Geographical, economic, social and cultural barriers to accessing services in rural areas are widely reported. Less widely discussed are dilemmas posed by individual and community reluctance to address sensitive health issues. This article, focusing on the highly sensitive area of mental health, and employing a participatory action approach,…

Context: The challenge of providing meaningful health care services to veterans living in rural communities is a major public health concern that involves redefining the traditional facility-based model of care delivery employed in urban areas. Purpose: This paper describes the steps of a demonstration project, the Elko Telehealth Outreach Clinic.…

Describes mental health service needs in rural America and barriers to improving its quality and availability. Federal programs, especially the Office of Rural Health Policy, are described and policy recommendations for improving rural mental health care are presented. (DM)

Purpose: We describe and evaluate a project designed to pilot test an evidence-based clinical intervention for assessing and treating depression in older adults in rural primary care clinics. Project ADAPT--Assuring Depression Assessment and Proactive Treatment--utilized existing primary care resources to overcome barriers to sustainability…

Health Start is being carried out to develop ways of coordinating health resources and to extend Head Start-type health services to a greater number of poor pre-school children. (Author/CB)

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…

Summarizes the 20-year history of the Appalachian Regional Commission's innovative, flexible, $550M model health care delivery system. Cites achievements in establishing primary care clinics; tackling black lung disease; and expanding health manpower, health education, maternal and child health care, and rehabilitation centers. (NEC)

Traces Southern West Virginia Regional Health Council's decade of delivering/linking cradle-to-grave health services for 500,000 rural residents. Describes microwave communications radio network; clinics; services in family planning, genetic counseling, prenatal care, maternal/child care, nutrition, heart/respiratory disease screening, renal…

The problem of occupational diseases must be addressed by social workers who are trained to actively work for changes on a social level. A training model is described, wherein graduate students organized a small community to combat and prevent Brown Lung Disease among textile workers. (DS)

Curriculum content, course objectives, and program development and implementation processes are discussed for this medical self-help training program for rural communities. (MB)

Two training programs in rural Iowa demonstrated community helpers can be trained to function effectively in rural mental health service delivery. Comparable training programs sponsored by the center are currently in progress. Training these natural helpers in interpersonal skills is an important service of community mental health centers. (Author)

The Geriatric Assessment Unit (GAU), which has proven successful in urban areas, may be a viable system for providing health care to the elderly in rural areas. GAUs engage in assessment, follow-up response to findings, education, and research. The assessment component includes, at minimum, physical health, functional ability in activities of…

This annual report of the Northeast Regional Center for Rural Development (NERCRD) highlights the Center's activities, programs, projects, and publications for fiscal year 1998. NERCRD receives modest funding from the U.S. Department of Agriculture and other funds from private foundations. Funds are used to link rural development efforts of the 15…

This paper describes a project which is attempting to strengthen existing mental health programs and develop new forms of support for rural children, since current programs are limited by a scarcity of funds, trained personnel, and supportive services. The setting of the project is a three-county area in Southwestern Pennsylvania which has been…

In an effort to prove that mental health services can be lay administered, a training program was implemented in the rural areas of Cedar County (October 1972-April 1973) and Iowa County, Iowa (October 1973-May 1974). Recruited via personal or telephone contact, 20 trainees were selected who demonstrated they: were good listeners; did not impose…