Amplifying research to improve health of rural residents

Numerous research grants from Health Resources and Services Administration expand rural health improvement across Texas
November 13, 2018

Living in a rural area is now considered a health risk. Isolation is partly to blame, but it is also a convergence of lack of access, economics, insurance coverage, chronic disease and education. Because Texas has more than 3 million rural residents, the Texas A&M University Health Science Center has made rural population health a priority.

Texas A&M has been working to chip away at the issue for some time and has made great strides recently to advance research into the areas of rural health that need the greatest attention. Now the Health Science Center has received more than $7 million from the U.S. Health Resources and Services Administration (HRSA) to make this priority reach every corner of rural Texas.

By collaborating across the university and with partners across the state, the rural health priority will make lasting and tangible impacts on rural health care.

Leveraging research expertise

With this federal funding, the Health Science Center can expand its research interests in rural health improvement. To provide leadership and mentorship for those receiving this federal funding, the Health Science Center is convening a HRSA Grant Advisory Committee so that researchers can learn with, from and about each other’s research to make the most of the opportunities created by this funding.

Steven Brown, MD, chief clinical officer and associate vice president of clinical strategy at Texas A&M Health Science Center, will lead this group of experts so they can support each other in completing the aims of their projects. It is another way to leverage the interprofessional strengths across the health professions of Texas A&M.

Addressing health disparities in mental health

Compared to urban populations, rural communities face significant disparities in regard to mental health care access. In order to address these inequities through telehealth counseling services, Carly McCord, PhD, licensed psychologist and research assistant professor at the Texas A&M School of Public Health, has been awarded $975,000 in funding from HRSA for the Telehealth Counseling Clinic (TCC), where she serves as clinical director.

“We will partner with six local communities in the greater Brazos Valley, all of which are designated as Mental Health Professional Shortage Areas by HRSA, to increase access to mental health services for low-income residents,” McCord said.

Regional health status assessments conducted by the Center for Community Health Development at the School of Public Health have consistently identified mental health and well-being concerns for more than a decade. This population has higher-than-average rates of depression, anxiety, Alzheimer’s disease and excessive drinking, among other indicators. The mental health professional to population ratio for the region is 7,554 to 1 compared with the state of Texas, which has a ratio of 990 to 1. Most of the social and health-related services are housed within suburban Brazos County, which is one hour and 45 minutes away from some of the rural residents.

Improving rural health care access

When rural hospitals close, it’s a loss that reverberates throughout the community and sometimes the region. Anyone without reliable transportation might forgo medical care altogether. Economically, the town suffers as medical, nursing and support positions disappear.

Now, Texas A&M has been chosen as the sole recipient of a five-year grant from the Vulnerable Rural Hospitals Assistance Program, funded by HRSA, an agency of the U.S. Department of Health and Human Services. The grant will fund the creation of the Center for Optimizing Rural Health, a technical advisory center for the nation, to actively help rural communities maintain their hospital or create other means of access to care after hospitals close.

The center will be based out of the A&M Rural and Community Health Institute, a health extension center offering programs that promote safe, effective health care practices. Since it was created 15 years ago, the A&M Rural and Community Health Institute has been identifying the challenges facing small hospitals and creating solutions for how health care can remain in the affected community.

Improving the dentistry health care workforce

The Texas A&M College of Dentistry received a $1.6 million Health Resources and Services Administration workforce grant to help bring more dentists to health professional shortage areas. Texas has the second-most health professional shortage areas in the nation—characterized by a lack of primary care, dental and mental health providers. The grant will be used to add 25 percent more practitioners to these health professional shortage areas by luring new dentists to work in the public health setting and thus improving the dentistry workforce in these areas.

It’s a collaboration you don’t see often: all of a state’s dental schools working together on a single grant with one goal. Texas’ dental schools (Texas A&M College of Dentistry, UT Health San Antonio, School of Dentistry and University of Texas School of Dentistry at Houston) will work together on this grant, with Peggy Timothé, DDS, MPH, MA, assistant professor in public health sciences at Texas A&M College of Dentistry, serving as a principal investigator.

Recruiting and training sexual assault nurse examiners

The Texas A&M College of Nursing received $1.47 million from HRSA to recruit and train nurses from rural and underserved areas in Texas to become certified adult sexual assault nurse examiners (SANE) and to help forensic nurses receive enhanced experimental learning or certification. Stacey Mitchell, DNP, SANE-A, SANE-P, DF-AFN, FAAN, clinical associate professor, will serve as principal investigator.

SANEs are registered nurses who complete education, clinical preparation and certification in providing comprehensive health care to survivors of sexual assault. They use their expertise to treat the acute and long-term consequences of the assault, with the patient’s physical, mental and emotional needs in mind.

“There is a critical need to increase the number of trained sexual assault nurses examiners across Texas,” Mitchell said. “For many people who experience sexual assault, particularly those in rural areas, access to health care is a challenge, especially when it comes to this specialized are of clinical practice.”

In addition to providing care for survivors of sexual assault, SANEs play a key role in justice being served. “Survivors deserve the opportunity to pursue justice through civil or criminal legal proceedings,” Mitchell said. “SANEs learn how to observe, collect and document evidence that can effectively be used to prosecute perpetrators.”

— Katherine Hancock

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