NCRCRD’s health initiatives focus on enhancing health and wellness in rural communities across the North Central Region. The Center increases the quality of life for individuals and communities by raising awareness, engaging community members to improve public health, and building community partnerships.
Community mental and physical health is crucial for the collective wellbeing of community members. Many factors influence health, including health behavior, clinical care, the physical environment, and social and economic conditions. Access to health services, education, and employment; healthy lifestyle; workforce development; and transportation resources are lagging in rural communities and have important implications on rural residents’ overall wellbeing and economic opportunities.
NC1100: A Systems Perspective to Community Resilience: Rural Healthcare at the Intersection of Households and Businesses
Typically, rural businesses generate lower revenues and employ fewer employees than their urban counterparts, in part because lower populations and lower income populations generate less demand for what businesses offer yet are dependent upon these offerings. Current assessments indicate that improvements in educational attainment and health status are lagging in rural areas, which threatens rural businesses as well as the vitality and resilience of rural communities. Over the last four decades, globalization and technological change have altered the nature of work in rural communities. In many cases, global outsourcing has replaced traditional trades in mining, manufacturing, and agriculture. While these trends have affected the entire economy similarly, the slowness or inability of rural areas to recover has created an increasing economic divide between the labor and economic opportunities in urban versus rural communities. This leaves in place a workforce that may be discouraged, displaced from previous jobs, and with no previous experience relative to the jobs available in these rural communities. As well, in some rural areas, out-migration has led to a labor shortage of working-age adults.
This project examines innovative and evidence-based approaches for enhancing workforce development and organizational wellbeing for small rural business owners, with an aim of promoting community prosperity and wellbeing. Specifically, objectives of the NC1100 project are listed below:
- Identify the strategies used by small rural businesses to maintain and develop a skilled and healthy labor force.
- Assess the effect of workforce wellness programs on firm outcomes such as employee retention and profitability.
- Assess the impact of health disparities on the wellbeing of households and business owning households in rural communities.
- Exploring the role of rural small businesses in community-based efforts to address substance use disorder.
Combating a Crisis: Exploring Community Responses to Opioids
November 5, 2019
Principal Investigator: John Leatherman, Kansas State University
Co-Principal Investigators: Bonnie Bressers, Kansas State University; Jami Dellifield, Ohio State University
In 2017, more than 70,000 drug overdose deaths occurred in the United States. Opioids are the main driver of drug overdose deaths, leading the federal government to declare a nationwide Public Health Emergency. Most federal assistance is targeted to states, while at the community level – where consequences of the epidemic are acute – local leaders, healthcare providers, and law enforcement are left to formulate a response. A tenet of this project is that the epidemic is too great a problem for any single local entity to handle. Rather, it requires collaboration of a coalition of local entities to reduce the incidence of opioid abuse. There is evidence such coalitions are forming and initiating remedial local efforts, but little is known about the extent to which this is occurring, the scope of coalition activities, or the progress of their efforts.
This project proposes a pilot study comparing Ohio, where the opioid problem is acute, to Kansas, where opioids are less problematic. We propose surveying mental health professionals to learn about community-based initiatives, the range of activities undertaken, and the extent of success or failure. We hypothesize we will find hopeful indications that local coalitions are forming and making progress in response to the opioid crisis. This information would be compelling toward securing additional resources to scale the effort to the national level with the goal of offering communities a viable strategy to combat opioids and best practices to effectively respond to the ravages of the epidemic.
Local Policymaker Perceptions of the Opioid Crisis and the Efficacy of Extension Communications
November 5, 2019
Principal Investigator: Daniel Bergan, Michigan State University
Co-Principal Investigator: Hillary Shulman, Ohio State University
How accurate are local policymaker perceptions of the opiate epidemic in their communities? What types of evidence are most useful to local policymakers in making judgments about the severity of the opiate epidemic and the effectiveness of local policies meant to address opiate abuse? We plan to measure local policymaker perceptions and attitudes about the opiate epidemic in their communities, comparing policymaker responses to objective data about the local impacts of the opiate epidemic. We also plan to explore the impact of evidence about the opioid crisis on policymaker perceptions of the prevalence of opioid-related problems in their community, perceived importance of the issue, and support for potential policy solutions. To answer these questions, we will use a unique field experimental design and an online survey of local policymakers in Michigan and Ohio. We will randomly assign policymakers to receive policy-relevant evidence, including locally tailored data on how the opiate epidemic affects their community, as well as reviews of the academic literature on opiate policy as well as narrative evidence about the success or failures of a variety of local opiate-related policies in jurisdictions across the Midwest. We will follow-up with an online survey of policymaker perceptions and attitudes about substance abuse policy.
Reducing Rural Young Adult Health Disparities through an Adaptive Mobile Relationship Intervention
November 5, 2019
Principal Investigator: James Kale Monk, University of Missouri
Co-Principal Investigators: Amber Vennum, Kansas State University; Elaine Johannes, Kansas State University
Due to the impact of intimate relationship quality and stability on mental and physical health, child outcomes, and the economy, the government instituted policy initiatives promoting healthy marriage through relationship education (RE). Many scholars recommend implementing RE with young adults given that early relationship dynamics while dating strongly predict later marital and health outcomes as individuals begin to focus on long-term committed unions during this key developmental period. Current RE initiatives are impaired by both limited resources to implement face-to-face classes, especially in rural areas, and the need for more adaptable, personalized content dissemination. The rapid development of mobile technologies provides opportunities for gathering information and delivering health interventions in real-time in rural areas. Indeed, 65% of rural Americans own smartphones and many young adults use their smartphones to seek health information and relationship advice online. Unfortunately, the information available online is often anecdotal and maladaptive. Thus, along with the assistance of an interdisciplinary team of scholars, clinicians, educators, and software engineers (i.e., “Relevate”), we seek to respond to these limitations by providing a relationship-specific, individually tailored platform (i.e., “MyRelevate”) to share evidence-based curricula and content with the public. In order to equip Extension professionals with the tools needed to help rural young adults make healthy relationship and well-being decisions, we are requesting $24,690 in financial support to finalize the development of the platform, create additional content, train Extension professionals in how to use MyRelevate, and support future grant submissions.
STEPping UP: Social-Emotional Learning for Rural Middle School Youth
November 15, 2018
Principal Investigator: Amber Letcher, South Dakota State University
Co-Principal Investigators: Kristine Ramsay-Seaner, South Dakota State University and Meagan Scott, North Dakota State University
Youth suicide rates continue to rise throughout the United States, particularly in rural areas such as South Dakota and North Dakota. South Dakota has the 14th highest suicide rate in the country, with two counties ranking in the top 1% for suicide rates nationally (South Dakota Department of Health, 2017). North Dakota presents similar statistics with an upward trend in high school students who have considered, planned, or attempted suicide over the past decade (North Dakota Department of Human Services, 2016). Research indicates that the majority of diagnosable mental illnesses start before age 14 (Kessler et al., 2005) suggesting an increased urgency in providing prevention programs that help youth, specifically, learn the skills needed to combat these suicidal thoughts.
Successful programming related to suicide awareness often targets social and emotional learning (SEL) which involves enhancing skills in emotion regulation, perspective-taking, decision-making, empathy, and self-awareness (CASEL, 2013). The current study aims to enhance SEL among middle school youth in rural North and South Dakota. Extension educators in both states will be trained in the Step Up curriculum, an evidence-based program targeting the development of SEL. Extension educators will implement the program with youth from their state (n = 100 per state) in a treatment versus waitlist control design. Results from treatment versus control youth will be compared to identify any significant differences in SEL and mood among the youth.
Capacity Building for Improved Behavioral Health in Rural America: Resilience in the Wake of COVID-19 (09/24/2020)
Presented by: Richard Spoth, Greg Pliler and Cassandra Knutson (Iowa State University)
The Opioid Addiction—Incarceration Pipeline: A National Public Health Crisis Compounded in Rural Areas (09/10/2020)
Presented by: David Young (Montana State University)
Supporting the Mental Health of Farm Families in the North Central Region (05/06/2020)
Presented by: Carrie Henning-Smith (University of Minnesota) and Florence Becot (National Farm Medicine Center)
Fentanyl – Just the Tip of the Iceberg (02/05/2020)
Presented by: Captain Tobias Frost (Lafayette Fire Department)
Integrating and Sustaining Financial Capability Services in Rural Healthcare Delivery (12/12/2019)
Presented by: J. Michael Collins (University of Wisconsin), Elizabeth Kiss (Kansas State University) and Suzanne Bartholomae (Iowa State University)
Will Local Foods and Technical Change Alter the Urban Form? (10/24/19)
Presented by: Scott Loveridge, John Mann & Spencer Thompson (Michigan State University)
The Impact of Naloxone Access Laws on Opioid Overdose Deaths in the U.S. (9/25/19)
Presented by: Elham Erfanian (West Virginia University)
The Relationship Between Opioid Prescriptions and Child Removals (5/8/19)
Presented by:Troy Quast (University of South Florida)
The Impact of the Opioid Crisis on Hospitals: A Nurse’s Perspective from the Bedside (3/28/19)
Presented by:Nicole Adams, PhD., RN, CEN, Purdue University
Understanding Stress & Depression in Farmers & Ranchers (3/12/19)
Presented by:Andrea Bjornestad (South Dakota State University) and Courtney Cuthbertson (Michigan State University)
Mental Health Promotion: An Opportunity for Opioid Overdose Prevention (2/21/19)
Presented by:Laura Schwab-Reese (Purdue University)
Dreamland: America’s Opiate Epidemic and How We Got Here (12/7/18)
Presented by:Sam Quinones, Journalist and Author
Demand-side Factors Influencing Endemic Drug Use in America (9/25/18)
Presented by:Michael Betz, The Ohio State University
Adverse Childhood Experiences: A Driver of the Opioid Epidemic (6/19/18)
Presented by:Michael Brumage (West Virginia University)
Redefining Rural Food Deserts by Transportation Networks (3/13/18)
Presented by:Gregory Newmark and Hyung Jin Kim (Kansas State University)
Recognition and Stigma in Prescription Drug Abuse and Alcohol Abuse (1/17/18)
Presented by:Robert Shupp and Scott Loveridge (Michigan State University)
Seed funding will be provided for multistate working groups focused on the NCRCRD’s three thematic areas of resilient communities and economies, develop leadership and civic engagement, and promote community health and wellness that integrate research and Extension. Funding can be used for team development and meetings, preliminary data collection, or other activities that facilitate multi-state regional and sustainable collaboration that lead to relevant regional outputs. These projects will result in scholarly work such as research publications, Extension curricula, and proposals for external funding.
Working groups must be comprised as follows:
- A representative of a North Central Region College or University (a minimum of six states must be represented)
- The team must have a balance between research and outreach