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Browsing by Author "Danek, Robin"
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Item Knowledge of current exercise guidelines and perceived utilization in rural Indiana(2023) Nettleton, Rachel; Danek, Robin; Ireland, Ellen; Reyes, EricPurpose: The aim of this research is to determine the understanding of current exercise guidelines in rural Indiana. A comparison of current exercise practices, barriers, and benefits of exercise were also briefly addressed. Methods: A survey was distributed to individuals (ages 18+) at a small family medicine clinic in a midwestern state (n=23). Findings: The sample size was 23, which comprised of mostly older females. Most participants responded that they do less than the recommended duration and intensity of exercise (Table 1). CDC recommendations were not well understood by 68% of participants. Conclusions: Results demonstrated that participants in rural Indiana underestimated the current CDC guidelines for exercise. They also fail to meet the CDC recommendations, as well as what they perceived the recommendations to be. Lack of motivation, energy and time were the most cited barriers. Increased energy and increased physical abilities were the most cited benefits.Item Measuring rurality in health services research: a scoping review(BMC, 2022-11-12) Danek, Robin; Blackburn, Justin; Greene, Marion; Mazurenko, Olena; Menachemi, NirPurpose: This study is a scoping review of the different methods used to measure rurality in the health services research (HSR) literature. Methods: We identified peer-reviewed empirical studies from 2010-2020 from seven leading HSR journals, including the Journal of Rural Health, that used any definition to measure rurality as a part of their analysis. From each study, we identified the geographic unit (e.g., county, zip code) and definition (e.g., Rural Urban Continuum Codes, Rural Urban Commuting Areas) used to classify categories of rurality. We analyzed whether geographic units and definitions used to classify rurality differed by focus area of studies, including costs, quality, and access to care. Lastly, we examined the number of rural categories used by authors to assess rural areas. Findings: In 103 included studies, five different geographic units and 11 definitions were used to measure rurality. The most common geographic units used to measure rurality were county (n = 59, 57%), which was used most frequently in studies examining cost (n = 12, 75%) and access (n = 33, 57.9%). Rural Urban Commuting Area codes were the most common definition used to measure rurality for studies examining access (n = 13, 22.8%) and quality (n = 10, 44%). The majority of included studies made rural versus urban comparisons (n = 82, 80%) as opposed to focusing on rural populations only (n = 21, 20%). Among studies that compared rural and urban populations, most studies used only one category to identify rural locations (n = 49 of 82 studies, 60%). Conclusion: Geographic units and definitions to determine rurality were used inconsistently within and across studies with an HSR focus. This finding may affect how health disparities by rural location are determined and thus how resources and federal funds are allocated. Future research should focus on developing a standardized system to determine under what circumstances researchers should use different geographic units and methods to determine rurality by HSR focus area.Item Self-Stigma vs. Perceived Public Stigma Toward Mental Illness in Rural Adults(2024-04-26) McCreary, Brent; Danek, Robin; Ireland, Ellen; Reyes, EricIntroduction: Mental illness is a clinically significant behavioral or psychological condition1. Stigma toward mental health comes in two primary forms: Self-stigma and perceived public stigma. Purpose: The objective of this study is to quantify the amount of stigma toward mental illness in rural adults and analyze differences in stigma across demographic groups. Methods: Adults were offered a 14-item questionnaire at five different sites from January 2023 to April 2023. Rural distinctions were made based on participants' reported county of residence following the Indiana Office of Community and Rural Affairs (OCRA) definition of rurality. Demographic information such as age, gender, marital status, total household income, and highest level of education were also obtained. Results: Rural adults experience mild amounts of self-stigma (14.52 +/- 5.0) and moderate amounts of perceived public stigma (18.4 +/- 4.3). Adults aged 46-65 experience more significant levels of perceived public stigma when compared to those of younger participants. An inverse relationship exists between the highest level of education and self-stigma towards mental illness. Seventy two percent of respondents agreed or strongly agreed with the statement, “In general, others believe that having a mental illness is a sign of personal weakness or inadequacy.” Conclusions: This study demonstrates that perceived public stigma toward mental illness presents a significant barrier to care for mental illness. Adults aged 46-65 are especially vulnerable to the perceived public stigma toward mental illness. To provide the largest benefit to rural populations, anti-stigma campaigns should focus on perceived public stigma among adults aged 46-65.Item Unmet mental health need and subsequent substance use in individuals with a history of depression: Are there differences between metro and nonmetro areas?(Wiley, 2023-07) Danek, Robin; Blackburn, Justin; Greene, Marion; Mazurenko, Olena; Menachemi, Nir; Health Policy and Management, School of Public HealthBackground and Objectives More than nine million U.S. adults have a co-occurring mental health and substance use disorder. The self-medication hypothesis suggests that individuals with unmet need may alleviate the symptoms of their mental illness by using alcohol or drugs. We examine the relationship between unmet mental health need and subsequent substance use among individuals with a history of depression as well as differences in metro and nonmetro areas. Methods We used repeated cross-sectional data from the National Survey on Drug Use and Health (NSDUH), 2015–2018 after identifying individuals with depression in the past year (n = 12,211). We used logistic regressions with interaction terms to examine the association between unmet need for mental health care and substance use by geographic location. Results Unmet mental health need was associated with increased use of marijuana (odds ratio [OR] = 1.32, 95% confidence interval [CI]: 1.08–1.64), illicit drugs (OR = 1.75, 95% CI: 1.19–2.58), and prescription drugs (OR = 1.89, 95% CI: 1.19–3.00) among individuals with depression, which did not vary by geographic location. Unmet need was not associated with increased heavy alcohol drinking (OR = 0.87, 95% CI: 0.60–1.26). Discussion and Conclusions No differences in substance usage between metro and nonmetro populations were observed for those with an unmet need for mental health care. We found support for the self-medication hypothesis among individuals with depression with respect to alcohol. Scientific Significance We examine whether individuals with depression and unmet care needs are more likely to self-medicate with substances including prescription drugs. Due to higher unmeet needs in nonmetro areas, we examine whether the likelihood of self-medication differs in metro and nonmetro areas.