Health Researcher Profile: April 25, 2019
A paper focusing on part of the Thorsens’ research, “Measuring efficiency of community health centers: A multi-model approach considering quality of care and heterogeneous operating environments,” was published recently in Health Care Management Science. Other co-authors on the paper were Ronald G. McGarvey and Rohith Madhi Reddy, both from the University of Missouri.
Evidence of growing health inequalities in the United States underscores the critical importance of federally qualified health centers for improving health outcomes and equity, Maggie Thorsen noted. However, while the health centers generally target disadvantaged and underserved populations who are at a higher risk for poor health, there is considerable variation across these centers in terms of the populations they serve and the environments in which they are located. For example, a federally qualified health center serving low-income patients in rural Montana may face different challenges than a federally qualified health center in New York City.
Variations in the health centers may lead to variations in patient outcomes as well, according to Andreas Thorsen. That’s why one of the goals of the Thorsens’ pilot project is to understand differences among the centers in terms of efficiency, quality of care, and pregnancy-related health outcomes and disparities.
A second goal of the project is to conduct an analysis of pregnancy-related health care facilities located in Montana.
“Access to obstetric services in rural areas in Montana and across the nation is diminishing,” Andreas Thorsen said. “This is a big issue, particularly in Montana. We’re looking at how we could reduce driving times for certain populations. For example, if we see an area of the state that’s high-risk, we might consider expanding or adding facilities. Could we identify optimal places for those facilities?”
Alex Adams, M.D., Ph.D., director and principal investigator for CAIRHE, said the Center is excited to support the Thorsens’ important research. Their pilot project will inform a larger research project, led by Andreas Thorsen as PI and Maggie Thorsen as Co-Investigator, that will be part of CAIRHE’s next phase of NIH funding, to begin September 2019. “I believe their work will make a significant contribution toward improving health equity for rural mothers and their infants,” Adams said.
Maggie Thorsen said the current pilot project benefits from an innovative interdisciplinary approach—an approach that will continue in the scaled-up project. “Eventually, our aim is to develop an interactive mapping application so we could take results of our analyses and have a user-driven system where stakeholders could look at this, understand what’s happening in their communities, and figure out how solutions could impact them,” he said. “They could understand how to better increase access and improve health outcomes.”
The hope is that a better understanding of the centers’ unique challenges, as well as their outcomes, will ultimately help experts devise a system that improves patient outcomes, Maggie Thorsen said.
“If we can better understand factors that impact the health of our youngest members of society, then this has implications for their health across their life course as well as their outcomes in other domains,” she said.
National Rural Health Activity Winner: Richland County Communities in Action
The Montana Office of Rural Health invited health organizations, schools and rural communities to sponsor National Rural Health Day Activities to celebrate the power of rural and help transform this day into a movement! Participants were asked to share photos and descriptions of the activities their organization sponsored for NRHD to be entered into a drawing for $100.
Richland County Communities in Action has been in place for over a decade, working through Action Groups to address community needs and build a healthy community. This program and its Action Groups envision Richland County as being a healthy, clean and safe place for families and individuals to grow.
Richland County Communities in Action’s description: “To celebrate National Rural Health Day this year Communities in Action decided to integrate an activity into the Richland County Strategic Planning Conference on November 13th. We wanted something that brought attention to rural health while also being interactive for the group. Our AmeriCorps members decided on a giant puzzle of Richland county, where each community member at the conference would get a piece, showing how we all make up our collective community. On the puzzle pieces we asked everyone to write or draw their answer to the question “What makes a healthy community?”. We purposefully left the instructions vague so that we would get a variety of responses. As the pieces were completed, we began hanging them up during the conference. In the end we got a beautiful mixture of what our community believes makes up our healthy rural community. We plan to get the poster laminated and hang it somewhere public for the community to see and cherish”.
Congratulations Richland County Communities in Action and thank you for your submission!!!
To learn more about Communities in Action, check out their website here!
Health Researcher Profile
Montana INBRE investigator, Mark Schure, addresses Montana’s high suicide rate using modern tools and technology.
Over a decade’s worth of statistics show that Montana, predominantly a rural state, consistently ranks among the highest – if not the highest – per capita suicide rates in the US. Montana State University associate professor and Montana INBRE investigator, Mark Schure, has spent the past few years responding to the crisis.
According to Schure, people living in Montana’s more rural corners are among the most at risk in the state due, in part, to poor access to traditional forms of mental healthcare. Schure says that the ripple effects of suicide reach virtually everyone in the state on one level or another.
“Most people living in Montana just don’t have access to the same resources commonly available in more urban areas,” he said. “That’s one of the reasons our project is so critical.”
Initiated from MSU’s Center for Mental Health and Research Recovery and supported by a grant from Montana INBRE, the project Schure and his team have been field testing is modified version of an Internet-based mental health intervention called Thrive. Originally developed by Waypoint Health Innovations, Thrive is a computerized Cognitive Behavior Therapy (cCBT) program designed to help persons positively cope with depression and anxiety symptoms.
Schure says that programs like Thrive can help rural Montanans
overcome common barriers that can prevent people from getting help – barriers such as the cost of traditional care, the perceived stigma of receiving counseling services, and the long distances between where Montana’s live and where appropriate health care can be found.
“Basically, anyone who has regular access to high speed internet and has a Thrive account can use the program,” said Schure. “That’s a useful tool in a place like Montana where the nearest town can be dozens of miles away along a bumpy dirt road.”
According to Schure, Thrive uses programmed algorithms to curate tailored educational videos based on the user’s input regarding how she or he is feeling and doing. The videos provide information, guidance, and feedback to the user on ways to improve their mental wellbeing – feedback that Schure says can make a difference.
“Thrive gives depressed people the tools to cope and avoid situations from getting worse,” he said. “From a public health perspective, we look for interventions that prevent poor health outcomes and lower quality of life.”
To test whether Thrive could work in Montana, Schure partnered with MSU Extension faculty, Sandy Bailey, and non-profit organization, One Montana, to demo the program. The goals of the demo were to gauge how well the program reduced depression and anxiety symptoms within a Montana-specific context and to develop a waitlist for a future randomized controlled trial. In 2016, the research team conducted focus groups and key informant interviews throughout the state to understand community members’ perspectives on Thrive’s potential to help with depression.
“The focus groups and interviews were helpful in developing new videos that would better resonate with rural Montanans,” Schure said. “We call the modified program Thrive-Montana in part to help convey that specific placed-based relevancy for participants.”
After those adaptations, Schure’s research team then worked with MSU Extension agents to identify and use community-specific ways to effectively recruit study participants. They set an initial goal of recruiting 464 adult Montanans, and all aspects of the trial, from screening to intervention to evaluation, were conducted online.
Preliminary results of that study are just starting to take shape.
“The first phase evaluation outcomes have been positive, showing overall short-term marked improvements in depression and anxiety symptoms,” said Schure. “We’re also seeing improvement in participants’ ability to function better socially and in psychological resilience – a belief in one’s ability to cope during adversity.”
He added, “A program like this can never really replace [in-person talk therapy], but can offer additional ways to learn positive coping skills.”
Schure says that evidence from the current Thrive trial has helped secure funding for suicide prevention programming with the Montana Department of Public Health and Human Services in Helena. He anticipates that these funds will allow his team to offer the Thrive-Montana program for free to 1,000 additional adult Montanans in the coming years. The plan, says Schure, is to dig deeper and rigorously test whether the program can reduce suicidal thinking.
In addition, Schure is also working with a communications company to develop tailored marketing messages and strategies that can effectively reach individuals who are most at risk for suicide and could benefit from the program.
“What’s really exciting is that if we build on the current momentum of providing evidence-based mental health programs in this state, we will significantly raise awareness of mental health and increase our opportunity to make a
meaningful impact,” he said.
Going forward, Schure plans to apply for additional National Institutes of Health funding in order to expand on his work with Thrive and similar type mental health interventions.
“[Montana] INBRE has been essential for laying the groundwork for a larger NIH proposal,” he said.
Schure is also interested in projects that pilot non-traditional therapies – a push he views as an opportunity to examine innovative interventions that have the potential to help address stress and positively impact a variety of mental health issues. In this vital work, Schure anticipates rich collaborations with other researchers with multiple skillsets and similar passions.
“Traditional evidence-based methods have great utility,” he said, “but there are so many other promising avenues to examine.”
Research reported in this story was supported by the National Institute of General Medical Sciences of the National Institutes of Health under Award Number P20GM103474. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Find out more about Montana INBRE here!
Spring 2018 Basic X-Ray Techniques Workshop
Sponsored by: Eastern Montana AHEC & RiverStone Health
Event Date/Times: March 9-10-11-12 & continues March 23-24-25-26, 2018. Class times run 8:00am – 6:00pm
Event Location: RiverStone Health, 123 South 27th Street Billings, MT 59101
Registration fee per person: $1315.00 (includes all workshop materials provided by instructors and refreshments during workshop, participants are responsible for the purchase of the textbook)
Event Description: This training is designed for those preparing to become a licensed Limited Permit Holder in Radiology in Montana. This workshop is the required 104 hours of training approved by Montana for licensure eligibility. The course follows the (ARRT) American Registry of Radiologic Technologists content specifications and will prepare those taking the ARRT National Registry Exam. This workshop is a great way to become cross-trained for your facility, to start a new career path or a great way to refresh your skills as a radiographer. All participants are responsible for setting up their own clinical site after the completion of the training. A basic knowledge of human anatomy/terminology will help but is not a prerequisite for the workshop.
Registration deadline is February 16, 2018
Website: The brochure/registration form is available on the RiverStone Health website at https://riverstonehealth.org/basicxrayapp
Contact: Please contact Nikole Bakko for more information or questions. 406-247-3284 or at firstname.lastname@example.org
National Rural Health Day 2017
Rural health photo contest winners:
1st place- “DePuydt Farm-Saco, MT” by Janiel Olson
2nd place- “Plaid and alfalfa” by Kailey Foster
3rd place- “Enjoying the beautiful MT trails” by Olga Bobko
The Rural Health Initiative received a proclamation from Governor Bullock and Senator Daines sent us a video explaining how rural health is important to Montana. Click here to learn more about how we celebrated NRHD!
Congratulations to our May 2017 Mental Health Awareness Photo Contest Winner, Amy Nelson!
She improves her mental health by adventuring and exploring!
Thank you to all participants who submitted photos!
Congratulations to our Montana Healthy Communities Mini-Grant Winners!
- The River Valley Farmers Market- Hardin, MT
- Richland County Backpack Food Program- Sidney, MT
- Diabetes Self-Management Education- Big Timber, MT
- Waukesha Garden Hoophouse- Helena, MT
- Food for Thoughts Counseling Program- Red Lodge, MT
- Chemo Care Packages- Forsyth, MT
- Parents as Leaders- Missoula, MT
- Kids in Motion: Bicycle Light Project- Billings, MT
Thank you for your submissions!
In honor of National Rural Health Day, the Montana Office of Rural Health/AHEC and Montana Rural Health Association is pleased to announce the Dr. Frank Newman Rural Health Award winners. Dr. Newman represented the spirit of Montana in nearly 50 years of service to rural communities and healthcare in our state. The nominees who most exemplify what Dr. Newman represented are as follows:
Frank Newman Rural Clinician Leadership Award- Dr. Greg Rice of Libby, Montana. Nominated by Dr. Jay Erickson
Frank Newman Rural Health Leadership Award- Dr. David Mark of Hardin, Montana. Nominated by Cindy Stergar and Mary Helgeson
Frank Newman Health Equity Award: Alma Knows His Gun McCormick, Executive Director of Messengers for Health, an Indigenous non-profit organization dedicated to improving health of individuals on the Apsaalooke Reservation. Nominated by Suzanne Held
Frank Newman Future of Rural Health Award- Kayla Schmid of Dillon, Montana. Nominated by Lisa Benzel
Frank Newman Rural Health Lifetime Achievement Award- Edith Clark of Sweetgrass, Montana. Nominated by Shani Rich
Congratulations and thank you for your dedication to improving health in rural Montana!
The Montana Rural Health Initiative hosted 3 contests to celebrate the #PowerOfRural
Health Care Careers Interview Contest
Check out their creative video submission below:
Kaycee is in the fifth grade and is interested in becoming a nurse!
Rural Health Photo Contest Winner
Lorette Carter is our National Rural Health Day photo contest winner!
Dr. Frank Newman Rural Health Award
The National Organization of State Offices of Rural Health sets aside the third Thursday of every November – November 17 of 2016 – to celebrate National Rural Health Day. National Rural Health Day is an opportunity to “Celebrate the Power of Rural” by honoring the selfless, community-minded, “can do” spirit of that prevails in rural America. It also gives us a chance to bring to light the unique healthcare challenges that rural citizens face – and showcase the efforts of rural healthcare workers.
In honor of National Rural Health day, the Montana Office of Rural Health & Area Health Education Center is holding two fun contests to help raise awareness about the importance of rural health!
Health Care Careers Interview Contest
Recognizing healthcare workers and giving students a chance to explore healthcare careers!
Seeking students who are interested in healthcare! Do you know or want to know more about someone in your community who works in healthcare? Want to find out more about a certain healthcare position? Now you can! We are asking students to:
- Identity a local healthcare professional you want to recognize
- Snap a photo of them in their working environment
- Ask the health care professional the following questions:
- How did you become interested in your health career?
- What are the benefits of working in a rural community?
- What do you love about working in a rural community?
- Record their answers, and include a paragraph of why you think health care careers in rural areas are important.
- Submit your photo and answers via email to us at:
Please include the healthcare professional’s name and organization they work for, your first and last name, school, grade level, and tell us what health career path you are most interested in.
Two prize divisions:
Students in grades K-6 -and- Students in grades 7-12
1st place winners in each division will be awarded a $50 Amazon gift card!
Submission Deadline is November 11, 2016
Winners will be announced on National Rural Health Day!!!
Rural Health Photo Contest
The National Rural Health Day Photo Contest is an opportunity for you to be creative, and show us what rural means to you! You may choose to do this by snapping a photo highlighting your favorite Montana pastimes or showcasing the beauty of your rural community!
Submission Deadline is November 11, 2016
Citizens within Montana are eligible to enter the contest. Each photo/caption is one submission, you may submit up to 3 photos. All photos must have been taken in Montana and must be taken by you.
To submit a photo, send as high resolution version of the photo in a .jpeg, .gif, or .tif file format to:
Include a caption of the photo, where the photo was taken, your name, e-mail address, and phone number.
Adult Division (18 & Over)
1st Place – $50 Amazon gift card
2nd Place – $25 Amazon gift card
3rd Place – $25 Amazon gift card
Youth Division (17 & Under)
1st Place – $50 Amazon gift card
2nd Place – $25 Amazon gift card
3rd Place – $25 Amazon gift card
Contest winners will be notified on National Rural Health Day (November 17, 2016). If we are unable to reach the winner, the entry will be forfeited and the selection committee may choose a different winner. All photos will be posted on the RHI Facebook and Instagram page.
By submitting a photo you agree to RHI’s
Images submitted must be royalty-free. By submitting a photo, you understand you give the rights and permission of the photo to be used by the RHI and AHEC offices. Photos not meeting this requirement will not be eligible for prizes and will be disqualified from the National Rural Health Day Photo Contest.
2015 NATIONAL RURAL HEALTH DAY CONTEST WINNER!
Alexander Cruz Martinez
For George Clow, the biggest challenge of working in the rural community is that they are primarily a volunteer organization and it is hard to find skilled volunteers.
“One of the big challenges we have is making sure we have enough volunteers to cover 24 hours a day, seven days a week, 365 a year” says Clow. “One of the biggest challenges we have is being sure that we not only have enough people to staff those calls, but we count on our volunteers to have the skill sets to be able to deal with any type of medical emergency that they are going to find” said Clow. The tourists also can be challenging. More tourists can equal more accidents. “We have ski mountain, Beartooth Pass, and a number of things that draw tourists to visit and as a result we have a lot of ambulance calls, medical as well as trauma” says Clow.
They have about three full time paramedics to respond to the city of Red Lodge. Another challenge is the mountainous region. It is challenging to respond to people that are lost or injured in the woods or mountains.
Mr. Clow also said “I think what we all get out of it is really that sense of really helping people, you are doing something that nobody else can do,” says Clow, “People I work with I know we all are looking to help somebody.” They receive a lot of thank you cards and cookies and gifts from families and relatives. That’s one of the best parts of the job.
Congratulations, Alexander! And thank you Mr. Clow for all your hard work and dedication to the Red Lodge Fire Rescue Organization.
Want a chance to win money for your school AND for yourself?
Help Us Celebrate Rural Montana Healthcare Careers!
- Identity a local healthcare professional you want to recognize
- Snap a photo of them in their working environment
- Ask them the following questions:
- what are the challenges of working in a rural community?
- what are the benefits of working in a rural community?
- Record their answers
- Submit your photo and answers via email email@example.com
- Make sure to include the healthcare professional’s name and organization they work for
- Include your name, school, and grade level
- And don’t forget to tell us what career path you are most interested in!
How to Enter
We look forward to your submission!
Rural Health and Wellness Summer Photo Contest 2014!
What is the Rural Health and Wellness Summer Photo Contest?
The MontanaRHI is holding its first Summer Photo Contest to give you, and your community, an opportunity to visually share how you are staying healthy this summer. Wellness is the key theme, which encompasses (but not limited to) components like nutrition and physical activity. So, make sure to snap a photo as you tend to your garden or while you are out enjoying our Montana summer!
Our Summer Photo Contest has two categories: Individual and Community. Individuals are encouraged to submit photo’s that are specific to their personal healthy behaviors, and community members are asked to share with us what their community is doing that fosters local health and wellness. Please submit your Individual and Community photos with a title and paragraph explaining the details of your photo. Location of where the photo was taken must be included in the paragraph. Each photo will also be submitted for our annual Rural Health Photo Contest, which honors National Rural Health Day on November 21.
Contest Deadline and Eligibility:
For the months of June, July and August, we will pick both a Community and Individual winner. At the very end of the contest, a Community and Individual grand prize award will also be given. Submissions of photos for the monthly contest will be accepted until the last day of each summer month – Monday, June 30, Thursday, July 31 and Sunday, August 31. Throughout the three months, all submitted photos will be eligible for the grand prize award. Citizens within Montana are eligible to enter the contest. Each photo is one submission; however, you may submit as many photos as you would like. Employees of the Area Health Education Center /Montana Office of Rural Health are not eligible participants for this contest.
For the months of June, July and August, one Individual and one Community winner will be awarded a $25 Amazon gift card. One Individual photo and one Community photo will additionally be chosen for a $100 Amazon gift card grand prize award. The winners will be announced the following week of each monthly deadline.
Please email your rural health photos and descriptions to the Montana Rural Health Initiative at firstname.lastname@example.org. Participants can also post their submissions on Montana’s Rural Health Initiative Facebook page at https://www.facebook.com/MontanaRHI. Please indicate if RHI has permission to share your story on our social media outlets.
A panel of judges from the Montana Office of Rural Health will critique the photos based on creativity and how well they encompass healthy living. Each submission will be posted on our Facebook page, and our Instagram account (Montana RHI), where followers will be encouraged to ‘like’ their favorite post. Based off the number of ‘likes’ each photo receives and the input from our judges, a winning photo will be selected. A winning photo will capture the meaning of rural Montana health and wellness in a totally unique way. Need some inspiration or ideas? Check out our photo submissions from last year’s National Rural Health Day Photo Contest here!
The Montana Arthritis Program Mini-Grant Opportunity
The 2014 Excellence in Worksite Health Award Cycle Opens January 13, 2014!
The Montana Worksite Health Promotion Coalition (MWHPC) has sponsored the Excellence in Worksite Health Awards since 2007. These awards recognize businesses, schools, and other organizations whose wellness programs meet a certain wellness criteria. The awards are broken down into levels, Bronze, Sliver and Gold. Award categories build on one another with the Bronze Award going to a more basic wellness program and the Gold Award going to more comprehensive wellness initiatives. To learn more about these awards, the application process, the criteria, or to view the 2012 winners please visit the MWHPC website. If your worksite has a great wellness program or you know of an organization with a strong wellness program, we encourage you to apply for this wonderful award!
The RHI is hosting 2 National Rural Health Day Contests this year!
RHI’s Rural Health Success Story Contest
What is the Rural Health Success Story Contest? The Montana RHI is holding a National Rural Health Day Success Story Contest to give you an opportunity to share a story about how rural health has successfully helped a community in Montana.
RHI’s Rural Health Photo Contest
What is the Rural Health Photo Contest? The Montana RHI is holding its first National Rural Health Day Photo Contest to give you an opportunity to share, visually, what rural health means to you. Please submit your photo with a title and caption including the location of where the photo was taken. Contest Deadline and Eligibility: Submissions of photos will be accepted until 12:00 pm (MST) on Wednesday, November 20, 2013. Citizens within Montana are eligible to enter the contest. Each photo is one submission; however, you may submit as many photos as you would like. Prizes: The top three photo contest winners will be awarded a $25 Amazon gift card. The winners will be announced on National Rural Health Day: November 21, 2013. Judging: A panel of judges from the Montana Office of Rural Health will critique the photos based on creativity and how well they capture rural health in Montana. A winning photo will illuminate the meaning of rural health in Montana in a totally unique way. Need some inspiration or ideas? Check out the Centers for Rural Health National Rural Health Day Photo Contest submissions from 2011 here. Submission instructions for both contests: Please email your rural success stories or photos to the Montana Rural Health Initiative at email@example.com. Please indicate if RHI has permission to share your story on our website (http://montanaruralhealthinitiative.info/).
Prevention Means Business Infographic from the Prevention Institute
Nominate someone for a Health Hero Award!
ERM and AFHK would like to recognize individuals and/or public and private organizations that go above and beyond their job duties to promote health in Montana through nutrition and physical activity. If you know someone deserving such recognition, please submit a nomination describing how the nominee has made a noteworthy contribution to their organization, local community, or the state as a whole. Letters of nomination should include specific activities that warrant the award.
Please consider the following when making a nomination:
- Worked on a policy, program, project, or promotion to encourage healthy nutrition and physical activity choices and behaviors including but not limited to:
- Increasing access to healthy food choices or nutrition program participation
- Alleviating or decreasing hunger in the community
- Increasing access to physical activity for kids, families, or communities
- Advocating for workplace changes to support healthy choices
- Went beyond the normal requirements of the job
- Employed a creative or innovative method to overcome a problem
- Maximized limited resources
Deadline: Monday, July 10, 2013
ERM and AFHK will announce the awards in August and present the awards at Build a Stronger Montana: End Childhood Hunger Conference September 23-24 at Montana State University in Bozeman (www.montana.edu/cs/conferences/endchildhunger).
Thank you for taking the time to recognize those who work to improve health in our state. Please return the ERM AFHK Award Nomination Form May 2013 via email, fax, or mail to the contact information below:
Julie Middleton, Awards Committee Chair
Fax: (406) 994-5653 l Phone: (406) 994-5310
PO Box 170520
Bozeman, MT 59717
SAVE the DATE
September 23-24, 2013 at Montana State University, Bozeman
This Summit will:
- Highlight the experiences hungry children deal with in the Montana
- Showcase the Best Practices that are working to help hungry children
- Demonstrate pathways to ending child hungry in the community
- Promote community groups to identify their own needs, provide tools and help them develop plans for implementation in their towns, cities and counties.
- Enhance networking between participants across social, cultural and economic borders
- Show the connection between children’s health and their futures as well as the economic viability of the state and communities
Approximately 200-250 stakeholders from diverse public and private sectors will gather to learn about childhood hunger in Montana through pre-conference site visits, excellent presentations, networking, and round table discussions. An opening keynote will highlight the purpose of the Summit, provide background information about hunger in Montana and the United States, and motivate Summit participants to learn strategies to bring back to their own Montana communities.
Farm to Cafeteria Programs Across Montana
The Farm to Cafeteria Network, a project of NCAT, recently completed a survey of 35 institutions in Montana including healthcare facilities, correctional facilities, K-12 schools, and colleges. Check out the great map for information on where and how the institutions are utilizing local food systems.