In addition to accessible environments, successful employment and community participation of rural Americans requires successful health management. In rural America, health management resources are more geographically dispersed and tend to be more limited, which makes managing complex health needs more difficult. One approach to improving healthcare access for rural Americans is to promote and facilitate the effective and efficient use of existing healthcare services.
Our Consumer Self-Managed Use of Rural Healthcare program addresses this need by delivering individually focused self-management programs to rural participants, incorporating selected Living Well with a Disability (LWD) material. Our LWD program has helped improve the health of rural residents with disabilities in 32 states. By combining our unique goal-setting approach with health education, LWD participants report health behavior improvement, better health outcomes and decreases in healthcare utilization, especially emergency room use. Although LWD has been and continues to be successful, the program does have some limitations. Living Well is a group centered intervention with scheduling and transportation challenges that are greater problems in rural areas, and Living Well’s self-management strategies are not coordinated with the participants’ available healthcare resources.
In light of LWD limitations, the one-on-one format of our Consumer Self-Managed Use of Rural Healthcare Services decreases the challenges of scheduling and transportation. In addition, the national intervention program, Self-Advocacy for Rural American Health (SARAH), focuses on utilizing strategies that are coordinated with the participants’ available healthcare resources; the program also addresses an individual’s specific challenges to accessing these resources.
We compared the results of SARAH, a community and healthcare resource focused program, to our control program Conscientious Living for Rural American Health (CLARA). CLARA includes educational health content from LWD focusing on nutrition, physical activity, and self-management but does not address participants’ access to community and healthcare resources. The SARAH program was found to be associated with better long term maintenance of health behavior. Participants in SARAH showed fewer health problems related to secondary conditions and fewer days experiencing pain.
- Project dates: 2008-2013
- Funded by: National Institute on Disability and Rehabilitation Research Grant No.
- Principal staff: Craig Ravesloot, Ph.D., Tracy Boehm, M.P.H, Bob Liston, M.A., Tannis Hargrove, M.S., Lillie Greiman, M.A.
- Related projects: