This study explored 19 rural dwellers' perceptions of health care issues through semi-structured interviews. Sample selection, data collection, and analysis adhered to the grounded theory method in that an interactive design was maintained. The strategy of traveling for care describes how rural dwellers deal with the problem of varying access to health care. This study uncovers the influencing factors that impact on rural dwellers' decisions when traveling for care. Most rural dwellers choose to wait before seeking health care; those factors that contributed to the decision to wait includes limited financial resources to pay for health care, prior experiences within the system, and the prevalent belief that they can provide self-care effectively. When self-care was not successful they evaluated their resources to assist in their decision making. The last phase of this strategy was choosing the distance they would go to receive health care. Choosing the distance varied greatly among the participants. A few choose to go without health care whereas others would go to any lengths to resolve their health problem.

This paper reports on a study of social support and alcohol consumption of 153 women during pregnancy. The majority of women changed their alcohol intake patterns during pregnancy because of concern for the health of the fetus. Most women decreased the amount and frequency of drinking and changed their beverage of choice. Social support was found to be significantly related to reduction in alcohol use during pregnancy. Social support came from relationships with specific individuals and groups of individuals. Health care providers may be able to extend the range of their work by designing specific prevention strategies targeted toward the development and implementation of mutual support groups for pregnant women. The marketing discipline has identified certain characteristics of the mutual benefit association, an organization which exists exclusively for the benefit of its members. The authors propose that the mutual support group, often used to promote health-related behaviors, is a special case of the mutual benefit association; further, that appropriate application of established marketing principles and practices will be effective in promulgating the mutual support group. The authors offer a marketing strategy for the mutual support of pregnant women, a strategy which should be effective in further reducing the alcohol intake of pregnant women.

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This article describes an outreach continuing education program designed to increase the knowledge and skills of licensed practical nurses employed in longterm care facilities in 26 rural southeast Georgia counties. The program used a modular self-directed approach and was heavily supported with audiovisual materials. Four independent learning activities made up each of the nine modules. After pilot implementation of the curriculum, nonnurse health care providers asked to enroll in the course. Upon completion of the course, participants earned certificates as specialists in long-term care of the elderly as well as continuing education credit.

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