Garney examines lack of access to health care for rural residents

Whitney R. Garney, M.P.H.

Whitney R. Garney, M.P.H.

Whitney R. Garney, M.P.H., Brazos Valley regional manager with the Center for Community Health Development located at the Texas A&M Health Science Center School of Rural Public Health, recently authored an article on the lack of access to health care for rural residents.

Published in the May issue of the Journal of the American Board of Family Medicine, “Rural Community of Solution: Increasing Access to Care for Brazos Valley, Texas” presents a case study of the Brazos Valley Health Partnership (BVHP) and its implementation of health resource centers within rural counties. Center for Community Health Development researchers worked with the BVHP to design a strategy to increase continuous access to a variety of health-related services and to obtain resources for implementation.

“The resource center concept allowed for service providers, previously only able to offer services in more populous areas, to expand into the rural communities because of the reduced overhead costs,” Garney said. “It was created as a one-stop shop where multiple health and social service providers could be housed.”

This case study revealed that through the partnership of local health providers and community leaders, rural communities could increase access to sustained health services.

Additional authors include Kelly Drake, M.P.H., Monica Wendel, Dr.P.H., Kenneth McLeroy, Ph.D., Heather Clark, M.P.H, and Byron Ryder. The Center for Community Health Development is one 37 Prevention Research Centers designated and funded by the U.S. Centers for Disease Control and Prevention.

 

CCHD part of research study on depression in the Brazos Valley

Monica L. Wendel, Dr. P.H

Monica L. Wendel, Dr. P.H

Examining results from two surveys of the Brazos Valley, a recent study involving the Texas A&M Health Science Center (TAMHSC) School of Rural Public Health found African-Americans and women were at a greater risk for depression in predominately rural regions.

In the article, “Assessing Depression in Rural Communities,” in the March issue of Journal of Clinical Psychology, researchers from the school, Texas A&M University and the Veterans Affairs Gulf Coast Veterans Health Care System analyzed responses from the Brazos Valley Health Assessment surveys of 2006 and 2010.

According to Daniel F. Brossart, Ph.D., lead author and Texas A&M associate professor, the study found women and African-Americans in underserved and predominately rural areas may face unique issues that undermine their emotional well-being and potentially lead to the development of depressive symptoms.

The survey used of the seven Brazos Valley counties – Brazos, Burleson, Grimes, Leon, Madison, Robertson and Washington – was created by the Center for Community Health Development (CCHD) in the TAMHSC-School of Rural Public Health to gather individual and community information that provides an overview of the health status of the local community, as well as document issues that may need to be addressed to improve the local population’s health.

The assessment process includes a household survey, community discussion groups and an analysis of existing data that will provide context and comparison for the data gathered through the survey and discussion groups. The CCHD conducts these assessments every four years to inform policies and assist local organizations and communities in understanding the health-related needs of the residents.

James N. Burdine, Ph.D.

James N. Burdine, Ph.D.

“Our assessment process is designed to provide data that helps communities and the organizations that serve them,” said Monica L. Wendel, Dr.P.H., co-writer and assistant dean for Community Health Systems Innovation at TAMHSC-School of Rural Public Health and CCHD director. “Identifying populations at risk and potential factors underlying that risk helps us develop better services and programs to reach those who need it most.”

Emphasis was given to the importance of a systematic assessment and culturally sensitive treatment to better meet the needs of ethnic minorities and women in this underserved region. Men and women in rural areas are less likely to receive quality mental health treatment than those in more metropolitan communities.

In addition, issues of poverty, social isolation and limited access to premium health care that is present for underserved rural populations are even more compounded for ethnic minorities. It is argued there is a need for a more comprehensive assessment and treatment plan for the communities in these regions.

Additional authors included Timothy R. Elliot, Ph.D., and Linda G. Castillo, Ph.D., Texas A&M professors of educational psychology; Helene E. Cook, VA Gulf Coast Veterans Health Care System; and James N. Burdine, Dr.P.H., TAMHSC-School of Rural Public Health interim dean and assistant dean of public health practice.

 

CCHD conducting local health assessment across nine-county region, with Montgomery County recruitment beginning Feb. 4

Beginning this month, the Center for Community Health Development (CCHD) in the Texas A&M Health Science Center School of Rural Public Health is conducting the fourth local health assessment across a nine-county region.

The assessment includes a survey, with recruitment in Montgomery County beginning the week of Feb. 4.

Like the health assessments in 2002, 2006 and 2010, its purpose is to gather both individual and community information that can provide a “snapshot” of the health status of the local community and document community issues that may need to be addressed to improve the local population’s health.

Assessment data can assist local health care and related service providers, community organizations, policymakers, and residents in making informed decisions on improving access and minimizing barriers to care, creating efficiencies in the delivery of care, and participating in the development of local health care improvement strategies.

Previous assessments were focused on the Brazos Valley region of Brazos, Burleson, Grimes, Leon, Madison, Robertson and Washington counties. This assessment will expand its geographic scope to include this area along with Walker and Montgomery counties.

This geographic increase is to align with Regional Healthcare Partnership 17 (RHP 17), which was organized in March 2012 to develop a regional health care delivery system transformation plan under the state’s 1115 Medicaid Transformation Waiver. The focus on the RHP 17 region has led to a new name for the assessment, now called the 2013 RHP 17 Health Assessment.

Assessment findings will be released at an RHP 17 Health Summit in September.

As in previous years, the assessment process includes a household survey, community discussion groups and an analysis of existing data that will provide context and comparison for the data gathered through the survey and discussion groups.

CCHD has been working with a data committee comprised of regional health and social services representatives and CCHD-affiliated faculty to develop the household survey. The market research firm
ETC Institute has been contracted to recruit residents from the nine-county region to take this survey.

The recruitment process will consist of contacting residents via phone – both landline and cell – to request participation in the survey, which then will be mailed to the participant with a self-addressed stamped envelope for its return. Survey recruitment will be from Feb. 4 to May 3, with all surveys returned by the end of May.

CCHD is again partnering with its community advisory board, the Brazos Valley Health Partnership, to facilitate community discussion groups across the region. These groups are designed to capture the various perspectives of community members that are more difficult to obtain in a survey format.

CCHD will meet with various audiences, including health care and human service providers, community leaders, and the general public. It anticipates conducting more than 80 discussion groups in the region, beginning in February.

The results from the assessment will assist local organizations and communities in understanding the health-related needs of their residents. In the past, assessment results have been used to secure funding to develop and improve health infrastructure and access to care. Locally developed initiatives have focused on issues like rural transportation, mental health services, service coordination, patient education, physical activity and medication assistance.

For more information about the 2013 RHP 17 Health Status Assessment, go to www.CCHD.us.

 

Faculty publish annotated bibliography on social ecological models

Monica L. Wendel, Dr. P.H., M.A.

Monica L. Wendel, Dr. P.H., M.A.

Faculty from the Texas A&M Health Science Center (TAMHSC) School of Rural Public Health recently published “Ecological Approaches” online in Oxford Bibliographies.

Monica L. Wendel, Dr.P.H, M.A., assistant dean for community health systems innovation, and Regents Professor Kenneth McLeroy, Ph.D., co-wrote the article that is an annotated bibliography highlighting the body of work most central to the current understanding of social ecological models, as well as detailing the social ecological concepts now being applied within the public health community.

Kenneth McLeroy, Ph.D.

Kenneth McLeroy, Ph.D.

“The social ecological model provides a framework for understanding the social and contextual factors that produce and maintain health and health-related issues,” Dr. Wendel said.

The model facilitates identification of potential leverage points for broader system change and encourages a better understanding of how social problems are created and sustained within the social environment.

Dr. Wendel is director of the Center for Community Health Development at the TAMHSC-School of Rural Public Health while Dr. McLeroy is the principal investigator for the center.

 

CCHD helps with rural public health textbook to fill critical gap

Rural Populations and Health Textbook

Rural Populations and Health Textbook

The Center for Community Health Development (CCHD) at the Texas A&M Health Science Center (TAMHSC) School of Rural Public Health participated in publishing a rural public health textbook that fills a critical gap in the current literature.

The textbook, Rural Populations and Health, provides an overview of the critical issues surrounding rural health and offers rationale for rectifying rural health disparities in the United States.

Monica Wendel, Dr.P.H., M.A., CCHD director and assistant dean of community health systems innovations, served as an editor, along with three colleagues from the Prevention Research Center for Cancer Prevention at the University of Kentucky: Rick Crosby, Ph.D., Robin Vanderpool, Dr.P.H., and Baretta Casey, M.D., M.P.H.

“Several textbooks exist that focus on rural populations, but from perspectives such as nursing, medicine and social work,” Dr. Wendel said. “This is the first comprehensive textbook to focus on rural public health specifically. We were fortunate to have chapters authored by academic and community research partners from Prevention Research Centers like ours working in rural communities throughout the country.”

Members of the Brazos Valley Health Partnership Board and CCHD faculty, staff and students collaborated to publish a chapter on Capacity Building in Rural Communities, which highlights specific examples of CCHD’s partnership and work in the Brazos Valley.

Other chapters representing CCHD include:
•    Health Assessment in Rural Communities (Burdine, Clark, Shea, Appiah and Hollas)
•    Promoting Adolescent Health in Rural Communities (McKyer, Outley, Blake and Kelly)
•    Rural Food Disparities (Dean, Johnson and Sharkey)
•    Addressing Mental Health Issues in Rural Areas (McCord, Elliott, Brossart and Castillo).

The Center for Community Health Development is one of 37 Prevention Research Centers designated and funded by the U.S. Centers for Disease Control and Prevention nationally.