• Current Projects - (2)
• Completed Projects - (2)
• Publications - (23)

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Current Projects - (2)

• Addressing Rural Social Isolation as a Health and Mortality Risk Factor
  This project aims to describe rural/urban differences in the prevalence of social isolation, as well as to identify challenges and strategies related to addressing rural social isolation in order to inform policy-making.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Aging, Health promotion and disease prevention
  
• Caring for Caregivers: Available Support for Unpaid Caregivers in Rural Areas
  This project aims to describe rural-urban differences in the prevalence and intensity of informal caregiving for older adults and associated socio-demographic correlates and to identify potential policy interventions to improve the quality of life and health outcomes of rural caregivers.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Aging, Home health, Long-term care
  

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Completed Projects - (2)

• Paving the Way: Addressing Transportation as a Social Determinant of Health for Rural Residents
  This project will use a mixed-methods design to examine ways in which transportation operates as a social determinant of health for vulnerable rural residents, and to identify exemplar transportation programs that are successfully improving health and well-being of those residents.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Aging, Health services, Networking and collaboration, Transportation
  
• Skilled Nursing Facility Care for Rural Residents with Complex Care Needs
  This project will examine barriers to skilled nursing facility placement for rural residents with complex care needs, including obesity, dementia, and behavioral health problems, and explore potential implications for access to and quality of care.
  Research center: University of Minnesota Rural Health Research Center
  Topics: Health services, Hospitals and clinics, Long-term care
  

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Publications - (23)

• Access to Obstetric Services in Rural Counties Still Declining, with 9 Percent Losing Services, 2004-14
  University of Minnesota Rural Health Research Center
  Date: 09/2017
  Providing access to obstetric care in rural areas is a growing concern. By 2014, about 54% of rural counties in the United States did not have hospital obstetric services.
• Association Between Loss of Hospital-Based Obstetric Services and Birth Outcomes in Rural Counties in the United States
  University of Minnesota Rural Health Research Center
  Date: 03/2018
  This study examines whether the loss of obstetric services in hospitals in rural U.S. counties led to changes in childbirth outcomes or locations.
• Challenges Related to Pregnancy and Returning to Work after Childbirth in a Rural, Tourism-Dependent Community
  University of Minnesota Rural Health Research Center
  Date: 02/2018
  This case study highlights challenges related to pregnancy and returning to work after childbirth in a rural, tourism-dependent community in Minnesota.
• Closure of Hospital Obstetric Services Disproportionately Affects Less-Populated Counties
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2017
  This policy brief describes the scope of obstetric unit and hospital closures resulting in loss of obstetric services in rural U.S. counties from 2004 to 2014.
• Differences in Part D Plans Offered to Rural and Urban Medicare Beneficiaries
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 07/2015
  This brief analyzes how the plan options available to rural and urban beneficiaries differ in terms of premiums, deductibles, and copayments, as well as differences in plan options within rural areas.
• Does the Medicare Part D Decision-Making Experience Differ by Rural/Urban Location?
  University of Minnesota Rural Health Research Center
  Date: 02/2016
  Evaluates the personal experiences with choosing a Part D plan among rural residents. This study examines the geographic differences in Part D enrollees’ opinion of the plans decision-making process.
• Ensuring Access to High-Quality Maternity Care in Rural America
  University of Minnesota Rural Health Research Center
  Date: 05/2016
  Examines the access to high-quality for rural women care during pregnancy and childbirth. Policy interventions at the local, state, and federal levels could help to address maternity care workforce shortages and improve quality of care available to the one-half million rural U.S. women who give birth each year.
• The Maternity Care Nurse Workforce in Rural U.S. Hospitals
  University of Minnesota Rural Health Research Center
  Date: 05/2017
  Findings are shared from a study examining the maternity care nursing workforce in rural hospital in the United States.
• Medical Barriers to Nursing Home Care for Rural Residents
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2017
  This policy brief describes barriers rural residents with complex medical care needs may face when seeking placement in a nursing home and identifies potential policy strategies to overcome them.
• Medicare Costs and Utilization Among Beneficiaries in Rural Areas
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 03/2016
  This study assesses the relationship between service utilization patterns and costs for rural Medicare beneficiaries across the rural continuum. It also examines the relationships between rural beneficiaries’ service utilization and healthcare delivery market structure and evaluates strategies and policies to address high costs in rural areas.
• Quality Measures and Sociodemographic Risk Factors: The Rural Context
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2016
  This policy brief aims to inform discussions concerning whether or not to adjust provider quality measures for differences in patient characteristics by examining how rurality and key sociodemographic variables might affect quality-of-care outcomes.
• Regulating Network Adequacy for Rural Populations: Perspectives of Five States
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 08/2017
  The purpose of this study was to examine how five geographically-diverse states with significant rural populations define "network adequacy" and the degree to which they consider rural issues when regulating networks.
• Relationship Between Hospital Policies for Labor Induction and Cesarean Delivery and Perinatal Care Quality among Rural U.S. Hospitals
  University of Minnesota Rural Health Research Center
  Date: 11/2016
  This study focused on maternity care quality by taking a look at hospitals’ policies regarding induced labor and Cesarean deliveries.
• Rural and Urban Differences in Choice of and Satisfaction with Medicare Part D Plans
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 07/2015
  This brief examines whether rural Medicare beneficiaries are satisfied with their Medicare Part D drug plans and whether there is a difference in beneficiary satisfaction and plan selection experience by rurality.
• Rural Hospital Employment of Physicians and Use of Cesareans and Nonindicated Labor Induction
  University of Minnesota Rural Health Research Center
  Date: 03/2017
  Findings are shared from a study that discovered the types of doctors employed at rural hospitals may make a difference in the rates of cesarean births.
• Rural Implications of Expanded Birth Volume Threshold for Reporting Perinatal Care Measures
  University of Minnesota Rural Health Research Center
  Date: 04/2016
  In 2016 the minimum annual birth volume threshold for required reporting of the Joint Commission Perinatal Care measures by accredited hospitals decreased from 1,100 to 300 births. This study used the publicly available Join Commission Quality Check data from April 2014 to March 2015.
• Rural Transportation: Challenges and Opportunities
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 11/2017
  This policy brief uses survey data from 113 key informants across all 50 states to describe challenges and opportunities related to rural transportation.
• Rural-Urban Differences in Medicare Quality Outcomes and the Impact of Risk Adjustment
  University of Minnesota Rural Health Research Center
  Date: 09/2017
  This study examined the differences in quality of care outcomes between rural and urban Medicare beneficiaries. It concluded that rurality should be considered when discussing risk-adjustment procedures.
• Rural-Urban Differences in Medicare Quality Scores Persist After Adjusting for Sociodemographic and Environmental Characteristics
  University of Minnesota Rural Health Research Center
  Date: 09/2017
  Patient sociodemographic characteristics, such as age, race, gender, income, and education, can affect health outcomes and healthcare providers’ performance on quality measures. The discussion about how to tackle these issues around quality measurement haven’t included rurality, but this study examines it.
• Rural-Urban Differences in Satisfaction with Medicare Part D: Implications for Policy
  University of Minnesota Rural Health Research Center
  Date: 01/2016
  Examines the difference in rural and urban satisfaction with Medicare Part D coverage by using data from the 2012 Medicare Current Beneficiary Survey. The research found that rural residents have lower satisfaction with their coverage.
• State Variability in Access to Hospital-Based Obstetric Services in Rural US Counties
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 04/2017
  This policy brief describes state-level variations in 1) the availability of hospital-based obstetric services, and 2) the scope of obstetric unit and hospital closures resulting in the loss of obstetric services in rural U.S. counties from 2004 to 2014.
• State Variations in the Rural Obstetric Workforce
  Policy Brief
  University of Minnesota Rural Health Research Center
  Date: 05/2016
  Many types of staff are necessary to successfully run an obstetrics unit. Rural hospitals face unique staffing challenges. This policy brief describes the obstetric workforce in rural hospitals by state for nine states: Colorado, Iowa, Kentucky, New York, North Carolina, Oregon, Vermont, Washington, and Wisconsin.
• The Practice of Midwifery in Rural US Hospitals
  University of Minnesota Rural Health Research Center
  Date: 07/2016
  Analyzes the role of certified nurse-midwives (CNMs) in providing maternity care in rural US hospitals and to examine state-level variations on rural CNM practice. CNMs play an important role in the maternity care workforce in rural US hospitals.