Family Planning Practices in Appalachia: Focus Group Perspectives on Service Needs in the Context of Regional Substance Abuse

Swan, Laura E. T.; Auerbach, Samantha; Ely, Gretchen E.; Agbemenu, Kafuli; Mencia, Jessica J.; Araf, Nimah R

doi:10.3390/ijerph17041198

Cited by 20 publications

(26 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Several limitations should be considered when interpreting these results, including disparities in: diet (46,47), physical activity (48), socio-economic status (49), race (50), and drug use (51)(52)(53)(54), all inherent to the rural Appalachian population (55,56). We used the diagnosis of AD rather than the broader umbrella term dementia.…”

Section: Discussionmentioning

confidence: 99%

Hemorrhagic stroke outcomes of KApSR patients with co-morbid diabetes and Alzheimer’s disease

Trout¹,

McLouth²,

Kitzman³

et al. 2021

Ann Transl Med

View full text Add to dashboard Cite

Background: Vascular risk factors, such as diabetes mellitus (DM), are associated with poorer outcomes following many neurodegenerative diseases, including hemorrhagic stroke and Alzheimer's disease (AD).Combined AD and DM co-morbidities are associated with an increased risk of hemorrhagic stroke and increased Medicare costs. Therefore, we hypothesized that patients with DM in combination with AD, termed DM/AD, would have increased hemorrhagic stroke severity.Methods: Kentucky Appalachian Stroke Registry (KApSR) is a database of demographic and clinical data from patients that live in Appalachia, a distinct region with increased health disparities and stroke severity.Inpatients with a primary indication of hemorrhagic stroke were selected from KApSR for retrospective analysis and were separated into four groups: DM only, AD only, neither, or both.Results: Hemorrhagic stroke patients (2,071 total) presented with either intracerebral hemorrhage (ICH), n=1,448, or subarachnoid hemorrhage (SAH), n=623. When examining all four groups, subjects with AD were significantly older (AD+, 80.9±6.6 yrs) (DM+/AD+, 77.4±10.0 yrs) than non AD subjects (DM-/AD-, 61.3±16.5 yrs) and (DM+, 66.0±12.5 yrs). A higher percentage of females were among the AD+ group and a higher percentage of males among the DM+/AD+ group. Interestingly, after adjusting for multiple comparison, DM+/AD+ subjects were ten times as likely to suffer a moderate to severe stroke based on a National Institute of Health Stroke (NIHSS) upon admission [odds ratio (95% CI

show abstract

Section: Discussionmentioning

confidence: 99%

Hemorrhagic stroke outcomes of KApSR patients with co-morbid diabetes and Alzheimer’s disease

Trout¹,

McLouth²,

Kitzman³

et al. 2021

Ann Transl Med

View full text Add to dashboard Cite

show abstract

“…Other barriers to healthcare access can be linked to ineffective patient-provider communication. Patients who do not feel involved in healthcare decisions are less likely to adhere to treatment recommendations [ 70 ]. Patients who experience communication difficulties with providers may feel coerced, which generates disempowerment and leads patients to employ more covert ways of engagement [ 71 , 72 ].…”

Section: Methodsmentioning

confidence: 99%

A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access

Coombs

Campbell

Caringi

2022

BMC Health Serv Res

View full text Add to dashboard Cite

Background Ensuring access to healthcare is a complex, multi-dimensional health challenge. Since the inception of the coronavirus pandemic, this challenge is more pressing. Some dimensions of access are difficult to quantify, namely characteristics that influence healthcare services to be both acceptable and appropriate. These link to a patient’s acceptance of services that they are to receive and ensuring appropriate fit between services and a patient’s specific healthcare needs. These dimensions of access are particularly evident in rural health systems where additional structural barriers make accessing healthcare more difficult. Thus, it is important to examine healthcare access barriers in rural-specific areas to understand their origin and implications for resolution. Methods We used qualitative methods and a convenience sample of healthcare providers who currently practice in the rural US state of Montana. Our sample included 12 healthcare providers from diverse training backgrounds and specialties. All were decision-makers in the development or revision of patients’ treatment plans. Semi-structured interviews and content analysis were used to explore barriers–appropriateness and acceptability–to healthcare access in their patient populations. Our analysis was both deductive and inductive and focused on three analytic domains: cultural considerations, patient-provider communication, and provider-provider communication. Member checks ensured credibility and trustworthiness of our findings. Results Five key themes emerged from analysis: 1) a friction exists between aspects of patients’ rural identities and healthcare systems; 2) facilitating access to healthcare requires application of and respect for cultural differences; 3) communication between healthcare providers is systematically fragmented; 4) time and resource constraints disproportionately harm rural health systems; and 5) profits are prioritized over addressing barriers to healthcare access in the US. Conclusions Inadequate access to healthcare is an issue in the US, particularly in rural areas. Rural healthcare consumers compose a hard-to-reach patient population. Too few providers exist to meet population health needs, and fragmented communication impairs rural health systems’ ability to function. These issues exacerbate the difficulty of ensuring acceptable and appropriate delivery of healthcare services, which compound all other barriers to healthcare access for rural residents. Each dimension of access must be monitored to improve patient experiences and outcomes for rural Americans.

show abstract

“…These efforts are imperative to establishing competence and creating social work practitioners equipped to deal with problems that are experienced by vulnerable groups who are in need of accessible and affordable reproductive health care. The development of these kinds of social work skills are particularly important for bridging health access gaps in geographically disadvantaged regions, such as in rural areas or in Appalachia, where reproductive health care access is compromised (Swan et al, 2020), and social workers in public health-oriented roles are well positioned in the community to help better facilitate patient access to care (Ely et al, 2011).…”

Section: Social Work Educationmentioning

confidence: 99%

Looking Back, Looking Forward: Examining the Processing of Abortion Experiences Using Public Abortion Narratives

Swan

Rouland

Sperlich

et al. 2020

Affilia

Self Cite

View full text Add to dashboard Cite

Limited research has utilized public abortion narratives to understand how individuals process through their abortion experiences. To address this gap in the literature, this study used thematic analysis to consider the public abortion stories of 39 participants from the Tennessee Stories Project, focusing on how individuals process through these experiences and the context of the abortion experience in a person’s life course. Participants were primarily those who were abortion patients; however, abortion providers and supporters including partners or spouses, family members, and friends of those who received abortion care were also represented. Data analysis indicated that abortion seekers engage in introspection, involving political and religious/spiritual considerations; report specific feelings about their abortion experience, including having no regrets and feeling gratitude; process emotions related to the abortion experience by normalizing emotional responses and using mementos; and position their abortion in the context of their life, both in terms of their family and career opportunities and personal development. These findings provide valuable insight into how individuals process through the abortion experience, before, during, and after the abortion procedure, and suggest possible directions for service providers, advocates, and policy makers in order to better support abortion patients, providers, and family members.

show abstract

Family Planning Practices in Appalachia: Focus Group Perspectives on Service Needs in the Context of Regional Substance Abuse

Cited by 20 publications

References 40 publications

Hemorrhagic stroke outcomes of KApSR patients with co-morbid diabetes and Alzheimer’s disease

Hemorrhagic stroke outcomes of KApSR patients with co-morbid diabetes and Alzheimer’s disease

A qualitative study of rural healthcare providers’ views of social, cultural, and programmatic barriers to healthcare access

Looking Back, Looking Forward: Examining the Processing of Abortion Experiences Using Public Abortion Narratives

Contact Info

Product

Resources

About