Barriers to Healthcare and Social Service Utilization Among Rural Older Adults Who Use Drugs.

The objective of this study was to understand barriers to healthcare and social service utilization among older adults residing in rural areas who use drugs. A cross-sectional survey of persons who use opioids or inject drugs in rural counties with high overdose rates across ten states was conducted. For this analysis, participants were restricted to only the 375 individuals aged 50 and older.

Introducing SoNHR-Reporting guidelines for Social Networks In Health Research.

Objective: The overall goal of this work is to produce a set of recommendations (SoNHR-Social Networks in Health Research) that will improve the reporting and dissemination of social network concepts, methods, data, and analytic results within health sciences research.

Methods: This study used a modified-Delphi approach for recommendation development consistent with best practices suggested by the EQUATOR health sciences reporting guidelines network. An initial set of 28 reporting recommendations was developed by the author team.

Global rural health disparities in Alzheimer's disease and related dementias: State of the science.

Introduction: Individuals living in rural communities are at heightened risk for Alzheimer's disease and related dementias (ADRD), which parallels other persistent place-based health disparities. Identifying multiple potentially modifiable risk factors specific to rural areas that contribute to ADRD is an essential first step in understanding the complex interplay between various barriers and facilitators.

Methods: An interdisciplinary, international group of ADRD researchers convened to address the overarching question of: "What can be done to begin minimizing the rural health disparities that contribute uniquely to ADRD?" In this state of the science appraisal, we explore what is known about the biological, behavioral, sociocultural, and environmental influences on ADRD disparities in rural settings.

Sustainability in pediatric hospitals: An exploration at the intersection of quality improvement and implementation science.

Background: Although new evidence-based practices are frequently implemented in clinical settings, many are not sustained, limiting the intended impact. Within implementation science, there is a gap in understanding sustainability. Pediatric healthcare settings have a robust history of quality improvement (QI), which includes a focus on continuation of change efforts.

Situating the Pandemic in the Life-Course: Older Adults' Perspectives on the Challenges and Positives of the COVID-19 Pandemic.

Older adults experienced the highest rates of infections and deaths and significant social isolation during the COVID-19 pandemic. While these negative impacts are important to address, the positive outcomes among older adults during the pandemic are equally important. A survey was distributed to adults aged 65 or older living in St.

Around the EQUATOR with clinician-scientists transdisciplinary aging research (Clin-STAR) principles: Implementation science challenges and opportunities.

The Institute of Medicine and the National Institute on Aging increasingly understand that knowledge alone is necessary but insufficient to improve healthcare outcomes. Adapting the behaviors of clinicians, patients, and stakeholders to new standards of evidence-based clinical practice is often significantly delayed. In response, over the past twenty years, Implementation Science has developed as the study of methods and strategies that facilitate the uptake of evidence-based practice into regular use by practitioners and policymakers.

Emergency Department Communication in Persons Living With Dementia and Care Partners: A Scoping Review.

Objectives: To synthesize published research exploring emergency department (ED) communication strategies and decision-making with persons living with dementia (PLWD) and their care partners as the basis for a multistakeholder consensus conference to prioritize future research.

Design: Systematic scoping review.

Settings And Participants: PLWD and their care partners in the ED setting.

The adoption of social determinants of health documentation in clinical settings.

Objective: To understand the frequency of social determinants of health (SDOH) diagnosis codes (Z-codes) within the electronic health record (EHR) for patients with prediabetes and diabetes and examine factors influencing the adoption of SDOH documentation in clinical care.

Data Sources: EHR data and qualitative interviews with health care providers and stakeholders.

Study Design: An explanatory sequential mixed methods design first examined the use of Z-codes within the EHR and qualitatively examined barriers to documenting SDOH.

The Complex Intersection of Race and Rurality: The Detrimental Effects of Race-Neutral Rural Health Policies.

In this commentary, we discuss our experiences as women of different races growing up in the same rural area and how these experiences relate to health and health policy. Despite nearly five million Black people living in nonmetro areas, rural Black Americans face erasure in the rural narrative and the policies enacted to support them. This is detrimental to the overall uplifting of rural communities and to the elimination of the compounded disparities of being rural and Black.

Utility of Facebook's Social Connectedness Index in Modeling COVID-19 Spread: Exponential Random Graph Modeling Study.

Background: The COVID-19 (the disease caused by the SARS-CoV-2 virus) pandemic has underscored the need for additional data, tools, and methods that can be used to combat emerging and existing public health concerns. Since March 2020, there has been substantial interest in using social media data to both understand and intervene in the pandemic. Researchers from many disciplines have recently found a relationship between COVID-19 and a new data set from Facebook called the Social Connectedness Index (SCI).

Strategies for Disseminating and Implementing COVID-19 Vaccines in Rural Areas.

The United States has well-documented rural-urban health disparities, and it is imperative that these are not exacerbated by an inefficient rollout of coronavirus disease 2019 (COVID-19) vaccines to rural areas. In addition to the preexisting barriers to delivering and receiving health care in rural areas, such as high patient:provider ratios and long geographic distances between patients and providers, rural residents are significantly more likely to say they have no intention of receiving a COVID-19 vaccine, compared with urban residents. To overcome these barriers and ensure that rural residents receive the vaccine, officials and communities should look to previous research on how to communicate vaccine information and implement successful vaccination programs in rural areas for guidance and concrete strategies to use in their local efforts.

Discharge Planning: It's About the Destination and the Journey.

Hospitalization is a distressing time for patients and their care partners. While in the hospital, they are often thinking about how they will manage their healthcare once they leave the hospital. The hospital providers are tasked with conducting discharge planning with the patient and their care partners to ensure a smooth transition from the hospital.

Protocol to evaluate an enterprise-wide initiative to increase access to lung cancer screening in the Veterans Health Administration.

Introduction: The Veterans Affairs Partnership to increase Access to Lung Screening (VA-PALS) is an enterprise-wide initiative to implement lung cancer screening programs at VA medical centers (VAMCs). VA-PALS will be using implementation strategies that include program navigators to coordinate screening activities, trainings for navigators and radiologists, an open-source software management system, tools to standardize low-dose computed tomography image quality, and access to a support network. VAMCs can utilize strategies according to their local needs.

Defining and conceptualizing outcomes for de-implementation: key distinctions from implementation outcomes.

Background: Increasingly, scholars argue that de-implementation is a distinct concept from implementation; factors contributing to stopping a current practice might be distinct from those that encourage adoption of a new one. One such distinction is related to de-implementation . We offer preliminary analysis and guidance on de-implementation outcomes, including how they may differ from or overlap with implementation outcomes, how they may be conceptualized and measured, and how they could be measured in different settings such as clinical care vs.

Implementation and Sustainability of a Pharmacy-Led, Hospital-Wide Bedside Medication Delivery Program: A Qualitative Process Evaluation Using RE-AIM.

Few studies of hospital-based implementation assess sustainability or collect formal implementation outcomes, in part because the emphasis is often on initial adoption and rapid cycles of improvement. The purpose of this process evaluation was to assess the implementation of a pharmacy-led, hospital-wide program and contribute to the literature by collecting formal implementation outcomes, including sustainability. This was a qualitative process evaluation of a program that delivers discharge medications and related education to hospitalized patients' bedside prior to discharge.

Differences in Transitional Care Provided to Patients With and Without Dementia.

Older adults with dementia experience more care transitions than those without dementia yet are routinely excluded from transitional care studies. The purpose of the current study was to understand the transitional care delivered to older adults with dementia compared to those without dementia. The medical charts of 210 patients (126 with dementia, 84 without dementia) 70 years and older hospitalized at a single hospital were reviewed for evidence of transitional care, including discharge planning, patient education, and follow-up appointments.

Networks of hospital discharge planning teams and readmissions.

Improving the hospital discharge process to prevent readmission requires a focus on the coordination and communication between interprofessional team members in and outside of the hospital as well as with patients and their caregivers. Yet little is known about how these actors currently communicate and coordinate during the discharge process. Network analysis allows for a direct look at this communication and coordination.

Measuring the Delivery of Complex Interventions through Electronic Medical Records: Challenges and Lessons Learned.

Background: Health services and implementation researchers often seek to capture the implementation process of complex interventions yet explicit guidance on how to capture this process is limited. Medical record review is a commonly used methodology, especially when used as a proxy for provider behavior, with recognized benefits and limitations. The purpose of this study was to test the feasibility of chart review to measure implementation and offer recommendations for future researchers using this method to capture the implementation process.

Letting Go: Conceptualizing Intervention De-implementation in Public Health and Social Service Settings.

The discontinuation of interventions that should be stopped, or de-implementation, has emerged as a novel line of inquiry within dissemination and implementation science. As this area grows in human services research, like public health and social work, theory is needed to help guide scientific endeavors. Given the infancy of de-implementation, this conceptual narrative provides a definition and criteria for determining if an intervention should be de-implemented.

Rural Health Networks: How Network Analysis Can Inform Patient Care and Organizational Collaboration in a Rural Breast Cancer Screening Network.

Purpose: Rural health networks have the potential to improve health care quality and access. Despite this, the use of network analysis to study rural health networks is limited. The purpose of this study was to use network analysis to understand how a network of rural breast cancer care providers deliver services and to demonstrate the value of this methodology in this research area.

Informed Consent to Research with Cognitively Impaired Adults: Transdisciplinary Challenges and Opportunities.

Due to issues related to informed research consent, older adults with cognitive impairments are often excluded from high-quality studies that are not directly related to cognitive impairment, which has led to a dearth of evidence for this population. The challenges to including cognitively impaired older adults in research and the implications of their exclusion are a transdisciplinary issue. The ethical challenges and logistical barriers to conducting research with cognitively impaired older adults are addressed from the perspectives of three different fields-social work, emergency medicine, and orthopaedic surgery.