Standardizing post-cardiac arrest care across rural-urban settings - qualitative findings on proposed post-cardiac arrest learning community intervention.

Background: Standardization of post-cardiac arrest care between emergency department arrival and intensive care unit admission can be challenging, particularly for rural centers, which can experience significant delays in interfacility transfer. One approach to addressing this issue is to form a post-cardiac arrest learning community (P-CALC) consisting of emergency department (ED) and intensive care unit (ICU) physicians and nurses who use data, shared resources, and collaboration to improve post-cardiac arrest care. MaineHealth, the largest regional health system in Maine, launched its P-CALC in 2022.

Federal telehealth policy changes during the COVID-19 public health emergency: Associations with telemental health use among rural and urban Medicare beneficiaries.

Purpose: The COVID-19 public health emergency (PHE) led to increased mental health (MH) concerns among Medicare beneficiaries while inhibiting their access to MH services (MHS). To help address these problems, the federal government introduced temporary flexibilities permitting broader telehealth use in Medicare. This study compared rural versus urban patterns of change in telemental health (TMH) use among adult MHS users in fee-for-service Medicare from 2019 to 2020, when PHE-related telehealth expansions were enacted.

Engaging At-Risk Rural Residents in Secondary Lung Cancer Prevention.

Introduction: Rural residents are at elevated risk for lung cancer and related mortality, yet limited research has explored their perspectives on cancer risk or prevention options, including tobacco treatment and lung cancer screening with low-dose computed tomography (LDCT). This qualitative study examined attitudes and beliefs among rural adults who reported either current or former tobacco use, as well as disengagement from the health care system.

Methods: We conducted 6 focus groups with rural Maine residents at risk for lung cancer based on age and smoking history (n = 50).

Use of electronic health records to manage tobacco screening and treatment in rural primary care.

Purpose: Electronic health records (EHRs) can facilitate primary care providers' (PCPs) use of best practices in addressing tobacco dependence. It is unknown whether rural PCPs reap the same benefits as their urban counterparts when employing EHRs for this purpose. Our study examines this issue.

Recalled Coparenting Conflict, Paralysis of Initiative, and Sensitivity to Conflict during Late Adolescence.

During late adolescence, interpersonal acuity and decisiveness are facilitative of transitions to emerging adulthood. Disruptions in these capacities may be traceable to phenomena evoked by origin family coparental conflict - paralysis of initiative and hypersensitivity to conflict. Documenting such connections can lead to more beneficial interventions for adolescents transitioning into adulthood.

Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking.

Objectives: To examine change over time in cigarette smoking among rural and urban adolescents and to test whether rates of change differ by rural versus urban residence.

Methods: We used the 2008 through 2010 and 2014 through 2016 US National Survey of Drug Use and Health to estimate prevalence and adjusted odds of current cigarette smoking among rural and urban adolescents aged 12 to 17 years in each period. To test for rural-urban differences in the change between periods, we included an interaction between residence and time.

Long-Term Services and Supports Use Among Older Medicare Beneficiaries in Rural and Urban Areas.

State and federal policies have shifted long-term services and support (LTSS) priorities from nursing home care to home and community-based services (HCBS). It is not clear whether the rural LTSS system reflects this system transformation. Using the Medicare Current Beneficiary Survey, we examined nursing home use among rural and urban Medicare beneficiaries aged 65 and older.

Patterns of Telehealth Use Among Rural Medicaid Beneficiaries.

Purpose: Few studies have examined telehealth use among rural Medicaid beneficiaries. This study produced a descriptive overview of telehealth use in 2011, including the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use.

Methods: Using data from the 2011 Medicaid Analytic eXtract (MAX), we conducted bivariate analyses to test the associations between rurality and prevalence and patterns of telehealth use among Medicaid beneficiaries.

Mental Health First Aid in Rural Communities: Appropriateness and Outcomes.

Purpose: Mental Health First Aid (MHFA), an early intervention training program for general audiences, has been promoted as a means for improving population-level behavioral health (BH) in rural communities by encouraging treatment-seeking. This study examined MHFA's appropriateness and impacts in rural contexts.

Methods: We used a mixed-methods approach to study MHFA trainings conducted from November 2012 through September 2013 in rural communities across the country.

Rural considerations in establishing network adequacy standards for qualified health plans in state and regional health insurance exchanges.

Purpose: The Affordable Care Act (ACA) requires Health Insurance Exchanges (HIEs) to specify network adequacy standards for the Qualified Health Plans (QHPs) they offer to consumers. This article examines rural issues surrounding network adequacy standards, and offers recommendations for crafting standards that optimize rural access.

Method: This policy analysis reviews ACA requirements for QHP network adequacy standards, considering Medicaid managed care and Medicare Advantage (MA) standards as models.

Shame-proneness as a diathesis for dissociation in women with histories of childhood sexual abuse.

This study examined whether shame-proneness is associated with dissociation among abused women. Participants were 99 hospitalized women with and without reported histories of childhood sexual abuse. Hypotheses were that childhood sexual abuse and shame-proneness would each be associated with dissociation, and that the relationship between sexual abuse and dissociation would be greater among women with higher shame-proneness.

Individual Parental Adjustment Moderates the Relationship Between Marital and Coparenting Quality.

Contemporary family research studies have devoted surprisingly little effort to elucidating the interplay between adults' individual adjustment and the dynamics of their coparental relationship. In this study, we assessed two particularly relevant "trait" variables, parental flexibility and self-control, and traced links between these characteristics and the nature of the coparents' interactions together with their infants. It was hypothesized that parental flexibility and self-control would not only explain significant variance in coparenting quality, but also act as moderators attenuating anticipated relationships between marital functioning and coparental process.