• Current Projects - (3)
• Completed Projects - (2)
• Publications - (19)

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Current Projects - (3)

• Creating County- and Census Tract-Level Estimates of Childhood Obesity in the U.S.: A Spatial Multilevel Modeling Approach
  Using the 2016 National Survey of Children's Health, spatial multilevel models will be constructed to estimate county- and Census tract-level rates of childhood obesity in the U.S. Particular emphasis will be placed on rural areas, for which direct estimates are often unavailable because of small sample sizes in population-based surveys.
  Research center: Rural and Minority Health Research Center
  Topics: Children and adolescents, Obesity
  
• Planning and Pilot Testing of Evidence-Based Cancer Prevention and Control Interventions with Rural Health Clinics
  This project will leverage growing collaborative efforts between the Rural and Minority Health Research Center, South Carolina Office of Rural Health, South Carolina Primary Health Care Association, and Center for Rural and Primary Healthcare to assess and improve cancer prevention and control among rural South Carolina residents.
  Research center: Rural and Minority Health Research Center
  Topics: Cancer, Minority health, Rural Health Clinics (RHCs)
  
• Rural Colon and Cervical Cancer Environmental Scan
  Detailed research is needed to provide a complex, textured picture of rural healthcare and the ways in which existing federally supported providers can provide adequate services across the continuum of cancer care from prevention through survivorship.
  Research center: Rural and Minority Health Research Center
  Topics: Cancer, Minority health
  

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Completed Projects - (2)

• Colorectal Cancer Screening Bypass Behavior and Outcomes
  Studies have shown that increased distance to the closest endoscopy provider is associated with lower screening utilization among Medicare enrollees. The purpose of this study is to expand beyond the Medicare population to examine the travel behaviors of the entire population, comparing urban vs. rural residents in obtaining endoscopies for colorectal cancer screening.
  Research center: Rural and Minority Health Research Center
  Topics: Cancer, Health promotion and disease prevention, Medicare
  
• Potential Impact of ESRD Payment Reform on Rural Dialysis Patients
  This study will estimate the potential implications of rural dialysis facility loss for rural patients. Specifically, we will identify low-volume dialysis facilities in rural areas, profile the patients they serve, and estimate the additional travel burden that these patients would experience if facilities close.
  Research center: Rural and Minority Health Research Center
  Topics: Health services, Hospitals and clinics
  

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Publications - (19)

• Ambulatory Care-Sensitive Condition Hospitalizations Among Medicare Beneficiaries
  Rural and Minority Health Research Center
  Date: 06/2016
  Examines the relationship between the distribution of primary care physicians and Medicare beneficiaries' ambulatory care-sensitive condition hospitalizations using statistical and spatial analyses.
• A Bivariate Mapping Tutorial for Cancer Control Resource Allocation Decisions and Interventions
  Rural and Minority Health Research Center
  Date: 01/2020
  This study demonstrates how geographic information systems software, specifically ArcGIS, can be used to develop bivariate choropleth maps to inform resource allocation and public health interventions.
• Challenges of Using Nationally Representative, Population-Based Surveys to Assess Rural Cancer Disparities
  Rural and Minority Health Research Center
  Date: 08/2019
  Population-based surveys provide important information about cancer-related health behaviors across the cancer care continuum. However, due to small rural sample sizes, varying sampling methods, and/or other study design or analytical concerns, there are challenges in using population-based surveys for rural cancer control research and practice.
• Colonoscopy Access and Utilization – Rural Disparities in the Carolinas, 2001-2010
  Policy Brief
  Rural and Minority Health Research Center
  Date: 07/2016
  This study aims to use data on where patients travel for their colonoscopies to determine the extent to which access is changing over space and time, and to better understand utilization patterns among rural residents of North and South Carolina between 2001 and 2010.
• Development of a Childhood Obesogenic Environment Index
  Policy Brief
  Rural and Minority Health Research Center
  Date: 08/2019
  The purposes of this study were to describe the development of a childhood obesogenic environment index and examine differences in obesogenic environment index values by rurality and region across the U.S.
• Differences in Medicare Utilization and Expenditures in the Last Six Months of Life Among Patients with and without Alzheimer's Disease and Related Disorders
  Rural and Minority Health Research Center
  Date: 10/2018
  The purpose of this study was to examine differences in utilization of inpatient services and Medicare expenditures (overall and by category) in the last six months of life for patients with, versus those without, a diagnosis of Alzheimer's disease and related disorders.
• ESRD Facility Characteristics by Rurality and Risk of Closure
  Report
  Rural and Minority Health Research Center
  Date: 11/2017
  This study's purpose was to profile rural end stage renal disease (ESRD) facilities, focusing on those at greatest risk for closure. We examined the characteristics of these facilities, the quality of care provided, and the distance patients in rural areas would have to travel if the facilities closed.
• Financial Hardship Among Rural Cancer Survivors: An Analysis of the Medical Expenditure Panel Survey
  Rural and Minority Health Research Center
  Date: 11/2019
  This study examined contrasts in financial hardship among 1,419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement the Effects of Cancer and Its Treatment on Finances.
• Gender and Geographic Differences in Medicare Service Utilization During the Last Six Months of Life
  Rural and Minority Health Research Center
  Date: 11/2017
  End-of-life issues are important for senior women, particularly rural women, who are more likely than their urban counterparts to live alone. The role of residence has yet to be investigated. The purpose of this study is to examine whether service utilization in the last six months of life differs across gender and rurality.
• Geographic Disparities in Residential Proximity to Colorectal and Cervical Cancer Care Providers
  Rural and Minority Health Research Center
  Date: 11/2019
  Persistent rural‐urban disparities for colorectal and cervical cancers raise concerns regarding access to treatment providers. To the authors knowledge, little is known regarding rural‐urban differences in residential proximity to cancer specialists.
• Health-Related Quality of Life Among Adults 65 years and Older in the United States, 2011-2012: A Multilevel Small Area Estimation Approach
  Rural and Minority Health Research Center
  Date: 10/2016
  This study compiled estimates, at the county level, of poor health-related quality of life among those ages 65 and older. The study examined physical and mental health and found significant differences in health across the United States.
• Identification of High-Need Rural Counties to Assist in Resource Location Planning
  Policy Brief
  Rural and Minority Health Research Center
  Date: 05/2019
  To identify high-need, low-resource locations, we began by identifying counties that lacked safety-net providers. For the purposes of this analysis, we identified Medicare-certified Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs) and Critical Access Hospitals (CAHs).
• Identification of High-Need Rural Counties to Assist in Resource Location Planning for Primary Care
  Policy Brief
  Rural and Minority Health Research Center
  Date: 05/2019
  We examined simultaneously areas with poor health outcomes and limited access to primary care safety net settings. The combination of facility availability with health status indicators may help with identifying those areas in rural America that are in the greatest need of additional primary care resources.
• Multilevel Analysis in Rural Cancer Control: A Conceptual Framework and Methodological Implications
  Rural and Minority Health Research Center
  Date: 09/2019
  Our objective was two-fold: 1) to develop a multilevel conceptual framework describing how rural residence and relevant micro, macro, and supra-macro factors can be considered in evaluating disparities across the cancer control continuum and 2) to outline the unique considerations of multilevel statistical modeling in rural cancer research.
• Rural-Urban Differences in Costs of End-of-Life Care for the Last 6 Months of Life Among Patients with Breast, Lung, or Colorectal Cancer
  Rural and Minority Health Research Center
  Date: 04/2018
  Our findings indicate that Medicare expenditures are lower for rural beneficiaries with each type of cancer than urban beneficiaries, even after adjusting for age, gender, race, dual eligibility, region, chronic conditions, and type of service utilization.
• Rural-Urban Differences in Financial Burden Among Cancer Survivors: An Analysis of a Nationally Representative Survey
  Rural and Minority Health Research Center
  Date: 12/2019
  Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.
• Spatial Clustering Patterns and Regional Variations for Food and Physical Activity Environments Across the United States
  Rural and Minority Health Research Center
  Date: 01/2020
  This study examined spatial patterns of obesogenic environments for U.S. counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified differences across regions and rurality categories. This study highlights geographic clustering and disparities in food and PA access.
• Travel Grant Program 2018-2019
  Fact Sheet
  Rural and Minority Health Research Center
  Date: 01/2020
  This project promoted attendance at cancer-related meetings by Rural Health Research Centers by facilitating the dissemination of information regarding important cancer meetings and handling the travel arrangements for Rural Health Research Center personnel.
• Who Performs Colonoscopy? Workforce Trends Over Space and Time
  Rural and Minority Health Research Center
  Date: 11/2017
  Using data from South Carolina from 2001-2010, this study looked at changes in the types of facilities doing colonoscopies as well as the any changes in who is performing them.