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Traditionally, Chinese families have been the primary provider of care for older adults, and older people expected family care. However, along with the modernization and demographic transition, family functions have been weakened, and state-based care has begun to play an essential role in supporting family care for older people. This paper aims to assess the care preferences of older people and the different responsibilities of individuals and communities in modern China. Using data from the 2014 China Longitudinal Aging Social Survey (CLASS) and multinomial logistic regression modeling, we find that family care remains the cornerstone for older adults and their care preferences are associated with individual and community factors, mainly including the number of children, education level, residential area, the presence of health infrastructure and care facilities, and the values associated with filial piety of older adults. [ABSTRACT FROM AUTHOR]

Introduction: Rural and under-resourced urban communities face unique challenges in addressing patients' social determinants of health needs (SDoH). Community health workers (CHWs) can support patients experiencing social needs, yet little is known about how rural and under-resourced primary care clinics are screening for SDoH or utilizing CHWs. Methods: Interviews were conducted with primary care clinic providers and managers across a geographically large and predominately rural state to assess screening practices for SDoH and related community resources, and perspectives on using CHWs to address SDoH. Interviews were conducted by phone, recorded, and transcribed. Data were analyzed using thematic analysis. We completed interviews with 27 respondents (12 providers and 15 clinic managers) at 26 clinics. Results: Twelve (46.1%) clinics had a standardized process for capturing SDoH, but this was primarily limited to Medicare wellness visits. Staffing and time were identified as barriers to proper SDoH screening. Lack of transportation and affordable medication were the most cited SDoH. While respondents were all aware of CHWs, only 8 (30.8%) included a CHW on their care team. Perceived barriers to engaging CHWs included cost, space, and availability of qualified CHWs. Perceived benefits of engaging CHWs in their practice were: assisting patients with navigating resources and programs, relieving clinical staff of non-medical tasks, and bridging language barriers. Conclusions: Rural and under-resourced primary care clinics need help in identifying and addressing SDoH. CHWs could play an important part in addressing social needs and promoting preventive care if financial constraints could be addressed and local CHWs could be trained. [ABSTRACT FROM AUTHOR]

Rural school nurses are on the front lines of providing health care for children and families in rural Colorado, but there is little research from their perspective. To fill this gap, a descriptive phenomenological study examined the experiences of nine rural school nurses through in-person audiotaped interviews. Analysis of data revealed three main themes: (1) rural school nurses' efforts to meet students' extensive physical and mental health issues, (2) school nurses struggle to help rural students in extreme poverty, and (3) communication challenges experienced by rural school nurses. The findings of this study give voice to the experiences and challenges faced by rural school nurses in southern Colorado. [ABSTRACT FROM AUTHOR]

Relatively few studies have explored domestic violence from a multiplicity of African American perspectives, experiences, and socio-demographic backgrounds within rural African American communities. Community–based participatory action research methods were used to explore domestic violence perceptions of African Americans with heterogeneous backgrounds and experiences of violence. Ten focus groups were held throughout the community with 52 diverse women (n = 33) and men (n = 19) living in the northwest region of Arkansas. Demographic data were collected from 47 women (n = 28) and men (n = 19) participating in focus groups regarding their perceptions and experiences of domestic violence, media messages, help-seeking behaviors, and services. Data were analyzed using grounded theory methods. Three major themes emerged, including (a) a heightened awareness of race, gender, and class differences; (b) imbalanced and mixed messages from media; and (c) multi-systemic dynamics influencing abusive behavior and relationships. Results indicate that study participants' perspectives and experiences with domestic violence reflect a complex interrelated gamut of societal, community, familial, and individual dynamics. Participant recommendations related to interpersonal dynamics, media messages, and societal influences are reported with implications for practice, policy, and future research. [ABSTRACT FROM AUTHOR]