We propose to create a Rural Health and Nursing Research Center (RHNRC) that will provide the infrastructure to conduct and disseminate nursing research responsive to the clinical and information needs of rural populations in the United States. Broadly, the Center will test innovative clinical and system interventions for the rural health care system and adapt existing interventions for use in rural areas. Technological innovations will be a key factor in conducting this research in isolated rural communities. In support of this work, we will examine the barriers to care posed by such factors as poverty, isolation, and lack of specialty providers and resources, which are often a part of rural life. Special attention will be devoted to the health care needs of impoverished individuals, racial and ethnic minorities, and the elderly living in rural areas. The Center furthers the outreach goals of the University and, as such, will receive matching funds of $50,000 per year from the Office of the Vice President for Research and Graduate Studies. The Center will develop and support interdisciplinary teams of researchers, providing them with conceptual, technological and methodological support to achieve the following goals: (1) Build a research infrastructure by supporting the continued development of senior faculty, providing support and guidance for new investigators and developing nurse-researcher role models for students; (2) foster interdisciplinary collaboration, (3) develop descriptions of health, illness and health care delivery in rural areas; (4) evaluate the use of technology to deliver clinical and system interventions in rural settings; (5) design culturally appropriate interventions; (6) adapt interventions developed in tertiary health care settings for use in rural areas; (7) train rural healthcare providers in new assessment and therapeutic techniques and system improvements; and (8) develop long-term community partnerships with rural clinicians, policy makers and consumer groups. In the first years of funding, five pilots are proposed: (1) The Experience of Sexual Assault with Rural Women; (2) eScreening: Case Finding in Rural Primary Care; (3) A Decision-making program in Adolescents with Asthma; (4) Mammography Screening in the Rural African American Population; (5) Medication Adherence Among Older Adults in Rural Virginia. Only three pilots will begin in the first year.
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