Extension has a connection to the success and prosperity of rural communities through empowering individuals within those communities to utilize research-based practices. An increasingly critical need in rural communities today is support for developing skills to combat mental health challenges. In both North Dakota and South Dakota, 90% of the counties are classified as Mental Health Professional Shortage Areas. The limited number of mental health professionals may be a contributing factor in the growing rates of prescription opioid misuse and abuse within rural communities. An opportunity for increasing access to education and prevention programming related to the opioid epidemic lies within the Extension system. Using Cooperative Extension's National Framework for Health and Wellness as our guide, we describe Strengthening the Heartland (STH), a multi-state program for delivering opioid misuse prevention programming in two agriculture-based and predominantly rural states. Major activities included: (a) collaborating with human service organizations throughout the two states to facilitate presentations and reduce duplication of resources, (b) distributing educational resources, and (c) providing virtual trainings. This article describes the successful opportunities for implementing similar programming in rural and frontier communities. Public Health Significance StatementThis program description highlights the value of partnerships between the Cooperative Extension Service and community mental health providers in addressing the opioid epidemic. Through strategic partnerships, a multi-state collaborative, Strengthening the Heartland (STH), was formed to provide residents in two agriculture-based states with greater access to educational resources aimed at empowering them to prevent prescription opioid misuse. To date, thousands of Dakotans have been touched by STH through webinars, face-to-face presentations, electronic and print resources, trainings, and the program website, as STH serves as a model for other human service professionals implementing prevention programming in rural areas.

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Ein neues visuomotorisches Simulationstraining für Menschen nach Schlaganfall soll dabei helfen, die Bewegungskontrolle und -planung zu verbessern. Charlotte Heckmann und Sarah Haase berichten von ihren Erfahrungen mit dem Therapiesystem IVS3.

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Background: In 2017, 45% of rural adults reported being directly impacted by the opioid epidemic. While research on the experiences of those using prescription opioids in rural communities is increasing, less is known about a unique sub-population who may have high rates of exposure: rural agricultural workers. The purpose of this study was to explore the prevalence and perceptions related to prescription opioids among rural producers and farmworkers. Methods: A questionnaire was mailed in spring 2019 and spring 2020 to rural residents living in one of two agricultural-based states in the Upper Midwest. Individuals were eligible to participate if any member of their family was involved in the agricultural industry. A total of 1116 questionnaires were returned for a 27.9% response rate. Results: Participants were 68.1 years old on average. The majority identified as white, male, and married. Prescription opioid use was found in 8.2% of households currently, and 15.7% in the past year. There were no gender differences in prevalence of use, but women and older individuals reported significantly more perceived risk than men and younger individuals. Nearly half used alternative pain management, and received most information about prescription opioids from the radio (65.5%) and newsletters (13.5%). Conclusions. Despite their elevated age and working in an occupation at high risk of injury and chronic pain, study participants reported few opioid prescriptions and moderate use of alternative pain management. Perceived risk of prescription opioids may explain low prevalence. Outreach efforts that increase access to healthcare services and alternative pain management treatments for agricultural workers may mitigate the experience of chronic pain that can interfere with their overall quality of life.