Context: Health disparities on the basis of geographic location, social economic factors and education levels are well documented. However, even when health care services are available, there is no guarantee that all persons will take preventive health measures. Understanding the cultural beliefs, practices, and lifestyle choices that determine…

Context: Decades of behavioral research suggest that awareness of health threats is a necessary precursor to engage in health promotion and disease prevention, findings that can be extended to the community level. Purpose: We sought to better understand local perspectives on the main health concerns of rural Appalachian communities in order to…

Evidence-based substance use prevention programs have proliferated in schools and are being adopted by districts in rural settings and internationally. Little attention, however, has been paid to the adaptation process that occurs when these programs are moved to different contexts. In this commentary, the authors draw upon their experience with…

Findings from recent epidemiological investigations indicate that substance use in rural America has increased to the point where it nearly equals, if not exceeds, the rates found in suburban and urban areas. Although previous research has examined factors that have influenced use patterns, little attention has been devoted to the social and…

Context: Diabetes self-management is important for achieving successful health outcomes. Different levels of self-management have been reported among various populations, though little is known about ownership of equipment that can enhance accomplishment of these tasks. Purpose: This study examined diabetes self-management equipment ownership…

Context: Every social group shares beliefs about health and illness. Knowledge and understanding of these health beliefs are essential for education programs to address health promotion and illness prevention. Purpose: This analysis describes the diabetes Explanatory Models of Illness (EMs) of low-income, rural, white Southerners who have not been…

Context: Multiple national agencies and organizations recommend that women age 40 years and older have an annual screening mammogram. Women who are poor, less educated, lack a usual source of care, and reside in rural Appalachia are less likely to have had a recent mammogram. Purpose: To increase use of mammography among a rural Appalachian…

Surveys of 3,346 rural and small-town residents of Kentucky and 138 rural prenatal service providers found that neither males nor females were knowledgeable about the harmful effects of alcohol use during pregnancy, with males having significantly less knowledge. Service providers identified barriers to health promotion and prevention efforts and…

An Alabama initiative aimed to improve access to oral health care for Medicaid-eligible children through four components: improved Medicaid claims processing, increased reimbursement for providers, outreach and educational activities to support providers, and parent and patient education about children's oral health. In the first 3 program years,…

The Centers for Disease Control and Prevention works with public health agencies and other organizations to address chronic disease prevention and risk reduction in older adults. Efforts in the areas of physical activity, osteoarthritis, and chronic illness self-management are described. Other activities include older adult immunization programs…

A study evaluating an interactive adult telehealth education program in Arkansas surveyed 2,567 participants. Older adults, Blacks, American Indians, and participants with a high school diploma or less expressed significantly higher levels of satisfaction than other participants. This was attributed to development of sessions responding to…

In the Kentucky Homeplace Project, specially trained paraprofessionals who live in medically underserved rural communities make home visits, facilitate access to health care, and provide case management and culturally appropriate prevention education for poor families. Strengths include local administration and staff and holistic and traditional…

Complex community health promotion programs are being held accountable for their effectiveness, but rural public health departments lack staff and expertise to carry out evaluations. In Kentucky, a university evaluation expert trains local public health staff in technical skills for program evaluation and provides ongoing mentoring and technical…