Rural health promotion programs

These rural health disparities have many causes: Health Behaviors: Rural residents often have limited access to healthy foods and fewer opportunities to be physically active compared to their urban counterparts, which can lead to conditions such as obesity and high blood pressure.

Rural residents also have higher rates of smoking, which increases the risk of many chronic diseases. Health Care Access: Rural counties have fewer health care workers, specialists such as cancer doctors , critical care units, emergency facilities, and transportation options.

Residents are also more likely to be uninsured and to live farther away from health services. Healthy Food Access: National and local studies suggest that residents of low-income, minority, and rural neighborhoods often have less access to supermarkets and healthy foods.

Demographic Characteristics: Residents of rural areas tend to be older, with lower incomes and less education than their urban counterparts. These factors are linked to poorer health. Studying and reporting on rural health disparities and innovative programs to reduce those disparities. From a population health approach, good practices and themes identified in the literature defined six key elements described below for rural health population program planning and delivery that can be used to guide the development of rural health programs and which form the foundation of the Rural Health Framework.

A rural population health approach identifies rural areas using a common definition. Although there is no consensus on a standardized definition, the definition selected is at the discretion of program planners. In this framework, six main approaches to defining rural areas in Canada were used, as defined by Statistics Canada ; each definition emphasizes different criteria such as population size, labour market context, population density or settlement context and as such, has important implications for program planning.

A rural population health approach uses evidence to assess the health status of the population and respond to identified needs. Evidence-informed practice uses population health assessments, surveillance, research and program evaluation to generate evidence Ontario Ministry of Health and Long-Term Care It answers the following questions: How healthy is the rural population? How do we know? What are the community's priorities?

Are there any emerging issues? What are the priority populations? How does the health of the population look over time? Is the population health status getting worse or better? A rural population health approach uses multiple levels of support from various sectors and levels that have a vested interest in the health of the target population in every phase of the project. Early collaboration is recommended PHAC a and includes but is not limited to researchers, health professionals, community organizations, government and other key stakeholders.

A rural population health approach calls for the identification of rural health challenges and assets using a framework based on the social determinants of health PHAC b. Challenges are informed by population health assessment, surveillance, research, program evaluation and personal experiences. Examples of challenges are access to healthcare services, geographic and social isolation, and poverty. Assets are advantages and attributes within a rural community that are vital to sustainability and growth, such as physical infrastructure buildings , green space, social aspects of community living, agriculture and volunteerism.

A rural population health approach involves addressing health challenges and maximizing assets using a framework based on the social determinants of health. To illustrate the framework's usability, program coordinators, team members and staff with the Haldimand—Norfolk Health Unit HNHU applied it to public health practice in several programs including its immunization program, which provides routine immunization services for infants, children, youth and adults, as well as annual flu clinics for those six months of age and older.

The purpose of the immunization program is to provide resources that help minimize anxiety by emphasizing the safety and efficacy of publicly funded vaccines, and to reduce the incidence of vaccine-preventable diseases in the community.

This health unit serves Haldimand and Norfolk counties, which have a combined population of ,, with a population density of Multiple levels of community support can be integrated into this program: health professionals public health nurses, nurse practitioners, physicians, pharmacists , community organizations pharmacies, nursing agencies, community support services , government public health, Ministry of Health and Long-Term Care, long-term care homes and other key stakeholders e. Application of the Rural Health Framework to the planning and delivery of an influenza immunization program: Identified challenges, assets and solutions for key social determinants of health.

Strong social capital sense of belonging, inclusion, trust, participation in community life. Foster community engagement by integrating organizations and businesses to implement and mobilize the program pharmacies, industry. Educate nurses, health professionals and the public on the vaccine's efficacy and safety. Encourage clients to ask questions about immunization and consult with their family physicians or other care providers.

Encourage clients to ask questions about immunization, their health and the health of their family. Leverage multiple levels of support in the community to build public trust in the vaccine's efficacy and safety.

Minimize anxiety about the vaccine's safety and efficacy by educating nurses, health professionals and the public on the impact of influenza on absenteeism, and on possible side effects and contraindications. Utilize a rural outreach model to deliver the program in several geographical areas with high population density and short distance to travel.

Provide the clinic in local schools, the Norfolk Community Help Centre, the Health Unit and a centrally located church. Encourage community members to provide transportation to residents with no access to transportation. Uptake of the vaccine is very poor, possibly due to complacency among health professionals about rates and existing misinformation about adverse effects. Provide resources that help minimize anxiety by emphasizing the vaccine's benefits, efficacy and safety.

Provide education on possible side effects and contraindications of the vaccine as well as the impact of influenza on absenteeism.

The percentage of new mothers with low education is increasing 5. Provide parents with simple, easy-to-read educational materials, resources and information on child immunization to help promote the vaccine's efficacy and safety. Limited access to healthcare services; many travel outside counties to obtain services.

The application of the Rural Health Framework has assisted public health providers in providing more appropriate and adequate resources to help minimize anxiety by emphasizing the vaccine's benefits, efficacy and safety, and to increase uptake of the vaccine.

The framework was valuable in raising awareness about the specific challenges to immunization that are unique to rural communities so that effective strategies could be developed to overcome these. Although the initial focus was to apply the framework only to chronic disease programs, it was clearly adaptable to any rural health program. This adaptability illustrated the framework's broad utility and demonstrated that rural health programs and approaches can be more effective when related to health determinants.

The framework has also been used in information program evaluation aimed at delineating impacts through a program review process that is currently underway. Unlike other health promotion frameworks, in the Rural Health Framework, health promotion approaches and programs are linked to understand the rural community, emphasize rural health asset-mapping and identify challenges. The framework approaches the planning and delivery process by breaking it into smaller, more manageable pieces.

The elements also demonstrate linkages in a continuous cycle. One of the framework's contributions is that it encourages more comprehensive planning of health promotion programs from a rural perspective.

Frameworks of this type can assist program planners in improving the health status of a rural community. The lack of information on best practices for health planning in rural areas challenges program planners to develop relevant and effective health promotion programs for rural communities.

The Rural Health Framework described here provides an opportunity for policy makers and program planners to reflect on the key issues facing rural communities to ensure the development of strategies that will prudently and effectively meet population health needs. Based on a rural perspective, frameworks of this type have the potential to assist program planners in improving the health status of a rural community.

Applying the framework to existing programs within the health unit made evident the fact that these programs, without formal documentation, already incorporated aspects of the Rural Health Framework and employed key elements of rural program planning and delivery. The ultimate aim of the Rural Health Framework is to assist program planners in improving the health status of rural populations.

Limitations of the framework that require further exploration include the lack of an evaluation component as well as a promotion and communication strategy. Further research is needed to demonstrate significant changes in specific health indicators e. Further research, using qualitative approaches, is also needed on the perspectives of program planners using this framework in terms of ease of use, challenges, gaps and opportunities for improvements.

More research is needed on the framework's efficacy when applied early in the planning process and development phases of new health programs.

Further validation may be provided by more comprehensive searches of the literature, including programs completed in international settings and described in the grey literature, the lack of which in this current review is a limitation.

The author wishes to acknowledge the following individuals for their feedback and contributions on earlier reports of this project: Dr. National Center for Biotechnology Information , U. Journal List Healthc Policy v. Healthc Policy. Deanna White , MA. Author information Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Abstract Purpose: To describe the development and application of an evidence-based Rural Health Framework to guide rural health program, policy and service planning.

Methods: A literature review of rural health programs, focusing on health promotion, chronic disease prevention and population health, was conducted using several bibliographic databases.

Findings: Thirty papers met the criteria for review, describing chronic disease interventions and public health policies in rural settings. Conclusions: The Rural Health Framework was applied to an influenza immunization program to demonstrate its utility in assisting public health providers to increase uptake of the vaccine. Methods A literature review was conducted at the request of the Public Health Agency of Canada PHAC to identify effective rural health programs in relation to the social determinants of health, rural policy implications for public health and best practices in rural health interventions.

TABLE 1. Open in a separate window. TABLE 2. TABLE 3. Good Practices for Rural Health Promotion 1. Hospital health promotion evolved from patient education about specific diseases to programs focused on modifying of lifestyle practices to prevent future debilitating conditions.

Studies conducted in the early s show hospital-based health promotion programs increasing in number and including such target populations as senior citizens, children, business people, and hospital employees. However, the extent of involvement of the rural hospital in offering health promotion programs has not been clearly established.