartum. Women who were in the MOMS Orange County prenatal or postpartum home visitation program completed surveys and participated in focus groups. Descriptive and content analyses were used. Twenty-six women participated. Nearly all women (24, 92.3%) knew what health records were and most (80.8%) felt that keeping their records would increase or greatly increase their confidence in caring for themselves and their families. Approximately one third reported already keeping a copy of their health records. Common barriers to accessing and understanding health records included healthcare providers' noncompliance with the Health Information Technology for Economic and Clinical Health Act, limited EHR adoption, unfriendly patient portals, complicated medical terminology, rushed appointments with healthcare providers, lack of Spanish interpreters, and lack of Spanish-speaking healthcare providers. Programs are needed to educate and support women and providers in using health records to promote health literacy, pregnancy management, and patient-provider relationships in underserved populations.

  1. Impact of lysine-fortified wheat flour on morbidity and immunologic variables among members of rural families in northwest Syria.

    Science.gov (United States)

    Ghosh, Shibani; Pellett, Peter L; Aw-Hassan, Aden; Mouneime, Youssef; Smriga, Miro; Scrimshaw, Nevin S

    2008-09-01

    Previous studies have shown an effect of lysine fortification on nutrition and immunity of poor men, women, and children consuming a predominantly wheat-based diet. To examine the lysine value of diets and the effect of lysine fortification on functional protein status, anthropometry, and morbidity of men, women, and children in rural Syria. At baseline of a two-phase study using 7-day household food intake inventories (n = 98), nutrient availabilities per adult male equivalent were estimated. In the intervention phase, a 16-week double-blind trial, households (n = 106) were randomly assigned to control and lysine groups. Hematologic and anthropometric data were collected from men (n = 69; 31 control, 38 lysine), women (n = 99; 51 control, 48 lysine), and children (n = 69; 37 control, 32 lysine) at baseline, 12 weeks, and 16 weeks. Total CD3 T lymphocytes as well as T lymphocytes bearing the receptors CD4, CD8, and CD56, IgM, IgG, IgA, complement C3, C-reactive protein, serum albumin, prealbumin, transferrin, retinol-binding protein, hemoglobin, and hepatitis B surface antigen were determined. Health status and flour usage were monitored. Paired- and independent-sample t-tests and chi-square tests were performed. Mean nutrient availability per adult equivalent was 2,650 +/- 806 kcal, 70.1 +/- 26.4 g protein, 65 +/- 14% cereal protein, and 41.9 +/- 0.8 mg lysine per gram of protein. Complement C3 was significantly higher in men receiving lysine than in controls (p children, who have much higher morbidity and mortality rates from this disease than school-age children or adults.

  2. The structural influence of family and parenting on young people's sexual and reproductive health in rural northern Tanzania.

    Science.gov (United States)

    Wamoyi, Joyce; Wight, Daniel; Remes, Pieter

    2015-01-01

    This paper explores the structural role of the family and parenting in young people's sexual and reproductive health. The study involved eight weeks of participant observation, 26 in-depth interviews, and 11 group discussions with young people aged 14-24 years, and 20 in-depth interviews and 6 group discussions with parents/carers of children in this age group. At an individual level, parenting and family structure were found to affect young people's sexual behaviour by influencing children's self-confidence and interactional competence, limiting discussion of sexual health and shaping economic provision for children, which in turn affected parental authority and daughters' engagement in risky sexual behaviour. Sexual norms are reproduced both through parents' explicit prohibitions and their own behaviours. Girls are socialised to accept men's superiority, which shapes their negotiation of sexual relationships. Interventions to improve young people's sexual and reproductive health should recognise the structural effects of parenting, both in terms of direct influences on children and the dynamics by which structural barriers such as gendered power relations and cultural norms around sexuality are transmitted across generations.

  3. Homeless Children: Addressing the Challenge in Rural Schools. ERIC Digest.

    Science.gov (United States)

    Vissing, Yvonne M.

    Despite stereotypes to the contrary, homelessness is as prevalent in rural as urban areas. This digest examines the implications of homelessness for rural children and youth and discusses possible actions by rural educators. An estimated half of the rural homeless are families with children. Compared to urban counterparts, rural homeless families…

  4. Maternal HIV disclosure to HIV-uninfected children in rural South Africa: a pilot study of a family-based intervention.

    Science.gov (United States)

    Rochat, Tamsen J; Mkwanazi, Ntombizodumo; Bland, Ruth

    2013-02-18

    As access to treatment increases, large numbers of HIV-positive parents are raising HIV-negative children. Maternal HIV disclosure has been shown to have benefits for mothers and children, however, disclosure rates remain low with between 30-45% of mothers reporting HIV disclosure to their children in both observational and intervention studies. Disclosure of HIV status by parent to an HIV-uninfected child is a complex and challenging psychological and social process. No intervention studies have been designed and tested in Southern Africa to support HIV-positive parents to disclose their status, despite this region being one of the most heavily affected by the HIV epidemic. This paper describes the development of a family-centred, structured intervention to support mothers to disclose their HIV status to their HIV-negative school-aged children in rural South Africa, an area with high HIV prevalence. The intervention package includes printed materials, therapeutic tools and child-friendly activities and games to support age-appropriate maternal HIV disclosure, and has three main aims: (1) to benefit family relationships by increasing maternal HIV disclosure; (2) to increase children's knowledge about HIV and health; (3) to improve the quality of custody planning for children with HIV-positive mothers. We provide the theoretical framework for the intervention design and report the results of a small pilot study undertaken to test its acceptability in the local context. The intervention was piloted with 24 Zulu families, all mothers were HIV-positive and had an HIV-negative child aged 6-9 years. Lay counsellors delivered the six session intervention over a six to eight week period. Qualitative data were collected on the acceptability, feasibility and the effectiveness of the intervention in increasing disclosure, health promotion and custody planning. All mothers disclosed something to their children: 11/24 disclosed fully using the words "HIV" while 13/24 disclosed

  5. 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.

  6. Lack of Quality Primary Health Services: The Problems of the Underserved.

    Science.gov (United States)

    Hall, Daniel A.

    1978-01-01

    Major political and economic forces, which affect the provision of primary health services, particularly to underserved populations, are reviewed. Technological, professional, governmental, fiscal, and societal solutions are proposed. (GC)

  7. Breast Cancer Outreach for Underserved Women: A Randomized Trial and Cost-Effectiveness Analysis

    National Research Council Canada - National Science Library

    Pasick, Rena

    1999-01-01

    The current study, BACCIS-II, is a randomized controlled trial of an outreach intervention model designed to increase the rate of periodic mammography and clinical breast exam among underserved women...

  8. Designing for Underserved Populations: Constraints and Requirements of Personal Health Record Systems

    Centers for Disease Control (CDC) Podcasts

    In this podcast, Dr. Thomas Horan discusses how language, literacy, and access barriers can be overcome with electronic Personal Health Record (PHR) systems to improve health among the most vulnerable, isolated, and underserved populations.

  9. Children and Families in the Midwest: Employment, Family Services and the Rural Economy. Hearing before the Select Committee on Children, Youth, and Families. House of Representatives, Ninety-Ninth Congress, Second Session (Galesburg, IL, August 11, 1986).

    Science.gov (United States)

    Congress of the U.S., Washington, DC. House Select Committee on Children, Youth, and Families.

    The House select committee met to hear testimony from parents, children, service providers, and researchers concerning the effects of job and income loss on families in central Illinois. The testimony of the first panel consisted of personal narratives. A high school student whose parents may move the family in order to find better paying jobs…

  10. The Association Between Physical Activity, Mental Status, and Social and Family Support with Five Major Non-Communicable Chronic Diseases Among Elderly People: A Cross-Sectional Study of a Rural Population in Southern China.

    Science.gov (United States)

    Huang, Xiang; Yang, Huajie; Wang, Harry H X; Qiu, Yongjun; Lai, Xiujuan; Zhou, Zhiheng; Li, Fangjian; Zhang, Liwei; Wang, Jiaji; Lei, Jimin

    2015-10-21

    Non-communicable chronic diseases (NCDs) have become the top threat in China. This study aimed to estimate the prevalence of major NCDs among the elderly population in rural areas in southern China and explore its associated social determinants. A multistage cluster random sampling methodology was adopted to select a total of 9245 rural elderly people from 3860 rural households in Guangdong Province. Interviews and physical examinations were performed to collect patient information. Descriptive and logistic regression analyses were conducted to explore factors associated with the presence of major NCDs. Over one-third (38.5%) of the study population suffered from five major NCDs. The grade of activities of daily living (ADL), mental status, and social relationship of elderly people without NCDs were better than those with NCDs. The major factors associated with the presence of NCDs among the elderly people included age (70-79 years group and 80-89 years group), education level (senior high/technical secondary school and junior college and above), mental status (concentration, enrichment and happy life and memory), relationship with neighbours, activities of daily living (ADL) (being able to climb three floors and bend over), physical activity, marital status (bereft), and living conditions (with offspring and family members). The study identified several social determinants associated with the presence of major NCDs. A higher level of family support and physical exercise might contribute to improved physical condition, mental status, and ADL among the elderly people in rural areas in southern China.

  11. Habitus of social security in the lifestyles of rural families: the case of the São Miguel do Anta and Piranga municipalities in Zona da Mata Mineira, Brazil

    Directory of Open Access Journals (Sweden)

    Vanessa Aparecida Moreira de Barros

    Full Text Available ABSTRACT: The universalization of the right to social security for rural producers and rural workers is a recent victory for Brazilian society. The implementation of this benefit began in the early 1990s. This article aimed to analyze the effects of rural social security on the lifestyle of families with retirees. The research was conducted in two small municipalities with agricultural economies from Zona da Mata Mineira region. The research used cross-sectional data collection procedures by applying a survey with open and closed-ended questions about consumption and living. The research sample was representative of the study population, comprising 117 rural elderly people, 64 from Piranga City and 53 from São Miguel do Anta City. Data obtained were categorized, analyzed and tested using Statistical Package for Social Sciences (SPSS software. The survey results highlighted routine behavior and a predisposition to act based on a long term planning system, supported by the certainty of receiving the pension. Planned and long-term investments became a reality, including home improvement projects and acquisition of durable goods. Concerns about immediate family maintenance gave way to a perspective based on future planning.

  12. 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.

  13. Rural Health, Center of Excellence for Remote and Medically Under-served Area (CERMUSA)

    Science.gov (United States)

    2007-05-01

    Curriculum: Foundations, principles, and issues. Needham Heights, MA: Allyn and Bacon. Taylor, R. (2002). Pros and cons of online learning: A...Online 11/9 • 7. Preparation For Final Assignment • 7.1. Conducting a SWOT Analysis - Online 11/16 8. Ne class -Thanksgiving 11/23 9. O~en

  14. Can a Gender Equity and Family Planning Intervention for Men Change Their Gender Ideology? Results from the CHARM Intervention in Rural India.

    Science.gov (United States)

    Fleming, Paul J; Silverman, Jay; Ghule, Mohan; Ritter, Julie; Battala, Madhusudana; Velhal, Gajanan; Nair, Saritha; Dasgupta, Anindita; Donta, Balaiah; Saggurti, Niranjan; Raj, Anita

    2018-03-01

    We assess the effect of CHARM, a gender equity and family planning counseling intervention for husbands in rural India, on men's gender ideology. We used a two-armed cluster randomized control trial design and collected survey data from husbands (n=1081) at baseline, 9 months, and 18 months. We used a continuous measure of support for gender equity and a dichotomous measure of equitable attitudes toward women's role in household decision-making. To assess differences on these outcomes, we used generalized linear mixed models. After controlling for socio-demographic factors, men who received the CHARM intervention were significantly more likely than men in the control group to have equitable attitudes toward household decision-making at 9-months follow-up; there was a non-significant difference between the groups for the measure of support for gender equity. For household decision-making, differences were not sustained at 18-months follow-up. Given the role of husbands' gender ideology in women's contraceptive use, the CHARM intervention represents a promising approach for challenging root causes of women's unmet need for contraception. © 2018 The Population Council, Inc.

  15. 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.

  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. 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.

  18. Enhancing Maternal and Perinatal Health in Under-Served Remote Areas in Sub-Saharan Africa: A Tanzanian Model.

    Directory of Open Access Journals (Sweden)

    Angelo S Nyamtema

    Full Text Available In Tanzania, maternal mortality ratio (MMR, unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC services in underserved rural areas using associate clinicians.Ten health centres (HCs were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems. Twenty-three assistant medical officers (advanced level associate clinicians, and forty-four nurse-midwives and clinical officers (associate clinicians were trained in CEmONC and anaesthesia respectively. CEmONC services were launched between 2009 and 2012. Monthly supportive supervision and clinical audits of adverse pregnancy outcomes were introduced in 2011 in these HCs and their respective district hospitals.After launching CEmONC services from 2009 to 2014 institutional deliveries increased in all upgraded rural HCs. Mean numbers of monthly deliveries increased by 151% and obstetric referrals decreased from 9% to 3% (p = 0.03 in HCs. A total of 43,846 deliveries and 2,890 caesarean sections (CS were performed in these HCs making the mean proportion of all births in EmONC facilities of 128% and mean population-based CS rate of 9%. There were 190 maternal deaths and 1,198 intrapartum and very early neonatal deaths (IVEND in all health facilities. Generally, health centres had statistically significantly lower maternal mortality ratios and IVEND rates than district hospitals (p < 0.00 and < 0.02 respectively. Of all deaths (maternal and IVEND 84% to 96% were considered avoidable.These findings strongly indicate that remotely located health centres in resource limited settings hold a great potential to increase accessibility to CEmONC services and to improve

  19. Enhancing Maternal and Perinatal Health in Under-Served Remote Areas in Sub-Saharan Africa: A Tanzanian Model.

    Science.gov (United States)

    Nyamtema, Angelo S; Mwakatundu, Nguke; Dominico, Sunday; Mohamed, Hamed; Pemba, Senga; Rumanyika, Richard; Kairuki, Clementina; Kassiga, Irene; Shayo, Allan; Issa, Omary; Nzabuhakwa, Calist; Lyimo, Chagi; van Roosmalen, Jos

    2016-01-01

    In Tanzania, maternal mortality ratio (MMR), unmet need for emergency obstetric care and health inequities across the country are in a critical state, particularly in rural areas. This study was established to determine the feasibility and impact of decentralizing comprehensive emergency obstetric and neonatal care (CEmONC) services in underserved rural areas using associate clinicians. Ten health centres (HCs) were upgraded by constructing and equipping maternity blocks, operating rooms, laboratories, staff houses and installing solar panels, standby generators and water supply systems. Twenty-three assistant medical officers (advanced level associate clinicians), and forty-four nurse-midwives and clinical officers (associate clinicians) were trained in CEmONC and anaesthesia respectively. CEmONC services were launched between 2009 and 2012. Monthly supportive supervision and clinical audits of adverse pregnancy outcomes were introduced in 2011 in these HCs and their respective district hospitals. After launching CEmONC services from 2009 to 2014 institutional deliveries increased in all upgraded rural HCs. Mean numbers of monthly deliveries increased by 151% and obstetric referrals decreased from 9% to 3% (p = 0.03) in HCs. A total of 43,846 deliveries and 2,890 caesarean sections (CS) were performed in these HCs making the mean proportion of all births in EmONC facilities of 128% and mean population-based CS rate of 9%. There were 190 maternal deaths and 1,198 intrapartum and very early neonatal deaths (IVEND) in all health facilities. Generally, health centres had statistically significantly lower maternal mortality ratios and IVEND rates than district hospitals (p < 0.00 and < 0.02 respectively). Of all deaths (maternal and IVEND) 84% to 96% were considered avoidable. These findings strongly indicate that remotely located health centres in resource limited settings hold a great potential to increase accessibility to CEmONC services and to improve maternal and

  20. Work of female rural doctors.

    Science.gov (United States)

    Wainer, Jo

    2004-04-01

    To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are

  1. Cluster Randomized Controlled Trial Evaluation of a Gender Equity and Family Planning Intervention for Married Men and Couples in Rural India.

    Directory of Open Access Journals (Sweden)

    Anita Raj

    Full Text Available Despite ongoing recommendations to increase male engagement and gender-equity (GE counseling in family planning (FP services, few such programs have been implemented and rigorously evaluated. This study evaluates the impact of CHARM, a three-session GE+FP counseling intervention delivered by male health care providers to married men, alone (sessions 1&2 and with their wives (session 3 in India.A two-armed cluster randomized controlled trial was conducted with young married couples (N = 1081 couples recruited from 50 geographic clusters (25 clusters randomized to CHARM and a control condition, respectively in rural Maharashtra, India. Couples were surveyed on demographics, contraceptive behaviors, and intimate partner violence (IPV attitudes and behaviors at baseline and 9 &18-month follow-ups, with pregnancy testing at baseline and 18-month follow-up. Outcome effects on contraceptive use and incident pregnancy, and secondarily, on contraceptive communication and men's IPV attitudes and behaviors, were assessed using logistic generalized linear mixed models. Most men recruited from CHARM communities (91.3% received at least one CHARM intervention session; 52.5% received the couple's session with their wife. Findings document that women from the CHARM condition, relative to controls, were more likely to report contraceptive communication at 9-month follow-up (AOR = 1.77, p = 0.04 and modern contraceptive use at 9 and 18-month follow-ups (AORs = 1.57-1.58, p = 0.05, and they were less likely to report sexual IPV at 18-month follow-up (AOR = 0.48, p = 0.01. Men in the CHARM condition were less likely than those in the control clusters to report attitudes accepting of sexual IPV at 9-month (AOR = 0.64, p = 0.03 and 18-month (AOR = 0.51, p = 0.004 follow-up, and attitudes accepting of physical IPV at 18-month follow-up (AOR = 0.64, p = 0.02. No significant effect on pregnancy was seen.Findings demonstrate that men can be engaged in FP programming in

  2. Epidemiological study of metabolic syndrome and risk of diabetes mellitus in a rural family medicine practice in Bacau County.

    Science.gov (United States)

    Diaa, Alamir; Popa, Elena; Bacusca, Agnes; Traian, Maria Gabriela; Petrovanu, Rodica; Coman, Adorata Elena

    2014-01-01

    This descriptive epidemiological study included 615 subjects investigated by their family doctor in the interval October 2011- August 2012. Patients were selected according to 2012 IDF diagnostic criteria resulting 304 patients. There was a Gaussian distribution of waist circumference (WC) with a maximum in age-group 70-80 years (46.3%), followed by age- groups 50-60 years (37.8%) and 60-70 years (41.6%). Waist circumference measurement showed an average of 100.76 +/- 11.59 cm, ranges 72 cm - 134 cm, without statistical significance. Mean body mass index (BMI) was 28.25 +/- 4.72 kg/m2 vs. 27.79 +/- 4.48 kg/m2. The difference is statistically significant (p = 0.05). Considering categorical the patients with hypertension (AHT) according to the definition, we found that only 7 cases did not have AHT (4.4%) as compared to a prevalence of AHT of 13.7% in the MS (metabolic syndrome) group. Mean serum triglyceride level was 123.11 +/- 68.55 mg/dl versus 113.75 +/- 65.62 mg/dl in the MS group, significantly higher (p < 0.003). Mean HDL cholesterol was 57.58 +/- 17.11 mg/dl versus 58.54 +/- 15.02 mg/dl, statistically significant difference (p < 0.05). The prevalence of glucoregulation disorders is higher in the MS group. Proportional relationships were found between BMI, WC, and SBP and high blood glucose. Comparison of blood glucose levels at baseline and at 1 year follow up showed significant differences.

  3. Health problems and the health care provider choices: A comparative study of urban and rural households in Egypt

    Directory of Open Access Journals (Sweden)

    Salma B. Galal

    2014-06-01

    Conclusion: Urban families have less health complaints than rural; however, rural families recover sooner. Families bypass often public primary health care services. Urban families overuse outpatient clinics in public hospitals.

  4. 76 FR 63846 - Substantially Underserved Trust Areas (SUTA)

    Science.gov (United States)

    2011-10-14

    ... Cost Rural Communities; 10.861, Public Television Station Digital Transition Grant Program; 10.862... rule do not impose substantial unreimbursed direct compliance costs on Indian tribal, Alaska native, or native Hawaiian governments and sovereign institutions or have tribal implications that preempt tribal...

  5. Smartphone threshold audiometry in underserved primary health-care contexts.

    Science.gov (United States)

    Sandström, Josefin; Swanepoel, De Wet; Carel Myburgh, Hermanus; Laurent, Claude

    2016-01-01

    To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. A total of 94 subjects (mean age 41 years ± 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within ≤10 dB in 80.6% of cases with an average threshold difference of -1.6 dB ± 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (≤15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within ≤10 dB in 92.9% of cases with an average threshold difference of -1.0 dB ± 7.1 SD. Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

  6. Using Quality of Family Life Factors to Explore Parents' Experience of Educational Provision for Children with Developmental Disabilities in Rural Australia

    Science.gov (United States)

    Tait, Kathleen; Hussain, Rafat

    2017-01-01

    Australian education service provision includes the delivery of quality educational programmes to rural and remote living children. However, according to their parents, many children with developmental disabilities (such as Down Syndrome and Autism Spectrum Disorders) who are living in rural country areas in New South Wales (NSW) still do not have…

  7. Saúde de famílias do Movimento dos Trabalhadores Sem Terra e de bóias-frias, Brasil, 2005 Salud de familias del Movimiento de Trabajadores Sin Tierra y de trabajadores rurales "jornaleros", Brasil, 2005 Health of families from the Landless Workers' Movement and temporary rural workers, Brazil, 2005

    Directory of Open Access Journals (Sweden)

    Fernando Ferreira Carneiro

    2008-08-01

    del Movimiento de los Trabajadores Rurales Sin Tierra, el hecho de ser del Movimiento y estar organizado mejora sus perspectivas de salud, en comparación a los "jornaleros". Los resultados de la modernización conservadora en el campo brasileño ha empeorado las condiciones de vida de los trabajadores rurales "jornaleros" generando una superexplotación del trabajo humano, mientras que la Reforma Agraria ha hecho posible una mejor calidad de vida y salud para las familias, cuando comparadas en las áreas estudiadas.OBJECTIVE: To assess the health conditions of families from the Landless Rural Workers' Movement and temporary rural workers. METHODS: The research involved a comparative study of three populations: a settlement and a camp linked to the Rural Workers' Movement, and the families of temporary rural workers in a city of Southeast Brazil, in 2005. Information relating to sociodemographic characteristics and families were collected by means of questionnaires that were put to 202 families. In addition, structured observation and group discussions were used. A discriminative factor analysis was carried out to confirm differences between the communities. RESULTS: The three communities scored an average of 89%, which implies that they are distinct groups and supports the hypothesis that there are real differences between them when it come to health and lifestyle conditions. There was a high rate of food insecurity (39.5% among temporary rural workers, almost double that of families who were camping and four times greater than those living on settlements. Temporary rural workers' salaries were low and fluctuate, meaning that they were more exposed to pesticides than the families living on settlements or in camps. A striking characteristic of families living on the settlement was that they all practiced animal rearing, unlike the families of temporary rural workers, practically none of whom were able to do so in the city. The perceptions of most families who were

  8. Verbal Autopsies in Rural Tanzania

    African Journals Online (AJOL)

    Maternal mortality rates in rural Tanzania are high. In preparation for the introduction of an intervention to reduce maternal deaths by distribution of misoprostol and erythromycin to women living in rural Rorya District, Mara Region, Tanzania, we conducted a limited verbal autopsy by surveying family members of women ...

  9. Perceptions of health promoters about health promotion programmes for families with adolescents orphaned as a result of AIDS in the rural Hammanskraal region in South Africa

    Directory of Open Access Journals (Sweden)

    Maseapo P. Mthobeni

    2013-02-01

    Full Text Available South African communities are still greatly affected by the high rate of infection with HIV or who are living with AIDS, mirrored in the 2008 overall national HIV prevalence of 29.3%(UNAIDS 2010:10. In addressing the challenge, the health system is dependent on community care level workers such as caregivers to render health promotion and education in the homes and communities. The caregivers based in the communities are the ones with first-hand information on what is needed for the success of health promotion programmes. This study, aimed at exploring the challenges faced by the health promoters, described their perceptions regarding a health promotion programme for families with adolescents orphaned as a result of AIDS. Data were collected on the purposively selected participants at the rural Hammanskraal region in South Africa and the research question: ‘What is your perception regarding health promotion programmes for families with adolescents orphaned as a result of AIDS’ was asked and discussed by participants in a focus group interview. Data were analysed using the adapted Tesch method to organize and isolate the main categories, sub-categories and themes. The following main categories were isolated: attitudes of adolescents, effectiveness of home visits, need for health education and limited resources. Based on the findings, it was therefore recommended that health care planners assist in the improvement of health promotion and education by using the community and national media, providing information material and providing access to the internet in order to allow more people, including young people, to access the information.Suid-Afrikaanse gemeenskappe word steeds grootliks beïnvloed deur die hoë vlak van MIV en vigs, soos weerspieël in die algehele nasionale MIV-syfer in 2008 van 29.3% (UNAIDS 2010:10. In die aanspreek van hierdie uitdaging is die gesondheidstelsel afhanklik van gemeenskapsorgwerkers om gesondheidsbevordering

  10. Perceptions of health promoters about health promotion programmes for families with adolescents orphaned as a result of AIDS in the rural Hammanskraal region in South Africa

    Directory of Open Access Journals (Sweden)

    Maseapo P. Mthobeni

    2013-02-01

    Full Text Available South African communities are still greatly affected by the high rate of infection with HIV or who are living with AIDS, mirrored in the 2008 overall national HIV prevalence of 29.3%(UNAIDS 2010:10. In addressing the challenge, the health system is dependent on community care level workers such as caregivers to render health promotion and education in the homes and communities. The caregivers based in the communities are the ones with first-hand information on what is needed for the success of health promotion programmes. This study, aimed at exploring the challenges faced by the health promoters, described their perceptions regarding a health promotion programme for families with adolescents orphaned as a result of AIDS. Data were collected on the purposively selected participants at the rural Hammanskraal region in South Africa and the research question: ‘What is your perception regarding health promotion programmes for families with adolescents orphaned as a result of AIDS’ was asked and discussed by participants in a focus group interview. Data were analysed using the adapted Tesch method to organize and isolate the main categories, sub-categories and themes. The following main categories were isolated: attitudes of adolescents, effectiveness of home visits, need for health education and limited resources. Based on the findings, it was therefore recommended that health care planners assist in the improvement of health promotion and education by using the community and national media, providing information material and providing access to the internet in order to allow more people, including young people, to access the information. Suid-Afrikaanse gemeenskappe word steeds grootliks beïnvloed deur die hoë vlak van MIV en vigs, soos weerspieël in die algehele nasionale MIV-syfer in 2008 van 29.3% (UNAIDS 2010:10. In die aanspreek van hierdie uitdaging is die gesondheidstelsel afhanklik van gemeenskapsorgwerkers om gesondheidsbevordering

  11. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-06-01

    Full Text Available Abstract In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments; promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers; selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals; placement (programmes should match participants to areas in order to maximize participant satisfaction and

  12. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions.

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E

    2009-06-26

    In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes

  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. "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.

  15. Individual Breast Cancer risk assessment in Underserved Populations: Integrating empirical Bioethics and Health Disparities Research

    Science.gov (United States)

    Anderson, Emily E.; Hoskins, Kent

    2013-01-01

    Research suggests that individual breast cancer risk assessment may improve adherence to recommended screening and prevention guidelines, thereby decreasing morbidity and mortality. Further research on the use of risk assessment models in underserved minority populations is critical to informing national public health efforts to eliminate breast cancer disparities. However, implementing individual breast cancer risk assessment in underserved patient populations raises particular ethical issues that require further examination. After reviewing these issues, we will discuss how empirical bioethics research can be integrated with health disparities research to inform the translation of research findings. Our in-progress National Cancer Institute (NCI) funded study, How Do Underserved Minority Women Think About Breast Cancer?, conducted in the context of a larger study on individual breast cancer risk assessment, is presented as a model. PMID:23124498

  16. 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.

  17. Mobile and portable dental services catering to the basic oral health needs of the underserved population in developing countries: a proposed model.

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, Br; Goel, P; Hongal, Sg; Jain, M

    2014-05-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  18. Mobile and Portable Dental Services Catering to the Basic Oral Health Needs of the Underserved Population in Developing Countries: A Proposed Model

    Science.gov (United States)

    Ganavadiya, R; Chandrashekar, BR; Goel, P; Hongal, SG; Jain, M

    2014-01-01

    India is the second most populous country in the world with an extensive rural population (68.8%). Children less than 18 years constitute about 40% of the population. Approximately, 23.5% of the urban population resides in urban slums. The extensive rural population, school children and the urban slum dwellers are denied of even the basic dental services though there is continuous advancement in the field of dentistry. The dentist to population ratio has dramatically improved in the last one to two decades with no significant improvement in the oral health status of the general population. The various studies have revealed an increasing trend in oral diseases in the recent times especially among this underserved population. Alternate strategies have to be thought about rather than the traditional oral health-care delivery through private dentists on fee for service basis. Mobile and portable dental services are a viable option to take the sophisticated oral health services to the doorsteps of the underserved population. The databases were searched for publications from 1900 to the present (2013) using terms such as Mobile dental services, Portable dental services and Mobile and portable dental services with key articles obtained primarily from MEDLINE. This paper reviews the published and unpublished literature from different sources on the various mobile dental service programs successfully implemented in some developed and developing countries. Though the mobile and portable systems have some practical difficulties like financial considerations, they still seem to be the only way to reach every section of the community in the absence of national oral health policy and organized school dental health programs in India. The material for the present review was obtained mainly by searching the biomedical databases for primary research material using the search engine with key words such as mobile and/or portable dental services in developed and developing countries

  19. The Feasibility of Creating Partnerships Between Palliative Care Volunteers and Healthcare Providers to Support Rural Frail Older Adults and Their Families: An Integrative Review.

    Science.gov (United States)

    Connell, Braydon; Warner, Grace; Weeks, Lori E

    2017-09-01

    Background/Question: Volunteers are important in the support of frail older adults requiring palliative care, especially in rural areas. However, there are challenges associated with volunteer supports related to training, management and capacity to work in partnership with healthcare providers (HCP). This review addresses the question: What is the feasibility of a volunteer-HCP partnership to support frail older adults residing in rural areas, as they require palliative care? This integrative review identified ten articles that met the identified search criteria. Articles were appraised using the Critical Appraisal Skills Programme (CASP) checklists, designed for use across a range of quantitative and qualitative studies. Studies were drawn from international sources to understand how volunteer roles vary by culture and organization; the majority of studies were conducted in North America. Studies varied in methodology, including quantitative, qualitative and educational commentary. Identified factors that were crucial to the feasibility of volunteer-HCP partnerships in rural areas included volunteer training dynamics, relationships between volunteers and HCP, and rural environmental factors. Preliminary evidence indicates that a volunteer-HCP palliative partnership is feasible. However, training policies/procedures, volunteer-HCP relationships, and rural specific designs impact the feasibility of this partnership. Additional research is needed to further establish the feasibility of implementing these partnerships in rural settings.

  20. 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.

  1. "Dark Skies, Bright Kids" - First Year Of Outreach In Rural Virginia

    Science.gov (United States)

    Ries, Paul; Johnson, K.; Zasowski, G.; Beaton, R.; Carlberg, J.; Czekala, I.; de Messieres, G.; Drosback, M.; Gugliucci, N.; Jackson, L.; Lynch, R.; Romero, C.; Sivakoff, G.; Whelan, D.; Wong, A.

    2010-10-01

    Dark Skies, Bright Kids (DSBK) is an educational/public outreach program at the University of Virginia directed primarily towards rural elementary school students in grades 3-5. The program, which is run by a diverse community of volunteers (faculty, postdocs, grad students, and undergrads), targets schools in the rural areas surrounding UVa in southern Albemarle County. While these schools are privileged with remarkably dark skies, these same schools are also home to an economically under-privileged and educationally under-served population. DSBK seeks to use those dark skies, among other resources, to create excitement and interest in science and engineering as part of a weekly after-school program. A typical afternoon consists of 1.5-2.5 hours of science activities specifically centered around space and astronomy. Each week has a theme (e.g., rockets, invisible light) and we incorporate a mix of activities on that theme, such as hands-on experiments, stories, games, and creative play. We also encourage family involvement, so that the parents are actively involved in their children's education. Every other week, we hold a family observing night, so both the students and their parents can learn about the night sky together. The program lasts for one semester at each school, and we have just completed our second semester of work. Each new semester brings on new challenges, but also new lessons to make our program better in future semesters. Our group actively writes and then rewrites our own lesson plans as we learn what works best with the students. We are now in the process of putting our lesson plans online so other groups can take advantage of what we have learned and apply this program at other schools. On the web: http://www.astro.virginia.edu/dsbk/

  2. Gender and Rural Employment: A View from Latin America

    Science.gov (United States)

    Ballara, Marcela

    2007-01-01

    The paper focuses on women employment in rural areas and its impacts in food security. The presentation includes data on rural women employment and its different labour strategies: temporary work, non agriculture rural employment and permanent rural employment. Poverty alleviation and its impact on families as well as implications in the economic…

  3. Rural Airports

    Data.gov (United States)

    Department of Transportation — The Rural Airports database is the list of rural airports compiled annually by BTS for the Treasury Department/IRS. It is used by airlines to assist in establishing...

  4. Eroding students' rural motivation: first do no harm?

    Science.gov (United States)

    Hurst, Samia

    2014-01-01

    Migration of health professionals is one of the drivers of vast inequalities in access to healthcare, as medical graduates tend to move away from both poorer countries and rural areas. One of the central ethical problems raised in attempting to alleviate these inequalities is the tension between the healthcare needs of under-served patients and the rights of medical graduates to choose their place of work and specialty. If medical graduates had greater motivation to work in under-served rural areas, this tension would decrease accordingly. Medical schools have a duty to avoid eroding existing motivation for such training and practice. This duty has practical implications. Medical students' motivation regarding their choice of specialty changes during medical training, turning them away from choices such as primary care and rural practice towards more highly specialised, more hospital based specialties. Although students may be victims of a number of biases in the initial assessment, this is unlikely to be the whole story. Students' priorities are likely to change based on their admiration for specialist role models and the visibility of the financial and non-financial rewards attached to these specialties. Students may also have a false expectation upon admission that they will be proficient in rural medicine on graduation, and change their mind once they realise the limits of their skills in that area. Although the measures required to reverse this effect currently lack a solid evidence base, they are plausible and supported by the available data.

  5. American Dental Association White Paper Targets Dental Care for the Underserved

    Science.gov (United States)

    Berthold, Mark

    2005-01-01

    Reaffirming its leadership role toward better oral health for all Americans, the ADA has produced a white paper that also challenges policy-makers and the US to improve access to dental services. The white paper, "State and Community Models for Improving Access to Dental Care for the Underserved," was presented October 1 to the House of…

  6. 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…

  7. How to Guide: Aggregate under-served markets into buying pools

    Energy Technology Data Exchange (ETDEWEB)

    None

    2000-12-26

    This activity promotes new opportunities to increase energy security and lower energy costs for under-served markets. It involves market analysis and collaboration with community partners, as well as outreach activities to inform target markets and technical assistance for participants.

  8. Increasing access to health workers in underserved areas: a conceptual framework for measuring results

    NARCIS (Netherlands)

    Huicho, L.; Dieleman, M.; Campbell, J.; Codjia, L.; Balabanova, D.; Dussault, G.; Dolea, C.

    2010-01-01

    Many countries have developed strategies to attract and retain qualified health workers in underserved areas, but there is only scarce and weak evidence on their successes or failures. It is difficult to compare lessons and measure results from the few evaluations that are available. Evaluation

  9. Increasing access to health workers in underserved areas : a conceptual framework for measuring results

    NARCIS (Netherlands)

    Huicho, Luis; Dieleman, Marjolein; Campbell, James; Codjia, Laurence; Balabanova, Dina; Dussault, Gilles; Dolea, Carmen

    Many countries have developed strategies to attract and retain qualified health workers in underserved areas, but there is only scarce and weak evidence on their successes or failures. It is difficult to compare lessons and measure results from the few evaluations that are available. Evaluation

  10. Promising Practices: A Literature Review of Technology Use by Underserved Students

    Science.gov (United States)

    Zielezinski, Molly B.; Darling-Hammond, Linda

    2016-01-01

    How can technologies and digital learning experiences be used to support underserved, under-resourced, and underprepared students? For many years, educators, researchers, and policy makers looking for strategies to close the achievement gap and improve student learning have sought solutions involving new uses of technology, especially for students…

  11. A Smart Partnership: Integrating Educational Technology for Underserved Children in India

    Science.gov (United States)

    Charania, Amina; Davis, Niki

    2016-01-01

    This paper explores the evolution of a large multi-stakeholder partnership that has grown since 2011 to scale deep engagement with learning through technology and decrease the digital divide for thousands of underserved school children in India. Using as its basis a case study of an initiative called integrated approach to technology in education…

  12. Breaking Barriers to Bike Share: Insights from Residents of Traditionally Underserved Neighborhoods

    Science.gov (United States)

    2017-06-01

    Evidence has shown that higher income and white populations are overrepresented in both access to and use of bike share. Efforts to overcome underserved communities barriers to access and use of bike share have been initiated in a number of cities...

  13. Using Social Cognitive Theory to Predict Physical Activity and Fitness in Underserved Middle School Children

    Science.gov (United States)

    Martin, Jeffrey J.; McCaughtry, Nate; Flory, Sara; Murphy, Anne; Wisdom, Kimberlydawn

    2011-01-01

    Few researchers have used social cognitive theory and environment-based constructs to predict physical activity (PA) and fitness in underserved middle-school children. Hence, we evaluated social cognitive variables and perceptions of the school environment to predict PA and fitness in middle school children (N = 506, ages 10-14 years). Using…

  14. Compensation and Production in Family Medicine by Practice Ownership

    Directory of Open Access Journals (Sweden)

    Alison C. Essary

    2016-02-01

    Full Text Available The increasing focus on high performance, patient-centered, team-based care calls for a strategy to evaluate cost-effective primary care. The trend toward physician practice consolidation further challenges the primary care health care system. Productivity measures establish provider value and help inform decision making regarding resource allocation in this evolving health care system. In this national survey of family medicine practices, physician assistant (PA productivity, as defined by mean annual patient encounters, exceeds that of both nurse practitioners (NPs and physicians in physician-owned practices and of NPs in hospital or integrated delivery system-owned practices. Total compensation, defined as salary, bonus, incentives, and honoraria for physicians, is significantly more compared to both PAs and NPs, regardless of practice ownership or productivity. Physician assistants and NPs earn equivalent compensation, regardless of practice ownership or productivity. Not only do these data support the value and role of PAs and NPs on the primary care team but also highlight differences in patient encounters between practice settings. Rural and underserved community practices, where physician-owned practices persist, also merit further consideration. Further research is needed to inform both organizational and policy decisions for the provision of high-quality, cost-effective, and accessible primary health care.

  15. Rural women's health

    National Research Council Canada - National Science Library

    Thurston, Wilfreda E; Leach, Belinda; Leipert, Beverly

    2012-01-01

    ... about reduction of government funding and access to health care, and about the shortage of new volunteers to replace them when they burn out. These are a few of the stories told in the chapters of this book. This ground-breaking collection of essays identifies priority issues that must be addressed to ensure rural women's well-being, and offers innovative ideas for improvement and further research. Rural women play a critical role within their families and communities, and the health of these wome...

  16. Investigating the Climate Change Beliefs, Knowledge, Behaviors, and Cultural Worldviews of Rural Middle School Students and their Families During An Out-of-School Intervention: A Mixed-Methods Study

    Science.gov (United States)

    Gutierrez, Kristie Susan

    In a recent nationwide survey, 63% of American adults believe that there is global warming, yet 52% received a 'grade' of 'F' on climate change knowledge and beliefs. Climate change is a politically-charged topic in the 21st century. Even for those who support the 97% of scientists who assert that climate change is occurring, many are still uncertain about the role that humans play in this complex process. This mixed-methods study examined the climate change beliefs, content knowledge, worldviews, and behaviors of rural middle school students and their families in four rural, high poverty school districts in the Southeastern United States (US). The students, who ranged from 5-8th grades, were part of an after school STEM Career Club program that met for two hours, six times per semester. STEM Club students (N = 243) and selected students' families (n = 15) interacted with climate change activities and materials in the student clubs and in an at-home intervention. Quantitative pre- and post-intervention surveys were used to measure any changes in climate change content knowledge and beliefs as well as participants' worldviews. Qualitative audio data gathered from at-home intervention activities with students and their family members, as well as during family dyad interviews, was coded using the Determinants of Behavior framework that reflected climate change awareness, during and post-intervention. This embedded mixed-methods design with climate change education was designed to reflect place-based examples in these rural, southeastern US communities, and to empower families to see the relevance of this global issue, consider their role, learn more about climate science, and take actions locally. Initially, a large percentage of students believed that global warming is occurring (69.5%) and is occurring at least in some part due to human influence (69.3%). Students had learned significantly more total climate change knowledge, post-intervention. Analyses of variance

  17. Rural maternity care.

    Science.gov (United States)

    Miller, Katherine J; Couchie, Carol; Ehman, William; Graves, Lisa; Grzybowski, Stefan; Medves, Jennifer

    2012-10-01

    To provide an overview of current information on issues in maternity care relevant to rural populations. Medline was searched for articles published in English from 1995 to 2012 about rural maternity care. Relevant publications and position papers from appropriate organizations were also reviewed. This information will help obstetrical care providers in rural areas to continue providing quality care for women in their communities. Recommendations 1. Women who reside in rural and remote communities in Canada should receive high-quality maternity care as close to home as possible. 2. The provision of rural maternity care must be collaborative, woman- and family-centred, culturally sensitive, and respectful. 3. Rural maternity care services should be supported through active policies aligned with these recommendations. 4. While local access to surgical and anaesthetic services is desirable, there is evidence that good outcomes can be sustained within an integrated perinatal care system without local access to operative delivery. There is evidence that the outcomes are better when women do not have to travel far from their communities. Access to an integrated perinatal care system should be provided for all women. 5. The social and emotional needs of rural women must be considered in service planning. Women who are required to leave their communities to give birth should be supported both financially and emotionally. 6. Innovative interprofessional models should be implemented as part of the solution for high-quality, collaborative, and integrated care for rural and remote women. 7. Registered nurses are essential to the provision of high-quality rural maternity care throughout pregnancy, birth, and the postpartum period. Maternity nursing skills should be recognized as a fundamental part of generalist rural nursing skills. 8. Remuneration for maternity care providers should reflect the unique challenges and increased professional responsibility faced by providers in

  18. 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 ...

  19. Effects of racial and ethnic group and health literacy on responses to genomic risk information in a medically underserved population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Stafford, Jewel D; McGowan, Lucy D'Agostino; Seo, Joann; Lachance, Christina R; Goodman, Melody S

    2015-02-01

    Few studies have examined how individuals respond to genomic risk information for common, chronic diseases. This randomized study examined differences in responses by type of genomic information (genetic test/family history) and disease condition (diabetes/heart disease), and by race/ethnicity in a medically underserved population. 1,057 English-speaking adults completed a survey containing 1 of 4 vignettes (2-by-2 randomized design). Differences in dependent variables (i.e., interest in receiving genomic assessment, discussing with doctor or family, changing health habits) by experimental condition and race/ethnicity were examined using chi-squared tests and multivariable regression analysis. No significant differences were found in dependent variables by type of genomic information or disease condition. In multivariable models, Hispanics were more interested in receiving a genomic assessment than Whites (OR = 1.93; p literacy had greater interest than those with adequate health literacy. Blacks (OR = 1.78; p = .001) and Hispanics (OR = 1.85; p = .001) had greater interest in discussing information with family than Whites. Non-Hispanic Blacks (OR = 1.45; p = .04) had greater interest in discussing genomic information with a doctor than Whites. Blacks (β = -0.41; p literacy was negatively associated with number of health habits participants intended to change. Findings suggest that race/ethnicity may affect responses to genomic risk information. Additional research could examine how cognitive representations of this information differ across racial/ethnic groups. Health literacy is also critical to consider in developing approaches to communicating genomic information.

  20. Family sucession in rural properties: A study of the succession situation among academics of UFFS Agronomy Course Erechim and their parents

    OpenAIRE

    S. Paula; A. B. Moreira,; D. A. Mota

    2017-01-01

    Among the numerous studies dealing with the issue of family succession, the majority cities the succession process as a key issue in social reproduction and perpetuation of family farms. Thus, the study aimed to identify the actual situation among academics of UFFS Agronomy Course and their parents when the topic family succession is placed in focus. The methodology used was the application of a structured survey prepared in order to answer the doubts. The survey was designed in online way be...

  1. Financial incentives for return of service in underserved areas: a systematic review

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-05-01

    Full Text Available Abstract Background In many geographic regions, both in developing and in developed countries, the number of health workers is insufficient to achieve population health goals. Financial incentives for return of service are intended to alleviate health worker shortages: A (future health worker enters into a contract to work for a number of years in an underserved area in exchange for a financial pay-off. Methods We carried out systematic literature searches of PubMed, the Excerpta Medica database, the Cumulative Index to Nursing and Allied Health Literature, and the National Health Services Economic Evaluation Database for studies evaluating outcomes of financial-incentive programs published up to February 2009. To identify articles for review, we combined three search themes (health workers or students, underserved areas, and financial incentives. In the initial search, we identified 10,495 unique articles, 10,302 of which were excluded based on their titles or abstracts. We conducted full-text reviews of the remaining 193 articles and of 26 additional articles identified in reference lists or by colleagues. Forty-three articles were included in the final review. We extracted from these articles information on the financial-incentive programs (name, location, period of operation, objectives, target groups, definition of underserved area, financial incentives and obligation and information on the individual studies (authors, publication dates, types of study outcomes, study design, sample criteria and sample size, data sources, outcome measures and study findings, conclusions, and methodological limitations. We reviewed program results (descriptions of recruitment, retention, and participant satisfaction, program effects (effectiveness in influencing health workers to provide care, to remain, and to be satisfied with work and personal life in underserved areas, and program impacts (effectiveness in influencing health systems and health outcomes

  2. Information needs of rural health professionals: a review of the literature.

    Science.gov (United States)

    Dorsch, J L

    2000-10-01

    This review analyzes the existing research on the information needs of rural health professionals and relates it to the broader information-needs literature to establish whether the information needs of rural health professionals differ from those of other health professionals. The analysis of these studies indicates that rural health practitioners appear to have the same basic needs for patient-care information as their urban counterparts, and that both groups rely on colleagues and personal libraries as their main sources of information. Rural practitioners, however, tend to make less use of journals and online databases and ask fewer clinical questions; a difference that correlates with geographic and demographic factors. Rural practitioners experience pronounced barriers to information access including lack of time, isolation, inadequate library access, lack of equipment, lack of skills, costs, and inadequate Internet infrastructure. Outreach efforts to this group of underserved health professionals must be sustained to achieve equity in information access and to change information-seeking behaviors.

  3. Efficacy of a multilevel intervention on the mental health of people living with HIV and their family members in rural China.

    Science.gov (United States)

    Li, Li; Ji, Guoping; Liang, Li-Jung; Lin, Chunqing; Hsieh, Julie; Lan, Chiao-Wen; Xiao, Yongkang

    2017-09-01

    HIV has a profound impact on infected individuals and their families. This study evaluated the efficacy of an intervention aimed at improving the mental health of people living with HIV (PLH) and their family members. A randomized controlled trial of 475 PLH and 522 family members was conducted in Anhui, China. The intervention comprised activities at individual, family, and community levels. The study outcomes, which included depressive symptoms and coping with illness for the PLH and depressive symptoms and caregiver burden for the family members, were assessed at baseline and at 6-, 12-, 18-, and 24-month follow-up. We used a mixed-effects regression model with village- and participant-level random effects to assess the intervention effect on the improvement of outcome measures. Relative to the control condition, the PLH and family members of the intervention group reported a significant reduction in depressive symptoms. The largest difference in depressive symptoms was observed at 6 months for the PLH and at 12 months for family members. Decreases in perceived caregiver burden over time were observed for family members in both conditions; however, the group difference did not reach statistical significance. Significant intervention effect on the coping with illness was reported by the PLH. The study highlights the importance of empowering families affected by HIV to confront the challenges together rather than individually. It may be optimal for future programs to include both PLH and their family members to maximize intervention effects through strengthening interactions and support within a family. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  4. Adult and adolescent livestock productive asset transfer programmes to improve mental health, economic stability and family and community relationships in rural South Kivu Province, Democratic Republic of Congo: a protocol of a randomised controlled trial.

    Science.gov (United States)

    Kohli, Anjalee; Perrin, Nancy A; Remy, Mitima Mpanano; Alfred, Mirindi Bacikenge; Arsene, Kajabika Binkurhorhwa; Nadine, Mwinja Bufole; Heri, Banyewesize Jean; Clovis, Mitima Murhula; Glass, Nancy

    2017-03-14

    People living in poverty have limited access to traditional financial institutions. Microfinance programmes are designed to meet this gap and show promise in improving income, economic productivity and health. Our Congolese-US community academic research partnership developed two livestock productive asset transfer programmes, Pigs for Peace (PFP) and Rabbits for Resilience (RFR), to address the interlinked health, social and economic well-being of individuals, their families and communities. The community-based randomised controlled trials examine the effectiveness of PFP and RFR to improve health, economic stability, and family and community relationships among male and female adults and adolescents living in 10 rural, postconflict villages of eastern Democratic Republic of Congo. PFP participants include adult permanent residents of rural villages; adolescent participants in RFR include male and female adolescents 10-15 years old living in the selected rural villages. Participants were randomised to intervention or delayed control group. Participants in PFP completed baseline interview prior to intervention and follow-up interview at 6, 12 and 18 months postintervention. In RFR, participants completed baseline interview prior to intervention and follow-up interview at 6, 12 and 18 months postbaseline. The primary outcome of both trials, the change in baseline mental health distress at 18 months in the intervention group (adults, adolescents) compared to control group, is used to calculate sample size. The Johns Hopkins Medical Institute Internal Review Board approved this protocol. A committee of respected Congolese educators and community members (due to lack of local ethics review board) approved the study. The findings will provide important information on the potential for community-led sustainable development initiatives to build on traditional livelihood (livestock raising, agriculture) to have a sustained health, economic and social impact on the

  5. Disseminating relevant health information to underserved audiences: implications of the Digital Divide Pilot Projects*

    Science.gov (United States)

    Kreps, Gary L.

    2005-01-01

    Objective: This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. Method: The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. Results: The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. Implications: The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations. PMID:16239960

  6. Disseminating relevant health information to underserved audiences: implications of the Digital Divide Pilot Projects.

    Science.gov (United States)

    Kreps, Gary L

    2005-10-01

    This paper examines the influence of the digital divide on disparities in health outcomes for vulnerable populations, identifying implications for medical and public libraries. The paper describes the results of the Digital Divide Pilot Projects demonstration research programs funded by the National Cancer Institute to test new strategies for disseminating relevant health information to underserved and at-risk audiences. The Digital Divide Pilot Projects field-tested innovative systemic strategies for helping underserved populations access and utilize relevant health information to make informed health-related decisions about seeking appropriate health care and support, resisting avoidable and significant health risks, and promoting their own health. The paper builds on the Digital Divide Pilot Projects by identifying implications for developing health communication strategies that libraries can adopt to provide digital health information to vulnerable populations.

  7. Effects of dance on depression, physical function, and disability in underserved adults.

    Science.gov (United States)

    Murrock, Carolyn J; Graor, Christine Heifner

    2014-07-01

    This study documented the feasibility and immediate effects of a dance intervention two times per week for 12 weeks on depression, physical function, and disability in older, underserved adults. The one-group, pretest-posttest study had a convenience sample of 40 participants recruited from a federally subsidized apartment complex located in an economically depressed, inner-city neighborhood. Depression, physical function, and disability were measured at baseline and 12 weeks. Average age was 63 years (SD = 7.9), 92% were female, and 75% were African American. At baseline, participants reported increased depression (M = 20.0, SD = 12.4), decreased physical function (M = 56.6, SD = 10.9), and increased disability limitations (M = 65.7, SD = 14.9). At posttest, paired t tests showed that the dance intervention significantly decreased depression, t = 6.11, p dance intervention may be an effective adjunct therapy to improve depression, disability, and physical function in underserved adults.

  8. The challenges of working in underserved areas: a qualitative exploratory study of views of policy makers and professionals.

    Science.gov (United States)

    AbuAlRub, Raeda F; El-Jardali, Fadi; Jamal, Diana; Iblasi, Abdulkareem S; Murray, Susan F

    2013-01-01

    The inadequate number of health care providers, particularly nurses, in underserved areas is one of the biggest challenges for health policymakers. There is a scarcity of research in Jordan about factors that affect nurse staffing and retention in underserved areas. To elucidate the views of staff nurses working in underserved areas, directors of health facilities in underserved areas and key informants from the policy and education arena on issues of staffing and retention of nurses in underserved areas. An exploratory study using a qualitative approach with semi-structured interviews was utilized to elucidate the views of 22 key informants from the policy and education arena, 11 directors of health centers, and 19 staff nurses on issues that contribute to low staffing and retention of nurses in underserved areas. The five stage 'framework approach' proposed by Bryman et al. (1993) was utilized for data analysis. Nursing shortage in underserved areas in Jordan are exacerbated by a lack of financial incentives, poor transportation and remoteness of these areas, bad working conditions, and lack of health education institutions in these areas, as well as by opportunities for internal and external migration. Young Jordanian male nurses usually grab any opportunity to migrate and work outside the country to improve their financial conditions; whereas, female nurses are more restricted and not encouraged to travel abroad to work. Several strategies are suggested to enhance retention in these areas, such as promoting financial incentives for staff to work there, enhancing the transportation system, and promoting continuous and academic education. Nurses' administrators and health care policy makers could utilize the findings of the present study to design and implement comprehensive interventions to enhance retention of staff in underserved areas. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Designing for Underserved Populations: Constraints and Requirements of Personal Health Record Systems

    Centers for Disease Control (CDC) Podcasts

    2009-02-11

    In this podcast, Dr. Thomas Horan discusses how language, literacy, and access barriers can be overcome with electronic Personal Health Record (PHR) systems to improve health among the most vulnerable, isolated, and underserved populations.  Created: 2/11/2009 by Coordinating Center for Health Information Service (CCHIS), Healthy Healthcare Settings Goal Team, Office of Strategy and Innovation.   Date Released: 9/2/2009.

  10. Health effects of training laypeople to deliver emergency care in underserviced populations: a systematic review protocol

    OpenAIRE

    Orkin, Aaron M; Curran, Jeffrey D; Fortune, Melanie K; McArthur, Allison; Mew, Emma J; Ritchie, Stephen D; Van de Velde, Stijn; VanderBurgh, David

    2016-01-01

    Introduction The Disease Control Priorities Project recommends emergency care training for laypersons in low-resource settings, but evidence for these interventions has not yet been systematically reviewed. This review will identify the individual and community health effects of educating laypeople to deliver prehospital emergency care interventions in low-resource settings. Methods and analysis This systematic review addresses the following question: in underserviced populations and low-reso...

  11. Mission-driven marketing: a rural example.

    Science.gov (United States)

    Rohrer, J E; Vaughn, T; Westermann, J

    1999-01-01

    Marketing receives little attention in the academic healthcare management literature, possibly because it is associated with pursuit of profit rather than community benefit. However, a marketing perspective can be applied to the pursuit of the traditional missions of healthcare delivery organizations. Mission-oriented market selection criteria could include characteristics such as relevance to mission, underserved or vulnerable population status, resistance to care, limited resources, and low accessibility. A survey conducted in a rural county is used to demonstrate ways that underserved market segments can be identified and targeted. In the market surveyed, men used less medical care than women; depressed people and those with low levels of education used less medical care than people without these characteristics. Consumers were more likely to defer care because of cost if they lacked health insurance coverage, were female, were under age 55, had fair health status, were depressed, and were chronically ill. Marketing strategies worthy of consideration relate to price (e.g., free care, coupons and sales for eligible individuals), distribution (e.g., visiting nurses, malls and fairs, occupational medicine programs), product (e.g., satisfaction, waiting time, attractiveness, assertive follow-up), and promotion (education about insurance benefits, facilitating development of regular sources of care, health education).

  12. Extending the Pathway: Building on a National Science Foundation Workforce Development Project for Underserved k-12 Students

    Science.gov (United States)

    Slattery, W.; Smith, T.

    2014-12-01

    own learning and shows promise of raising parents, teachers, administrators and other k-12 students awareness of educational opportunities in the geosciences, confidence in the ability of underserved rural students to reach their educational goals and supporting them through the critical middle and high school years towards a geoscience career.

  13. Workplace physical violence among hospital nurses and physicians in underserved areas in Jordan.

    Science.gov (United States)

    AbuAlRub, Raeda Fawzi; Al Khawaldeh, Abdullah Talal

    2014-07-01

    To: (1) examine the incidence, frequency and contributing factors to workplace violence among nurses and physicians in underserved areas in Jordan, and (2) identify the existing policies and the management modalities to tackle workplace violence. Workplace violence is a major problem in healthcare organisations. An understanding of the nature of violence is essential to implementing successful management. A descriptive exploratory research design. The questionnaire that was developed in 2003 by the International Labor Office, the International Council of Nurses, the World Health Organization, and the Public Services International was used to collect data from a convenience sample of 521 Jordanian physicians and nurses (396 nurses, 125 physicians) who worked in hospitals located in underserved areas. Around 15% of the participants were exposed to physical violence. The factors that contributed to workplace violence were related to absence of policies, inadequate staffing and lack of communication skills. Only 16·9% of participants indicated that there were specific policies available for dealing with physical workplace violence. Strengthening security and providing training were some of the important factors indicated by participants for decreasing violence in the workplace. Workplace violence is a problem in underserved areas that needs attention from administrators. Most participants were very dissatisfied with the way the administrators dealt with the incidents. Instituting firm policies against perpetrators and developing protective violence guidelines to support healthcare staff in managing workplace violence are paramount to tackle the problem of workplace violence. © 2013 John Wiley & Sons Ltd.

  14. Physician assistants as servant leaders: meeting the needs of the underserved.

    Science.gov (United States)

    Huckabee, Michael J; Wheeler, Daniel W

    2011-01-01

    The purpose of this study was to determine if the level of servant leader characteristics in clinically practicing physician assistants (PAs) in underserved populations differed from PAs serving in other locales. Five subscales of servant leadership: altruistic calling, emotional healing, wisdom, persuasive mapping, and organizational stewardship, were measured in a quantitative study of clinically practicing PAs using a self-rating survey and a similar survey by others rating the PA. Of 777 PAs invited, 321 completed the survey. On a scale of 1 to 5, mean PA self-ratings ranged from 3.52 (persuasive mapping) to 4.05 (wisdom). Other raters' scores paired with the self-rated PA scores were comparable in all subscales except wisdom, which was rated higher by the other raters (4.32 by other raters, 4.01 by PAs, P= .002). There was no significant difference in the measures of servant leadership reported by PAs serving the underserved compared to PAs serving in other populations. Servant leader subscales were higher for PAs compared to previous studies of other health care or community leader populations. The results found that the PA population studied had a prominent level of servant leadership characteristics that did not differ between those working with underserved and nonunderserved populations.

  15. Intrinsic rewards experienced by a group of dentists working with underserved populations.

    Science.gov (United States)

    Gardner, S P; Roberts-Thomson, K F; Winning, T A; Peterson, R

    2014-09-01

    The aim of this study was to explore, using qualitative methods, the intrinsic reasons why dentists work with underserved groups. Minority and marginalized groups of Australians suffer a greater burden of dental disease than the general population due to disparities in accessing care. Recruitment and retention of dentists to care for underserved groups is problematic due to personal, professional and structural reasons. What drives dentists to work with underserved groups is not widely known. Sixteen dentists were recruited using 'snowball' purposeful sampling. Semi-structured in-depth interviews were conducted. Thematic analysis was conducted on the transcriptions to identify themes. Five key themes emerged: (1) 'tapped on the shoulder', being personally approached or invited; (2) 'dental school experience', the challenges faced as a student; (3) 'empathic concern', the non-judgemental expressions of care toward others; (4) 'resilience', the ability to bounce back after setbacks; (5) 'intrinsic reward', the personal gain and satisfaction received. This study focuses on the intrinsic rewards which were found to be simple, unexpected, and associated with relieving pain, community engagement and making a difference. Emphasizing personal fulfilment and intrinsic reward could be useful when promoting dentistry as a career and when encouraging graduates to consider working with disadvantaged groups. © 2014 Australian Dental Association.

  16. 7 CFR 2003.10 - Rural Development State Offices.

    Science.gov (United States)

    2010-01-01

    ... (CONTINUED) ADMINISTRATIVE REGULATIONS ORGANIZATION Functional Organization of the Rural Development Mission... oversight and leadership on major program functions. Major program functions include: Single Family and...

  17. Development of Sustainable Rural Tourism

    Directory of Open Access Journals (Sweden)

    Sandra Kantar

    2017-06-01

    Full Text Available This paper presents a sociological view of possibilities for the development of sustainable rural tourism in Koprivnica-Krizevci county, which is located in the north-western part of Croatia. The possibilities for developing rural tourism within the concept of sustainable development have been researched through qualitative empirical research interview method. Research subjects were the owners of tourist farms, decision makers, experts and other stakeholders in the tourism development. Rural tourism represents an alternative to maritime tourism and is relatively undeveloped but important in terms of development of rural areas and family farms. This paper enables an insight into an integrated sustainability of rural tourism which consists of four dimensions: biologicalecological, economic, socio-cultural and political sustainability. In conclusion, integral sustainability in rural tourism is not achieved in all dimensions. Therefore, rural tourism could be a strategy for sustainable development for rural areas and also could be a tool for product differentiation for area that are at stagnation stage.

  18. 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.

  19. A psychosocial approach to dentistry for the underserved: incorporating theory into practice.

    Science.gov (United States)

    Flaer, Paul J; Younis, Mustafa Z; Benjamin, Paul L; Al Hajeri, Maha

    2010-01-01

    Dentistry for the underserved is more than an egalitarian social issue--it is a key factor in the health and social progress of our nation. The first signs or manifestations of several diseases such as varicella (i.e., chicken pox and shingles), STDs, and influenza become apparent in the oral cavity. The value of access to quality dentistry is an immeasurable factor in maintaining general medical health of people and fulfilling their psychosocial needs of pain reduction and enhanced cosmetics. In the United States, for the most part, only the middle and upper classes receive non-extraction, restorative, and prosthetic dentistry that is economically within their ability to pay. In addition, uninsured and poverty-level individuals often must face overwhelming long waiting lists, unnecessary referrals, lack of choice, and bureaucratic hurdles when seeking primary dental care. Therefore, it seems pertinent to put forth the question: What are the critical values and beliefs of psychosocial theory that can underscore the practice of dentistry for underserved populations in the United States? The widely employed public health theory, the health belief model (HBM), is applied to evaluate psychosocial factors in dental care for the underserved. The HBM is used to predict and explain behavioral changes in dental health and associated belief patterns. The HBM as applied to dentistry for the underserved predicts self-perceptions of susceptibility and seriousness of dental disease, health status, cues to action, and self-efficacy. Furthermore, patients can make judgments about benefits, costs, and risks of dental treatment. A theoretical approach to dentistry employing the HBM, mediated by values and culture, can provide significant insights into patient thinking, beliefs, and perceptions. These insights can mediate access to and use of primary care dental services by underserved populations. Evidence-based practice (i.e., based on research using the scientific method) has been

  20. Rural Communatcation: legitimizing digital inclusion in rural field

    Directory of Open Access Journals (Sweden)

    Juliana Correa Bernardes

    2016-03-01

    Full Text Available Through contemporary analysis, it was noted that the countryside of São Paulo experienced drastic transformation and demanded rural family farmers to adapt themselves to technological innovations, where the most striking is the use of the internet in search of information to the sustainable development of rural property.  The research adopted a methodological way of exploratory, through the case study, which analyzed the general objective the dissemination and usability of information and communication technologies in rural areas in the interior of forms-based applied to farmers in the family farms belonging to theAssociation of banana growers of Tupã. In seeking to achieve this goal, reflected on the use of internet in rural areas and measured-factors that enhance digital communication barriers in rural addressing the digital divide becomes a limiting factor to access. In this sense, the rural communication emerges as relational link mediating solutions and incorporating the diffusion of innovations in the pursuit of digital literacy of farmers contributing to the democratization of society in the information age.

  1. The Teacherage in American Rural Education.

    Science.gov (United States)

    Maxcy, Spencer J.

    1979-01-01

    Traces the historical evolution of the teacherage, initially proposed as a solution to the problem of housing teachers and as a model home for the edification of rural families. Pinpoints the conceptual connection between the teacherage and the parsonage--each linking the institution to the rural community. (CAM)

  2. WHO Parents Skills Training (PST) programme for children with developmental disorders and delays delivered by Family Volunteers in rural Pakistan: study protocol for effectiveness implementation hybrid cluster randomized controlled trial.

    Science.gov (United States)

    Hamdani, S U; Akhtar, P; Zill-E-Huma; Nazir, H; Minhas, F A; Sikander, S; Wang, D; Servilli, C; Rahman, A

    2017-01-01

    Development disorders and delays are recognised as a public health priority and included in the WHO mental health gap action programme (mhGAP). Parents Skills Training (PST) is recommended as a key intervention for such conditions under the WHO mhGAP intervention guide. However, sustainable and scalable delivery of such evidence based interventions remains a challenge. This study aims to evaluate the effectiveness and scaled-up implementation of locally adapted WHO PST programme delivered by family volunteers in rural Pakistan. The study is a two arm single-blind effectiveness implementation-hybrid cluster randomised controlled trial. WHO PST programme will be delivered by 'family volunteers' to the caregivers of children with developmental disorders and delays in community-based settings. The intervention consists of the WHO PST along with the WHO mhGAP intervention for developmental disorders adapted for delivery using the android application on a tablet device. A total of 540 parent-child dyads will be recruited from 30 clusters. The primary outcome is child's functioning, measured by WHO Disability Assessment Schedule - child version (WHODAS-Child) at 6 months post intervention. Secondary outcomes include children's social communication and joint engagement with their caregiver, social emotional well-being, parental health related quality of life, family empowerment and stigmatizing experiences. Mixed method will be used to collect data on implementation outcomes. Trial has been retrospectively registered at ClinicalTrials.gov (NCT02792894). This study addresses implementation challenges in the real world by incorporating evidence-based intervention strategies with social, technological and business innovations. If proven effective, the study will contribute to scaled-up implementation of evidence-based packages for public mental health in low resource settings. Registered with ClinicalTrials.gov as Family Networks (FaNs) for Children with Developmental

  3. 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.

  4. Rural Aging

    Science.gov (United States)

    ... for Success Am I Rural? Evidence-based Toolkits Economic Impact Analysis Tool Community Health Gateway Sustainability Planning ... Transportation to medical appointments, grocery shopping, and other essential and leisure activities Housing quality and affordability, including ...

  5. INTERACCIONES ENTRE FAMILIAS Y GRUPOS ARMADOS ILEGALES EN LAS zONAS RURALES DE ANTIOQUIA -- INTERACTIONS AMONG FAMILIES AND ILLEGAL ARMED GROUPS IN COUNTRY AREAS FROM ANTIOQUIA

    Directory of Open Access Journals (Sweden)

    JAIME ALBERTO CARMONA PARRA

    2008-06-01

    Full Text Available In this article, we explore the point of view of 21 girls disentailed from the guerrilla and paramilitar groups from Antioquia, in relation to the interactions they perceived between their families and these groups, as well as the performed role by these interactions in their decision to bind to them. The theoretical focus used is the symbolic interactionism, according to which, family, seen as version of the generalized “other”, becomes an interactional escenary, basic to the subjective constitution and referent in a definition of the world. Based on this family role, it is identified on the girls, and the people in general, the ability to interpret the contexts and situations, which, at the same time, condition their reactions and decisions.

  6. Early Childhood Behavioral Health Integration in Pediatric Primary Care: Serving Refugee Families in the Healthy Steps Program

    Science.gov (United States)

    Buchholz, Melissa; Fischer, Collette; Margolis, Kate L.; Talmi, Ayelet

    2016-01-01

    Primary care settings are optimal environments for providing comprehensive, family-centered care to young children and their families. Primary care clinics with integrated behavioral health clinicians (BHCs) are well-positioned to build trust and create access to care for marginalized and underserved populations. Refugees from around the world are…

  7. Genital Ulcers and Sexual Transmitted Disease in Rural Nigeria ...

    African Journals Online (AJOL)

    Casual sex was a dominant behavioural pattern. The phenomenon of denial was encountered in females. STDs are not uncommon in rural Nigeria. Integration of Sexual health in rural health, family health, and school health is urgently needed. Key Words: Genital ulcers, STDs, Rural Nigeria Jnl of Medical Investigation and ...

  8. Paths to Work in Rural Places: Key Findings and Lessons from the Impact Evaluation of the Future Steps Rural Welfare-to-Work Program. Final Report

    Science.gov (United States)

    Meckstroth, Alicia; Burwick, Andrew; Ponza, Michael; Marsh, Shawn; Novak, Tim; Phillips, Shannon; Diaz-Tena, Nuria; Ng, Judy

    2006-01-01

    Helping low-income families in rural areas find gainful employment and achieve economic self-sufficiency is an ongoing policy concern. The Rural Welfare-to-Work Strategies demonstration is using rigorous experimental designs to build knowledge about how to help low-income families in rural areas strive toward sustained employment and…

  9. A CROSS-SECTIONAL PROSPECTIVE STUDY ON CUTANEOUS DISEASES IN PAEDIATRIC PATIENTS BELONGING TO LOW INCOME GROUP FAMILIES ATTENDING PRIMARY HEALTH CENTRES AT BANGALORE RURAL, SOUTH

    Directory of Open Access Journals (Sweden)

    Megha Chandrashekar

    2017-12-01

    Full Text Available BACKGROUND The incidence and the spectrum of paediatric dermatological diseases vary from one part of the world to another.1 Skin diseases, though very common in many developing countries are not often regarded as a significant health problem.2 Majority of the skin diseases tend to occur in children under the age of 5 years. This high prevalence could be due to the lower immunity or higher frequency of hospital visits by infants due to greater parental care. The aim of the study is to compare the present spectrum of cutaneous disorders between two age groups of children less than 5 years and 5-14 years old and their correlation with socioeconomic status attending primary health centre, Bangalore rural, south. MATERIALS AND METHODS A prospective cross-sectional study was conducted from March 22 to November 22, 2017, in children with skin disorders under 14 years old who attended primary health centre at Bangarappanagar and Uttarahalli in Bangalore. RESULTS A total of 522 children with skin diseases, 486 children were included in the study and they were divided into two groups of those less than 5 years with the sex ratio (M:F 1.5:1 and 5-14 years old with the sex ratio (M:F 1.3:1. The most common dermatological disease among less than 5 years age group was infections, eczema, infestations and pigmentary disorders and the most common dermatological diseases between 5-14 years was infections, scabies, eczema and acne. CONCLUSION Skin problems mainly scabies, tinea, impetigo and eczema were common in children who attended the primary health centres at Bangalore rural. There is a high prevalence of communicable diseases among children belonging to parents of low socioeconomic status. Community health education regarding personal hygiene coupled with that of the surrounding environment can help in controlling these diseases in the long run.

  10. Family sucession in rural properties: A study of the succession situation among academics of UFFS Agronomy Course Erechim and their parents

    Directory of Open Access Journals (Sweden)

    S. Paula

    2017-12-01

    Full Text Available Among the numerous studies dealing with the issue of family succession, the majority cities the succession process as a key issue in social reproduction and perpetuation of family farms. Thus, the study aimed to identify the actual situation among academics of UFFS Agronomy Course and their parents when the topic family succession is placed in focus. The methodology used was the application of a structured survey prepared in order to answer the doubts. The survey was designed in online way being sent an access link to the e-mail address previously, and then collected from every academic who had links with the countryside. For others, it was printed, delivered, and then collected. The data were analyzed using descriptive statistics. As a result was obtained that even though there are differences of opinion, the vast majority of young people show comfortable in become a farmer and to continue the current business of the parents. Over 83% of men and 92% of women in the parent class intend to hold family succession still alive, and the children respect this opinion giving autonomy to the parents to carry out the succession when they consider most appropriate.

  11. Naming for kin and the development of modern family structures: an analysis of a rural region in the Netherlands in the nineteenth and early twentieth centuries

    NARCIS (Netherlands)

    van Poppel, F.W.A.; Bloothooft, G.; Gerritzen, D.; Verduin, J.

    1999-01-01

    It is generally assumed that the conjugal family—the family that lived independently from extended in—came into existence in the Netherlands relatively early, and that a new attitude towards children, characterized by an emphasis on the individuality of the child, developed at more or less the same

  12. Evaluation of a U.S. Evidence-Based Parenting Intervention in Rural Western Kenya: From Parents Matter! to Families Matter!

    Science.gov (United States)

    Vandenhoudt, Hilde; Miller, Kim S.; Ochura, Juliet; Wyckoff, Sarah C.; Obong'o, Christopher O.; Otwoma, Nelson J.; Poulsen, Melissa N.; Menten, Joris; Marum, Elizabeth; Buve, Anne

    2010-01-01

    We evaluated Families Matter! Program (FMP), an intervention designed to improve parent-child communication about sexual risk reduction and parenting skills. Parents of 10- to 12-year-olds were recruited in western Kenya. We aimed to assess community acceptability and FMP's effect on parenting practices and effective parent-child communication.…

  13. Family Planning Knowledge, Attitudes, and Practices among Married Men and Women in Rural Areas of Pakistan: Findings from a Qualitative Need Assessment Study

    Directory of Open Access Journals (Sweden)

    Ghulam Mustafa

    2015-01-01

    Full Text Available This paper presents the findings of a qualitative assessment aimed at exploring knowledge, attitudes, and practices regarding family planning and factors that influence the need for and use of modern contraceptives. A descriptive exploratory study was conducted with married women and men aged between 15 and 40. Overall, 24 focus group discussions were conducted with male and female participants in three provinces of Pakistan. The findings reveal that the majority knew about some modern contraceptive methods, but the overall contraceptive use was very low. Knowledge and use of any contraceptive method were particularly low. Reasons for not using family planning and modern contraception included incomplete family size, negative perceptions, in-laws’ disapproval, religious concerns, side-effects, and lack of access to quality services. The majority preferred private facilities over the government health facilities as the later were cited as derided. The study concluded the need for qualified female healthcare providers, especially for long term family planning services at health facilities instead of camps arranged occasionally. Addressing issues around access, affordability, availability, and sociocultural barriers about modern contraception as well as involving men will help to meet the needs and ensure that the women and couples fulfill their childbearing and reproductive health goals.

  14. 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...

  15. Meeting Increasing Demands for Rural General Surgeons.

    Science.gov (United States)

    Mccarthy, Mary C; Bowers, Howard E; Campbell, Damon M; Parikh, Priti P; Woods, Randy J

    2015-12-01

    Dynamic assessment of the effective surgical workforce recommends 27,300 general surgeons in 2030; 2,525 more than are presently being trained. Rural shortages are already critical and there has been insufficient preparation for this need. A literature review of the factors influencing the choice of rural practice was performed. A systematic search was conducted of PubMed and the Web of Science to identify applicable studies in rural practice, surgical training, and rural general surgery. These articles were reviewed to identify the pertinent reports. The articles chosen for review are directed to four main objectives: 1) description of the challenges of rural practice, 2) factors associated with the choice of rural practice, 3) interventions to increase interest and preparation for rural practice, and 4) present successful rural surgical practice models. There is limited research on the factors influencing surgeons in the selection of rural surgery. The family practice literature suggests that physicians are primed for rural living through early experience, with reinforcement during medical school and residency, and retained through community involvement, and personal and professional satisfaction. However, more research into the factors drawing surgeons specifically to rural surgery, and keeping them in the community, is needed.

  16. An approach to rural distribution network design for sub-Saharan Africa

    International Nuclear Information System (INIS)

    Sebitosi, A.B.; Pillay, P.; Khan, M.A.

    2006-01-01

    The bulk of rural populations in sub-Saharan Africa have no access to electricity and are under-served by any other form of modern infrastructure. The cost of infrastructure to mainly scattered communities has been perennially cited as largely to blame. Quite often rural networks are overdesigned, resulting in under utilization and, therefore, costly overheads. One reason often cited for the overspecification is anticipation of load growth. In most sub-Sahara African rural areas, however, economic growth rates are low, and a designer has no justification in specifying an infrastructure capacity exceeding more than a few percent of existing consumer requirements. This paper proposes methods that critically look at the geometry of small grid network designs to address the construction challenges in rural sub-Saharan Africa

  17. Population dynamics and rural poverty.

    Science.gov (United States)

    Fong, M S

    1985-01-01

    An overview of the relationship between demographic factors and rural poverty in developing countries is presented. The author examines both the micro- and macro-level perspectives of this relationship and the determinants and consequences of population growth. The author notes the prospects for a rapid increase in the rural labor force and considers its implications for the agricultural production structure and the need for institutional change. Consideration is also given to the continuing demand for high fertility at the family level and the role of infant and child mortality in the poverty cycle. "The paper concludes by drawing attention to the need for developing the mechanism for reconciliation of social and individual optima with respect to family size and population growth." The need for rural development projects that take demographic factors into account is stressed as is the need for effective population programs. (summary in FRE, ITA) excerpt

  18. 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.

  19. 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.

  20. 8224 OCCUPATIONAL DIVERSIFICATION AMONG RURAL ...

    African Journals Online (AJOL)

    reviews current literature in the field in both farm and non-farm occupations and ... One major negative effect is withdrawal of critical labour from the family farm which ... rural women to equip them with the necessary skills to work in non-farm .... stratification of roles by gender in African households, but also because the ...

  1. African leaders' views on critical human resource issues for the implementation of family medicine in Africa.

    Science.gov (United States)

    Moosa, Shabir; Downing, Raymond; Essuman, Akye; Pentz, Stephen; Reid, Stephen; Mash, Robert

    2014-01-17

    The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team-based primary health care. Whilst these

  2. Factors influencing participation in worksite wellness programs among minority and underserved populations.

    Science.gov (United States)

    Thompson, Sharon E; Smith, Brenda A; Bybee, Ronald F

    2005-01-01

    In the United States, employers and employees are increasingly paying a larger portion of the nation's healthcare bill. Preventive measures are being employed by businesses in an effort to contain the escalating costs of employee healthcare. The work site is an ideal setting for health promotion because 130 million Americans are employed and spend one third of their time at work. However, unhealthy workers tend to be the least likely to participate in health promotion activities. Worksite Wellness Programs must be designed to engage segments of the work force with the greatest health needs. Culturally sensitive and appropriate programs must be developed to engage economically challenged minority and other underserved populations.

  3. Innovative Educational Initiatives to Train Psychodynamic Psychiatrists in Underserved Areas of the World.

    Science.gov (United States)

    Alfonso, César A; Michael, Marco Christian; Elvira, Sylvia Detri; Zakaria, Hazli; Kalayasiri, Rasmon; Adlan, Aida Syarinaz A; Moinalghorabaei, Mahdieh; Lukman, Petrin Redayani; San'ati, Mohammad; Duchonova, Katerina; Sullivan, Timothy B

    2018-06-01

    Psychodynamic psychiatry remains a challenging subject to teach in underserved areas, where enthusiasm to learn is substantial. Besides logistical and psychiatric workforce shortcomings, sensible cultural adaptations to make psychodynamic psychiatry relevant outside of high-income countries require creative effort. Innovative pedagogical methods that include carefully crafted mentoring and incorporate videoconferencing in combination with site visits can be implemented through international collaborations. Emphasis on mentoring is essential to adequately train future psychodynamic psychotherapy supervisors. Examples of World Psychiatric Association initiatives in countries such as Indonesia, Iran, Malaysia, and Thailand are presented as possible models to emulate elsewhere. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Neighborhood Social Predictors of Weight-related Measures in Underserved African Americans in the PATH Trial.

    Science.gov (United States)

    McDaniel, Tyler C; Wilson, Dawn K; Coulon, Sandra M; Hand, Gregory A; Siceloff, E Rebekah

    2015-11-05

    African Americans have the highest rate of obesity in the United States relative to other ethnic minority groups. Bioecological factors including neighborhood social and physical environmental variables may be important predictors of weight-related measures specifically body mass index (BMI) in African American adults. Baseline data from the Positive Action for Today's Health (PATH) trial were collected from 417 African American adults. Overall a multiple regression model for BMI was significant, showing positive associations with average daily moderate-to-vigorous physical activity (MVPA) (B =-.21, Psocial interaction (B =-.13, Psocial interaction was associated with healthier BMI, highlighting it as a potential critical factor for future interventions in underserved, African American communities.

  5. Family networks and income hiding

    NARCIS (Netherlands)

    Beekman, Gonne; Gatto, Marcel; Nillesen, Eleonora

    2015-01-01

    This study investigates the relationship between family network density and income hiding in rural Liberia. We link people's behaviour in a modified lottery experiment and a time preference game to detailed information about their family networks. We find that individuals with a dense family

  6. Transition from the Lactational Amenorrhea Method to other modern family planning methods in rural Bangladesh: barrier analysis and implications for behavior change communication program intervention design.

    Science.gov (United States)

    Kouyaté, Robin Anthony; Ahmed, Salahuddin; Haver, Jaime; McKaig, Catharine; Akter, Nargis; Nash-Mercado, Angela; Baqui, Abdullah

    2015-06-01

    The timely transition from Lactational Amenorrhea Method (LAM)(2) to another modern family planning method contributes to healthy spacing of pregnancies by increasing the adoption of family planning during the first year postpartum. Yet, literature suggests challenges in completing a timely LAM transition. To guide program implementation in Bangladesh, this study identified factors influencing women's transition decisions. Eighty postpartum women, comprising 40 who transitioned from LAM(3) and 40 who did not,(4) participated. Half of each group participated in in-depth interviews to explore the decision-making process. All participants responded to a "Barrier Analysis" questionnaire to identify differences in eight behavioral determinants. More than half of transitioners switched to another modern method before or within the same month that LAM ended. Of the 18 transitioners who delayed,(5) 15 waited for menses to return. For non-transitioners, key barriers included waiting for menses to return, misconceptions on return to fertility, and perceived lack of familial support. The LAM transition can help women prevent unintended pregnancy during the first year postpartum. Increased emphasis on counseling women about the risk of pregnancy, and misconceptions about personal fertility patterns are critical for facilitating the transition. Strategies should also include interventions that train health workers and improve social support. Copyright © 2015. Published by Elsevier Ltd.

  7. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan.

    Science.gov (United States)

    Azmat, Syed Khurram; Ali, Moazzam; Hameed, Waqas; Mustafa, Ghulam; Abbas, Ghazanfer; Ishaque, Muhammad; Bilgrami, Mohsina; Temmerman, Marleen

    2014-05-30

    High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as 'Suraj' (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group.

  8. A study protocol: using demand-side financing to meet the birth spacing needs of the underserved in Punjab Province in Pakistan

    Science.gov (United States)

    2014-01-01

    Background High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women’s health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan. Methods/Design This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as ‘Suraj’ (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period. Discussion The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group. PMID:24885657

  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. Rate Familiarity of the Members of local Organizations in the Northen Provinces of Iran about the Family Physician Programme and Rural Insurance

    Directory of Open Access Journals (Sweden)

    M Kabir

    2015-09-01

    Results: 521 (84.7% individuals (out of 601 members of local organizations were male. The age range was 19-81 years. Mean and standard deviation of participants age was 45±9.7 years. 47.1% of persons had academic education level. Out of total score 27, mean and SD of the familiarity in village magor was 12.4±4, in health council’s members 11.6±3.7, in village council’s members 11.4±4.1, in school managers 10.6±3.3. in dispute resolation council’s members 10.5±5.1 and in native teachers was 8.8±4.9. There were significant relationships between the level of familiarity and being participated in trustees council of the health center, sex and the work type of local organization (p0.05. Conclusion: This Study Showed that the level of familiarity of members of local organizations in rural regions of Iran is not sufficient and interventional Programs must be Planned and Performed for improvement.

  11. A qualitative study of medical students in a rural track: views on eventual rural practice.

    Science.gov (United States)

    Roseamelia, Carrie; Greenwald, James L; Bush, Tiffany; Pratte, Morgan; Wilcox, Jessica; Morley, Christopher P

    2014-04-01

    Rural tracks (RTs) exist within medical schools across the United States. These programs often target those students from rural areas and those with primary care career interests, given that these factors are robust predictors of eventual rural practice. However, only 26% to 64% of graduates from RTs enter eventual rural practice. We conducted a qualitative, exploratory study of medical students enrolled in one school's RT, examining their interests in rural training, specialization, and eventual rural practice, via open coding of transcripts from focus groups and in-depth individual interviews, leading to identification of emerging themes. A total of 16 out of 54 eligible first- and second-year preclinical medical students participated in focus group sessions, and a total of seven out of 17 eligible third- and fourth-year medical students participated in individual interviews. Analyses revealed the recognition of a "Rural Identity," typical characteristics, and the importance of "Program Fit" and "Intentions for Practice" that trended toward family medicine specialization and rural practice. However, nuances within the comments reveal incomplete commitment to rural practice. In many cases, student preference for rural practice was driven largely by a disinterest in urban practice. Students with rural and primary care practice interests are often not perfectly committed to rural practice. However, RTs may provide a haven for such students within medical school.

  12. Weight status as a moderator of the relationship between motivation, emotional social support, and physical activity in underserved adolescents.

    Science.gov (United States)

    St George, Sara M; Wilson, Dawn K; Lawman, Hannah G; Van Horn, M Lee

    2013-05-01

    This study examined weight status as a moderator of the relationship between motivation (controlled, autonomous, regulatory), emotional social support (parents, peers) and moderate-to-vigorous physical activity (MVPA) in underserved adolescents (ethnic minority, low-income). Participants from the Active by Choice Today Trial (n = 1,416; 54% girls, 73% African American, 52% overweight/obese) completed baseline measures, including height and weight, psychosocial surveys, and 7-day accelerometry estimates. Weight status was defined by body mass index z-score (zBMI). Weight status moderated the effects of controlled, autonomous, and regulatory motivation on MVPA, such that these variables were more strongly associated with MVPA in adolescents with lower versus higher zBMI scores. A better understanding of why motivation is not related to MVPA in underserved youth with a higher weight status is needed. Future pediatric obesity treatment in underserved youth may need to move beyond motivation into environmental factors associated with long-term behavior change.

  13. Rural Households

    DEFF Research Database (Denmark)

    Bruun, Ole

    2013-01-01

    dependency on state institutions under the Vietnamese transition to a market society. It discusses present poverty definitions and measures by comparing survey data with the formal economic categorization of rural households. Both the overall characteristics of rural society and qualitative data indicate...... that the reforms have set in motion a process by which a mix of new opportunities and increasing pressures creates new winners and losers. Second, the chapter draws attention to the nature of interactions between households, local communities and the Vietnamese state. This shows both potentials and limitations...

  14. Toward an assessment of the social role of rural midwives and its implication for the family planning program: an Iranian case study.

    Science.gov (United States)

    Beeman, W O; Bhattacharyya, A K

    1978-01-01

    An axiom of family planning programming is the importance of culturally-appropriate communicators and motivators. Traditional midwives seem ideal for this task but few studies have been done to verify this assumption by analyzing the midwife's social role as perceived by the community. 325 married women and 81 unmarried girls from a "model village" near Shiraz were interviewed by female undergraduates. 82.5% of the women are of childbearing age; 66% married before 14 years; 33% use contraception, mostly the pill, but most want large families because they expect high child mortality rates. Most of the older women are able to assist in childbirth but none, except the village's one recognized midwife, who is considered to have divine backing, will do so except in an emergency. The midwife's activities cause her to be held in low esteem by the community because 1) she has contact with a woman's sexual parts and this fact is public; 2) she has contact with vaginal excretia which are, in Islam, polluting; and 3) she is paid for her services, which labels her as a woman "without shame". The midwife is, however, widely used since women and their husbands fear the trip to the hospital and treatment by a male doctor much more than a midwife-supervised birth. The midwife in the study village had been there only 2 years and feels that she is not fully trusted. She is not consulted on birth control at all, because women expect the pill to be dispensed by doctors and consider other methods as a matter strictly between husband and wife. The midwife's role seems to complement that of the government health authorities rather than compete. The midwife's low status and circumscribed sphere of activity, the weak respect in which her advice is held and the pattern of having only 1 recognized midwife in a village at a time make the midwife a poor agent for family planning services. Her effectiveness as an agent of social change could be improved by training her in hygienic practices of

  15. Effect of Health Literacy on Decision-Making Preferences among Medically Underserved Patients.

    Science.gov (United States)

    Seo, Joann; Goodman, Melody S; Politi, Mary; Blanchard, Melvin; Kaphingst, Kimberly A

    2016-05-01

    Participation in the decision-making process and health literacy may both affect health outcomes; data on how these factors are related among diverse groups are limited. This study examined the relationship between health literacy and decision-making preferences in a medically underserved population. We analyzed a sample of 576 primary care patients. Multivariable logistic regression was used to examine the independent association of health literacy (measured by the Rapid Estimate of Adult Literacy in Medicine-Revised) and patients' decision-making preferences (physician directed or patient involved), controlling for age, race/ethnicity, and gender. We tested whether having a regular doctor modified this association. Adequate health literacy (odds ratio [OR] = 1.7;P= 0.009) was significantly associated with preferring patient-involved decision making, controlling for age, race/ethnicity, and gender. Having a regular doctor did not modify this relationship. Males were significantly less likely to prefer patient-involved decision making (OR = 0.65;P= 0.024). Findings suggest health literacy affects decision-making preferences in medically underserved patients. More research is needed on how factors, such as patient knowledge or confidence, may influence decision-making preferences, particularly for those with limited health literacy. © The Author(s) 2016.

  16. Employing Young Talent from Underserved Populations: Designing a Flexible Organizational Process for Assimilation and Productivity

    Directory of Open Access Journals (Sweden)

    Arthur Mark Langer

    2013-04-01

    Full Text Available This article describes an ongoing 13-year-old program designed to improve the ability of organizations to assimilate young talent from underserved populations, mostly students who have recently graduated from high school. Although many firms have internship and orientation programs, few have well-tested organizational approaches for assimilating 17-20 year-olds into their organizations in an efficient and productive manner. The objective of this study is to describe and evaluate the solution introduced by Workforce Opportunity Services (WOS, a non-profit agency that provides organizations with well-trained talent from underserved local communities. The WOS model is a systemic design involving a lead agency (WOS, corporate clients, training partnerships with local colleges and universities, and underutilized human capital. Over 290 students have completed the WOS program and obtained long-term employment, mostly in IT jobs that normally are outsourced. The results of the study show that companies have success employing young talent when they follow the WOS organizational process. Companies need to have patience with WOS student employees, but within six months most members of the WOS program make positive contributions to their sponsoring firm and have a strong likelihood of becoming permanently employed. Implications of the WOS model for organization design are discussed.

  17. 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.

  18. Impact of Patient Empathy Modeling on Pharmacy Students Caring for the Underserved

    Science.gov (United States)

    Chen, Judy T.; LaLopa, Joseph

    2008-01-01

    Objective To determine the impact of the Patient Empathy Modeling pedagogy on students' empathy towards caring for the underserved during an advanced pharmacy practice experience (APPE). Design Pharmacy students completing an APPE at 2 primary care clinics participated in a Patient Empathy Modeling assignment for 10 days. Each student “became the patient,” simulating the life of an actual patient with multiple chronic diseases who was coping with an economic, cultural, or communication barrier to optimal healthcare. Students completed the Jefferson Scale of Physician Empathy (JSPE) before and after completing the assignment, and wrote daily journal entries and a reflection paper. Assessment Twenty-six students completed the PEM exercises from 2005-2006. Scores on the JSPE improved. Students' comments in journals and reflection papers revealed 3 major themes: greater appreciation of the difficulty patients have with adherence to medication and treatment regimens, increased empathy for patients from different backgrounds and patients with medical and psychosocial challenges, and improved ability to apply the lessons learned in the course to their patient care roles. Conclusion A Patient Empathy Modeling assignment improved pharmacy students' empathy toward underserved populations. Integrating the assignment within an APPE allowed students to immediately begin applying the knowledge and insight gained from the exercise. PMID:18483606

  19. Practices Caring For The Underserved Are Less Likely To Adopt Medicare's Annual Wellness Visit.

    Science.gov (United States)

    Ganguli, Ishani; Souza, Jeffrey; McWilliams, J Michael; Mehrotra, Ateev

    2018-02-01

    In 2011 Medicare introduced the annual wellness visit to help address the health risks of aging adults. The visit also offers primary care practices an opportunity to generate revenue, and may allow practices in accountable care organizations to attract healthier patients while stabilizing patient-practitioner assignments. However, uptake of the visit has been uneven. Using national Medicare data for the period 2008-15, we assessed practices' ability and motivation to adopt the visit. In 2015, 51.2 percent of practices provided no annual wellness visits (nonadopters), while 23.1 percent provided visits to at least a quarter of their eligible beneficiaries (adopters). Adopters replaced problem-based visits with annual wellness visits and saw increases in primary care revenue. Compared to nonadopters, adopters had more stable patient assignment and a slightly healthier patient mix. At the same time, visit rates were lower among practices caring for underserved populations (for example, racial minorities and those dually enrolled in Medicaid), potentially worsening disparities. Policy makers should consider ways to encourage uptake of the visit or other mechanisms to promote preventive care in underserved populations and the practices that serve them.

  20. Cancer screening promotion among medically underserved Asian American women: integration of research and practice.

    Science.gov (United States)

    Yu, Mei-yu; Seetoo, Amy D; Hong, Oi Saeng; Song, Lixin; Raizade, Rekha; Weller, Adelwisa L Agas

    2002-01-01

    Mammography and Pap smear tests are known to be effective early detection measures for breast and cervical cancers, respectively, but Asian Americans are reluctant to make visits for routine preventive care. Quantitative and qualitative research conducted by the Healthy Asian Americans Project (HAAP) between 1996 and 1999 indicated that Asian residents in southeastern Michigan, like the general Asian population in the US, underutilized early cancer screening programs due to cultural, psychosocial, linguistic, and economic barriers. This article reports how the HAAP's research findings guided the Michigan Breast and Cervical Cancer Control Program (BCCCP) promotion (conducted from 2000 to 2001 among medically underserved Asian women residing in southeastern Michigan), and how evaluation of the HAAP's BCCCP promotion will direct future research and health promotion programs. The article presents strategies used to improve access to cancer screening programs for diverse Asian sub-groups as well as outcomes of the 2-year HAAP's BCCCP promotion among the target population. Discussion regarding lessons and experiences gained from integration of research and practice has implications on design and implementation of the cancer screening promotion for the rapidly increasing Asian American population as well as other medically underserved minority populations in the US.

  1. Family welfare.

    Science.gov (United States)

    Sinha, N K

    1992-01-01

    Between 1901-1921, India gained 12.9 million people because mortality remained high. The death rate fell between 1921-1951, but birth rates remained the same. Therefore 110 million people were added--2 times the population increase between 1891-1921. Between 1951-1981, the population increased to 324 million. Socioeconomic development was responsible for most of the downward trend in the birth rate during the 20th century. Even though large families were the norm in early India, religious leaders encouraged small family size. The 1st government family planning clinics in the world opened in Mysore and Bangalore in 1930. Right before Independence, the Bhore Committee made recommendations to reduce population growth such as increasing the age of marriage for girls. Since 1951 there has been a change in measures and policies geared towards population growth with each of the 7 5-Year Plans because policy makers applied what they learned from each previous plan. The 1st 5-Year Plan emphasized the need to understand what factors contribute to population growth. It also integrated family planning services into health services of hospitals and health centers. The government was over zealous in its implementation of the sterilization program (2nd 5-Year Plan, 1956-1961), however, which hurt family planning programs for many years. As of early 1992, sterilization, especially tubectomy, remained the most popular family planning method, however. The 7th 5-Year Plan changed its target of reaching a Net Reproductive Rate of 1 by 2001 to 2006-2011. It set a goal of 100% immunization coverage by 1990 but it did not occur. In 1986, the Ministry of Health and Family Welfare planned to make free contraceptives available in urban and rural areas and to involve voluntary organizations. The government needs to instill measures to increase women's status, women's literacy, and age of marriage as well as to eliminate poverty, ensure old age security, and ensure child survival and

  2. The Effect of Integrating Family Planning with a Maternal and Newborn Health Program on Postpartum Contraceptive Use and Optimal Birth Spacing in Rural Bangladesh.

    Science.gov (United States)

    Ahmed, Saifuddin; Ahmed, Salahuddin; McKaig, Catharine; Begum, Nazma; Mungia, Jaime; Norton, Maureen; Baqui, Abdullah H

    2015-09-01

    Meeting postpartum contraceptive need remains a major challenge in developing countries, where the majority of women deliver at home. Using a quasi-experimental trial design, we examine the effect of integrating family planning (FP) with a community-based maternal and newborn health (MNH) program on improving postpartum contraceptive use and reducing short birth intervals MNH activities in the intervention arm, but provided only MNH services in the control arm. The contraceptive prevalence rate (CPR) in the intervention arm was 15 percent higher than in the control arm at 12 months, and the difference in CPRs remained statistically significant throughout the 24 months of observation. The short birth interval of less than 24 months was significantly lower in the intervention arm. The study demonstrates that it is feasible and effective to integrate FP services into a community-based MNH care program for improving postpartum contraceptive use and lengthening birth intervals. © 2015 The Population Council, Inc.

  3. [Evaluation of the inclusion of organic food from family-based agriculture in school food in municipalities of rural territories of the state of Rio Grande do Sul, Brazil].

    Science.gov (United States)

    dos Santos, Fernanda; Fernandes, Patrícia Fogaça; Rockett, Fernanda Camboim; de Oliveira, Ana Beatriz Almeida

    2014-05-01

    Organic food enables the promotion of Food and Nutritional Safety (FNS) and sustainable regional development. In this context, the National School Food Program (NSFD) seeks to comply with the requirements of FNS. This study evaluated the inclusion of organic food in school food in the municipalities of rural territories of the state of Rio Grande do Sul by means of interviews with local managers. Eight territories were visited, albeit of its 153 municipalities only 102 comprised the sample for this study. Of these, 20.58% said they buy organic produce from family farms. The Center South Territory revealed the highest percentage of purchase, in which 40% of the municipalities visited purchased organic produce, followed by the Center Mountain Territory with 33.3%, while the lowest percentage was 7.1% in the Countryside Territory. The study identified the need for intersectoral action to develop organic production, as well as stimulate the consumption of these foods in the school environment, in order to meet the requirements of FNS.

  4. What do beginning students, in a rurally focused medical course, think about rural practice?

    Science.gov (United States)

    Young, Louise; Lindsay, Daniel B; Ray, Robin A

    2016-12-07

    Medical schools may select students for their attitudes towards rural medical practice, yet the rural-urban disparity in availability of medical practitioners and services has not diminished in recent times despite government initiatives and increasing numbers being trained for a career in medicine. One medical school, with a focus on rural and remote medicine, aims to select students with positive perceptions for rural medical practice. A research project collected data on the perceptions of these medical students in the first week of their medical studies. Students completed a low stakes essay on the life and work of a rural doctor. Initially, this formed part of a literacy assessment to determine any students requiring remediation. All students were asked if they would consent to their essay being reviewed for a research project. Data was obtained from those students who consented and handed their essays in for review. The 103 student essays underwent thematic analysis and sentences were coded into three main themes of rural lifestyle, doctor role and rural practice. Second level themes were further elicited and results were quantified according to whether they were positive or negative. Positive themes included rural lifestyle, doctor role, views of doctor, impact on community, broader work and skills knowledge, and better relationships with community and patients. Negative themes included doctor's health, pressure on doctor, family problems, greater workload, privacy and confidentiality issues, cultural issues, isolation, limited resources and financial impacts. Quantitisation of this data was used to transform essay sentences into a numerical form which allowed statistical analysis and comparison of perceptions using Z tests. No significant differences on the number of positive and negative responses for rural lifestyle and rural practice were found. The rural doctor role had a significantly more positive than negative views. Significant differences were

  5. Effect of Active Videogames on Underserved Children's Classroom Behaviors, Effort, and Fitness.

    Science.gov (United States)

    Gao, Zan; Lee, Jung Eun; Pope, Zachary; Zhang, Dachao

    2016-09-30

    The purpose of this study was to examine the effect of active videogames (AVGs) on underserved minority children's on-task classroom behavior, academic effort, and fitness. A one group pre- and posttest repeated measures design was used. In Fall 2013, 95 fourth grade children (57 boys, 38 girls; 96% of minority) from three classes at an underserved urban elementary school participated in teacher-supervised AVG activities (e.g., Wii Sports, Xbox Just Dance). Specifically, students participated in a 50-minute weekly AVG program at school for 6 weeks. Children's academic effort was evaluated by classroom teachers using a validated scale that assessed activity, attention, conduct, and social/emotional behavior. Moreover, children's classroom behavior was observed immediately before and after each AVG session by trained researchers. Finally, cardiovascular fitness was also measured. A paired t-test was used to assess teacher-rated student effort, while one-way (gender) analysis of variance (ANOVA) with repeated measures was performed to analyze children's on-task classroom behavior. There was a significant effect on children's effort between the first (mean = 3.24, SD = 0.75) and last week (mean = 3.41, SD = 0.73) assessments, t = 2.42, P = 0.02. In addition, there was a significant effect on classroom behavior, F = 33.103, P < 0.01. In detail, children scored significantly higher on on-task behavior during the post-AVG observation (mean = 81.4, SD = 12.3) than seen during the pre-AVG observation (mean = 69.8, SD = 14.9). However, no main effect was indicated for gender, F = 0.39, P = 0.54. No significant improvement in cardiovascular fitness was observed, although slight improvements were seen. Offering an AVG program at school could improve underserved minority children's classroom on-task behavior and academic effort. Future studies may include a control group to further confirm the effectiveness of AVG

  6. Diet and Exercise Adherence and Practices among Medically Underserved Patients with Chronic Disease: Variation across Four Ethnic Groups

    Science.gov (United States)

    Orzech, Kathryn M.; Vivian, James; Huebner Torres, Cristina; Armin, Julie; Shaw, Susan J.

    2013-01-01

    Many factors interact to create barriers to dietary and exercise plan adherence among medically underserved patients with chronic disease, but aspects related to culture and ethnicity are underexamined in the literature. Using both qualitative ("n" = 71) and quantitative ("n" = 297) data collected in a 4-year, multimethod study…

  7. Recruitment practices for U.S. minority and underserved populations in NRG oncology: Results of an online survey

    Directory of Open Access Journals (Sweden)

    Elise D. Cook

    2018-06-01

    Full Text Available Introduction: Cancer clinical trials (CCT provide much of the evidence for clinical guidelines and standards of care. But low levels of CCT participation are well documented, especially for minorities. Methods and materials: We conducted an online survey of 556 recruitment practices across the NRG Oncology network. Survey aims were 1 to learn how sites recruit minority/underserved populations; 2 to better understand the catchment areas of the NRG institutions; and 3 to aid in planning education programs for accrual of minority/underserved populations. Results: The survey response rate was 34.9%. The most effective methods reported for recruiting minority/underserved participants were patient navigators (44.4% and translators (38.9%. All institutions reported using a mechanism for eligibility screening and 71% of institutions reported using a screening/enrollment tracking system. CCT training was required at 78.1% and cultural competency training was required at 47.5% of responding institutions. Only 19.9% of sites used community partners to assist with minority recruitment and just 37.1% of respondents reported a defined catchment area. Sites reported very little race and ethnicity data. Conclusion: This NRG Oncology online survey provides useful data for improvements in trial enrollment and training to recruit minority/underserved populations to CCT. Areas for further investigation include web-based methods for recruitment and tracking, cultural competency training, definition of catchment areas, use of patient navigators, and community partnerships. The survey results will guide recruitment training programs.

  8. 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.

  9. Against Cursory Treatments in Ethics of Medical Migration from Underserved Countries.

    Science.gov (United States)

    Yuksekdag, Yusuf

    2017-06-01

    In a recent paper, Mpofu, Sen Gupta, and Hays (2016) attempt to outline the obligations of recruiting high-income countries (HICs) and would-be emigrant health workers (HWs) to tackle the effects of mass exodus of health workers from underserved regions. They reconstruct (i) Rawlsian and Kantian global justice approaches to argue for moral obligations of HICs and (ii) an individual justice approach to point to non-enforceable social responsibilities of HWs to assist their compatriots. This critical commentary demonstrates that the argumentation within their individual justice approach is problematic on the basis of three reasons: (1) their discussion under-theorizes and undervalues individual rights and more specifically the right to exit, (2) their argumentation in the latter part, even if problematically, does rather point to moral obligations in lieu of social responsibilities of HWs, and (3) they overlook many other important freedoms, interests, and values pertinent to the issue of retention.

  10. Evaluation of a student-run smoking cessation clinic for a medically underserved population

    Directory of Open Access Journals (Sweden)

    Ebbert Jon O

    2011-03-01

    Full Text Available Abstract Background Smoking is common among medically underserved populations. Accessible resources to encourage and support smoking cessation among these patients are limited. Volunteer medical student-run free smoking cessation clinics may provide an effective option to help these individuals achieve smoking abstinence. In order to demonstrate the feasibility and cost-effectiveness of a student-run clinic, we analyzed a case series of patients receiving care in a medical student-run Smoking Cessation Clinic (SCC at the Rochester, Minnesota Salvation Army Good Samaritan Health Clinic (GSHC. Findings Between January 2005 and March 2009, 282 cigarette smokers seeking care at the SCC were analyzed. Student providers at the SCC conducted 1652 weekly individual counseling sessions averaging 18 minutes per encounter. Patients were offered a choice of pharmacotherapies including nicotine replacement therapy (NRT, bupropion, and varenicline for up to 12 weeks. Smoking abstinence was confirmed with exhaled carbon monoxide (CO. Thirty-two patients completed the entire 12-week program (11.3%. At last contact, 94 patients (33.3% abstained from smoking for ≥ 7 days and 39 patients (13.8% were continuously abstinent for ≥ 4 weeks. The 7-day point prevalence abstinence rates at last contact were 58.6% for varenicline, 41.2% for bupropion, 33.9% for NRT, and 23.5% for bupropion and NRT. Analyzing missing patients as smoking, the 7-day point prevalence abstinence rates were 7.1%, 8.9%, and 8.2%, at 1 month, 2 months, and 3 months after program enrollment, respectively. No serious adverse drug reactions were recorded. Conclusions Our medical student-run smoking cessation clinic provided an effective and safe experience for medically underserved patients who might not otherwise have access to conventional smoking cessation programs because of high cost, lack of insurance, or other disparities. Similar medical student initiatives focusing on healthy lifestyles

  11. 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

  12. Training Psychologists for Rural Practice: Exploring Opportunities and Constraints.

    Science.gov (United States)

    Domino, Marisa Elena; Lin, Ching-Ching Claire; Morrissey, Joseph P; Ellis, Alan R; Fraher, Erin; Richman, Erica L; Thomas, Kathleen C; Prinstein, Mitchell J

    2018-04-17

    To examine trends in the psychologist workforce and training opportunities, including factors that may influence the decision of clinical psychologists to practice in rural settings. We use a mixed-methods approach to examine the psychologist workforce nationally and in North Carolina (NC), including (1) an analysis of the location of programs awarding doctoral degrees; (2) an analysis of the practice, demographic, and educational characteristics of the psychologist workforce; and (3) interviews with directors of doctoral programs in clinical psychology to understand where current graduates are getting jobs and why they may or may not be choosing to practice in rural communities. Fewer than 1% of programs and institutions awarding doctoral degrees in psychology in the United States are located in rural areas. In NC, approximately 80% of practicing psychologists have out-of-state degrees and about 80% of recent NC graduates are not currently licensed in the state. This juxtaposition undermines the utility of adding more in-state degree programs. While expansion of training programs within rural areas could help alleviate the shortages of mental health providers, adding new degree-granting programs alone will not necessarily increase supply. We discuss complementary recruitment and retention strategies, including greater incentives for rural training and practice as well as training in emerging technologies that don't require providers to be physically located in underserved areas, such as telemedicine. Increasing the supply of psychologists practicing in rural areas will require a thoughtful, multipronged approach to training this critical part of the behavioral health workforce. © 2018 National Rural Health Association.

  13. Rural residents' perspectives on the rural 'good death': a scoping review.

    Science.gov (United States)

    Rainsford, Suzanne; MacLeod, Roderick D; Glasgow, Nicholas J; Wilson, Donna M; Phillips, Christine B; Wiles, Robert B

    2018-05-01

    The 'good death' is one objective of palliative care, with many 'good death' viewpoints and research findings reflecting the urban voice. Rural areas are distinct and need special consideration. This scoping review identified and charted current research knowledge on the 'good' rural death through the perspectives of rural residents, including rural patients with a life-limiting illness, to identify evidence and gaps in the literature for future studies. A comprehensive literature search of English language articles (no date filter applied) was conducted in 2016 (2 January to 14 February) using five library databases. Reference lists of included articles, recent issues of eight relevant journals and three grey literature databases were also hand-searched. Twenty articles (for 17 studies and one systematic review) were identified after a two-phase screening process by two reviewers, using pre-determined inclusion criteria. Data from each study were extracted and charted, analysed using a thematic analysis of the included articles' content, and with a quantitative analysis of the scoping review. These papers revealed data collected from rural patients with a life-limiting illness and family caregivers, rural healthcare providers, the wider rural community, rural community leaders and rural health administrators and policy makers. Rural locations were heterogeneous. Residents from developed and developing countries believe a 'good death' is one that is peaceful, free of pain and without suffering; however, this is subjective and priorities are based on personal, cultural, social and religious perspectives. Currently, there is insufficient data to generalise rural residents' perspectives and what it means for them to die well. Given the extreme importance of a 'good death', there is a need for further studies to elicit rural patient and family caregiver perspectives. © 2016 John Wiley & Sons Ltd.

  14. Medicaid and Rural Health

    Science.gov (United States)

    ... State Guides Rural Data Visualizations Rural Data Explorer Chart Gallery Maps Case Studies & Conversations Rural Health Models & ... services provided by state Medicaid programs might include dental care, physical therapy, home and community-based services, ...

  15. 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.

  16. Libyan intuitive for rural electrification

    International Nuclear Information System (INIS)

    Ibrahim, I. M. Saleh; Kreama, N. M.; Khalat, M. A.

    2006-01-01

    One of the obstacles in rural electrification is choosing the type of the electric source which best fits rural areas technically, socially, and economically. Renewable sources can be used to electrify rural areas. Rural electrification in Libya by photovoltaic systems in a national program which is devoted to electrify isolated villages, as part of this program the installation of 300 systems was started at the beginning of the year 2003 with a total power of 400 K Wp, the sizes of stand alone systems are 1.8 K Wp, 1.2 K Wp, 0.75 K Wp, and 0.15 K Wp, beside a hybrid system of diesel and PV. The systems was designed to supply different family needs a total of 5000 inhabitants will benefit from this project. In this paper we will introduce the rural photovoltaic electrification in Libya program, company the performance of three different PV sizes through the first two years of working. The systems performing well and with performance ratio much more than the deigned, very little power failure was reported, and there are social and technical issues to be addressed before, and after the installation of the PV system.(Author)

  17. The Importance of Broadband for Socio-Economic Development: A Perspective from Rural Australia

    Directory of Open Access Journals (Sweden)

    Julie Freeman

    2016-10-01

    Full Text Available Advanced connectivity offers rural communities prospects for socio-economic development. Despite Australia’s national broadband infrastructure plans, inferior availability and quality of rural Internet connections remain persistent issues. This article examines the impact of limited connectivity on rural socio-economic opportunities, drawing from the views of twelve citizens from the Boorowa local government area in New South Wales. The available fixed wireless and satellite connections in Boorowa are slow and unreliable, and remote regions in the municipality are still without any Internet access. Participants identified four key areas in their everyday lives that are impacted by insufficient connectivity: business development, education, emergency communication, and health. Rural citizens often already face challenges in these areas, and infrastructure advancements in urban spaces can exacerbate rural-urban disparities. Participants’ comments demonstrated apprehension that failure to improve connectivity would result in adverse long-term consequences for the municipality. This article suggests that current broadband policy frameworks require strategic adaptations to account for the socio-economic and geographic contexts of rural communities. In order to narrow Australia’s rural-urban digital divide, infrastructure developments should be prioritised in the most underserved regions.

  18. Inclusive Early Childhood Development: Ensuring the Rights and Well-Being of Infants and Toddlers with Disabilities and Their Families

    Science.gov (United States)

    Wertlieb, Donald

    2018-01-01

    The science and practice of early childhood development now stands ready to address the needs and ensure the rights of infants and young children with disabilities and their families, among the most underserved and marginalized in all regions of the world. Synergies in global policies such as the "United Nations Convention on the Rights of…

  19. Parent-child reading interactions among English and English as a second language speakers in an underserved pediatric clinic in Hawai'i.

    Science.gov (United States)

    Kitabayashi, Kristyn M; Huang, Gary Y; Linskey, Katy R; Pirga, Jason; Bane-Terakubo, Teresa; Lee, Meta T

    2008-10-01

    The purpose of this study was to compare reading patterns between English-speaking and English as a Second Language (ESL) families in a health care setting in Hawai'i. A cross-sectional study was performed at an underserved pediatric primary care clinic in Hawai'i. Caregivers of patients between the ages of 6 months to 5 years were asked questions regarding demographics and parent-child reading interactions. Respondents were categorized into English-speaking or ESL groups based on primary language spoken at home. Pearson chi2 tests and Fisher exact tests were performed to compare demographic differences, reading frequency, and reading attitudes between groups. One-hundred three respondents completed the survey Fifty percent were ESL. All ESL respondents were of Asian-Pacific Islander (API) or mixed Asian ethnicity. All Caucasians in the study (n = 9) were in the English-speaking group. Between the English-speaking (n = 52) and ESL (n = 51) groups, there were no significant statistical differences in age or gender of the child, reading attitudes, or parent's educational status. Parents in the ESL group read to their children significantly fewer days per week than their English-speaking counterparts, had significantly fewer books in the home, and lived significantly fewer years in the United States. The findings suggest that API immigrant families share similar attitudes about reading as English-speaking families in Hawai'i but have significantly fewer books in their household and read significantly less frequently Physicians working with API populations should be aware that immigrant children may have fewer reading interactions and should counsel parents on the importance of reading daily.

  20. Sobre regimes demográficos restritos: comportamento reprodutivo e cultura familiar entre os ucranianos no meio rural paranaense (1895-1980 Sobre regímenes demográficos restringidos: comportamiento reproductivo y cultura familiar entre los ucranianos en el medio rural paranaense (1895-1980 On restricted demographic regimes: reproductive behavior and ukrainian family culture in rural areas of the Brazilian state of Paraná (1895-1980

    Directory of Open Access Journals (Sweden)

    Maria Luiza Andreazza

    2008-06-01

    esto restó considerar que el comportamiento reproductivo es fruto de un complejo sistema de representaciones, en el cual interactúan modos de concebir las relaciones de género y las inter-generacionales, así como el papel del casamiento y de la constitución familiar. Si así fuera, las prácticas concernientes a la fecundidad corresponden, sobremanera, al ejercicio social de una determinada visión del mundo. En especial en los grupos que viven en cierto aislamiento social, las posibilidades de reproducir modelos ancestrales de reposición generacional son favorecidas. Entre los inmigrantes estudiados, casi un siglo en Brasil fue insuficiente para cambiar el sistema familiar que vino en su bagaje: aquí continuaron reproduciendo una prole extensa, aunque por eso hubieran activado una continuada migración de los hijos excedentes.This study focuses on the family dynamics of immigrants from the present country of the Ukraine. the ancestors of these families came to Brazil in 1895 and settled in a rural area of the State of Paraná known as Colônia Antonio Olynto. Due to the group's high legitimate fertility rate in the cohorts established for the study (1895-1949/1950-1980, the research focused on understanding the maintenance of this high rate during the period analyzed (between 8 and 9 children in the first group and 7 and 8 in the second and the consequences in terms of family, home and social organization. In other words, the analysis questions the reasons why this group tried to perpetuate a reproductive system that historically corresponded to the realities of a quite different social space, when, in their adopted country the gross fertility rate was quickly reduced, particularly in the period that corresponded to the second group of the study. the only conclusion possible would seem to be that reproductive behavior is the result of a complex system of representation interfacing the different ways of conceiving gender-based and inter-generational relations

  1. Relationships Between Health Literacy and Genomics-Related Knowledge, Self-Efficacy, Perceived Importance, and Communication in a Medically Underserved Population.

    Science.gov (United States)

    Kaphingst, Kimberly A; Blanchard, Melvin; Milam, Laurel; Pokharel, Manusheela; Elrick, Ashley; Goodman, Melody S

    2016-01-01

    The increasing importance of genomic information in clinical care heightens the need to examine how individuals understand, value, and communicate about this information. Based on a conceptual framework of genomics-related health literacy, we examined whether health literacy was related to knowledge, self-efficacy, and perceived importance of genetics and family health history (FHH) and communication about FHH in a medically underserved population. The analytic sample was composed of 624 patients at a primary care clinic in a large urban hospital. About half of the participants (47%) had limited health literacy; 55% had no education beyond high school, and 58% were Black. In multivariable models, limited health literacy was associated with lower genetic knowledge (β = -0.55, SE = 0.10, p interval [CI; 0.28, 0.90], p = .020), and greater perceived importance of genetic information (OR = 1.95, 95% CI [1.27, 3.00], p = .0022) but lower perceived importance of FHH information (OR = 0.47, 95% CI [0.26, 0.86], p = .013) and more frequent communication with a doctor about FHH (OR = 2.02, 95% CI [1.27, 3.23], p = .0032). The findings highlight the importance of considering domains of genomics-related health literacy (e.g., knowledge, oral literacy) in developing educational strategies for genomic information. Health literacy research is essential to avoid increasing disparities in information and health outcomes as genomic information reaches more patients.

  2. Implicações do turismo no espaço rural e em estabelecimentos da agricultura familiar

    Directory of Open Access Journals (Sweden)

    Luciano Zanetti Pessôa Candiotto

    2011-10-01

    Full Text Available Considering the expansion of rural tourism in the world and in Brazil and the incentive of public and private sectors to family farms open their properties to tourism, we wrote this article to presents and discuss the implications of rural tourism and to emphasize their consequences in family farms. So, we worked with brazilian and foreigners literature that analyses the spatial implications and changes of this activity and try to present our impressions about rural tourism, which may grow in rural spaces and modify its social and spatial dynamics. Keywords: tourism; rural space; social and spatial implications; family farm; family unity of production and life (UPVF.

  3. 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 ...

  4. Exploring the Influence of Social Determinants, Social Capital, and Health Expertise on Health and the Rural Church.

    Science.gov (United States)

    Plunkett, Robyn; Leipert, Beverly; Olson, Joanne

    2016-09-01

    In rural communities, religious places can significantly shape health for individuals, families, and communities. Rural churches are prominent community centers in rural communities and are deeply woven into rural culture. Thus, health influences arising from the rural church likely have health implications for the greater community. This article explores health influences emerging from rural churches using social determinants of health, social capital, and health expertise. Although nurses are important health resources for all populations, their value in rural areas may be exceedingly significant. The contribution of nurses to church-based health capital in rural communities may be quite significant and underestimated, although it remains poorly understood. © The Author(s) 2015.

  5. Knowledge of communicable and noncommunicable diseases among Karen ethnic high school students in rural Thasongyang, the far northwest of Thailand.

    Science.gov (United States)

    Lorga, Thaworn; Aung, Myo Nyein; Naunboonruang, Prissana; Junlapeeya, Piyatida; Payaprom, Apiradee

    2013-01-01

    The double burden of communicable and noncommunicable diseases (NCD) is an increasing trend in low- and-middle income developing countries. Rural and minority populations are underserved and likely to be affected severely by these burdens. Knowledge among young people could provide immunity to such diseases within a community in the long term. In this study we aimed to assess the knowledge of several highly prevalent NCDs (diabetes, hypertension, and chronic obstructive pulmonary disease [COPD]) and several highly incident communicable diseases (malaria and diarrheal diseases) among Karen high school students in a rural district in far northwest of Thailand. The aim of the study is to explore information for devising life-course health education that will be strategically based in schools. A cross-sectional survey approved by the ethics committee of Boromarajonani College of Nursing Nakhon Lampang (BCNLP), Lampang, Thailand was conducted in Thasongyang, Tak province, from September 2011 to January 2012. Questionnaires for assessing knowledge regarding diabetes, hypertension, COPD, malaria, and diarrheal diseases were delivered to all 457 Karen high school students attending Thasongyang high school. A total of 371 students returned the questionnaires. Experts' validation and split-half reliability assessment was applied to the instrument. Students' main sources of health information were their teachers (62%), health care workers (60%), television (59%), and parents (54%). Familial risk factors of diabetes and hypertension were not known to more than two thirds of the students. Except obesity and physical inactivity, lifestyle-related risk factors were also not known to the students. Though living in a malaria-endemic area, many of the Karen students had poor knowledge about preventive behaviors. Half of the students could not give a correct answer about the malaria and hygienic practice, which might normally be traditionally relayed messages. Health education and

  6. Knowledge of communicable and noncommunicable diseases among Karen ethnic high school students in rural Thasongyang, the far northwest of Thailand

    Directory of Open Access Journals (Sweden)

    Lorga T

    2013-07-01

    Full Text Available Thaworn Lorga,1 Myo Nyein Aung,1,2 Prissana Naunboonruang,1 Piyatida Junlapeeya,1 Apiradee Payaprom31Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand; 2Department of Public Health, Graduate School of Medicine, Juntendo University, Tokyo, Japan; 3Thasongyang Hospital, Thasongyang, Tak, ThailandBackground: The double burden of communicable and noncommunicable diseases (NCD is an increasing trend in low- and-middle income developing countries. Rural and minority populations are underserved and likely to be affected severely by these burdens. Knowledge among young people could provide immunity to such diseases within a community in the long term. In this study we aimed to assess the knowledge of several highly prevalent NCDs (diabetes, hypertension, and chronic obstructive pulmonary disease [COPD] and several highly incident communicable diseases (malaria and diarrheal diseases among Karen high school students in a rural district in far northwest of Thailand. The aim of the study is to explore information for devising life-course health education that will be strategically based in schools.Method: A cross-sectional survey approved by the ethics committee of Boromarajonani College of Nursing Nakhon Lampang (BCNLP, Lampang, Thailand was conducted in Thasongyang, Tak province, from September 2011 to January 2012. Questionnaires for assessing knowledge regarding diabetes, hypertension, COPD, malaria, and diarrheal diseases were delivered to all 457 Karen high school students attending Thasongyang high school. A total of 371 students returned the questionnaires. Experts' validation and split-half reliability assessment was applied to the instrument.Results: Students' main sources of health information were their teachers (62%, health care workers (60%, television (59%, and parents (54%. Familial risk factors of diabetes and hypertension were not known to more than two thirds of the students. Except obesity and physical

  7. Masa ciała dzieci uczących się w podstawowych szkołach wiejskich a styl życia rodzin = The body weight of rural primary school pupils and the lifestyle of their families

    Directory of Open Access Journals (Sweden)

    Zdzisława Szadowska-Szlachetka

    2016-09-01

    ła, iż podczas spożywania posiłków zasiadała wspólnie przy stole. Wnioski. Nadwaga u dzieci ma związek z piciem przez nie słodkich napojów. Stosowanie nagród w postaci słodkich przekąsek, dodatkowego korzystania z TV i komputera, sposób spędzania wolnego czasu przez rodzinę i sposób spożywania posiłków nie ma związku istotnego statystycznie z masą ciała dzieci w badanej grupie. Słowa kluczowe. masa ciała, dzieci, szkoła podstawowa, styl życia, rodzice, BMI.   Abstract Objective. The objective of the study was to analyse the body weight of rural school pupils and the lifestyle of their families. Material and method. The survey covered 100 parents of children from grades 1-6 of rural primary schools in the Opole Lubelskie District. The diagnostic survey with the interview technique was used as the research method, and  a self-designed interview questionnaire was applied. Results. In the surveyed group the body weight of 65% of children was normal, 18% of children were underweight and 17% - overweight. Among the fathers of overweight children there was a correlation close to the statistical significance threshold, i.e. p = 0.06, referring to their overweight. There was no statistically significant connection between the number of meals consumed by the children per day and their body weight. In some children (approx. 20% overweight occurred when, as a reward for good behaviour or grades, they received sweets or were allowed to use the computer or watch television. The self-designed survey results show a connection between daily consumption of sweet carbonated drinks by children and their body weight p = 0.044. Most of the surveyed parents, i.e. 83%, declared that their children undertook physical activity in addition to physical education classes. The statistical analysis demonstrates that there is no correlation between the way in which families spend their free time (watching television, games and playing outdoors, using the computer, reading

  8. Rural school in the Tenza Valley, rural education and agroecology reflections on rural “development”

    Directory of Open Access Journals (Sweden)

    Mejia Alfonso Miguel Fernando

    2011-08-01

    Full Text Available family: ";Arial";,";sans-serif";; font-size: 10pt; mso-fareast-font-family: MinionPro-Regular; mso-fareast-language: EN-US; mso-ansi-language: EN-US; mso-bidi-language: AR-SA;" lang="EN-US">

    family: ";Arial";,";sans-serif";; font-size: 10pt; mso-fareast-font-family: MinionPro-Regular; mso-ansi-language: EN-US;" lang="EN-US">The municipality of Sutatenza (Boyaca, constitutes an important reference for rural education in Colombia due to “Radio Sutatenza” (Educational Radio and the People’s Cultural Action in the mid-twentieth century. Currently, in the same town, a process called the Campesina Community School del Valle de Tenza has been brewing, under an agroecological approach, guided in its work to the cultural and productive Andean farmers, their families and their young people to cultivate in them a return the field. This article addresses this educational experience for contrasting approaches of “development” with the perceptions and visions that emerge from the rural world, without being radically different, it raises important questions for the call for and controversy of development, from the local.

  9. Women in rural development.

    Science.gov (United States)

    Palmer, I

    1980-01-01

    The integration of women in rural development means something more than mere labor involvement, but there has never been a clear definition of what it means. 4 principal concerns of policy-makers are briefly described as they affect women: unemployment and inadequate employment; 2) the satisfaction of basic needs and women's participation in decision-making; 3) population issues; and 4) rural-to-urban migration. The actual inter-household and inter-personal distribution of more work and higher productivity work could result in some hard-working people working even longer hours because of additional tasks with others losing their intermittent employment opportunities due to mechanization. These contradictions can be particularly acute for women. The non-material basic need of decision-making powers is more important in the case of women than of men, yet the personal status of women is being threatened by the institution-building that accompanies peasant-based agricultural intensification plans and anti-poverty programs. The education of females has been seen as a possible factor favoring family planning. In addition, education for women can mean access to public information and new expectations from life for themselves. At this time more women than men seem to be migrating to towns and cities in a number of countries with varied economic structures. 3 cases studies of agricultural development in Kenya, Bangladesh and Java, Indonesia are presented.

  10. A 5A's communication intervention to promote physical activity in underserved populations

    Directory of Open Access Journals (Sweden)

    Carroll Jennifer K

    2012-10-01

    Full Text Available Abstract Background The present study protocol describes the trial design of a clinician training intervention to improve physical activity counseling in underserved primary care settings using the 5As. The 5As (Ask, Advise, Agree, Assist, Arrange are a clinical tool recommended for health behavior counseling in primary care. Methods/Design The study is a two-arm randomized pilot pragmatic trial to examine a primary care clinician communication intervention on use of the 5As in discussion of physical activity in audio-recorded office visits in an ethnically diverse, low-income patient population. The study setting consists of two federally qualified community health centers in Rochester, NY. Eligible clinicians (n=15 are recruited and randomized into two groups. Group 1 clinicians participate in the training intervention first; Group 2 clinicians receive the intervention six months later. The intervention and its outcomes are informed by self-determination theory and principles of patient-centered communication. Assessment of outcomes is blinded. The primary outcome will be the frequency and quality of 5As discussions as judged by evaluating 375 audio-recorded patient visits distributed over baseline and in the post-intervention period (immediately post and at six months. Secondary outcomes will be changes in patients’ perceived competence to increase physical activity (Aim 2 and patients and clinicians beliefs regarding whether pertinent barriers to promoting exercise have been reduced. (Aim 3. Exploratory outcomes (Aim 4 are potential mediators of the intervention’s effect and whether the intervention affects actual enrollment in the community program recommended for exercise. The analysis will use repeated measures (in the form of recorded office visits from each clinician at each time point and aggregate measures of Groups 1 and 2 over time. Discussion Results will help elucidate the role of 5As communication training for clinicians on

  11. 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.

  12. El mundo rural y su problemática socioeducativa

    Directory of Open Access Journals (Sweden)

    Sindo FROUFE QUINTAS

    2009-11-01

    Full Text Available RESUMEN: El mundo rural con todas sus necesidades sociales y educativas es uno de los problemas actuales más agudos y permanentes. La cultura rural va desapareciendo en favor de la cultura industrial y cibernética. La cultura rural está definida por ámbitos sociales concretos: lengua, formas de administración familiar, sentido de la vida, etc. Analizamos los movimientos sociales en el mundo rural como agentes capaces de producir cambios y transformaciones en el medio rural. Comentamos la función educativa de los Colegios Rurales Agrupados, la potenciación del turismo rural y la necesidad de caminar hacia un Desarrollo Sostenible, que satisfaga las necesidades del presente, sin poner en peligro la vida y el desarrollo medioambiental de las generaciones futuras.ABSTRACT: One of the serious and longest-standing problems which exiss at the present time is to be found in the social and educational needs of the rural world. Rural culture is fast disappearing as it is ousted by industrial and cybernetic forms of family government, sense of values, etc. We shall analyse these social movements in the rural world as agents capable of producing changes and transformations in the rural environment. We shall comment on the role of CRAs, on support for rural tourism and on the need for moving towards a Sustained Development which can satisfy present needs without endangering the life and environmental development of future generations.

  13. What Is Rural? Revised

    Science.gov (United States)

    US Department of Agriculture, 2016

    2016-01-01

    Many people have definitions for the term rural, but seldom are these rural definitions in agreement. For some, rural is a subjective state of mind. For others, rural is an objective quantitative measure. In this brief report the United States Department of Agriculture presents the following information along with helpful links for the reader: (1)…

  14. Promoting Effective Parenting Practices and Preventing Child Behavior Problems in School among Ethnically Diverse Families from Underserved, Urban Communities

    Science.gov (United States)

    Brotman, Laurie Miller; Calzada, Esther; Huang, Keng-Yen; Kingston, Sharon; Dawson-McClure, Spring; Kamboukos, Dimitra; Rosenfelt, Amanda; Schwab, Amihai; Petkova, Eva

    2011-01-01

    This study examines the efficacy of "ParentCorps" among 4-year-old children (N = 171) enrolled in prekindergarten in schools in a large urban school district. "ParentCorps" includes a series of 13 group sessions for parents and children held at the school during early evening hours and facilitated by teachers and mental health…

  15. Factors Associated With Medical School Graduates' Intention to Work With Underserved Populations: Policy Implications for Advancing Workforce Diversity.

    Science.gov (United States)

    Garcia, Andrea N; Kuo, Tony; Arangua, Lisa; Pérez-Stable, Eliseo J

    2018-01-01

    Given projected U.S. physician shortages across all specialties that will likely impact underserved areas disproportionately, the authors sought to explore factors most correlated with medical school graduates' intention to work with underserved populations (IWUP). Data from the 2010-2012 Association of American Medical Colleges Medical School Graduation Questionnaire (n = 40,846) were analyzed. Variables (demographics, career preference, debt burden, intention to enter loan forgiveness programs) were examined using chi-square tests and logistic regression models. Respondents included 49.5% (20,228/40,846) women, 16.6% (6,771/40,837) underrepresented minorities (URMs), and 32.4% (13,034/37,342) with primary care intent. The median educational debt was $160,000. Respondents who were women (adjusted odds ratio [aOR] 1.59, 95% confidence interval [CI] 1.49, 1.70), URMs (aOR 2.50, 95% CI 2.30, 2.72), intended to enter loan forgiveness programs (aOR 2.44, 95% CI 2.26, 2.63), intended to practice primary care (aOR 1.65, 95% CI 1.54, 1.76), and intended to emphasize nonclinical careers (aOR 1.23, 95% CI 1.11, 1.37) had greater odds of reporting IWUP. Among those who chose specialties and careers with a nonclinical emphasis, and among those with greater burdens of educational and consumer debt, URMs were nearly twice as likely as other minorities and whites to report IWUP. Findings suggest physician characteristics that may be associated with filling workforce gaps in underserved areas. Restructuring financial incentive programs to support physician leaders and specialists with characteristics associated with IWUP may complement similar policies in primary care and could have key impacts on health equity in underserved areas.

  16. 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...

  17. 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 ...

  18. Marriage and Suicide among Chinese Rural Young Women

    Science.gov (United States)

    Zhang, Jie

    2010-01-01

    Suicides by young females in rural China contribute substantially to the high rate of suicide and the total number of suicides in China. Given the traditional familial structure that remains largely intact in rural China, this research focuses on whether being married is a risk or protective factor for suicide by young women. I examined 168 rural…

  19. Bush Tracks: Journeys in the Development of Rural Pedagogies

    Science.gov (United States)

    McConaghy, Cathryn; Lloyd, Linley; Hardy, Joy; Jenkins, Kathy

    2006-01-01

    The academic and social achievements of students in rural schools are very uneven and often absenteeism and suspension rates are high. Factors such as globalisation, economic restructuring, unemployment, youth suicide and family trauma, drought and environmental change (see Bourke & Lockie 2001) also impact on rural schooling and add further…

  20. Rural Math Excel Partnership (RMEP) Project Final Performance Report

    Science.gov (United States)

    Harmon, Hobart; Tate, Veronica; Stevens, Jennifer; Wilborn, Sandy; Adams, Sue

    2018-01-01

    The goal of the Rural Math Excel Partnership (RMEP) project, a development project funded by the U.S. Department of Education Investing in Innovation (i3) grant program, was to develop a model of shared responsibility among families, teachers, and communities in rural areas as collective support for student success in and preparation for advanced…

  1. Motivation for Math in Rural Schools: Student and Teacher Perspectives

    Science.gov (United States)

    Hardre, Patricia L.

    2011-01-01

    Rural schools, students, teachers, administrators, families and community leaders face unique challenges from those of their urban and suburban counterparts. This paper investigates motivation in rural secondary schools, with a particular focus on mathematics, from teacher and student perspectives. It integrates recent research on math learning…

  2. Ideal family population In a rural Tswana

    African Journals Online (AJOL)

    1983-04-09

    Apr 9, 1983 ... may obviate this problem, but this is often too time-consuming to be practical. ... communication may be responsible for their opinion that their husbands want more ... can no longer be accepted at face value. The following ...

  3. 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.

  4. Dental Therapists as New Oral Health Practitioners: Increasing Access for Underserved Populations.

    Science.gov (United States)

    Brickle, Colleen M; Self, Karl D

    2017-09-01

    The development of dental therapy in the U.S. grew from a desire to find a workforce solution for increasing access to oral health care. Worldwide, the research that supports the value of dental therapy is considerable. Introduction of educational programs in the U.S. drew on the experiences of programs in New Zealand, Australia, Canada, and the United Kingdom, with Alaska tribal communities introducing dental health aide therapists in 2003 and Minnesota authorizing dental therapy in 2009. Currently, two additional states have authorized dental therapy, and two additional tribal communities are pursuing the use of dental therapists. In all cases, the care provided by dental therapists is focused on communities and populations who experience oral health care disparities and have historically had difficulties in accessing care. This article examines the development and implementation of the dental therapy profession in the U.S. An in-depth look at dental therapy programs in Minnesota and the practice of dental therapy in Minnesota provides insight into the early implementation of this emerging profession. Initial results indicate that the addition of dental therapists to the oral health care team is increasing access to quality oral health care for underserved populations. As evidence of dental therapy's success continues to grow, mid-level dental workforce legislation is likely to be introduced by oral health advocates in other states. This article was written as part of the project "Advancing Dental Education in the 21 st Century."

  5. ITEAMS: Increasing the Self-Identification for Girls and Underserved Youth in Pursuing STEM Careers

    Directory of Open Access Journals (Sweden)

    R. Bruce Ward

    2012-02-01

    Full Text Available We report early findings on the efficacy of a technology-based project in increasing self-identification for girls and underserved youth to self-select STEM (science, technology, engineering, and mathematics careers. ITEAMS (Innovative Technology- Enabled Astronomy for Middle Schools – an out-of-schooltime program with online, robotic telescopes as its central focus – targets girls and minority students underrepresented in STEMrelated vocations. The participating students attend urban schools in Eastern Massachusetts. ITEAMS’ twofold goal is to: a provide inspiration for the participants to pursue STEM careers, and b increase the students’ mastery of foundational subject matter so they are prepared for the rigor of further STEM study. We use an online system for surveys and assessments, the former to capture attitudinal changes about career choices, and the latter to assess the students’ subject matter knowledge. Participating students take pre-, intermediate, and post subject-matter tests and career-interest surveys. While we find statistically significant gains in subject matter knowledge free of gender, race, or school bias, we also find girls profess less interest than boys in STEM careers as early as grades five and six, although other attitudinal indicators suggest ways to reverse that trend.

  6. Identifying elements of patient-centered care in underserved populations: a qualitative study of patient perspectives.

    Directory of Open Access Journals (Sweden)

    Sheela Raja

    Full Text Available Patient-centered care is an important goal in the delivery of healthcare. However, many patients do not engage in preventive medical care. In this pilot study, we conducted twenty in depth, semi-structured qualitative interviews at the University of Illinois at Chicago Health Sciences campus in a four month time frame. Many patients were underserved and underinsured, and we wanted to understand their experiences in the healthcare system. Using content analysis, several themes emerged from the interview data. Participants discussed the need for empathy and rapport with their providers. They identified provider behaviors that fostered a positive clinical relationship, including step-by step explanations of procedures, attention to body language and clinic atmosphere, and appropriate time management. Participants identified cost as the most common barrier to engaging in preventive care and discussed children and social support as motivating factors. A long-term relationship with a provider was an important motivator for preventive care, suggesting that the therapeutic alliance was essential to many patients. Conversely, many participants discussed a sense of dehumanization in the healthcare system, reporting that their life circumstances were overlooked, or that they were judged based on insurance status or ethnicity. We discuss implications for provider training and healthcare delivery, including the importance of patient-centered medical homes.

  7. Enrolling Underserved Women in mHealth Programs: Results From Text4baby Outreach Campaigns.

    Science.gov (United States)

    Bushar, Jessica A; Fishman, Jodie; Garfinkel, Danielle; Pirretti, Amy

    2018-03-01

    Public health practitioners have increasingly leveraged technology-based communication to get health information into the hands of hard-to-reach populations; however, best practices for outreach and enrollment into mobile health (mHealth) programs are lacking. This article describes enrollment results from campaigns focused on enrolling underserved pregnant women and mothers in Text4baby-a free, mHealth service-to inform outreach strategies for mHealth programs. Text4baby participants receive health and safety information, interactive surveys, alerts, and appointment reminders through at least three weekly texts and a free app-timed to users' due date or babies' birth date. Text4baby worked with partners to implement national, state, and community-based enrollment campaigns. Descriptive statistics were used to compare baseline enrollment prior to a campaign with enrollment during a campaign to generate enrollment estimates. Enrollment rates were calculated for campaigns for which the number targeted/reached was available. National television campaigns resulted in more than 10,000 estimated enrollments. Campaigns that were integrated with an existing program and text-based recruitment had the highest enrollment rates, ranging from 7% to 24%. Facebook advertisements and traditional media targeting providers and consumers were least effective. mHealth programs should consider text-based recruitment and outreach via existing programs; additional research is needed on return on investment for different outreach strategies and on the effectiveness of different outreach strategies at reaching and enrolling specific target populations.

  8. Transformations of Rural Society between 1700–1850

    Czech Academy of Sciences Publication Activity Database

    Velková, Alice

    2008-01-01

    Roč. 13, - (2008), s. 109-158 ISSN 1210-8499 Institutional research plan: CEZ:AV0Z80150510 Keywords : social stratification * property transfers * rural family * the 18th century Subject RIV: AB - History

  9. The status of hygiene and sanitation practice among rural model ...

    African Journals Online (AJOL)

    The status of hygiene and sanitation practice among rural model families of the Health Extension Program (HEP) in Wolayta and Kembata Tembaro Zones of Southern Nations, Nationalities and Peoples' Region of Ethiopia.

  10. The Jones Family's Culture of Literacy

    Science.gov (United States)

    Johnson, Amy Suzanne

    2010-01-01

    This article considers the uses of literacy within the Jones family (all names are pseudonyms), an African American family who lives in the rural South of the United States. Drawing on life history data with three women in the Jones family--Harriet Jones (grandmother), Sally Harris (mother), and Lola Harris (granddaughter)--the author traces how…

  11. The Role Of Rural Women In Crop And Poultry Production In Cross ...

    African Journals Online (AJOL)

    This paper examines the roles of rural women in crops and poultry production in rural areas in Cross River State, and their contribution to food production and preservation. The paper also revealed that rural women participate in food production and bearing responsibility for food marketing and distribution, family health, ...

  12. Comparison of Migrants in Two Rural and an Urban Area of Central Brazil.

    Science.gov (United States)

    Wilkening, E. A.

    The goal of this study was to compare the migration and adaptation of settlers in urban areas with settlers in rural areas of Brazil. A sample of 1,255 families, divided into an urban group, a near-urban rural group, and a rural group were interviewed. The migration patterns of the groups were discussed and factors related to migration were…

  13. Leisure Today--Family Cohesion Through Leisure and Recreation.

    Science.gov (United States)

    Smith, S. Harold, Ed.; And Others

    1984-01-01

    Family relationships can be strengthened through recreation and leisure activities. Articles dealing with leisure research, values, computers, recreation in rural areas, and youth sports are offered for those interested in facilitating the development of strong families. (DF)

  14. SUICIDAL ATTEMPTS AMONG YOUNG RURAL INHABITANTS

    Directory of Open Access Journals (Sweden)

    Zdzisław Brzeski

    2010-06-01

    Full Text Available In recent years changes have been noted in the motivations for acute suicidal poisonings among young people from various environments, which are due to psychosocial changes both in the urban and rural environments. Suicidal attempts are accompanied – especially in the rural environment – by low social status, difficulties with adapting to a free market economy, emotional tension within the family, at school, in the environment of young people, addiction to alcohol, drug overuse, including psychotropes. Based on clinical material concerning rural inhabitants hospitalized due to suicidal poisonings, the authors performed the analysis of attitudes, motivations and causes of acute poisonings among the young rural population. Among rural adolescents who continued school or university education the dominant causes of undertaking a suicidal attempt were: adolescent period problems, conflicts within the family, conflicts with mates, and disappointment in love. Among young adults the motivations were as follows: difficulties with finding employment in the place of residence, conflicts within the family, overuse of stimulants, and sometimes states of depression during the period of aggravation of a disease.

  15. Integration and Optimization of Renewables and Storages for Rural Electrification

    Directory of Open Access Journals (Sweden)

    Morris Brenna

    2016-09-01

    Full Text Available The electricity access in Sub-Saharan African countries is below 10%; thus, introducing a microgrid for rural electrification can overcome the endemic lack of modern electricity access that hampers the provision of basic services such as education, healthcare, safety, economic and social growth for rural communities. This work studies different possible comparison methods considering variations such as land area required, location for the storage, efficiency, availability and reliability of energy resources, and technology cost variability (investment cost and levelized cost of electricity, which are among the major key parameters used to assess the best possible utilization of renewables and storage system, either using them in the form of integrated, hybrid or independent systems. The study is carried out largely with the help of the Micropower optimization modeling simulator called HOMER for Ethiopia. As a result, the study proposes the use of Photovoltaic (PV–Wind–Hydro–Battery hybrid system model that concludes the optimal configuration of power systems at affordable price for underserved rural communities.

  16. A rural Appalachian faith-placed smoking cessation intervention.

    Science.gov (United States)

    Schoenberg, Nancy E; Bundy, Henry E; Baeker Bispo, Jordan A; Studts, Christina R; Shelton, Brent J; Fields, Nell

    2015-04-01

    Although health promotion programming in faith institutions is promising, most faith-based or placed health projects focus on diet, exercise, or cancer screening and many have been located in urban environments. This article addresses the notable absence of faith programming for smoking cessation among underserved rural US residents who experience tobacco-related health inequities. In this article, we describe our faith-oriented smoking cessation program in rural Appalachia, involving 590 smokers in 26 rural churches randomized to early and delayed intervention groups. We present three main themes that account for participants' positive evaluation of the program; the program's ability to leverage social connections; the program's convenience orientation; and the program's financial support for smoking cessation. We also present themes on the roles of faith and church in smoking cessation programming, including some mixed perceptions on smoking stigma and comfort in church settings; challenges in faith-placed smoking cessation recruitment; and the positive perception of such programming by church leaders. We conclude that faith-placed smoking cessation programs offer great potential, although they must be administered with great sensitivity to individual and community norms.

  17. 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.

  18. Teledentistry in rural California: a USC initiative.

    Science.gov (United States)

    Chang, Su-Wen; Plotkin, Daniel R; Mulligan, Roseann; Polido, José C; Mah, James K; Meara, John G

    2003-08-01

    Dentistry, in a synergistic combination with telecommunications technology and the Internet, has yielded a relatively new and exciting field that has endless potential. "Teledentistry" emerges from the fusion of dental practice and technology and can take on two forms--real-time consultation and "store and forward." The first entity to put teledentistry into practice was the Army, which, in 1994, successfully undertook consultations between dentists and service personnel located more than 100 miles apart. Since then, various institutions and organizations in the United States and farther afield have practiced teledentistry, with varying degrees of success. The Children's Hospital Los Angeles Teledentistry Project, being run in association with the University of Southern California's Mobile Dental Clinic, seeks to increase and enhance the quality of oral health care that is provided to children living in remote rural areas of California, areas often severely underserved by dental health providers. The project has three phases: Phase I involves the establishment and organization of the teledentistry network; Phase II will introduce technologies to provide orthodontic consultation and treatment; and Phase III will expand the network and provide increased specialty care into further areas of California and beyond, providing services to more children in desperate need of dental health care.

  19. MANAGEMENT IN RURAL AREAS

    Directory of Open Access Journals (Sweden)

    Danimir Štros

    2015-07-01

    Full Text Available Croatia has been seeking to achive pre-war results in tourism since its independence. Rural tourism in Croatia based on family farma faces a number of problems legal foundations, the involement of local communities, inadequate entepreneur support etc. The political will for development exists, but there is lack of willingness and the ability to get things started, which results in the closure of family farma who cannot cope with the parallel job of agriculture and tourism. Arriving guests certainly want a new type of tourism: peace, clean environment, cultural intangible and tangible treasures, all without the noise and stress; and Croatia can definitely offer it, either in coastal or inland areas with traditional food and drinks. The destinations connection is not satisfactora. there is also an evident lack of legislation and regional spatial development plans for sustainable tourism which is a prerequisite for successful tourism. With these plans presumptins accepted, Croatian tourism would become distinctive and inland and coastal branches of tourism could complement each other so that the customer can spend his vacation both in the continental ant the maritime part of the country, getting to know our culture and enjoy the traditional cousine.

  20. 7 CFR Exhibit C to Subpart L of... - Housing in Underserved Areas

    Science.gov (United States)

    2010-01-01

    ... metropolitan statistical area that has a population exceeding 1 million; 3. Is designated by the State or... percent or more of their population at, or below, poverty level and 13 percent or more of their occupied... concentrations of poverty and substandard housing and have severe, unmet rural housing needs. B. To provide for...