Dialysis More Available Than Patient Education in Counties With High Diabetes Prevalence.

Introduction: Poorly controlled diabetes is a principal cause of end stage renal disease (ESRD), generating an estimated 44% of new cases. Diabetes self-management education and support (DSMES) has been documented to reduce adverse outcomes such as ESRD. Helping patients better manage their condition could ultimately reduce ESRD prevalence.

Geographic variations in driving time to US mental health care, digital access to technology, and household crowdedness.

Rural residents face significant barriers in accessing mental health care, particularly as the demand for such services grows. Telemedicine has been proposed as an answer to rural gaps, but this service requires both access to appropriate technology and private space in the home to be useful. Our study documented longer travel time to mental health facilities in rural areas and greater barriers to digital devices for telemedicine access in those same areas.

Integrating maternal depression care at primary private clinics in low-income settings in Pakistan: A secondary analysis.

Introduction: The prevalence of depression among women in Pakistan ranges from 28% to 66%. There is a lack of structured mental healthcare provision at private primary care clinics in low-income urban settings in Pakistan. This study investigated the effectiveness and processes of a facility-based maternal depression intervention at private primary care clinics in low-income settings.

A qualitative study of ecological and motivational factors to inform weight management interventions for Black men in the rural South of the United States.

Rationale And Objective: Black men in the rural South of the United States (US) are underrepresented in weight management behavioral trials. Qualitative research is needed to inform interventions that can reduce obesity and health disparities in this population. We explored how intrapersonal, social, and environmental factors affect motivation and weight-related behaviors and how to culturally adapt behavioral interventions for Black men in the rural South.

Rural-Urban Disparities in Quality of Inpatient Psychiatric Care.

Objective: Rural residents have higher rates of serious mental illness than urban residents, but little is known about the quality of inpatient psychiatric care available to them locally or how quality may have changed in response to federal initiatives. This study aimed to examine differences and changes in the quality of inpatient psychiatric care in rural and urban hospitals.

Methods: This national retrospective study of 1,644 facilities examined facility-level annual quality-of-care data from the Inpatient Psychiatric Facility Quality Reporting program, 2015-2019.

Comparison of US Hospital Charity Care Policies Before vs After Onset of the COVID-19 Pandemic.

Importance: Tax-exempt hospitals are required to provide charity care to maintain their tax-exempt status; charity care policies must be published online with clear eligibility criteria. Prior research has shown wide variability in charity care policy content; it is unknown how hospitals change their charity care policies over time.

Objective: To examine changes to tax-exempt hospital charity care policies before vs after the COVID-19 pandemic.

Availability of hospital-based cancer services before and after rural hospital closure, 2008-2017.

Introduction: Rural populations have less access to cancer care services and experience higher cancer mortality rates than their urban counterparts, which may be exacerbated by hospital closures. Our objective was to examine the impact of hospital closures on access to cancer-relevant hospital services across hospital service areas (HSAs).

Methods: We used American Hospital Association survey data from 2008 to 2017 to examine the change in access to cancer-related screening and treatment services across rural HSAs that sustained hospitals over time, experienced any closures, or had all hospitals close.

Examining the association between rurality and positive childhood experiences among a national sample.

Purpose: The present study examines the association between rurality and positive childhood experiences (PCEs) among children and adolescents across all 50 states and the District of Columbia. Recent work has quantified the prevalence of PCEs at the national level, but these studies have been based on public use data files, which lack rurality information for 19 states.

Methods: Data for this cross-sectional analysis were drawn from 2016 to 2018 National Survey of Children's Health (NSCH), using the full data set with restricted geographic data (n = 63,000).

The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups.

Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation.

Trends in Cancer Treatment Service Availability Across Critical Access Hospitals and Prospective Payment System Hospitals.

Background: Rural residents experience worse cancer prognosis and access to cancer care providers than their urban counterparts. Critical access hospitals (CAHs) represent over half of all rural community hospitals. However, research on cancer services provided within CAHs is limited.

Current turnover intention among nurse managers, directors, and executives.

Background: Nursing leadership turnover can adversely affect nurse retention and thus quality of care. Little research has examined the way nurses at differing levels of leadership experience their workplace and voluntarily decide to leave.

Purpose: Our study sought to explore and compare intent to leave and turnover experiences of acute care nurse managers, directors, and executives.

COVID-19 risk mitigation behaviors among rural and urban community-dwelling older adults in summer, 2020.

Purpose: Risk mitigation behaviors are important for older adults, who experience increased mortality risk from COVID-19. We examined these reported behaviors among rural and urban community-dwelling adults aged 65 and older.

Methods: We analyzed public use files from the National Health and Aging Trends Study, which fielded a COVID survey from June to October, 2020, restricted to community-dwelling adults (n = 2,982).

Trends in spatial access to colonoscopy in South Carolina, 2000-2014.

Background: Colonoscopy use has increased since Medicare began covering screening for average-risk persons. Our objective was to describe changes in spatial access to colonoscopy in South Carolina (SC) between 2000 and 2014.

Methods: Using data from the SC Ambulatory Surgery Database, we created annual ZIP Code Tabulation Area (ZCTA) spatial accessibility scores.

Untreated Dental Caries May be Associated with Subsequent Mortality among Working-Age Adults: Evidence from NHANES III.

Objectives: Poor oral health has been shown to be associated with selected adverse health outcomes. This study assessed the association between untreated dental caries and mortality and examined whether having dental insurance mitigates the risk of mortality among working-age US adults with dental caries.

Methods: Analysis used the publicly available linked mortality file for NHANES III, an observational study conducted in 1988-1994, with follow-up through December 2015.

Turnover Intention Among Nurses in Nurse Managers, Directors, and Executives: Developing a Tool for Measuring Environmental Factors.

Background And Purpose: Turnover among nurse managers, directors, and executives is associated with staff nurse retention and patient outcomes. The purpose of this article is to describe the development of an instrument to evaluate factors associated with intent to leave among these leaders within acute care facilities.

Methods: The Nurse Leader Environment Support Survey (NLESS) was developed and evaluated using exploratory factor analysis and reliability testing (Cronbach's α).

A National Survey of RN-to-BSN Programs: Are They Reaching Rural Students?

Background: Increased representation of Bachelor of Science in Nursing (BSN)-prepared nurses improves health and reduces costs. Fewer rural U.S.

The role of dental insurance in mitigating mortality among working-age U.S. adults with periodontitis.

Aim: To assess the relationship of dental insurance with all-cause mortality and mortality due to cardiovascular diseases (CVD), diabetes mellitus (DM), and cerebrovascular diseases (CBD) among those with periodontitis.

Materials And Methods: NHANES III and its associated mortality data set were used in this study. The outcome variables were "all-cause mortality" and "combined mortality" due to CVD, DM, and CBD.

Rural-Urban Mortality Disparities: Variations Across Causes of Death and Race/Ethnicity, 2013-2017.

To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and stroke) by rural versus urban county of residence in the United States and race/ethnicity for the period 2013 to 2017. Rural populations, across all racial/ethnic groups, had higher all-cause mortality rates than did their urban counterparts.

Factors Associated With Perceived Job Preparedness Among RNs: Results From a National Survey.

This article examines perceived job preparedness by demographic and professional characteristics among practicing RNs who completed a national survey. Rural and male nurses felt less prepared for nursing practice and may benefit from tailored educational experiences to improve perceptions of being prepared for the workforce.

Charity Care Characteristics and Expenditures Among US Tax-Exempt Hospitals in 2016.

To examine content of financial assistance polices (FAPs) among US tax-exempt hospitals and determine whether restrictive policies were associated with reduced charity care spending. Using hospital tax filings with the Internal Revenue Service in 2016 and FAPs obtained from hospital Web sites, we examined characteristics of FAPs and associated expenditures for charity care in a representative sample of 170 tax-exempt hospitals. We identified common eligibility requirements and used them to define restrictiveness of FAPs.

Freestanding Dialysis Facility Quality Incentive Program Scores and Mortality Among Incident Dialysis Patients in the United States.

Rationale & Objective: The Centers for Medicare & Medicaid Services introduced the Quality Incentive Program (QIP) along with the bundled payment reform to improve the quality of dialysis care in the United States. The QIP has been criticized for using easily obtained laboratory indicators without patient-centered measures and for a lack of evidence for an association between QIP indicators and patient outcomes. This study examined the association between dialysis facility QIP performance scores and survival among patients after initiation of dialysis.