Meeting the Needs of Rural Populations Through Interdisciplinary Partnerships

Abstract

This article describes the organization and outcomes of a Rural Health Outreach Initiative (RHOI) designed to increase collaboration between the medical education and health care delivery sectors to improve the quality of health care delivery and health outcomes in rural communities. Two inter-related partnership strategies were utilized in rural communities to address the health and social service needs of rural populations. The partnerships were created through the efforts of a rural health professions education program located in a community-based medical school. The two partnership models were implemented at the same time and target the same rural populations. Both strategies relied upon interdisciplinary collaborations to achieve their goals and outcomes. One strategy involved the creation of partnerships among rural medical students and the projects they initiate, using the model of community oriented primary care (COPC). The second strategy involved the establishment of partnerships by a variety of rural, community-based entities that resulted from a three-year Health Resources and Services Administration Rural Health Outreach grant that supported a "mini-grant" program. This article summarizes the process and results of these innovative collaborations that occurred at two levels: (1) between health and service institutions representing multiple disciplines and (2) between academic institutions and local communities. Specific attention is given to projects that resulted from the work of the partnerships that address the needs of older adults residing in the rural communities. The two strategies are compared and implications for the success of similar efforts are discussed.

Congregate meal sites participants: Can they manage their diets?

“…If these individuals have a chronic condition, they have adapted to living with it and rely on medication to treat their condition. In many cases, older individuals have been relieved of the responsibility of managing their own diets due to the fact they are prescribed medications to treat their conditions (Glasser et al, 2003). Many older individuals see this as an easier option than trying to decipher confusing and sometimes contradicting nutrition information prior to eating (Hermann et al, 2000;Miller et al, 2002).…”

“…Particular concern has been shown for socially isolated rural older individuals because many of them practice poor dietary behaviors, mismanage chronic diseases (Glasser et al, 2003), lack consistent health care insurance (Beverly et al, 2005), and have a general mistrust of health care services. These aspects of rural culture have made these individuals more prone to suffer from chronic conditions, develop poor dietary habits, and attempt to manage their chronic conditions independently.…”

“…Rural older individuals usually have limited income, little or no health insurance coverage (Beverly et al, 2005), frail skeletal structures, a lack social support regarding health care, infrequent visits to their physicians, long wait times at the physician offices (Coburn and Bolda, 2001), and insufficient transportation to physicians. Rural older individuals also have been described as reactive rather than proactive when seeking health services (Glasser et al, 2003). Such a delay in receiving appropriate care allows chronic conditions to worsen and can lead to the development of other debilitating conditions.…”

“…Due to these preexisting limitations, attracting doctors, nurses, and other service professionals are difficult for many rural areas (USDA Economic Research Reserve, 2007). Given the limited number of services in rural areas, the health care services located in such areas are expected to provide the entire spectrum of care: urgent care, chronic disease management, rehabilitation, outreach, and specialty care for rural older patients (Glasser et al, 2003) -services normally available in more developed regions.…”

Conceiving land grant university community engagement as adaptive leadership

“…First, universities are extraordinarily sub-specialized and ''siloed'' organizations whose members do not often speak with one another across organizational lines (Glasser et al 2003). Thus, environmental engineers may share many substantive interests with environmental policy analysts and with crop and soil scientists, for example, but never realize that fact since little would ever bring them together across disciplinary boundaries within the university's formal organizational structure of colleges and departmental organizational silos.…”