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Health Education

Community-Based Models

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Handbook of Rural Health

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Abstract

In 1997, approximately 54 million Americans lived in rural areas (Beale, 1999), and over 22 million rural Americans lived in areas that are designated primary care health professional shortage areas (Health Resources and Services Administration, 1998). In 1996, only 53.7% of residents in rural areas had private health insurance, while 62.5% of urban residents had such coverage (Vistnes & Monheit, 1997). According to the Agency for Health Care Policy and Research, 28% of the adult rural population reported their health status as fair to poor (Health Care Financing Administration, 1995). Chronic conditions were also more prevalent in rural areas, with 46.7% of rural adults reporting a chronic condition compared with 39.2% of the urban population (Braden & Beauregard, 1994). These data underscore the need for community health education programs that can improve awareness, promote changes in health behavior and increase access to rural health care.

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References

  1. American Hospital Association. (1992). Hospital closures 1980 through 1991: A statistical profile. Chicago: American Hospital Association.

    Google Scholar 

  2. American Hospital Association. (1997). A profile of nonmetropolitan hospitals, 1991–1995 (Table 1 ). Chicago: AHA Center for Health Care Leadership, Section for Small or Rural Hospitals.

    Google Scholar 

  3. American Indian Health Care Association. (1989). Urban Native American women’s cancer prevention pmject. St. Paul, MN: American Indian Health Care Association.

    Google Scholar 

  4. Azjen, I., & Fishbein, M. (1980). Understanding attitudes and predicting social behavior. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  5. Bandura, A. (1986). Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall.

    Google Scholar 

  6. Bandura, A. (1989). Perceived self-efficacy in the exercise of personal agency. Psychologist: Bulletin of the British Psychological Society, 10, 411–424.

    Google Scholar 

  7. Bandura, A. (1991). A social cognitive approach to the exercise of control over AIDS infection. In R. DiClemente (Ed.), Adolescents and AIDS: A generation in jeopardy (pp. 1–20 ). Beverly Hills, CA: Sage.

    Google Scholar 

  8. Beale, C. L. (1996). The ethnic dimension of persistent poverty in rural and small-town areas. In L. L. Swanson (Ed.), Racial/ethnic minorities in rural areas: Progress and stagnation, 1980–90 (pp. 2632). (Agricultural economic report No. 731 ). U.S. Department of Agriculture: Rural Economy Division, Economic Research Service.

    Google Scholar 

  9. Beale, C. (1999). Nonmetro population rebound: Still real but diminishing. Rural Conditions and Trends, 9(2), 20–27, 46–51.

    Google Scholar 

  10. Becker, M. (1974). The health belief model and personal health behavior. Health Education Monographs, 2, 324–508.

    Google Scholar 

  11. Bentley, J., Feldman, C., & Oler, J. (1989). The rural dental health program: The long-range effect of a school-based enriched dntal health program on children’s oral health. The Journal of Rural Health, 5(3), 231–245.

    Google Scholar 

  12. Braden, J., & Beauregard, K. (1994). Health status and access to care of rural and urban populations. National Medical Expenditure Survey Research Findings 18. (AHCPR pub. no. 94–0031 ). Rockville, MD: Public Health Service, Agency for Health Care Policy and Research.

    Google Scholar 

  13. Bureau of Primary Health Care, Health Resources and Services Administration. (1999). Community health center program. (September, 1999). [http:// www.bphc.hrsa.dhhs.gov/]

    Google Scholar 

  14. Candelaria, J., Campbell, N., Lyons, G., Elder, J. P., & Villaseflor, A. (1998). Strategies for health education: Community-based methods. In S. Loue (Ed.), Handbook of immigrant health. New York: Plenum Press.

    Google Scholar 

  15. Chapman, L. J., Schuler, R. T., Skjolaas, C. A., & Wilkinson, T. L. (1995a). Agricultural work safety efforts by Wisconsin Extension agricultural agents. Journal of Rural Health, 11(4), 295–304.

    Google Scholar 

  16. Chapman, L. J., Schuler, R. T., Wilkinson, T. L., & Skjolaas, C. A. (1995b). Farm-work hazard prevention efforts by school-based agricultural education instructors. American Journal of Industrial Medicine, 28 (4), 565–577.

    Article  PubMed  CAS  Google Scholar 

  17. Cheadle, A., Pearson, D. Wagner, E., Psaty, B. M., Diehr, P., & Koepsell, T. (1995). A community-based approach to preventing alcohol use among adolescents on an American Indian reservation. Public Health Reports, 110(4), 439–447.

    Google Scholar 

  18. Cheh, V., & Thompson, R. (1997). Rural health clinics: Improved access at a cost. Princeton, NJ: Mathematica Policy Research, November 25.

    Google Scholar 

  19. Crown, M., Duncan, K., Hurrell, M., Ootoova, R., Tremblay, R., & Yazdanmehr, S. (1993). Making HIV prevention work in the North. Canadian Journal of Public Health, 84 (suppl. 1), S55 - S58.

    Google Scholar 

  20. Dagata, E. M. (1999). The socioeconomic well-being of rural children lags that of urban children. Rural Conditions and Trends, 9 (2), 85–90.

    Google Scholar 

  21. Davis, S. M., Going, S. B., Helitzer, D. L., Teufel, N. I., Snyder, P., Gittelsohn, J., Metcalfe, L., Arviso, V., Evans, M., Smyth, M., Brice, R., & Altaha, J. (1999). Pathways: A culturally appropriate obesity-prevention program for American Indian schoolchildren. American Journal of Clinical Nutrition, 69 (suppl.), 796S - 802S.

    PubMed  CAS  Google Scholar 

  22. Dignan, M. B., Beal, P. E., Michielutte, R., Sharp, P. C., Daniels, L. A., & Young, L. D. (1990). Development of a direct education workshop for cervical cancer prevention in high risk women: The Forsyth County project. Journal of Cancer Education, 5(4), 217–223.

    Google Scholar 

  23. Dignan, M., Sharp, P., Blinson, K., Michielutte, R., Konen, J., Bell, R., & Lane, C. (1994). Development of a cervical cancer education program for Native American women in North Carolina. Journal of Cancer Education, 9 (4), 235–242.

    Google Scholar 

  24. Dignan, M. B., Michielutte, R., Blinson, K., Wells, H. B. Case, L. D., Sharp, P., Davis, S., Konen, J., & McQuellon, R. P. (1996). Effectiveness of health education to increase screening for cervical cancer among eastern-bank Cherokee Indian Women in North Carolina. Journal of the National Cancer Institute, 88 (22), 1670–1676.

    Article  PubMed  CAS  Google Scholar 

  25. Dorresteyn-Stevens, C. (1993). The rural hospital as a provider of health promotion programs. The Journal of Rural Health, 9 (1), 63–67.

    Article  PubMed  CAS  Google Scholar 

  26. Earp, J. A., Altpeter, M., Mayne, L., Viadro, C. I., & O’Malley, M. S. (1995). The North Carolina breast cancer screening program: Foundations and design of a model for reaching older, minority, rural women. Breast Cancer Research and Treatment, 35, 7–22.

    Article  PubMed  CAS  Google Scholar 

  27. Earp, J. A., Viadro, C. I., Vincus, A. A., Altpeter, M., Flax, V., Mayne, L., & Eng, E. (1997). Lay health advisors: A strategy for getting the word out about breast cancer. Health Education & Behavior, 24 (4), 432–451.

    Article  CAS  Google Scholar 

  28. Earp, J, O’Malley, M., & Rauscher, G. (1999). Increasing mammography use among older, rural, African-American women. Presentation at the American Public Health Association Conference, UNC Lineberger Comprehensive Cancer Center University of North Carolina, Chapel Hill.

    Google Scholar 

  29. Elder, J. P., Geller, E. S., Hovell, M. H., & Mayer, J. A. (1994). Motivating health behavior. New York: Delmar.

    Google Scholar 

  30. Elder, J. P., Apodaca, J. X., Parra-Medina, D. & Zufiiga de Nuncio, M. L. (1998). Strategies for health education: Theoretical models. In S. Loue (Ed.), Handbook of immigrant health (pp. 567–585). New York: Plenum Press.

    Google Scholar 

  31. Eng, E., & Young, R. (1992). Lay health advisors as community change agents. Journal of Family and Community Health 15 (1), 4–40.

    Google Scholar 

  32. Eng, E. (1993). The Save Our Sisters Project: A social network strategy for reaching rural black women. Cancer, 72 (suppl.), 1071–1077.

    Article  PubMed  CAS  Google Scholar 

  33. Eng, E., Parker, E., & Harlan, C. (1997). Lay health advisor intervention strategies: A continuum from natural helping to paraprofessional helping. Health Education & Behavior, 24 (4), 413–417.

    Article  CAS  Google Scholar 

  34. Ferguson, K. J. Gjerde, C. L., Mutel, C., Donham, K. J. Hradek, C., Johansen, K., & Merchant, J. (1989). An educational intervention program for prevention of occupational illness in agricultural workers. The Journal of Rural Health, 5(1),33–47.

    Google Scholar 

  35. Fishbein, M. (1980). A theory of reasoned action: Some applications and implications. In H. Howe & M. Page (Eds.), Nebraska symposium on motivation, 1979 (pp. 65–116 ). Lincoln: University of Nebraska Press.

    Google Scholar 

  36. Fishbein, M., & Azjen, I. (1975). Belief attitude, intention, and behavior: An introduction to theory and research. Boston: Addison-Wesley.

    Google Scholar 

  37. Frenzen, P. D. (1994). Health care: Premiums and coverage in rural areas. Agricultural Outlook AO-209 (pp. 22–25 ), Washington, DC: U.S. Department of Agriculture, Economic Research Service.

    Google Scholar 

  38. Georgia Department of Health and Human Services. (1998, January). Hospital closure: 1997. Atlanta, GA: Office of Inspector General.

    Google Scholar 

  39. Ghelfi, L. M. (1999). Rural per capita income grows slightly faster than urban. Rural Conditions and Trends, 9(2), 63–65.

    Google Scholar 

  40. Green, L. W. (1984). Modifying and developing health behaviors. In L. Breslow, J. A. Fielding, & L. B. Lave (Eds.), Annual review of public health (Vol. 5; pp. 215–236). Palo Alto, CA: Annual Reviews. Green, L. W., & Kreuter, M. W. (1991). Health promoLion planning: An educational and environment approach ( 2nd ed.). Mountain View, CA: Mayfield.

    Google Scholar 

  41. Health Care Financing Administration. (1995). HCFA current beneficiary survey, 1995. [www.hcfa.gov/]

    Google Scholar 

  42. Health Resources and Services Administration. Selected statistics on health professional shortage areas: As of December 31, 1998. Washington, DC: Department of Health and Human Services, Division of Shortage Designation, Bureau of Primary Health Care.

    Google Scholar 

  43. Hodge, F. S., Fredericks, L., & Rodriguez, B. (1996). American Indian Women’s Talking Circle: A cervical cancer screening and prevention project. Cancer Supplement, 78(7) 1592–1597.

    Google Scholar 

  44. Hodge, F. S., Stubbs, H. A., & Fredericks, L. (1999). Talking Circles: Increasing cancer knowledge among American Indian women. Cancer Research Therapy and Control, 8, 103–111.

    Google Scholar 

  45. Hooks, C., Ugarte, C., Silsby, J. Brown, R. Weinman, J., Fernandez, G., Foxwell, J., Newton, N., & Connally, L. B. (1996). Obstacles and opportunities in designing cancer control communication research for farmworkers on the Delmarva Peninsula. The Journal of Rural Health,12(4), 332342.

    Google Scholar 

  46. Knobloch, M. J., & Broste, S. K. (1998). A hearing conservation program for Wisconsin youth working in agriculture. Journal of School Health, 68(8), 313318.

    Google Scholar 

  47. Konyha, M. E. (1975). Cooperative Extension Service’s potential to meet the needs in rural health education and in rural institutional development. Public Health Reports, 90 (4), 340–343.

    PubMed  CAS  Google Scholar 

  48. McNab, W. L. (1998). Incorporating farm safety into the health education curriculum. Journal of School Health, 68(5), 213–215.

    Google Scholar 

  49. McWhorter, W. P., Schatzkin, A. G., Horm, J. W., & Brown, C. C. (1988) Contribution of socio-economic status to black/white differences in cancer incidence. Cancer, 63, 982–987.

    Article  Google Scholar 

  50. Nelson, D. (1993). AIDS prevention programs in a smaller community. Canadian Journal of Public Health, 84 (suppl. 1), S39 - S41.

    Google Scholar 

  51. O’Dea, P. J. Murphy, B., & Balzer, C. (1997). Traffic and illegal production of drugs in rural America. In E. B. Robertson, Z. Sloboda, G. M. Boyd, L. Beatty, & N. J. Kozel (Eds.), Rural substance and abuse: State of knowledge and issues (N1DA Monograph no. 168; pp. 79–89). Arlington, VA: U.S. Department of Health and Human Services.

    Google Scholar 

  52. Prochaska, J., & DiClemente, C. (1983). Stages and processes of self-change in smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51, 390–395.

    Article  PubMed  CAS  Google Scholar 

  53. Project HOPE. (1998). Financial dependence of rural hospitals on outpatient revenue. Bethesda, MD: Project Hope.

    Google Scholar 

  54. Randolph, S. A., & Migliozzi, A. A. (1993). The role of the agricultural health nurse. American Association of Occupational Health Nurses Journal, 42 (9), 429–433.

    Google Scholar 

  55. Reding, D. J., Fischer, V., Gunderson, P., Lappe, K., Anderson, H., & Calvert, G. (1996). Teens teach skin cancer prevention. Journal of Rural Health, 12(4), 265–272.

    Google Scholar 

  56. Rhoades, E. R., Hammond, J., Welty, T. K., Handler, A. O., & Amber, R. W. (1987). The Indian burden of illness and future health interventions. Public Health Report, 102(4), 361–368.

    Google Scholar 

  57. Ricketts, T. C., Johnson-Webb, K. D., & Taylor, P. ( 1998, July 1). Definitions of rural: A handbook for health policy makers and researchers. Washington, DC: U.S. Department of Health and Human Services, Federal Office of Rural Health Policy, Health Resources and Services Administration.

    Google Scholar 

  58. Rogers, C. C. (1999). Socioeconomic circumstances of minority elderly differ from those of wWhite elderly. Rural Conditions and Trends, 9(2), 35–41.

    Google Scholar 

  59. Schafer, E., Vogel, M. K., Viegas, S., & Hausafus, C. (1998). Volunteer peer counselors increase breast-feeding duration among low-income women. BIRTH, 25(2), 101–106.

    Google Scholar 

  60. Service, C., & Salber, E. (Eds.) (1979). Community health education: The lay health advisor approach. Durham, NC: Duke University Health Care System.

    Google Scholar 

  61. Skinner, B. F. (1953). Science and human behavior. New York: Macmillan.

    Google Scholar 

  62. Vistnes, J. P., & Monheit, A. C. (1997). Health insurance status of the civilian noninstitutionalized population. Medical Expenditure Panel Survey (MEPS) Research Findings, Number 1, Agency for Health Care Policy and Research Pub. No. 97–0030.

    Google Scholar 

  63. What difference do lay health advisors make? Initial results from NC-BCSP’s outcome evaluation

    Google Scholar 

  64. North Carolina Breast Cancer Screening Program, 14,4–5.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Alliance Healthcare Foundation, San Diego, California, 92123, USA

    Gail E. Souare

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  1. Gail E. Souare
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Editors and Affiliations

  1. Case Western Reserve University, Cleveland, Ohio, USA

    Sana Loue

  2. University of Texas, Houston, Houston, Texas, USA

    Beth E. Quill

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Souare, G.E. (2001). Health Education. In: Loue, S., Quill, B.E. (eds) Handbook of Rural Health. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3310-5_18

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  • DOI: https://doi.org/10.1007/978-1-4757-3310-5_18

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4419-3347-8

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