Browsing by Subject "rural"
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Item Characteristics of Primary Care Physicians Serving in Texas Medically Underserved Areas(2006-08-01) Lancaster, Scott Bradley; Kristine Lykens; Russell Gamber; Jeffrey TalbertLancaster, Scott Bradley, Characteristics of Primary Care Physicians Serving in Texas Medically Underserved Areas, 2005. Master of Public Health (Health Management and Policy), May 2006, 63 pp., 13 tables, bibliography, 59 titles. Primary care physician demographics were examined to determine if subgroups differed in choice of practice location in urban and rural Medically Underserved Areas (MUAs) in Texas. Compared with the overall proportion of physicians practicing in rural MUAs (8.8%), subgroups that significantly differed were Dos (13.5%), males (10.6%), general practitioners (19.4%), family physicians (12.4%), and graduates of medical school prior to or during 1960 (18.8%) and from 1961-1970 (11.2%). Compared with the overall proportion of physicians practicing in urban MUAs (23.2%), subgroups that significantly differed were females (25%), Blacks (29.7%), and Latinos (38.7). Binary logistic regression showed that Asian ethnicity, general practice specialty, and graduate year of 1961-1970 predicted MUA practice location. The statistically significant differences observed underscore the importance of further study to examine potential differences between rural and urban MUAs. Public policy that provides incentives for more equitable physician distribution should be based on sound research.Item Kinzie, Earl C., D.O.(1984-02-22) Kinzie, Earl C.; Stokes, C. RayA pioneer country doctor, Dr. Kinzie has practiced more than four decades in East Texas, delivering more than 2,000 babies, including football star Earl Campbell. He shares the highlights of his long and exciting career. Interviewed by C. Ray Stokes, February 22, 1984.Item Richards, David M., D.O. (1994)(1994-01-25) Richards, David M.; Hailey, BlakePresident of TCOM since 1985, Dr. Richards joined the college as vice president of academic affairs in 1981. Under his administration emphasis has been placed on academic excellence and a continued effort toward basic and clinical research. Interviewed by Blake Hailey, January 25, 1994Item Urbanicity and Mammography Utilization: How Living in an Urban or Rural Area Affects Mammography Screening Utilization Among Women in the United States(2008-05-01) Ylitalo, Kelly R.; Kathryn Cardarelli; Fang Fang Zhang; Nuha LackanYlitalo, Kelly R., Urbanicity and Mammography Utilization: How Living in an Urban or Rural Area Affects Mammography Screening Utilization among Women in the United States. Master of Public Health (Epidemiology), May 2008, 67 pp., 7 tables, 1 figure, references. Mammography is a widely used screening tool that can help prevent breast cancer mortality, yet utilization is not consistent. We utilized the 2006 Behavioral Risk Factor Surveillance System data to evaluate differences in mammography screening practices by urbanicity (urban vs. rural residence). Chi-square analyses, logistic regression, and propensity score matching were utilized to determine the association between urbanicity and mammography compared to women who lived in rural areas, even after controlling for individual variables. Geographic access to health care as represented by individual urban or rural residence may contribute to mammography screening practices in the United States.Item Utilizing PRISM and RE-AIM to implement and evaluate the Rural Telementoring Training Center (RTTC) for health care workforce development in rural communities(Frontiers Media S.A., 2023-11-06) Melhado, Trisha V.; Schneegans, Suyen; Rochat, Andrea; Kawasaki, Keito; Finley, Erin P.; Wheeler, Denna; Allison, Waridibo E.INTRODUCTION: Amid rural health worker shortages and hospital closures, it is imperative to build and maintain the local workforce. Telementoring (TM) or technology-enabled mentoring, is a tool for improving health care quality and access by increasing workforce capacity and support. The national Rural Telementoring Training Center (RTTC) was developed to compile and disseminate TM best practices by delivering free training, tools, and technical assistance to support the implementation, sustainability, and evaluation of new and current TM programs for rural health workers. This paper details how the Practical, Robust Implementation and Sustainability Model (PRISM) was used to understand the context that shaped implementation as well as how Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) was concurrently applied to frame outcomes. METHODS: The RTTC has three implementation strategies: outreach, training and technical assistance (TTA), and a Quality Measure Toolkit. Ongoing periodic reflections with the RTTC team, informed by PRISM, were collected, as were RE-AIM outcomes. Central to this design was the continuous review of incoming data in team meetings to inform programmatic changes by identifying challenges and applying modifications to strategies in real time. RESULTS: Major implementation changes discussed during reflections included providing timely and relevant messaging through various platforms, streamlining and customizing a TTA approach, and offering different options for accessing the Toolkit. The outreach strategy resulted in high Reach across the US, with over 300 organizations contacted. The effectiveness of the RTTC was demonstrated by counts of people engaging with outreach (ex. over 8,300 impressions on LinkedIn), the website (over 6,400 views), and e-bursts (33% open rate). Moreover, there were 32 TTA requests and 70 people accessing the Toolkit. Adoption was demonstrated by 27 people participating in TTA and 14 individuals utilizing the Toolkit. DISCUSSION: The integration of PRISM and RE-AIM frameworks promoted a holistic implementation and evaluation plan. Using PRISM, the RTTC team was able to reflect on the implementation strategies through the lens of contextual factors and make rapid programmatic changes within team meetings. That process resulted in outcomes framed by RE-AIM. The integration of two frameworks in tandem provided an adaptive and comprehensive approach to implementing a large-scale, national program.Item WHAT ARE THE BARRIERS TO BREAST CANCER SCREENING/MAMMOGRAPHY IN FREDERICKSBURG, TX?(2014-03) Baker, Laura; Patel, Pinal; Chiapa-Scifres, Ana; Bowling, JohnBreast cancer screening via mammography has been shown to catch cancer at earlier stages than would otherwise be caught. There are multiple reasons that women do not get mammograms and these reasons tend to differ in rural versus urban populations. This survey was distributed to female patients age 40 and over at Fredericksburg clinic in Fredericksburg, TX. Purpose (a): There are many barriers to breast cancer screening. Research has shown that lack of information about mammography, lower socioeconomic status, lower education level, lack of insurance, and travel burden are barriers to breast cancer screening. A lot of these barriers tend to exist in different proportions in a rural community versus an urban city. These barriers exist in Fredericksburg, but to varying degrees than other areas. The aim of this study was to determine what the barriers to breast cancer screening are in Fredericksburg, TX. Methods (b): Surveys were distributed to female patients over the age of 40 in Fredericksburg Clinic. The study sample included 36 surveys collected from January to March of 2013. The survey included demographic information, medical history, and factors related to breast cancer screening. Results (c): Average age of surveyed patients was 61.4 years. About 70% of respondents said that travel was not a burden to getting an annual mammogram out of the 91.2% that were screened. Out of 77.1% surveyed who thought that travelling was not a burden to getting an annual mammogram, 60% would need to drive less than 20 miles for a mammogram. The relationship between doctor recommendation of a mammogram and insurance coverage was investigated using Pearson product-moment correlation coefficient. There was a positive correlation between the two variables, r=.46, n=36,p=0.005. Conclusions (d): A statistically significant association was found between travel distance and whether they thought travel was a burden. Most patients will travel in order to get a once yearly mammogram but it can be considered to be a burden. Efforts to decrease the distance that some patients have to drive for a mammogram would increase the rates of women that get recommended screenings. Patients that had health insurance were more likely to see a doctor regularly and be recommended further health screenings. With an increase of healthcare coverage, doctors should be able to better recommend preventative health practices to patients.