Journal of Rural Health最新文献

{"title":"Rural patients’ experiences with diagnosis and treatment of endometrial cancer","authors":"Victoria M. Petermann PhD, RN,&nbsp;Brianna D. Taffe MPH,&nbsp;Blen M. Biru MSc,&nbsp;Jennifer Leeman DrPH, MPH, MDiV,&nbsp;Ashley Leak Bryant PhD, RN, OCN, FAAN,&nbsp;Benjamin B. Albright MD, MS,&nbsp;Stephanie B. Wheeler PhD, MPH,&nbsp;Victoria L. Bae-Jump MD, PhD,&nbsp;Lanneau Grainger MD,&nbsp;Lisa P. Spees PhD","doi":"10.1111/jrh.70065","DOIUrl":"https://doi.org/10.1111/jrh.70065","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rural endometrial cancer (EC) patients are less likely to receive lymph node evaluation, high-quality surgical care, and adjuvant therapy compared to urban patients. Developing interventions to effectively address barriers to quality care requires understanding patient experiences across the cancer care continuum. Our objective was to understand the diagnostic and treatment experiences of rural EC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted semistructured interviews with 23 participants (22 patients, one caregiver) from rural counties in North Carolina. We developed a semistructured interview guide to examine the experiences of patients during diagnosis and treatment. Initial codes were derived from a multilevel conceptual framework of rural cancer control, and transcribed interviews were analyzed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified six themes reflecting determinants of diagnosis and seven themes for treatment of EC for rural patients. Provider knowledge of EC symptoms, patient symptom normalization, and fear were all discussed as major factors impacting delays in EC diagnosis. Participants noted that social networks influenced them to seek care for symptoms they did not otherwise see as concerning. During treatment, participants experienced financial burdens, and many reported significant challenges traveling to treatment. Social networks were critical for financial support and transportation to and from treatment. Personal health care experiences and community perceptions about rural cancer care also influenced decisions about where to seek gynecologic cancer treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study highlights the need to improve rural provider adherence to guidelines for EC detection, increase symptom knowledge among rural communities, and implement comprehensive assessments of unmet needs of rural patients during treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144891704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing aid acquisition patterns among US Veterans who use VA health care","authors":"Laura Coco PhD, AuD,&nbsp;Loretta Shields PhD,&nbsp;Rachel Phillips MS,&nbsp;Stephanie Pesa AuD,&nbsp;Matthew Hamilton-Sutherland AuD,&nbsp;Kathleen F. Carlson PhD, MS,&nbsp;Dawn L. Konrad-Martin PhD,&nbsp;Kelly M. Reavis PhD, MS, MPH","doi":"10.1111/jrh.70068","DOIUrl":"https://doi.org/10.1111/jrh.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary objective of this observational study was to describe the population of Veterans who did and did not receive a hearing aid following an incident hearing loss diagnosis during the 12-year study period. We also sought to measure the relationship between hearing loss severity and hearing aid acquisition and explore how this association differs according to Veterans’ urban/rural residential status. Understanding associations of clinical or demographic characteristics with hearing aid acquisition by US Veteran health care users may contribute to more effective treatment of hearing loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We examined all Veteran electronic health records to identify participants with an incident (new) hearing loss diagnosis between January 2011 and June 2023. Hearing loss was identified using International Classification of Diseases diagnosis codes and audiogram results. Hearing aid fittings were identified using Current Procedural Terminology codes. Poisson regression models were used to compute rate ratios and 95% confidence intervals of hearing aid acquisition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 256,409 Veterans with an incident hearing loss diagnosis, the prevalence of hearing aid acquisition was 81% (<i>n</i> = 206,438) during the study period. Among Veterans who received hearing aids, a greater proportion were older, male, White, non-Hispanic, married, and from higher income groups. The average number of days between hearing loss diagnosis and hearing aid fitting was less than 1 year (<i>M</i> = 200 days; SD = 502 days). The association between hearing loss severity and hearing aid acquisition was stronger among urban Veterans compared to rural Veterans, and there was a significant interaction between hearing loss severity and urban/rural status (<i>p</i> &lt; .0001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This large, national cohort study provides the first description of hearing aid acquisition patterns among Veterans using VA health care. Hearing aid uptake was high overall but varied by demographic and geographic factors. The observed differences may reflect structural challenges or variations in perceived need. These findings can help inform targeted VA programs aimed at improving timely uptake of hearing care, particularly among rural Veteran populations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144861652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tobacco retailer density and rurality across four US states: California, Connecticut, North Carolina, and Ohio","authors":"Emerson Webb MS,&nbsp;Peter F. Craigmile PhD,&nbsp;Meghan E. Morean PhD,&nbsp;Grace Kong PhD,&nbsp;Joseph G. L. Lee PhD,&nbsp;Ryan J. Martin PhD,&nbsp;Jessica Barrington-Trimis PhD,&nbsp;Rui Qiang PhD,&nbsp;Vitoria Borges Spinola DDS,&nbsp;Megan E. Roberts PhD","doi":"10.1111/jrh.70073","DOIUrl":"https://doi.org/10.1111/jrh.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Research has demonstrated many types of disparities in tobacco retailer density (TRD), but these analyses often fail to explore rural disparities. Given the substantial burden of rural tobacco use in the USA, this is a critical gap. The purpose of the present study was to estimate rural disparities in TRD across four US states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>For the states of California, Connecticut, North Carolina, and Ohio, we used spatial statistical methods to model per capita TRD at the census tract level. Rurality was defined by the US Department of Agriculture Rural-Uran Commuting Area (RUCA) codes and categorized into Metropolitan, Micropolitan, Small Town, and Rural.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Tobacco retailer count was highest in California (22,533), but TRD was highest in Connecticut (1.23 retailers per 1000 residents). In models for California, North Carolina, and Ohio (but not Connecticut), there was an association between rurality and TRD, such that rural census tracts had greater TRD than metropolitan census tracts. Micropolitan and small town (vs. metropolitan) census tracts also had greater TRD, although the association was not as strong. Models further showed associations between TRD and census tract poverty, racial and ethnic composition, and Appalachian designation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although there are notable state-level differences, TRD is clearly associated with rurality. Given the literature on the impacts of living in tobacco-retailer-dense areas, rural disparities in TRD likely contribute to rural disparities in tobacco use. There is a need for further policies in rural areas of the USA that address the tobacco retailer environment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144853806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comparison of classifications for geographic location and their associations with tobacco use among US adults","authors":"Jenny E. Ozga PhD,&nbsp;Andrea Milstred PhD,&nbsp;Melissa D. Blank PhD,&nbsp;Mary Kay Rayens PhD,&nbsp;Brittney Keller-Hamilton PhD,&nbsp;Megan E. Roberts PhD,&nbsp;Seth Himelhoch MD, MPH,&nbsp;Cassandra A. Stanton PhD","doi":"10.1111/jrh.70070","DOIUrl":"https://doi.org/10.1111/jrh.70070","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study compared two classifications of rurality and their associations with cigarette, e-cigarette, and smokeless tobacco (SLT) use among a nationally representative sample of 31,196 US adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data from Wave 1 of the Population Assessment of Tobacco and Health Study. Weighted descriptive statistics and multivariable logistic regressions assessed whether two classifications of rurality were differentially associated with past 30-day (P30D) cigarette, e-cigarette, or SLT use in separate models. Classifications were (1) the US Census Bureau's classification as urban/non-urban; and (2) the National Center for Education Statistic (NCES)’s classification as urban/suburban/town/rural. This study is reported in accordance with STROBE guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>With the Census Bureau classification, 79.3% were in urban areas. With the NCES classification, 34.3% were in urban, 35.1% in suburban, 9.4% in town, and 21.1% in rural areas. With the Census Bureau classification, non-urban (vs. urban) residence was associated with reduced odds of e-cigarette use (AOR = 0.79; 95% CI = 0.70–0.88) and increased odds of SLT use (AOR = 2.32; 95% CI = 1.97–2.72). With the NCES classification with urban as reference, rural residence was associated with reduced odds of e-cigarette use (AOR = 0.77; 95% CI = 0.75–0.98); both town (AOR = 2.16; 95% CI = 1.69–2.78) and rural (AOR = 2.75; 95% CI = 2.16, 3.48) were associated with increased odds of SLT use. Location was not associated with cigarette use for either classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Location was similarly associated with P30D e-cigarette and SLT use across both classifications in adjusted models. The use of classifications with more categories may be beneficial to understand nuanced location differences in tobacco use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer screening barriers, facilitators, and promotion recommendations by Alaska Native people who are non-adherent to colorectal cancer screening","authors":"Diana Redwood PhD,&nbsp;Melissa Toffolon PhD,&nbsp;Christie Flanagan MPH,&nbsp;Lauren Jeffries MPH,&nbsp;Danika Bailie  ,&nbsp;Lila Finney Rutten PhD,&nbsp;John Kisiel MD","doi":"10.1111/jrh.70067","DOIUrl":"https://doi.org/10.1111/jrh.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We examined barriers and facilitators to colorectal cancer (CRC) screening among Alaska Native individuals who had never been screened or were not up to date with screening guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>As part of a larger study investigating the use of the multitarget stool DNA test in rural Alaska communities, we conducted focus groups and in-depth interviews with 28 never screened or not up-to-date Alaska Native people in two remote communities between November 2022 and July 2023. Participants shared their barriers to CRC screening and offered suggestions to improve programs to better reach those who are guideline discordant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>General screening barriers included lack of knowledge, fear of discovering you have cancer, and cultural health beliefs. Colonoscopy-specific barriers included embarrassment from knowing the local medical staff, having rectal area viewed or touched, fear of pain and injury, difficulty scheduling a procedure due to traditional food gathering activities, lack of provider referrals/reminders, and the high cost of air travel required to get to a colonoscopy facility. Stool DNA-specific concerns included not feeling that it was as good as colonoscopy, lack of privacy to do the test, and hesitancy collecting stool samples. Suggestions for increasing screening rates included increasing access via paid air transportation, using local indigenous languages, improving provider relationships and reminder systems, and providing CRC and screening education using trusted messengers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This was the first exploration of the perceptions of CRC screening among guideline discordant Alaska Native people. Identified themes can be used to improve screening program outreach effectiveness in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144782320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An analysis of syringe service programs across the rural-urban continuum in the United States","authors":"Nathan A. Dockery MPH,&nbsp;Qian Huang PhD, MA, MPA,&nbsp;Casey P. Balio PhD","doi":"10.1111/jrh.70072","DOIUrl":"https://doi.org/10.1111/jrh.70072","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Syringe service programs (SSPs) have been proven to reduce transmission of viral infections, prevent substance use and overdose deaths, and help support public safety in operational areas. This study aims to provide a snapshot of the current distribution of SSPs across the United States and analyze them based on community characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>SSP information was collected from state health department websites and the North American Syringe Exchange Network (NASEN) dashboard. Bivariate, multivariate, and geospatial analyses were conducted on the study population to observe significant differences between SSP presence and access between urban and rural populations and to see if community characteristics impact the presence of SSPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Findings showed that a greater proportion of urban counties had at least one SSP compared to rural counties (<i>N</i> = 353, 30% vs. <i>N</i> = 236, 12% respectively, <i>p</i> &lt; 0.001). The logistic regression model showed that urban counties had 66% greater odds of having an SSP than their rural counterparts. Geospatial hot-spot analysis showed significant hot spots in the West and Northeast United States, and cold spots throughout the Midwest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This research provides the most current and comprehensive look at the current count of SSPs in the United States and highlights an increased need in rural areas for SSP presence and access. This study could be used as a benchmark for policymakers and other decision-makers, especially in rural areas, to properly allocate resources for SSP creation and to ensure that policy does not restrict the creation of SSPs or their ability to function properly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“It's not about me. It's about what's best for my community”: Factors impacting COVID-19 vaccine uptake among Native Americans and Latinos from two agricultural communities","authors":"Lina Truong MPH,&nbsp;Alexandra K. Adams MD, PhD,&nbsp;Sonia Bishop BS,&nbsp;Virgil Dupuis BS,&nbsp;Lorenzo Garza  ,&nbsp;Thomas Quigley BS,&nbsp;Laurie Hassell BS,&nbsp;Paul K. Drain MD, MPH,&nbsp;Genoveva Ibarra  ,&nbsp;Anna Whiting Sorrell PhD,&nbsp;Teresa Warne MSc,&nbsp;Charlie Gregor MPH,&nbsp;Eliza Webber MPH,&nbsp;Linda K. Ko PhD","doi":"10.1111/jrh.70057","DOIUrl":"https://doi.org/10.1111/jrh.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>While SARS-CoV-2 significantly impacts rural Native American and Latino communities, COVID-19 vaccines offer an effective and safe mitigation strategy. Vaccine uptake is disproportionately lower in rural communities than in urban communities across the nation. This study examined barriers and motivators of COVID-19 vaccine uptake in two Native American and Latino rural agricultural communities in eastern Washington and Montana.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted 28 key informant interviews with trusted community members and six community focus groups with 39 participants from May 2021 to June 2021. Participants were from the Yakima Valley (WA) and Flathead Reservation (MT). The Social Cognitive Theory and Social Context Framework informed development of the interview and focus group moderator guides. We used deductive and inductive approach to code transcripts and thematic analysis to generate themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Barriers to COVID-19 vaccine uptake were misconceptions about COVID-19 vaccines shaped by misinformation, politicization of vaccines, historical trauma and mistrust in government, and structural barriers in rural agricultural communities. Having access to accurate and understandable COVID-19 vaccine information and receiving information from trusted sources were motivators of COVID-19 vaccine uptake. Protecting families, children, elders, and the community, and striving to return to normal life were also noted as motivators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Understanding the community's perceptions and experiences around the COVID-19 vaccine is critical for successful implementation of strategies to increase vaccine uptake during future public health emergencies. Strategies for vaccine uptake among communities in the Flathead Reservation and Yakima Valley need to address barriers and highlight motivators of COVID-19 vaccine uptake.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeking connection: A qualitative study of psychosocial support needs of rural cancer survivors in Minnesota","authors":"Morgan Gruner MD,&nbsp;Katherine Brown BS,&nbsp;Renee Anderson BS,&nbsp;Shaunequa James MSW, LICSW,&nbsp;Xuan Li MD, MS,&nbsp;Carrie Henning-Smith PhD,&nbsp;Anne Blaes MD, MS,&nbsp;Patricia Jewett PhD,&nbsp;Rachel I. Vogel PhD","doi":"10.1111/jrh.70066","DOIUrl":"https://doi.org/10.1111/jrh.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Individuals diagnosed with cancer have extensive and often unmet psychosocial support needs. We established a partnership between the University of Minnesota and Gilda's Club to identify survivorship issues, unmet psychosocial support needs, and barriers to receiving cancer support in rural Minnesota.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted six focus groups and 16 interviews (41 total participants) between November 2022 and January 2024 among cancer survivors living in rural Minnesota. Structured interview guides included questions about survivors’ definition of cancer support, what community support is desired and available, and barriers to obtaining support. Transcripts were analyzed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>The mean participant age was 57.1 ± 13.4 years; the majority were female (68%), non-Hispanic White (95%), and college graduates (58%), and they represented many cancer diagnoses, with hematologic (20%) and breast cancers (17%) most frequently reported. Most (73%) were under surveillance (median 4 years from diagnosis). Many participants mentioned extensive travel burdens due to lack of local care, and virtually all participants agreed emotional support was critical. Over half (56%) of participants wished for peer support that they did not have, and 44% said their cancer information needs were insufficiently addressed. Some emphasized that having nurses facilitating care coordination and options for local care made care feel more personalized. Participants identified virtual options for cancer support as potentially beneficial, particularly when meeting in person was not possible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Lack of peer support, lack of local care, and travel burdens are significant concerns among rural cancer survivors. Participants expressed positive views about their rural residence and mentioned alternatives and rural strengths such as virtual support options, help from nurses, and caring relationships in their communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70066","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining geographic disparities in access to no-cost naloxone in North Carolina: A cross-sectional survey of naloxone distribution programs","authors":"Grace Marley PharmD,&nbsp;Caroline Shubel MPh,&nbsp;Carolyn T. Thorpe PhD MPh,&nbsp;Izabela E. Annis M.S.,&nbsp;Paul Delamater PhD,&nbsp;Delesha Carpenter PhD MSPh,&nbsp;Bayla Ostrach PhD, MA, CIP","doi":"10.1111/jrh.70069","DOIUrl":"https://doi.org/10.1111/jrh.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The objective of this study was to comprehensively identify the programs that distribute naloxone at no-cost in North Carolina, identify where and to whom these programs distribute naloxone, and evaluate disparities in reported naloxone distribution by geographic area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional online survey was delivered to potential no-cost naloxone distributors in NC identified by a community advisory panel. Descriptive statistics and Fisher exact tests were utilized to identify disparities in naloxone access by population served (people who use drugs, people who inject drugs) and location of naloxone distribution (rural; urban/suburban).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Approximately 76.5% (241/315) of respondents representing 341 different programs reported that their program(s) distributed no-cost naloxone to community members. Programs represented included health departments (<i>n</i> = 81), treatment programs/centers (<i>n</i> = 59), and syringe service programs(SSPs) (<i>n</i> = 41), among others. Programs reported distributing naloxone most frequently to people who use drugs (94.2%) and people with a substance use disorder history (94.3%). No-cost naloxone distribution was reported less frequently to all patient populations in rural ZIP codes when compared to urban ZIP codes, including justice-involved populations (86.4% vs. 98.3%) and individuals leaving treatment or detox (87.9% vs. 98.6%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study indicates that although most areas in NC were served by at least one no-cost naloxone program, distribution to rural populations may be limited, indicating a need for increased public investment in no-cost naloxone distribution to populations at greatest risk of overdose.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jrh.70069","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Route and efficiency analysis of cancer health care (REACH): Investigating sociodemographic and rurality of metastatic breast cancer patients at an NCI-designated facility","authors":"Amanda Golden MD,&nbsp;Sarah Humble MS,&nbsp;Rachelle Roy BPH,&nbsp;Allison B. Anbari PhD, RN, CLT,&nbsp;Lindsay L. Peterson MD, MSCR,&nbsp;Ashley J. Housten OTD, MSCI","doi":"10.1111/jrh.70063","DOIUrl":"https://doi.org/10.1111/jrh.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Breast cancer is one of the most common malignancies affecting women worldwide. Metastatic breast cancer (MBC) patients experience unique challenges regarding access to care, particularly rural populations. Geographic location may increase travel, impacting time to treatment and adding to patient burden. This study aimed to evaluate the association between rurality and access to care by examining travel distance, time to treatment, and sociodemographic factors in patients with MBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study using data from Siteman Cancer Center (SCC) Oncology Data Services registry from 2011–2021 with 519 female MBC patients. Rurality was defined by state definition. We used Geographic Information Systems (GIS) software to calculate travel distances and times from patients’ homes to treatment site. We evaluated travel distance (miles) and time to treatment initiation (days) using <i>t</i>-tests and ANOVA and evaluated any differences based on sociodemographic characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>We found that rural patients traveled farther for treatment compared to urban patients (mean 87.3 miles vs. 18.0 miles; <i>p</i> &lt; 0.001). There was no statistically significant difference found with time to treatment initiation between groups (mean 36.1 vs. 35.0 days; <i>p</i> = 0.68). No difference in travel time or treatment initiation was found when comparing sociodemographic factors, including insurance status and comorbidity scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rural MBC patients face longer travel times, which may contribute to barriers to care. However, we found no difference for time to treatment initiation. Future studies characterizing rural patients' experiences can contribute to the development of targeted interventions to mitigate rural patient burden and improve access to cancer care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":50060,"journal":{"name":"Journal of Rural Health","volume":"41 3","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144767707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}