Current Projects

Intimate partner violence (IPV) includes physical violence, sexual violence, stalking, psychological aggression, and reproductive control by a current or former boyfriend or girlfriend, domestic partner, or spouse. This project will determine rural-urban disparities in the prevalence of intimate partner violence-related hospitalizations using a national representative sample of hospital admissions for the period between 2009-2014.


Community Health Worker Roles, Regulation, and Growth in Rural America

Timothy Callaghan, PhD
callaghan@sph.tamhsc.edu

David Washburn, ScD
dwashburn@sph.tamhsc.edu

 This project examines the role of Community Health Workers (CHWs) and Promotores in improving access to health care services in rural and urban environments. This project focuses on the growing and changing roles of these influential actors and how their responsibilities vary based on setting (hospital, clinic, community, etc.), location (rural vs. urban), and regulations. Proposed topics to be examined are (1) understanding the role that CHWs believe they play in health access, (2) studying how this role varies based on rurality and setting, (3) analyzing the different regulatory frameworks that states employ regarding CHWs and their activities, and (4) investigating the relationship between these regulatory frameworks and the number of CHWs across rural and urban environments in different states.


Disaster Planning, Preparedness, & Response for Rural Long-Term Care Providers

Tiffany A. Radcliff, PhD
radcliff@tamhsc.edu

 This project will collect data that captures how disasters affect long- term care services and patient experiences in rural areas. We will: (1) develop and pilot test a long-term care provider survey regarding emergency preparedness and response, and (2) conduct detailed case studies of disaster-impacted, rural communicates with respect to implications for long-term care services planning, recovery, and resilience.


Midterm Examination of Healthy People 2020: How Well Are We Doing Meeting Mortality Objectives

Jane Bolin, BSN, JD, PhD 
jbolin@sph.tamhsc.edu

Alva O. Ferdinand, JD, DrPH
ferdinand@sph.tamhsc.edu

Timothy Callaghan, PhD
callaghan@sph.tamhsc.edu

Rural Americans have historically faced significant challenges in accessing healthcare and preventive healthcare services, including ambulatory care, dental care, emergency services, and pharmaceutical services. This Year-3 study is national in scope and will examine rural versus urban differences and disparities in how the United States is meeting the Healthy People 2020 mortality objectives for the top 10 leading causes of death.


Texas CSTEP resident TexasC-stepLogo.jpg

Texas C-Step: CPRIT Funded Cancer Prevention

https://texascstep.org

Principal Investigator for Colorectal Cancer Grant
Jason McKnight, MD

Principal Investigator for Breast and Cervical Cancer Grant
Anna Lichorad, MD

Co-Principal Investigator
Jane Bolin, BSN, JD, PhD

The Texas Cancer Screening, Training, Education and Prevention Program, or Texas C-STEP, is conducted through the Texas A&M Physicians Family Medicine Center. Texas C-STEP provides critical safety-net services, such as cancer screenings and certain advanced diagnostics, to uninsured, underserved and low-income Texans through funding from the Cancer Prevention & Research Institute of Texas. The 17 counties served by Texas C-STEP are primarily rural counties.


diabetes

Diabetes Education

https://diosk.org

 

 The diabetes education kiosk (aka DIOSK) was developed by the Texas A&M Health Science Center School of Public Health as a self-management tool to provide diabetes education to persons with diabetes, caregivers, or those persons at risk for diabetes. Using touch-screen interactive technology, the DIOSK now consists of web-based modules on diabetes, asthma, and infectious diseases that can be viewed from any tablet, cell phone or computer. Dissemination of the DIOSK is currently funded through Healthy South Texas

Previous Projects

Rural/Urban Differences in Chronic Diseases and Delay of Needed Care

Jane N. Bolin, PhD, JD, BSN
jbolin@sph.tamhsc.edu

 

 This project examines rural versus urban differences, among adults in the U.S., in the prevalence, incidence, stage and severity of selected chronic diseases including heart disease, stroke and several five types of cancers. There is a particular focus on examining foregone or delayed access to preventive or needed care, and whether rural residents present later and with more advanced disease states.


In an effort to learn more about the distinctive health needs and priorities of rural communities in the Episcopal Diocese of Texas, the Episcopal Health Foundation selected the Southwest Rural Health Research Center to conduct a series of community planning and participatory group meetings in Grimes, Madison, and Robertson Counties. The goal of this project was to facilitate and support community champions’ efforts to lead sustainable Coalitions to address identified needs of communities and to move county-specific projects towards fruition.


Malpractice Claims Among Rural and Urban Providers: Do State Telehealth Laws Make a Difference?

Alva O. Ferdinand, JD, DrPH
ferdinand@sph.tamhsc.edu

Michael A. Morrisey, PhD
morrisey@tamhsc.edu

This project examines trends in state telehealth laws in the U.S. and whether they have affected the malpractice environments of rural and urban environments differentially. Data from the National Practitioner Data Bank are used to determine whether changes in telehealth laws are associated with increased malpractice claims and other adverse actions among rural and urban healthcare providers.


lawyer advising client

Examining the Legal Landscape in Rural America: Implications for the Healthcare Workforce, Access to Care, and Population Health 

Alva O. Ferdinand, JD, DrPH
ferdinand@sph.tamhsc.edu

Michael A. Morrisey, PhD
morrisey@tamhsc.edu

This project explores whether there are any differences between urban and rural health care providers in the prevalence of malpractice claims, clinical privilege actions, and state licensure actions. This research also explores whether variations in nurse practitioner scope of practice laws affect rural residents differentially, especially with respect to preventive care. Data used for this project include: National Practitioner Data Bank; National (Nationwide) Inpatient Sample; State Emergency Department Databases; and Area Health Resources File. 


young mother with baby

Are Rural Mothers and Infants Benefiting from Changes in National Women, Infants and Children (WIC) Policy?

E. Lisako J. McKyer, Ph.D., MPH
mckyer@sph.tamhsc.edu

Ariun Ishdorj, PhD
aishdorj@tamu.edu

This study explores breastfeeding practices among rural WIC participants, and examines differences before and after a major federal policy change involving the WIC program. Data from the National Food and Nutrition Survey, conducted before and after (repeated cross-section) implementation of the WIC policy changes, are used to examine effects on breastfeeding rates, infant feeding practices, and food/beverage consumption among low-income infants and women in rural areas.


nurse examining elderly patient in hospital bed

Provision of Skilled Nursing in Rural America: Skilled Nursing Facilities and Swing Beds

Darcy McMaughan, PhD
mcmaughan@tamhsc.edu

Swing beds and skilled nursing facilities provide critical skilled nursing services in rural areas, which are often lacking appropriate options for long term care. This study allows researchers and policy makers to understand the nature of swing bed and skilled nursing facility care provision in rural areas, and the potential benefits of swing beds to rural communities, through development of a national picture of swing beds and skilled nursing facilities in rural areas of the U.S. and comparison of swing beds and skilled nursing facilities with regard to facility, resident, and care characteristics.


patient using glucometer

This project determines rural versus urban differences in type 2 diabetes mellitus (T2DM) prevalence, and related morbidity and mortality in the U.S. This project examines rural versus urban differences and disparities in T2DM rates and associated demographics pre-and post-Affordable Care Act implementation. Analyses include controlled and uncontrolled diabetes and associated complications across rural versus urban geographic regions of the U.S. The project is national in scope and utilizes data from the Behavioral Risk Factor Surveillance System and selected Healthcare Cost and Utilization Project state emergency department and inpatient survey databases.