Rural Health in Virginia: Disparities, Dilemmas, and Overview of a JMU School of Nursing Solution

Background: There is no unified definition of rurality; this makes studying rurality, rural health, and associated health disparities and health outcomes difficult. Rural Americans constitute approximately 15% of the U.S. population, and they experience multiple barriers to healthcare and numerous health disparities as a result, particularly related to chronic disease, mental health, and increased lifestyle-linked health risks. Rural Americans should be viewed as a unique and vulnerable population, one with specific health promotion and disease prevention needs. Local problem: Although Virginia as a whole is a wealthy state, much inequity exists between the “Golden Crescent” and the “Rural Horseshoe” regions of Virginia, which includes the western portion of the State. Rural Virginians face higher unemployment, a higher poverty rate, and decreased access to care. One such area is Page County, Virginia, a local underserved health professional shortage area. Methods: In 2018, JMU obtained a HRSA grant focusing on Nursing Education, Practice, Quality, and Retention called, “The Undergraduate Primary Care and Rural Education (UPCARE) Project: a Community-based Nursing Education Collaboration. Intervention: The UPCARE Project allows JMU School of Nursing to respond to the needs for 1) BSN student education focusing on community health and primary care in a rural area, and 2) the creation two RN preceptor positions which incorporate a enhanced primary care RN role within 4 Rural Health Clinics (RHCs), all of whom are facilitated by a faculty-led grant team, including a Nurse Liaison. This two-pronged approach enables nurses to work to meet the health needs of the residents of Page County, Virginia. It is an innovative approach in keeping with Virginia’s State Rural Health Plan. Results: The JMU UPCARE Project is a collaborative, community-focused solution to the rural health disparities facing Page County. To date, nine students have started their clinical experiences in Page County, and two RN preceptors are starting their enhanced primary care RN role in the Rural Health Clinics. Conclusions/ Implications: This presentation will focus on rural health nursing in general, rural health disparities in Virginia, the creation of the UPCARE Project as part of the solution to meet the health care needs of rural Virginians. In keeping with the theme of the conference, the presentation will focus on the development of an enhanced primary care RN role, which is designed for RNs to work at the top of their practice scope