2.50
Hdl Handle:
http://hdl.handle.net/10755/151842
Type:
Presentation
Title:
Health Care Access in Rural Appalachia
Abstract:
Health Care Access in Rural Appalachia
Conference Sponsor:Sigma Theta Tau International
Conference Year:2002
Conference Date:July, 2002
Author:Schaller-Ayers, Jennifer
P.I. Institution Name:East Tennessee State University
Title:Associate Professor
Objective: Although the patient-provider ratio in southwest Virginia is similar to the rest of the state, southwest Virginians' health status is poorer than other Virginians. Since little is known about southwest Virginians' perceptions of their health problems and access to health care, this study was undertaken to identify reasons for the poor health status of southwest Virginians. This paper reports on the qualitative data from the study. Design: This qualitative/quantitative descriptive study was completed in three stages. Stage 1 used focus groups to gain an understanding of health and health care issues of people living in rural southwest Virginia. Stage 2 involved pilot testing an instrument (Rural Health Care Access Survey [RHCAS]) developed from Stage 1 findings. Stage 3 employed the RHCAS instrument tested in Stage 2 to do a descriptive study of the target population. Population: In Stage 1, 24 individuals of a small southwest Virginia community participated in one of three focus groups; plus three additional people did individual interviews. Key informants and snowball techniques were used to identify focus group participants. In Stage 2, 100 randomly selected people were mailed an instrument; 14 were returned. In Stage 3, 922 randomly selected individuals, ages 20-95, completed the RCHAS instrument. Additionally, 643 instruments were completed in convenience samples of users of 12 community health centers and uninsured and underinsured participants of a large health fair. Only one instrument per household was completed. The combined total of completed RCHAS instruments was 1563, representing 4,103 individuals. The random sample's return rate was 16%. Variables: Variables studied were health problems; health insurance coverage; health status; frequency of health care visits and satisfaction with availability of appointments, activities and behaviors of providers, and hours of availability. Participants were asked for comments regarding their health care satisfaction, likes and dislikes, and how to fix health care problems. Methods: Using focus group information, themes were identified to modify a previously developed instrument to include items/responses, such as the difficulty of purchasing health care services and to "suffer it out" for individuals seeking care for health problems. The instrument's Chronbach's alpha was .86 for the pilot study and .72 to .96 for the different sub-scales. Using a random sampling software package, potential participants were selected; 6,786 instruments were mailed with stamped self-addressed envelopes. Slightly over 1,100 were returned with undeliverable addresses. Twelve community health centers participated in making instruments for patients to voluntarily complete and return. While waiting to receive health care at a health fair, people were asked to complete an instrument. For those unable to read the instrument, it was read to them. This research project was approved by the University of Virginia's College at Wise, Human Investigation Committee. All participation was voluntary. SPSS was used to analyze quantitative data and constant comparative analysis was used for qualitative data. Findings: The most frequently identified health problems were hypertension, arthritis, back problems, asthma, dental caries, loss of many teeth, "nerves," depression, and overweight. All except overweight were at levels that far exceeded Virginian's general population percentages for the same health problems. Current health status rating was also much lower among southwest Virginians than other Virginians; the majority in this study rated health as poor or fair while 60% of other Virginian's rate their health as excellent. Over 90% of the participants stated that lack of or inadequate health insurance coverage negatively impacts their quality of life. Qualitative data identified the themes of sense of community, my story, making do (making a shift), quality of time with provider, problems with language, fixes, and parting comments. Conclusions: People of southwest Virginia do have poorer health status and access to timely health care than do other Virginians. The sense of community and pride, the desire for more health promotion activities, and the willingness to take advantage of health activities are strengths of southwest Virginia's population who desire affordable health care and insurance. Implications: Using community strengths to identify interventions for increasing health status is an important consideration for any strategy. A strategy for ameliorating southwest Virginia's health care problems and health care access is through community partnerships because southwest Virginians care about their families and neighbors and want to be a part of the solution.

Repository Posting Date:
26-Oct-2011
Date of Publication:
Jul-2002
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleHealth Care Access in Rural Appalachiaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151842-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Health Care Access in Rural Appalachia</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">July, 2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Schaller-Ayers, Jennifer</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">East Tennessee State University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Associate Professor</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">schaller@etsu.edu</td></tr><tr><td colspan="2" class="item-abstract">Objective: Although the patient-provider ratio in southwest Virginia is similar to the rest of the state, southwest Virginians' health status is poorer than other Virginians. Since little is known about southwest Virginians' perceptions of their health problems and access to health care, this study was undertaken to identify reasons for the poor health status of southwest Virginians. This paper reports on the qualitative data from the study. Design: This qualitative/quantitative descriptive study was completed in three stages. Stage 1 used focus groups to gain an understanding of health and health care issues of people living in rural southwest Virginia. Stage 2 involved pilot testing an instrument (Rural Health Care Access Survey [RHCAS]) developed from Stage 1 findings. Stage 3 employed the RHCAS instrument tested in Stage 2 to do a descriptive study of the target population. Population: In Stage 1, 24 individuals of a small southwest Virginia community participated in one of three focus groups; plus three additional people did individual interviews. Key informants and snowball techniques were used to identify focus group participants. In Stage 2, 100 randomly selected people were mailed an instrument; 14 were returned. In Stage 3, 922 randomly selected individuals, ages 20-95, completed the RCHAS instrument. Additionally, 643 instruments were completed in convenience samples of users of 12 community health centers and uninsured and underinsured participants of a large health fair. Only one instrument per household was completed. The combined total of completed RCHAS instruments was 1563, representing 4,103 individuals. The random sample's return rate was 16%. Variables: Variables studied were health problems; health insurance coverage; health status; frequency of health care visits and satisfaction with availability of appointments, activities and behaviors of providers, and hours of availability. Participants were asked for comments regarding their health care satisfaction, likes and dislikes, and how to fix health care problems. Methods: Using focus group information, themes were identified to modify a previously developed instrument to include items/responses, such as the difficulty of purchasing health care services and to &quot;suffer it out&quot; for individuals seeking care for health problems. The instrument's Chronbach's alpha was .86 for the pilot study and .72 to .96 for the different sub-scales. Using a random sampling software package, potential participants were selected; 6,786 instruments were mailed with stamped self-addressed envelopes. Slightly over 1,100 were returned with undeliverable addresses. Twelve community health centers participated in making instruments for patients to voluntarily complete and return. While waiting to receive health care at a health fair, people were asked to complete an instrument. For those unable to read the instrument, it was read to them. This research project was approved by the University of Virginia's College at Wise, Human Investigation Committee. All participation was voluntary. SPSS was used to analyze quantitative data and constant comparative analysis was used for qualitative data. Findings: The most frequently identified health problems were hypertension, arthritis, back problems, asthma, dental caries, loss of many teeth, &quot;nerves,&quot; depression, and overweight. All except overweight were at levels that far exceeded Virginian's general population percentages for the same health problems. Current health status rating was also much lower among southwest Virginians than other Virginians; the majority in this study rated health as poor or fair while 60% of other Virginian's rate their health as excellent. Over 90% of the participants stated that lack of or inadequate health insurance coverage negatively impacts their quality of life. Qualitative data identified the themes of sense of community, my story, making do (making a shift), quality of time with provider, problems with language, fixes, and parting comments. Conclusions: People of southwest Virginia do have poorer health status and access to timely health care than do other Virginians. The sense of community and pride, the desire for more health promotion activities, and the willingness to take advantage of health activities are strengths of southwest Virginia's population who desire affordable health care and insurance. Implications: Using community strengths to identify interventions for increasing health status is an important consideration for any strategy. A strategy for ameliorating southwest Virginia's health care problems and health care access is through community partnerships because southwest Virginians care about their families and neighbors and want to be a part of the solution.<br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:15:30Z-
dc.date.issued2002-07en_GB
dc.date.accessioned2011-10-26T11:15:30Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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