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Foreword
Middle Eastern Literatures Pub Date : 2017-05-04 , DOI: 10.1080/1475262x.2017.1342456
Özen Nergis Dolcerocca 1
Affiliation  

Rural areas can be defined in many ways.1,2 Although rurality is often defined by geographic location or population density, the concept of rural is most aptly described within the context of people, culture, environment, and health care access.2 To better understand the health of rural residents, researchers, practitioners, and policy makers must rethink the lens through which they view rural populations. This includes economic and social resources that, along with geography, collectively define rurality, and impact the lives of residing residents. Framing the research issues within place and context gives specific meaning to rural health challenges. Understanding the unique challenges facing a rural region or rural population of interest gives greater meaning and relevance to the research message. Although the majority of Americans live in metropolitan areas, the effect of place and context on families and communities is of growing concern, and relevance in understanding the correlates and influences of rural residence remains salient.2,3 It is well documented that rural areas, and those residing within them, encounter unique health challenges. Families and communities dwelling in rural areas often have less access to preventive health services and health care compared to their counterparts residing in more urban or suburban areas.4 The health infrastructures in these rural areas are commonly more dispersed, which forces residents to travel farther distances to obtain screenings, interact with health care professionals, and find appropriate health-related treatments.4 Further, rural areas are confronted by shortages of health providers and medically-related deficiencies.5 The unique characteristics of rural and underserved areas emphasize the need for effective health interventions, innovative techniques to integrate existing assets and deliver services, and dynamic partnerships necessary to maximize the reach and effect of community resources. In addition to disparities regarding health care and services, preventive behaviors including physical activity and nutritional provisions may be compromised in rural areas because of variations in the built environment, transportation, and access to healthy food or exercise facilities. Despite existing research examining health and behavioral variation across the rural-urban continuum, merely residing in a rural or frontier area does not adequately provide insight into the origins or influences of rural disparities in America. For this reason, when assembling this collection of manuscripts, the Co-editors of this issue employed a philosophy of selecting articles that highlight what it means to be a person living in a rural area, not just studies focusing on rural participants. Recognizing that rurality is different in many parts of the country, this issue highlights research and practice across the country as well as in specific rural areas often characterized by poverty and lack of health services (eg, Appalachia). This issue addresses key national policy issues such as how the expansion of the Patient Centered Medical Home model into rural and underserved populations can be part of a transformative strategy to address health care access, efficiency, quality, and sustainability.6 Health status disparities are explored with a family focused concern of examining both parental and child health status in relationship to health care access.7 Qualitative research about the performance of rural health clinics sheds light on factors associated with greater efficiency and effectiveness of these care models designed to improve primary care in rural areas.8 There are many barriers to screening for preventive care in rural areas, especially for cancer which still carries a stigma in many rural areas. Strategies for improving participation in cancer prevention and control studies are highlighted which can help others in general recruitment efforts,9 although it is important to be aware of the role of both insurance coverage and personality factors (eg, fatalism) in cancer screening behaviors.10 There has been increasing attention to a range of technological, behavioral, and environmental interventions to address rural health disparities. Tele-health has promise for increasing mental health services as demonstrated through a unique academic-campus partnership that has been mutually beneficial for both students and community members.11 Interventions to improve child health that draw upon and extend community partnerships can promote healthy lifestyles and also raise awareness for health-related careers.12 These programs embedded in school life can sustain benefits in active living and healthy eating.13 A community-wide health and wellness coalition which spurs a coordinated effort in many different sectors (eg, health, schools, community, government) can have a transformative effort.14 Focused urban design efforts to encourage transportation alternatives are beneficial to promoting

中文翻译:

前言

可以通过多种方式定义农村地区。 1,2 虽然农村地区通常由地理位置或人口密度来定义,但在人、文化、环境和医疗保健的背景下最恰当地描述农村的概念。 2 为了更好地了解农村居民的健康状况,研究人员、从业人员和政策制定者必须重新思考他们看待农村人口的视角。这包括经济和社会资源,连同地理,共同定义农村,并影响居民的生活。在地方和背景下构建研究问题赋予农村健康挑战特定的意义。了解农村地区或感兴趣的农村人口面临的独特挑战,赋予研究信息更大的意义和相关性。尽管大多数美国人生活在大都市地区,但地方和环境对家庭和社区的影响越来越受到关注,理解农村居住的相关性和影响的相关性仍然很重要。 2,3 有充分证据表明,农村地区、以及居住在其中的人们面临着独特的健康挑战。与居住在更多城市或郊区的家庭和社区相比,居住在农村地区的家庭和社区通常获得预防性卫生服务和医疗保健的机会较少。 4 这些农村地区的卫生基础设施通常更加分散,这迫使居民走得更远进行筛查,与医疗保健专业人员互动,并找到适当的与健康相关的治疗方法。 4 此外,农村地区面临卫生服务提供者短缺和医疗相关不足的问题。 5 农村和服务欠缺地区的独特特征强调需要有效的卫生干预措施、整合现有资产和提供服务的创新技术,以及最大限度地扩大覆盖面所必需的动态伙伴关系和社区资源的作用。除了卫生保健和服务方面的差异之外,农村地区的预防行为(包括体育活动和营养供应)可能会因建筑环境、交通以及获得健康食品或锻炼设施的差异而受到影响。尽管现有研究检查了城乡连续体的健康和行为变化,仅仅居住在农村或边境地区并不能充分洞察美国农村差异的起源或影响。出于这个原因,本期的共同编辑在汇编这本手稿时采用了一种哲学,即选择强调生活在农村地区的人意味着什么的文章,而不仅仅是关注农村参与者的研究。认识到该国许多地区的农村情况不同,本期重点介绍了全国以及通常以贫困和缺乏卫生服务为特征的特定农村地区(例如阿巴拉契亚)的研究和实践。强调了提高癌症预防和控制研究参与度的策略,这可以帮助其他人进行一般招聘工作,9 尽管了解保险范围和性格因素(例如,宿命论)在癌症筛查行为中的作用很重要。 10人们越来越关注一系列技术、行为和环境干预措施,以解决农村健康差距问题。远程医疗有望增加心理健康服务,这一点通过独特的学术-校园伙伴关系得到证明,这种伙伴关系对学生和社区成员都是互利的。 11 利用和扩展社区伙伴关系来改善儿童健康的干预措施可以促进健康的生活方式,也提高对健康相关职业的认识。
更新日期:2017-05-04
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