Abstract：
INTRODUCTION:Portions of Montgomery County, Virginia, are designated a Medically Underserved Area with a large portion of this population experiencing limited access to healthcare services. In September 2008, the Federal Bureau of Primary Care awarded the authors a planning grant to assess community need in Montgomery County and to develop a strategic plan to establish a Federally Qualified Health Center (FQHC) to best meet these needs. An FQHC is a federally funded clinic mandated to provide medical, dental and mental health services to underserved communities. As part of the planning process, the decision was made to include qualitative data to better understand the needs of underserved residents in the community. Descriptive studies of target populations can provide further insight into community priorities for effective health improvement and planning. The objective of the study was to investigate and describe the perceptions, beliefs and practices that impact healthcare utilization among underserved populations in Montgomery County, Virginia. This study was conducted as part of a comprehensive community assessment to determine the feasibility of developing a FQHC. METHODS:Community focus groups were conducted with target populations which were representative of the community. A thematic analysis of the transcribed field notes and group interviews was conducted. Qualitative data analysis was performed using the Analysis Software for Word-Based Records (AnSWR) developed by the Centers for Disease Control. RESULTS:Three important categories of beliefs which may impact healthcare utilization emerged from the discussions: (1) cultural health perceptions; (2) perceived barriers to care; and (3) coping strategies. Participants expressed a right to access quality care, preferred to spend money on basic living expenses rather than healthcare services; frequently neglected seeking care for adults while rarely neglecting to seek care for their children; valued but infrequently utilized preventative care; and had a lack of confidence in the care that was provided. Perceived barriers to healthcare services reported by participants included a lack of access to affordable care; complexities of health insurance and payer status; limited hours of clinic operation; lack of transportation and geographic distance; and the complexity of navigating the healthcare system. Finally, participants reported using various coping strategies to overcome barriers to accessing healthcare services. These strategies included delaying treatment and self-care; seeking financial and transportation assistance; and using community resources to navigate the system. CONCLUSION:Establishing care that is culturally relevant, targets perceived barriers and incorporates and enhances coping strategies is needed to increase accessibility and utilization of preventative and comprehensive healthcare services. The findings from this study will assist in creating a strategic plan for a FQHC that capitalizes on community strengths while addressing the challenges and complex needs of the community.
journal_name
Rural Remote Healthjournal_title
Rural and remote healthauthors
Pieh-Holder KL,Callahan C,Young Psubject
Has Abstractpub_date
2012-01-01 00:00:00pages
1816issn
1445-6354pii
1816journal_volume
12pub_type
杂志文章abstract：CONTEXT:Solomon Islands is a small developing island state located in the south-western Pacific Ocean. A population of approximately 680 000 people live on more than one-third of the 992 islands that make up the country. Approximately 80% of the population reside in rural areas, many in remote, difficult to reach and p...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH5787
更新日期：2020-08-01 00:00:00
abstract：INTRODUCTION:In Italy the course to become a general practitioner (GP) lasts 3 years and includes both theoretical and practical study. Different from the theoretical part, until recently the practical activity has not been assessed at all. The Emilia Romagna Regional Health Authority has developed a special program ca...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-07-01 00:00:00
abstract：INTRODUCTION:There has been no research exploring the financial impact on the live renal donor in terms of testing, hospitalisation and surgery for kidney removal (known as nephrectomy). The only mention of financial issues in relation to live renal transplantation is the recipients' concerns in relation to monetary pa...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：:Rural clinicians require expertise across a broad range of specialties, presenting difficulty in maintaining currency of knowledge and application of best practice. Free open access medical education is a new paradigm in continuing professional education. Use of the internet and social media allows a globally accessib...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2015-07-01 00:00:00
abstract：INTRODUCTION:Mental health literacy assists patients to recognize, manage and prevent emotional disorders such as depression. Depression literacy is a specific type that varies among populations; however, there is a paucity of research on the depression literacy of rural Americans. The purposes of this study were to ev...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
abstract：INTRODUCTION:This paper reports on research to ascertain the views of general practitioners (GPs) practising in rural and remote areas of South Australia, on evidence-based medicine (EBM). It follows our previous paper that identified, through a literature search, the key issues in moving towards EBM in general practic...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2002-01-01 00:00:00
abstract：INTRODUCTION:The Indian Ocean Territories (IOT) comprising Christmas and Cocos (Keeling) Islands are situated over 2500 km from Perth, Australia, and are accessible by commercial aircraft only twice a week. The IOT Health Service (IOTHS) is administered from the Department of Transport and Regional Services in Canberra...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2007-04-01 00:00:00
abstract：INTRODUCTION:Health worker shortages and maldistribution have important implications for the capacity of health systems. Ghana has one of the highest physician emigration rates in the world, and over 75% of those who remain work in Ghana's two largest cities. The aim of this study was to investigate the contribution of...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:Violence and injuries are under-reported in developing countries, especially during natural disasters such as floods. Compounding this, affected areas are isolated from the rest of the country. During 2007 Bangladesh experienced two consecutive floods which affected almost one-third of the country. The obj...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：INTRODUCTION:Occupational noise injury and hearing loss are common features of agricultural workforces internationally. Farmsafe Australia has identified hearing health as one of its 4 key priority goals and targets. Currently, approximately 60-70% of Australian farmers have measurable hearing loss, compared with 27% o...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-01-01 00:00:00
abstract：INTRODUCTION:The Nurse Practitioner - Aged Care Models of Practice Initiative supported the roll-out of a range of nurse practitioner (NP) models of practice, across Australia. One of these models was a community-based clinic-located practice, situated in a remote tourist destination where there is no resident general ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-04-01 00:00:00
abstract：INTRODUCTION:For many women, and particularly rural women, birthing locally and within their own community is important for personal, social and/or cultural reasons. If concerns about the woman or her baby mean transfer to a secondary or tertiary facility is necessary, this can be disruptive and stressful, especially i...
journal_title：Rural and remote health
pub_type： 杂志文章,多中心研究
doi：
更新日期：2011-01-01 00:00:00
abstract：INTRODUCTION:The Papua New Guinea Department of Health monitors the performance of the health system using a computerised national health information system. This article draws on the recent evaluation of a national-wide donor-project community development initiative to highlight the problems of the lack of and disaggr...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-10-01 00:00:00
abstract：CONTEXT:This article describes the development and evaluation of a tool to prioritize physiotherapy referrals in a remote, under-serviced region in Canada's eastern Arctic. The Baffin Region of Nunavut is home to approximately 16 000 people dispersed across 12 communities accessible only by air. Physiotherapists are ba...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:The traditional view of paramedic practice is one of provision of emergency care and transport within community or industrial settings. With greater integration of emergency services with the overall health system, this role is changing. Paramedics, especially in rural areas, are now working more closely w...
journal_title：Rural and remote health
pub_type： 杂志文章,评审
doi：
更新日期：2014-01-01 00:00:00
abstract：INTRODUCTION:The aim of this project was to identify if there is a link between what nursing students learn in simulated clinical laboratory sessions and what they experience during their clinical placements. Clinical laboratories are commonly used to assist students to develop clinical nursing skills through simulatio...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-04-01 00:00:00
abstract：INTRODUCTION:Australia is the sixth largest country (in area) in the world with a total area of over 7.5 million km² (3 million miles²). To date much of the research and policy activity in the dental workforce has been based on simple statistical analysis including practitioner-to-population ratios; however, risks are ...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2013-10-01 00:00:00
abstract：INTRODUCTION:The authors examined the effect of referrals from outreach specialists on total hospitalisation costs of rural Chinese patients receiving surgical treatment for digestive tract cancer at a tertiary hospital within a vertically integrated medical consortium. METHODS:A retrospective cohort study was conduct...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2014-01-01 00:00:00
abstract：CONTEXT:Exposure of undergraduate medical students to general practice and community healthcare services is common practice in the international medical curricula. Nevertheless, proponents of the hospital and biotechnology based paradigm, which is still dominant within the medical academic environment, question both th...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2013-01-01 00:00:00
abstract：CONTEXT:Finding providers to work in the hospitals and clinics in the small towns of the USA is a significant struggle. In the traditional model, the primary care doctor sees patients in the inpatient setting in addition to a clinic practice. In the usual hospitalist model, providers specialize to work only in the inpa...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH4419
更新日期：2018-08-01 00:00:00
abstract：INTRODUCTION:One approach to facilitating student interactions with patient pathways at Keele University School of Medicine, England, is the placement of medical students for 25% of their clinical placement time in general practices. The largest component is a 15-week 'student attachment' in primary care during the fin...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2016-04-01 00:00:00
abstract：INTRODUCTION:In Nepal, a number of private sector medical schools have opened recently; although sufficient numbers of doctors are graduating there continues to be a doctor shortage in rural areas. This article analysed the rural doctor shortage in Nepal and reviewed the international literature for strategies that may...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2010-07-01 00:00:00
abstract：INTRODUCTION:Internationally, musculoskeletal conditions are a major morbidity issue for Indigenous populations and the social and economic burden imposed by musculoskeletal complaints is significant. However, little is known about the prevalence and associated pain and impairment of musculoskeletal conditions among ru...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2004-07-01 00:00:00
abstract：INTRODUCTION:Surveys of dental health among Aboriginal children in Canada, using scales such as the Decayed, Missing, and Filled Teeth (DMFT) score, indicate that Aboriginal children have 2 to 3 times poorer oral health compared with other populations. A remote First Nations community approached requested assistance in...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-04-01 00:00:00
abstract：INTRODUCTION:Behavioral determinants can enable or hinder motivation towards registration and donorship and, subsequently, action or inertia towards organ donation. Nevertheless, there is limited information about the role of self-efficacy in relation to organ donation awareness and presumed consent among individuals a...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：10.22605/RRH5241
更新日期：2019-10-01 00:00:00
abstract：INTRODUCTION:Malnutrition is a serious public health problem, particularly in developing countries, linked to a substantial increase in the risk of mortality and morbidity. Women and young children are most often affected. Rural disadvantage is a known factor, but little attention has been paid to rural-urban disparity...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2008-04-01 00:00:00
abstract：INTRODUCTION:In mid-July 2010 flash flooding in Pakistan destroyed the basic water, environmental sanitation and livelihood infrastructures in 82 districts. Two months later, the local press of Swat (northern Pakistan) reported that several residents of Marghazar town became ill and were hospitalized after drinking con...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：INTRODUCTION:This paper will discuss health issues among Filipinas (women born in the Philippines) living in remote and rural environments in Queensland in comparison to Filipinas living in other parts of the state. The sample was recruited as part of the University of Queensland component of the Australian Longitudina...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2003-01-01 00:00:00
abstract：INTRODUCTION:Child farm safety has been identified as a key public health concern in Australia. To date, communication strategies for child farm safety have primarily targeted rural based adults as custodians of children, and because the greatest proportion of deaths occur in pre-school children. However, emerging inte...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2007-10-01 00:00:00
abstract：INTRODUCTION:Rural health workforce issues are a priority area for the Australian Government and substantial funding has been provided for rural education programs to address health workforce disparities across Australia's rural and remote communities. The Australian Government established a Rural Health Strategy in 20...
journal_title：Rural and remote health
pub_type： 杂志文章
doi：
更新日期：2011-01-01 00:00:00
