Performing Department
Family and Consumer Sciences
Non Technical Summary
The project entitled 'Assessing the potential of evidence-based design to improve the dlivery of health care in rural settings' will employ a variety of activities to determine how and if better design of rural health care faciltiies can lead to improved patient and provider outcomes in the rural setting. There is a growing body of knowledge that points to tangible and measurable facility related benefits in the urban care setting--namely well-funded hospitals and clinics that can avail themselves of cutting edge health care design expertise. As nearly 20% of health care in the United States is delivered in a rural setting, and as rural facilities are often in older and otherwise non-compliant buildings (such as old schools, churches, and modular structures that have exceeded their intended lifespans), and as rural health care budgets generally don't provide for the engagement of high-priced health care design expertise, and as rural health care administrators are often not well-versed in the field of evidence-based design, the door is open to an influx of knowledge that has the potential to move the needle on health care delivery in rural settings. This project builds upon two original pilot studies I conducted to assess the perceived facility related impacts to healthcare participation in six different populations in Appalachia: elderly, patients with disabilities, disability policy makers, caregivers of patients with disabilities, health care providers who treat patients with disabilities, and administrators of a rural health care system.
Animal Health Component
0%
Research Effort Categories
Basic
30%
Applied
30%
Developmental
40%
Goals / Objectives
The overarching goals of this proposal are to raise awareness of evidence-based design in the rural setting and to bring about a transfer of knowledge--urban setting to rural setting--fromthis burgeoning field. It is important that we find a way to bridge the knowledge gap as nearly 20% of health care is delivered in the rural setting where there are limited dollars for capital improvements. When there is funding for facility upgrades, those capital improvements should be maximized in order to help those facilities deliver the best care possible. My first published manuscript, "Impact of Design on Patient Participation in Healthcare in a Rural Health Clinic in Appalachia," Health Environments Research and Design Journal, 2017, highlighted a connection between the design of the physical facility and the participation of elderly patients in their own healthcare. My follow up study used a similar methodology and found additional connections on facillity and participation in a different population--those who identied as having a disability. My work over the next three years will build on the foundation I've established.
Project Methods
My primary methods will mix both qualitative and quantitative approaches.Qualitative methodology will consist of a continuation of my general inquiry via interviews and focus groups of different populations who access their healthcare in rural areas. I have done this successfully with six different populations on two separate, but related, studies. I conduct the interviews/focus groups, record the conversations, transcribe the recordings, and analyze the recordings, along with my notes, for patterns and themes.Quantitative methodology will consist of surveys I have developed and/or will develop from my qualitative findings. I will also make use of other validated facility assessments such as the previously mentioned Outpatient Health Clinic Usability Profile. I will also analyze regularly collected data from specific partner health care facilties that engage in pre/post-design change types of projects to see how participation is impacted. The participation metrics can be teased out with a variety of data: no show rates (appointment keeping) for starters. Patient's self-reported success with sticking to treatment /prevention regimens, and biometric data (such as blood pressure, weight loss, blood borne markers) collected by the health clinics can provide some longitudinal picture of potential impacts related to change of participation. I will explore the use of other relevant data collection tools as they are developed.