Perception of Health Care Access in Rural Georgia: Findings From a Community Health Needs Assessment Survey

Background: Limited access to health care services has been cited as a barrier to care for individuals who live in rural areas, contributing to significant health disparities in this population. While perception of services has been cited as a determinant of utilization of health services, it is unknown how perception of services influences health care access in rural areas. The paucity of studies specific to areas in the United States that are medically underserved, necessitated this study and its quantification of the issues that are relevant to individuals living in rural Georgia. Methods: This study examined the perception of health care access of rural Georgians by analyzing results from a Community Health Needs Assessment survey. Multiple linear regression was performed to examine associations between perception of health care access and several environmental and sociocultural factors. Results: Two hundred and fourteen surveys were completed over a 6-week period by a largely Caucasian (85%) and female (78%) sample. Perception of health care quality was significantly related to perception of local health care access. Conclusion: Interventions and protocols that are implemented to increase health care access in rural areas should include how perception of health care quality might influence a person’s understanding and consequent decision to access local health care services. Because of the ambiguous nature of how “health care quality” is defined, future research is warranted to better understand how the term is operationalized and what relationship there is between the perception of “health care quality” and health care access in a rural area

Mentorship in the Field of Aging: Purposes, Pivots, and Priorities

The Gerontological Society of America (GSA) is a multi-disciplinary organization dedicated to advancing the field of aging and improving the lives of older adults. With a long-standing commitment to mentorship and career development, this article focuses on GSA’s Mentoring Consultancies and Career Conversations events and their pivot to meet the needs and demands of current and future gerontologists amid the COVID-19 pandemic. This article provides a description of these events in the context of planning, content, and member engagement. Recommendations are provided to other organizations seeking to enrich their membership through mentorship and career development activities

Lessons Learned in the Early Stages of a Community-Academic Partnership to Address Health Disparities in a Rural Community

In rural Georgia, African American men are burdened by chronic health diseases such as cancer, diabetes, and cardiovascular disease. Community-academic partnerships that leverage community-based participatory research (CBPR) principles can facilitate the adaptation and translation of multilevel programs to address chronic disease prevention and management in rural areas. The objective of this study was to explore key components of the CBPR process that bolstered the early stages of a partnership established between rural-residing community leaders and academic partners in Georgia. Qualitative methodology was used to collect and assess data regarding the initial engagement between the community and academic partners. Findings indicate that five components supported initial engagement: utilizing the public service and outreach arm of the university to connect with rural communities; creating synergy around identified community health needs; encouraging community members to provide input into the research design to ensure the research goals reflect community values; enhancing the capacity of community partners; and following the lead of the community. Findings provide insights into how to begin engaging rural communities in the southeast in order to strengthen the adaptation and translation of initiatives to improve cancer, diabetes and cardiovascular disease outcomes

Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs as well as facilitate aging-in-place

Organizational Readiness to Implement the Chronic Disease Self-Management Program in Dialysis Facilities

A gap exists between the development and uptake of evidence-based health promotion programs in health care settings. One reason for this gap is lack of attention to organizational readiness. The objective of this study was to assess organizational readiness to implement the Chronic Disease Self-Management Program in dialysis facilities. Survey data were collected from dialysis staff using a semi-structured Organizational Readiness for Implementing Change questionnaire. Change efficacy and change commitment scale ratings were all above 3.0, indicating a moderate level of readiness among staff. Profession and level of education were significantly associated with mean change efficacy scale ratings. Textual data revealed benefits to patients, implementation barriers and facilitators, and the influence of facility environment and culture. The findings of the current study suggest that additional efforts to advance the implementation of evidence-based health promotion programs in dialysis facilities are needed