The MI-PHOTOS Project: Understanding the Health and Wellbeing of Rural Historically Marginalized Mothers Through Photovoice

2021 ◽  
pp. 109019812110570
Author(s):  
Katherine H. LeMasters ◽  
Sarah E. Bledsoe ◽  
Jada Brooks ◽  
Stephanie Chavis ◽  
Erica Little ◽  
...  
Keyword(s):  
Rural Communities ◽  
Maternal Health ◽  
Support Group ◽  
Rural Women ◽  
Home Visiting ◽  
The United States ◽  
Community Based ◽  
Raising Children ◽  
Pregnancy And Postpartum ◽  
Therapeutic Services

Despite the persistent health inequities faced by rural women in the United States, few researchers have partnered with women in rural communities to co-create sustainable change. To fill this gap, Mothers Improving Pregnancy and Postpartum Health Outcomes Through stOry Sharing (MI-PHOTOS) employed a community-based participatory research (CBPR) approach by partnering with mothers, community leaders, and community-based organizations in Robeson County, North Carolina, a rural, racially diverse county. The project’s aims were (a) to promote maternal health by listening to mothers’ stories of having and raising children in their community and (b) to develop a shared understanding of these mothers’ strengths and challenges. MI-PHOTOS utilized photovoice, an exploratory and qualitative CBPR methodology. Grounded theory guided data analysis. During photovoice discussions, conversation focused on maternal experiences and evoked strengths, facilitators, and barriers impacting maternal health. Themes focused on (a) MI-PHOTOS serving as a social support group for the community and family stressors that mothers faced and (b) the necessity of professional support programs. Three overarching findings emerged during this process: (a) MI-PHOTOS as an informal support group, (b) mental health stigmatization, and (c) the need to bridge home visiting programs with peer and confidential therapeutic services. Future work should incorporate mothers’ and communities’ strengths into program development by drawing on existing home visiting programs, identifying opportunities for peer-support, and creating referral networks for individual, confidential therapeutic services. Through continued community partnership, we can generate fuller understandings of mothers’ experiences of having and raising children and ultimately promote health equity among rural mothers.

scholarly journals Serving Rural Veterans with Disabilities: A National Survey of Centers for Independent Living

2020 ◽  
Author(s):  
Jennifer Hale-Gallardo ◽  
Consuelo M. Kreider ◽  
Yuxin Ni ◽  
Luz M. Semeah ◽  
Zaccheus J. Ahonle ◽  
...  
Keyword(s):  
Rural Communities ◽  
Independent Living ◽  
Univariate Analysis ◽  
The United States ◽  
Community Based ◽  
National Examination ◽  
Catchment Areas ◽  
The Status ◽  
Services And Supports ◽  
Community Based Services

Abstract This study comprises a systematic national examination of how Centers for Independent Living can and do support Veteran consumers, especially those living in rural communities. This research provides contextualized understanding of rural Veteran needs for community-based services and resources available through Centers for Independent Living. A survey was administered to the leadership of 383 Centers for Independent Living throughout the United States, the majority of which have rural catchment areas and serve rural Veterans through both main and satellite offices. Descriptive univariate analysis was used to describe responses. Study respondents represented a total of 39 states, with 20% of respondents reporting that their consumers were 100% rural and only 3% entirely urban. Services and supports from Centers for Independent Living provided to rural Veterans most frequently included housing, transportation, and peer support. Approximately half of all Centers for Independent Living reported tracking the status of their Veteran consumers.

scholarly journals Rural community based study of Magnitude of Anaemia in Women of Reproductive age

2020 ◽  
pp. 05-10
Author(s):  
Chhabra S ◽  
Varma Shivkumar P
Keyword(s):  
Rural Communities ◽  
Rural Women ◽  
Economic Status ◽  
Age Groups ◽  
Central India ◽  
Reproductive Age ◽  
Maximum Effect ◽  
Women Of Reproductive Age ◽  
Community Based ◽  
Significant Difference

Background: Despite several steps taken by governments, anaemia continues to be common, and affects women’s health negatively. Last demographic health survey in India revealed 27% women of 15-49 years age anaemic, so it was decided to look into present status in rural communities. Objective was to know community-based magnitude of anaemia in rural women of reproductive age. Material and Methods: Community based study was conducted for knowing magnitude of anaemia in nonpregnant women of 15 to 49 years. In 28 villages around 75±10 km away from study institute in Central India, as per availability, 1267 women were randomly screened, keeping in mind inclusion and exclusion criteria. After information and request to permit, minimum 25 women per village, who so ever volunteered, fitted in inclusion criteria were screened. Results: Of 1267 women randomly screened 858 (67.72%) were anaemic, 850 mildly or moderately anaemic. Eight (0.6%) severely anaemic, (Hb less than 7 gms/dl) were straight referred to hospital for work up and appropriate management. Others were also advised to get investigations, treatment, not part of study. Maximum burden of anaemia, (68.86%), was in women of 35-49 yrs age, 67.37% among 20-34 yrs old and 65.92% in adolescents, no significant difference in different age groups. Of 1267 screened, 972 (76.7%) were from lower economic status, 280(22.1%) middle economic status only 15(1.2%) from upper economic status, maximum anaemic was out of LES women. Most women with four and more births were anaemic. Parity affected maximum compared to age, economic status and education. Conclusion: Around 70% women of reproductive age without any obvious disorders. were found to be anaemic in rural communities Parity had maximum effect.

Gay (White) Male Speech and the E(race)sure of Identity

2020 ◽  
Author(s):  
Brianna R. Cornelius
Keyword(s):  
Racial Identity ◽  
Language Use ◽  
White Male ◽  
The United States ◽  
Gay Identity ◽  
Community Based ◽  
Language Varieties ◽  
Gay Male ◽  
Men Of Color ◽  
African American Language

Although a notable body of work has emerged describing gay male speech (GMS), its overlap with African American language (AAL) remains comparatively understudied. This chapter explores the assumption of whiteness that has informed research on gay identity and precluded intersectional considerations in sociolinguistic research. Examining the importance of racial identity, particularly Blackness, to the construction of gay identity in the United States, the chapter investigates the treatment of GMS as white by default, with the voices of gay men of color considered additive. The desire vs. identity debate in language and sexuality studies contributed to an understanding of gay identity as community-based practice, thereby laying a necessary framework for the study of GMS. However, this framework led to a virtually exclusive focus on white men’s language use. Although efforts to bring a community-based understanding to gay identity have been groundbreaking, the lack of consideration of intersectionality has erased contributions to GMS from racially based language varieties, such as AAL.

scholarly journals Presentation, Management, and Outcomes across the Rural-Urban Continuum for Hepatocellular Carcinoma

2020 ◽  
Author(s):  
Kali Zhou ◽  
Trevor A Pickering ◽  
Christina S Gainey ◽  
Myles Cockburn ◽  
Mariana C Stern ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Rural Communities ◽  
Urban Areas ◽  
Tumor Stage ◽  
The United States ◽  
Population Based ◽  
Urban Residents ◽  
Place Of Residence ◽  
Incidence And Mortality ◽  
Receive Treatment

Abstract Background Hepatocellular carcinoma is one of few cancers with rising incidence and mortality in the United States. Little is known about disease presentation and outcomes across the rural-urban continuum. Methods Using the population-based SEER registry, we identified adults with incident hepatocellular carcinoma between 2000–2016. Urban, suburban and rural residence at time of cancer diagnosis were categorized by the Census Bureau’s percent of the population living in non-urban areas. We examined association between place of residence and overall survival. Secondary outcomes were late tumor stage and receipt of therapy. Results Of 83,368 cases, 75.8%, 20.4%, and 3.8% lived in urban, suburban, and rural communities, respectively. Median survival was 7 months (IQR 2–24). All stage and stage-specific survival differed by place of residence, except for distant stage. In adjusted models, rural and suburban residents had a respective 1.09-fold (95% CI = 1.04–1.14, p < .001) and 1.08-fold (95% CI = 1.05–1.10, p < .001) increased hazard of overall mortality as compared to urban residents. Furthermore, rural and suburban residents had 18% (OR = 1.18, 95% CI 1.10–1.27, p < .001) and 5% (OR = 1.05, 95% CI = 1.02–1.09, p = .003) higher odds of diagnosis at late stage and were 12% (OR = 0.88, 95% CI = 0.80–0.94, p < .001) and 8% (OR = 0.92, 95% CI = 0.88–0.95, p < .001) less likely to receive treatment, respectively, compared to urban residents. Conclusions Residence in a suburban and rural community at time of diagnosis was independently associated with worse indicators across the cancer continuum for liver cancer. Further research is needed to elucidate the primary drivers of these rural-urban disparities.

scholarly journals Long-Term IoT-Based Maternal Monitoring: System Design and Evaluation

Sensors ◽  
2021 ◽  
Vol 21 (7) ◽  
pp. 2281
Author(s):  
Fatemeh Sarhaddi ◽  
Iman Azimi ◽  
Sina Labbaf ◽  
Hannakaisa Niela-Vilén ◽  
Nikil Dutt ◽  
...  
Keyword(s):  
Energy Efficiency ◽  
Maternal Health ◽  
Pregnant Women ◽  
Health Monitoring ◽  
Quality Care ◽  
Well Being ◽  
Pregnancy And Postpartum ◽  
Comprehensive Framework ◽  
Specific Health

Pregnancy is a unique time when many mothers gain awareness of their lifestyle and its impacts on the fetus. High-quality care during pregnancy is needed to identify possible complications early and ensure the mother’s and her unborn baby’s health and well-being. Different studies have thus far proposed maternal health monitoring systems. However, they are designed for a specific health problem or are limited to questionnaires and short-term data collection methods. Moreover, the requirements and challenges have not been evaluated in long-term studies. Maternal health necessitates a comprehensive framework enabling continuous monitoring of pregnant women. In this paper, we present an Internet-of-Things (IoT)-based system to provide ubiquitous maternal health monitoring during pregnancy and postpartum. The system consists of various data collectors to track the mother’s condition, including stress, sleep, and physical activity. We carried out the full system implementation and conducted a real human subject study on pregnant women in Southwestern Finland. We then evaluated the system’s feasibility, energy efficiency, and data reliability. Our results show that the implemented system is feasible in terms of system usage during nine months. We also indicate the smartwatch, used in our study, has acceptable energy efficiency in long-term monitoring and is able to collect reliable photoplethysmography data. Finally, we discuss the integration of the presented system with the current healthcare system.

scholarly journals More Than Shelter: Housing for Urban Maternal and Infant Health

2021 ◽  
Vol 18 (7) ◽  
pp. 3331
Author(s):  
Jason Reece
Keyword(s):  
Public Health ◽  
Maternal Health ◽  
Health Outcomes ◽  
City Planning ◽  
Infant Health ◽  
The United States ◽  
Housing Quality ◽  
Housing Discrimination ◽  
Maternal Health Outcomes ◽  
The Impact

Housing quality, stability, and affordability have a direct relationship to socioemotional and physical health. Both city planning and public health have long recognized the role of housing in health, but the complexity of this relationship in regard to infant and maternal health is less understood. Focusing on literature specifically relevant to U.S. metropolitan areas, I conduct a multidisciplinary literature review to understand the influence of housing factors and interventions that impact infant and maternal health. The paper seeks to achieve three primary goals. First, to identify the primary “pathways” by which housing influences infant and maternal health. Second, the review focuses on the role and influence of historical housing discrimination on maternal health outcomes. Third, the review identifies emergent practice-based housing interventions in planning and public health practice to support infant and maternal health. The literature suggests that the impact of housing on infant health is complex, multifaceted, and intergenerational. Historical housing discrimination also directly impacts contemporary infant and maternal health outcomes. Policy interventions to support infant health through housing are just emerging but demonstrate promising outcomes. Structural barriers to housing affordability in the United States will require new resources to foster greater collaboration between the housing and the health sectors.

scholarly journals Intimate Partner Violence and Structural Violence in the Lives of Incarcerated Women: A Mixed-Method Study in Rural New Mexico

2021 ◽  
Vol 18 (12) ◽  
pp. 6185
Author(s):  
Shilo St. Cyr ◽  
Elise Trott Jaramillo ◽  
Laura Garrison ◽  
Lorraine Halinka Malcoe ◽  
Stephen R. Shamblen ◽  
...  
Keyword(s):  
Intimate Partner Violence ◽  
Substance Use ◽  
New Mexico ◽  
Rural Communities ◽  
Interpersonal Relationships ◽  
Rural Women ◽  
Partner Violence ◽  
Qualitative Interviews ◽  
Incarcerated Women ◽  
Intimate Partner

Intimate partner violence (IPV) is a common feature in the lives of incarcerated women returning to rural communities, enhancing their risk of mental ill-health, substance use, and recidivism. Women’s experiences of IPV intersect with challenges across multiple social–ecological levels, including risky or criminalizing interpersonal relationships, geographic isolation, and persistent gender, racial, and economic inequities. We conducted quantitative surveys and qualitative interviews with 99 incarcerated women in New Mexico who were scheduled to return to micropolitan or non-core areas within 6 months. Quantitative and qualitative data were analyzed separately and then triangulated to identify convergences and divergences in data. The findings underscore how individual and interpersonal experiences of IPV, substance use, and psychological distress intersect with broad social inequities, such as poverty, lack of supportive resources, and reluctance to seek help due to experiences of discrimination. These results point to the need for a more proactive response to the mutually constitutive cycle of IPV, mental distress, incarceration, and structures of violence to improve reentry for women returning to rural communities. Policy and treatment must prioritize socioeconomic marginalization and expand community resources with attention to the needs of rural women of color.

scholarly journals EPID-07. ACCESS TO GLIOBLASTOMA CLINICAL TRIALS FOR RURAL PATIENTS IN THE UNITED STATES FROM 2010–2020

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii79-ii79
Author(s):  
Kathryn Nevel ◽  
Samuel Capouch ◽  
Lisa Arnold ◽  
Katherine Peters ◽  
Nimish Mohile ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trials ◽  
Rural Communities ◽  
The United States ◽  
Interventional Treatment ◽  
Phase Ii Trials ◽  
Treatment Trials ◽  
Rural Sites ◽  
Rural Patients ◽  
Urban Sites

Abstract BACKGROUND Patients in rural communities have less access to optimal cancer care and clinical trials. For GBM, access to experimental therapies, and consideration of a clinical trial is embedded in national guidelines. Still, the availability of clinical trials to rural communities, representing 20% of the US population, has not been described. METHODS We queried ClinicalTrials.gov for glioblastoma interventional treatment trials opened between 1/2010 and 1/2020 in the United States. We created a Structured Query Language database and leveraged Google application programming interfaces (API) Places to find name and street addresses for the sites, and Google’s Geocode API to determine the county location. Counties were classified by US Department of Agriculture Rural-Urban Continuum Codes (RUCC 1–3 = urban and RUCC 4–9 = rural). We used z-ratios for rural-urban statistical comparisons. RESULTS We identified 406 interventional treatment trials for GBM at 1491 unique sites. 8.7% of unique sites were in rural settings. Rural sites opened an average of 1.7 trials/site and urban sites 2.8 trials/site from 1/2010–1/2020. Rural sites offered more phase II trials (63% vs 57%, p= 0.03) and fewer phase I trials (22% vs 28%, p= 0.01) than urban sites. Rural locations were more likely to offer federally-sponsored trials (p< 0.002). There were no investigator-initiated or single-institution trials offered at rural locations, and only 1% of industry trials were offered rurally. DISCUSSION Clinical trials for GBM were rarely open in rural areas, and were more dependent on federal funding. Clinical trials are likely difficult to access for rural patients, and this has important implications for the generalizability of research as well as how we engage the field of neuro-oncology and patient advocacy groups in improving patient access to trials. Increasing the number of clinical trials in rural locations may enable more rural patients to access and enroll in GBM studies.

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