• Current Projects - (2)
• Completed Projects - (2)
• Publications - (11)

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Current Projects - (2)

• 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
  
• 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 - (11)

• 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.
• 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.
• 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.
• 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.
• 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.
• 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.