Objectives: The Screening, Brief Intervention, and Referral to Treatment (SBIRT) framework is a validated process that is used to identify individuals with substance use disorders (SUDs) and then encourage them to engage in and facilitate entry into treatment. It is not known how well SBIRT can be incorporated into prehospital practice and what barriers to Emergency Medical Services (EMS) implementation of an SBIRT program might arise. The aim of this project was to implement a pilot EMS based SBIRT program.
View Article and Find Full Text PDFBackground: Telemedicine remains an underused tool in rural emergency medical servces (EMS) systems. Rural emergency medical technicians (EMT) and paramedics cite concerns that telemedicine could increase Advanced Life Support (ALS) transports, extend on-scene times, and face challenges related to connectivity as barriers to implementation. Our aim in this project was to implement a telemedicine system in a rural EMS setting and assess the impact of telemedicine on EMS management of patients with chest pain while evaluating some of the perceived barriers.
View Article and Find Full Text PDFCompared with urban residents, rural Americans have seen slower declines in cancer deaths, have lower incidence but higher death rates from cancers that can be prevented through screening, have lower screening rates, are more likely to present with later-stage cancers, and have poorer cancer outcomes and lower survival. Rural health provider shortages and lack of cancer services may explain some disparities. The literature was reviewed to identify factors contributing to rural health care capacity shortages and propose policy recommendations for improving rural cancer care.
View Article and Find Full Text PDFBackground And Objectives: Physician location is an important element of health care access. However, physician shortages and disparities in geographic distribution exist. This study examines physician locations, relocation patterns, and factors associated with relocating.
View Article and Find Full Text PDFWhen semantically-related photos appear with true-or-false trivia claims, people more often rate the claims as true compared to when photos are absent-. This occurs even when the photos lack information useful for assessing veracity. We tested whether truthiness changed in magnitude as a function of participants' age in a diverse sample using materials appropriate for all ages.
View Article and Find Full Text PDFMedication for Opioid Use Disorder (MOUD) is recommended, but not always accessible to those who desire treatment. This study assessed the impact of expanding access to buprenorphine through federally qualified health centers (FQHCs) in Arizona. We calculated mean drive-times to Arizona opioid treatment (OTP) locations, office-based opioid treatment (OBOT) locations, and FQHCs clinics using January 2020 location data.
View Article and Find Full Text PDFIntroduction: While cancer deaths have decreased nationally, declines have been much slower in rural areas than in urban areas. Previous studies on rural cancer service capacity are limited to specific points along the cancer care continuum (eg screening, diagnosis or treatment) and require updating to capture the current rural health landscape since implementation of the 2010 Affordable Care Act in the USA. The association between current rural cancer service capacity across the cancer care continuum and cancer incidence and death is unclear.
View Article and Find Full Text PDFThe sunk-cost effect (SCE) is the tendency to continue investing in something that is not working out because of previous investments that cannot be recovered. In three experiments, we examine the SCE when continued investment violates the ethic of care by harming others. In Experiment 1, the SCE was smaller if the sunk-cost decision resulted in harmful consequences towards others (an interaction between sunk cost and the ethic of care).
View Article and Find Full Text PDFOral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services.
View Article and Find Full Text PDFPurpose: A seamless system of social, behavioral, and medical services for the uninsured was created to address the social determinants of disease, reduce health disparities, and foster local economic development in 2 inner-city neighborhoods and 2 rural counties in New Mexico.
Methods: Our family medicine department helped urban and rural communities that had large uninsured, minority populations create Health Commons models. These models of care are characterized by health planning shared by community stakeholders; 1-stop shopping for medical, behavioral, and social services; employment of community health workers bridging the clinic and the community; and job creation.
J Health Care Poor Underserved
February 2006
Using a socio-ecological framework to guide the initiative, New Mexico Community Voices developed, with state and local stakeholders, responsive oral health policies to address oral health disparities. Several policy objectives were achieved: increasing awareness of the public health importance of oral health; improving access to dental services for uninsured or underserved populations; enhancing dental services specialty care; and increasing sustainable oral health infrastructure through pipeline development of oral health providers to relieve service shortages and diversify the oral health workforce. Improving access to oral health and augmenting numbers of dental providers in rural areas were also successful.
View Article and Find Full Text PDFOral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services.
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