FORHP-funded Individual Grantees

Completed Projects

• Descriptive Analysis of the Health Status of a National Asbestos-Related Cohort
  Lead Researcher: Charlene A. Winters, PhD, ACNS-BC, Montana State University
  A collaborative study to establish a more comprehensive understanding of the health status and health service needs of persons exposed to Libby asbestos is being conducted by nurse researchers at Montana State University College of Nursing and healthcare providers at the Center for Asbestos Related Disease in Libby, Montana. Results of the descriptive study will provide healthcare providers and policy makers a better understanding of the health effects and healthcare needs of exposed persons.
  
• Evaluation of an Outpatient Modified Paper Prescription Form
  Lead Researcher: Amanda G. Kennedy, PharmD, BCPS, University of Vermont
  This project will evaluate a modified paper prescription form that may be implemented in rural primary care settings cheaply and quickly with the goal of outpatient prescription error reduction.
  
• Preventive Care: Supports and Barriers to Best Practices for a National Sample of Rural Medicare Beneficiaries
  Lead Researcher: Terri Tobin, PhD, Advocates for Human Potential, Inc.
  Preventive health screenings are generally underutilized in the United States by the elderly, especially those residing in rural areas. Using an integrative approach, including secondary data analysis of a large nationally representative dataset (Medicare Current Beneficiary Survey) and complementary qualitative interviews with rural elders, the proposed research study aims for a more complete understanding of the factors influencing use of these practices.
  
• Turnover Costs in Rural Emergency Medical Services
  Costs associated with providing Emergency Medical Services (EMS) transportation in rural areas are much higher than in urban communities. This study will measure the annual rate of turnover among rural EMS systems, identify costs associated with turnover, and create a budgeting tool for calculating the costs of turnover.
  
• Diabetes and Obesity: Is there a Rural-Urban Difference in the Burden?
  Lead Researcher: Santosh Krishna, PhD, EdS
  Persons with diabetes are more likely to be obese, increasing the economic burden of diabetes related care. Purpose of this study is to examine if being overweight and obese places additional economic burden and if there is a rural-urban difference in this regard. It will help understand the health and economic consequences of diabetes and obesity epidemic on people's health.
  
• Targeted Rural Health Primary Care Research in HIT Adoption and Scope of Use
  Lead Researcher: Ranjit Singh, MA, MB BChir (Cantab.), MBA, The State University of New York at Buffalo
  This project will conduct a national mail survey of 5,200 primary care practices in all 50 states and the District of Columbia to assess use of various forms of Health Information Technology (HIT) as well as physician-perceived barriers to and facilitators of HIT adoption. It will provide current, relevant data for designing targeted policies to promote expansion of HIT in diverse rural settings.
  
• Diabetes Burden and the Lack of Preventive Care in the Rural United States
  Lead Researcher: Santosh Krishna, PhD, EdS
  The project is designed to determine if there are disparities in diabetes care provided to persons with diabetes residing in rural areas as compared to those in urban areas. Additionally, the project will examine diabetes related health care resource utilization with implications for improving care and reducing the economic burden.
  
• National Study of Rural Medicaid Disease Management
  Lead Researcher: Wanda Fowler, MHA, Council of State Governments
  This project will identify those states with Medicaid disease management (DM) programs that serve clients in rural areas; analyze the characteristics of the rural DM programs, and identify benefits, challenges and issues for Medicaid programs providing DM services in rural areas.
  
• Rural-Urban Differences in Nursing Home Admissions, Service Usage and Discharge
  Lead Researcher: Emily Zimmerman, PhD, George Mason University
  An in-depth examination of rural-urban differences in recent nursing home first admissions, their service utilization patterns, and their discharge status over 12 months will be conducted to determine whether persons from rural areas admitted to rural nursing homes have higher functioning, receive fewer special nursing home services, and remain in care longer than rural admissions to urban nursing homes, urban admissions to urban nursing homes, or urban admission to rural nursing homes.
  
• Tribal Long-Term Care: Barriers to Best Practices in Policy and Programming for a National Sample of Rural Tribes
  Lead Researcher: R. Turner Goins, PhD, West Virginia University Research Corporation
  This project will examine barriers experienced by rural American Indian and Alaska Native (AI/AN) tribes in developing long term care policy and service provision, identify tribes which exemplify best practices in the area of long term care policy, and document what other tribes would need to know to develop successful long term care programs (i.e., lessons learned).
  
• U.S. Hospitalizations for Ambulatory Care Sensitive Conditions: A Rural/Urban Comparison
  Lead Researcher: Kyle Muus, PhD
  This project will assess trends, patterns, and predictors of hospitalizations for three ambulatory care sensitive conditions (ACSCs) (i.e., uncontrolled diabetes, bacterial pneumonia, and pediatric asthma) among rural and urban residents in the United States. The study will involve the examination of 2003 HCUP Nationwide Inpatient Sample data.
  
• Patient Bypass Behavior and Critical Access Hospitals: Implications for Patient Retention
  Lead Researcher: Jiexin (Jason) Liu, MBA, PhD, University of Maryland, School of Medicine
  This project drew on a survey of patients sampled from the service areas of 25 Critical Access Hospitals (CAHs) from different regions of the country. The purpose of this project is to identify policy and programmatic issues related to bypass, specifically targeting CAHs in order to offer evidence and guidance to policymakers, CAH administrators, and planners on the location of healthcare resources, factors that affect patient actions for planning programs, and the adjustment of policies in order to retain patients locally.
  
• Pharmaceutical Data Validity in Estimating Rural Population Health
  Lead Researcher: Ronald Cossman, PhD, Mississippi State University
  This project will allow for the quantification of variation in morbidity (via prescription use) across rural areas; identify locations that might be at risk for stunted economic development due to high levels of chronic illness in the working population; and potentially lead to the development of a valid and reliable measure of county-level rates of chronic illness using prescription data as a proxy.
  
• Rural Public Health Department Structure and Infrastructure
  Lead Researcher: Anthony Wellever, MPA
  This project is intended to generate hypotheses about the relationship of local public health department structure and infrastructure to performance. Using case studies of 12 rural public health departments in six geographically diverse states, investigators hope to identify elements of local health department (LHD) structure to serve as independent variables for future studies of LHD performance.
  
• Rural Safety Net Provision and Hospital Care in 11 States
  Lead Researcher: Patricia Ketsche, MBA, PhD, Georgia State University
  This project evaluated whether access to primary care is more effective at improving health outcomes and reducing costs in rural than urban markets, and identified the characteristics of communities which contribute to improved health outcomes and reducing preventable hospitalizations. This research informs policy relating funding access provision through public clinics to reduce the burden of uncompensated or under-compensated care on financially strained rural hospitals.
  
• Urban and Rural Differences in Access to Care and Treatment for Medicare Beneficiaries with Cancer
  Lead Researcher: Lisa S. Shugarman, RAND Corporation
  Little is known about the differences in the diagnosis, treatment and outcomes of care for cancer patients across urban and rural regions of the country. This study will extend our understanding of the challenge of providing high-quality cancer care to Medicare beneficiaries and how provider availability influences access to needed care in urban and rural areas.
  
• Impact of Bioterrorism on Rural Mental Health Needs
  Lead Researcher: Jennie C.I. Tsao, PhD, University of California, Los Angeles
  This project aims to assess and improve the preparedness of rural primary care professionals to care for mental health conditions in the wake of bioterrorism and infectious disease outbreaks.
  
• National Study of Home Health Access in Rural America
  Lead Researcher: Beth Virnig, PhD
  This project will develop home health care service areas that will allow for the measurement of access to home health care for rural Medicare beneficiaries who die of cancer, and recommend options for increasing access to home health care in underserved rural areas.
  
• Native Elder Care Needs Assessment: Development of a Long Term Care Planning Tool Kit
  Lead Researcher: Alan Allery, MHA
  A long term care planning tool kit will assist tribes with interpreting long term care data obtained through a national Native Elder Care Needs Assessment. It will also assist tribes in using the data to develop long term care infrastructure and comprehensive services that respond to local needs and services.
  
• Quality of Women's Care in Rural Health Clinics: A National Analysis
  Lead Researcher: Joellen B. Edwards, PhD, RN
  This study will analyze the rates at which women patients receive five recommended preventive screening interventions in a national, geographically stratified random sample of Rural Health Clinics. Results of the analysis will be used to derive implications for rural health policy.
  
• Rural Access and State Loan Repayment for Dentists
  Lead Researcher: Shelly Gehshan, MPP, National Conference of State Legislatures
  This project will identify and evaluate the effectiveness of state loan repayment programs for dentists on improving access to rural health care. This study will establish baseline information about these programs that can be used by states to design and tailor similar programs for rural access.
  
• Rural and Urban Differences in Utilization of Formal Home Care
  Lead Researcher: William J. McAuley, PhD
  This project uses the Medical Expenditure Panel Survey and other data sources to examine rural and urban differences in the utilization and costs of formal home care, including changes in utilization patterns and costs across residence types over time.
  
• Prevalence of Chronic Disease and the Degree of Rurality of American Indian Elders in a Nationally Representative Sample of 100 Tribes
  Lead Researcher: Patricia L. Moulton, PhD
  This project will determine if there are differences in prevalence of chronic disease in American Indian elders across age groups in urban vs. rural vs. frontier counties. Moderating factors of chronic disease will also be examined including health damaging behaviors, access to health care services and providers and degree of functional limitation.