Optimizing Hypertension Management in Underserved Rural Populations

Bale, Bradley Field

doi:10.1016/s0027-9684(15)30470-3

Cited by 22 publications

(16 citation statements)

References 43 publications

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“…Although participants discussed access to healthcare providers and resources to maintain a healthy lifestyle in a positive light, they also discussed challenges. Individuals living in rural communities oen face unique issues related to healthcare access including economic difficulties, fewer numbers of health care providers in the area, and lack of adequate transportation [38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Perceptions of Community Resources and Insights for Program Development from Southern, Rural Hypertensive Women

Ford

March

2013

ISRN Hypertension

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Background. Hypertension affects millions of Americans each year and is a signi�cant contributor to the development of cardiovascular disease. African Americans, especially those living in rural locations, experience greater disparities in the incidence and prevalence rates of hypertension and cardiovascular disease. Methods. is study utilizes qualitative descriptive methodology. Focus groups involving African American women reporting hypertension were conducted in a rural community in Alabama. Results. e mean age was 60.3 years of age (SD = 10.3). Most were married and half were college educated. e majority reported an overweight or obese status. Most were aware that they had hypertension for more than �ve years, all were nonsmokers, and the majority had a family history of heart disease, hypertension, and/or heart attack or stroke. Key themes emerging from the focus groups included strengths of the community, support for the community, support for a healthy lifestyle, and intervention development. Conclusion. Hypertension is a treatable and preventable disease that not only causes disability, but also signi�cantly decreases the quality of life in affected individuals. Findings from this study provide insight into the unique needs and perceptions of African American women residing in rural Alabama as they relate to community resources. BackgroundHypertension (HTN) affects millions of Americans each year and is a signi�cant contributing factor in the development of cardiovascular disease (CVD) [1,2]. Disparities related to HTN and CVD persist by gender, as well as race; however, while disparities in diagnosis, treatment, and outcomes have decreased signi�cantly in respect to gender, disparities related to race have not improved [3]. Greater disparities related to the incidence and prevalence rates of HTN and CVD are especially noted among African Americans [3,4], and African Americans are more likely to experience poor outcomes directly related to complications stemming from CVD and associated conditions [1]. Health disparities related to HTN and CVD are magni�ed even further among African Americans residing in rural locations [5]. High rates of HTN and CVD combined with the likely development of multiple comorbid conditions, and the long-term disabling effects of chronic disease are a source of deep concern.Local, state, and national initiatives related to ongoing health disparities address risk factors contributing to the incidence of HTN and CVD among African Americans [1,[6][7][8][9]. Other interventions for persons with established HTN focus on healthy lifestyle choices, such as physical activity and/or diet, in disease management [4,8,10]. However, although physical activity and dietary interventions are effective, long-term change in personal health behavior is difficult to maintain [7]. In addition to identifying interventions that stimulate long-term change, these strategies must address the unique needs of rural populations.Recent studies have focused on rural populations [11][12][13], yet few studi...

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Section: Discussionmentioning

confidence: 99%

Perceptions of Community Resources and Insights for Program Development from Southern, Rural Hypertensive Women

Ford

March

2013

ISRN Hypertension

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“…Optimization of healthcare delivery is needed for Hispanics who live in rural areas and who tend to be at higher risk for hypertension and less responsive to primary and specialty care compared with their urban counterparts [44]. The delivery of rural healthcare to patients with hypertension requires new strategies such as programs targeting therapeutic inertia, home-based monitoring of BP, and internet-based communication programs [45]. …”

Section: Promotoras and Community Health Workersmentioning

confidence: 99%

Cultural Considerations: Pharmacological and Nonpharmacological Means for Improving Blood Pressure Control among Hispanic Patients

Patel

Wood

Espino

2012

International Journal of Hypertension

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Cardiovascular disease is a leading cause of morbidity and mortality in the United States, and its prevention and treatment remain a priority for the medical community. Ethnic variations account for some differences in the prevalence of hypertension and blood pressure (BP) control rates among Hispanics, indicating the need for culturally appropriate management models. Aggressive treatment strategies are key to achieving optimal BP control in high-risk Hispanic patients. Hypertension in this ethnic group continues to be a major health concern. Of note, when provided access to comprehensive care, Hispanics demonstrate similar response rates to treatment as the majority of non-Hispanic whites. This highlights the importance of effective, culturally responsive hypertension management among high-risk Hispanic patients for achieving observable, positive health outcomes.

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“…; Colli et al . ; Bale ). Other environmental factors, such as occupational exposures in agricultural workers, may contribute to a rural resident's increased risk for Kca (Karami et al .…”

Section: Introductionmentioning

confidence: 97%

“…Another type of disparity, which has received relatively little examination but potentially impacts more than 20% of the US population, is disease variance between rural and urban populations. Kca risk factors such as smoking, obesity, hypertension, and diabetes are disproportionately more common in rural areas (Jackson et al 2005Doescher et al 2006;Colli et al 2009;Bale 2010). Other environmental factors, such as occupational exposures in agricultural workers, may contribute to a rural resident's increased risk for Kca (Karami et al 2012).…”

Section: Introductionmentioning

confidence: 99%

Delivering kidney cancer care in rural Central and Southern Illinois: a telemedicine approach

Alanee

Dynda

LeVault

et al. 2014

Eur J Cancer Care (Engl)

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There is a growing body of experience and research suggesting that telemedicine (video conferencing, smart phones and online patient portals) could be the solution to addressing gaps in the provision of specialised healthcare in rural areas. The proposed role of telemedicine in providing needed services in hard to reach areas is not new. The United States Telecommunication Act of 1996 provided the initial traction for telemedicine by removing important economic and legal obstacles regarding the use of technology in healthcare delivery. This initial ruling has been supplemented by the availability of federal funding to support efforts aimed at developing telemedicine in underserved areas. In this paper, we explore one aspect of disease disparity pertinent to rural Illinois (kidney cancer incidence and mortality) and describe how we are planning to use an existing telemedicine program at Southern Illinois University School of Medicine (SIUSOM) to improve kidney cancer (Kca) care in rural Illinois. This represents an example of the possible role of telemedicine in addressing healthcare disparities in rural areas/communities and provides a description of general challenges and barriers to the implementation and maintenance of such systems.

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Optimizing Hypertension Management in Underserved Rural Populations

Cited by 22 publications

References 43 publications

Perceptions of Community Resources and Insights for Program Development from Southern, Rural Hypertensive Women

Perceptions of Community Resources and Insights for Program Development from Southern, Rural Hypertensive Women

Cultural Considerations: Pharmacological and Nonpharmacological Means for Improving Blood Pressure Control among Hispanic Patients

Delivering kidney cancer care in rural Central and Southern Illinois: a telemedicine approach

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