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The significance of post-secondary education is investigated for rural Newfoundland women enrolled in undergraduate liberal arts degree programs. Data collection for this research involved comprehensive, detailed semi-structured biographical interviews with rural women studying liberal arts disciplines during the 2006-2007 academic year at Memorial University of Newfoundland. The data analyses drew on theories of experiential and embodied knowledge, social constructionist theories of gender and place, and research on women, rurality, and post-secondary education. The findings indicate that, overall, a liberal arts degree is a part of a search for a new home for the women interviewed. Images and experiences of life as women in rural Newfoundland act as forces that push and pull the women to and from their homes, with varying impact. Although the women were very pleased with their choice of a liberal arts major, for most this choice did not dominate the significance of enrolling in university. (Contains 9 notes.)

In this duoethnography, two rural Canadian women explore personal memories, stories, and conversations to illuminate the factors involved in our willingness/unwillingness to change to become more climate conscious in our everyday lives. Rural areas remain understudied and face unique challenges in sustaining changes to become more climate conscious. This work presents the divergent narratives of one person (myself) striving to make significant changes to her life in light of the climate crisis and another who resists these changes. Together we attempt to answer the question, 'What motivates and/or prevents us from living climate-conscious lives?' Our answers provide depth and insight into the influence of identity, belonging, relationships, early formative educational experience, and place on one's beliefs, emotions, and actions for our changing climate. This study will be valuable for environmental educators seeking to effect social change, as it will offer real examples of the complicated and diverse contexts that affect opinions on the climate crisis and inform pedagogical practice. Through this, I call for environmental educators to critically reflect on the influence that their contexts play in informing their own climate beliefs, emotions, and actions. [ABSTRACT FROM AUTHOR]

Background: In the past fifteen years there has been a wave of closures of small maternity services in Canada and other developed nations which results in the need for rural parturient women to travel to access care. The purpose of our study is to systematically document newborn and maternal outcomes as they relate to distance to travel to access the nearest maternity services with Cesarean section capabililty. Methods: Study population is all women carrying a singleton pregnancy beyond 20 weeks and delivering between April 1, 2000 and March 31, 2004 and residing outside of the core urban areas of British Columbia. Maternal and newborn data was linked to specific geographic catchments by the B.C. Perinatal Health Program. Catchments were stratified by distance to nearest maternity service with Cesarean section capabililty if greater than 1 hour travel time or level of local service. Hierarchical logistic regression was used to test predictors of adverse newborn and maternal outcomes. Results: 49,402 cases of women and newborns resident in rural catchments were included. Adjusted odds ratios for perinatal mortality for newborns from catchments greater than 4 hours from services was 3.17 (95% CI 1.45-6.95). Newborns from catchments 2 to 4 hours, and 1 to 2 hours from services generated rates of 179 and 100 NICU 3 days per thousand births respectively compared to 42 days for newborns from catchments served by specialists. Conclusions: Distance matters: rural parturient women who have to travel to access maternity services have increased rates of adverse perinatal outcomes. [ABSTRACT FROM AUTHOR]

Determinants of health such as physical activity and social inclusion are key to the health of rural women, the basis of effective health promotion endeavors, and essential for rural community life. This study reports on a national curling and health study conducted with 48 rural women and girls ages 12 to 75 years in three provinces in Canada using the innovative photovoice method. Photovoice, with its inclusion of photos taken by study participants, provides a unique opportunity for pertinent data provision and comprehensive analysis by people living the experience. The purpose of the study was to examine the influence of curling on the health and community life of rural women. Study participants took pictures, recorded in log books, and participated in two group sessions to discuss the influence of curling on their health and community. Narrative and pictorial findings reveal important implications for rural women's sport participation; physical, mental, and social health; and the sustainability and development of curling and rural community life. Further research is needed to reveal the significance and address the sustainability of curling and its important contributions to rural health and rural communities. [ABSTRACT FROM AUTHOR]

Background: Our aim was to determine if cervical cancer screening uptake would increase among under-screened women living in rural Ontario, Canada, if at-home self-collected sampling for human papillomavirus (HPV) testing was offered as a primary cervical cancer screening modality, compared to invited papanicolaou (Pap) testing or routine opportunistic screening., Methods: Women 30-70 years of age who were overdue for cervical cancer screening were randomized to receive (1) an at-home self-collected HPV kit, (2) a reminder invitation for Pap testing, or (3) standard of care opportunistic screening. The first two arms were also asked demographic and screening history questions. Women randomized to arm 1 were asked about acceptability., Results: In total, 818 eligible women were identified in a small rural community in Southwestern Ontario: 335 received a self-collected HPV testing kit, 331 received a reminder letter, and 152 received standard of care. In the HPV self-collection arm, 21% (70/335) returned the sample and questionnaire and 11% (37/335) opted to undergo Pap testing. In total, 32% from the HPV self-collection arm, 15% (51/331) from the Pap invitation arm, and 8.5% (13/152) with standard of care were screened. Women receiving the self-collected HPV kit were 3.7 (95% confidence interval 2.2-6.4) times more likely to undergo screening compared to the standard of care arm. In the HPV self-sampling arm, 80% (56/70) said they would be very likely to choose self-collected sampling in the future., Conclusions: Providing self-collected sampling for HPV testing was more effective than sending reminder letters to increase screening coverage in under-screened women.

Representatives from community and volunteer organizations (N = 37) in a rural region of Nova Scotia were interviewed on their views of the causes, prevention and treatment of depression in rural women. Utilizing a qualitative analysis, five themes were identified in their responses: the needs and stresses of women with depression; the problems of women in rural areas; obstacles and barriers to accessing services; the inadequacy of treatment services; and recommendations for improving prevention and treatment. The findings suggested that community service providers were consistent in their views of the needs and stresses of depressed women in rural areas and the kinds of services that would remedy them. Making community service providers aware of the consistencies in their views may promote more interagency cooperation and the development of community-centered approaches to the treatment of depression in rural women. [ABSTRACT FROM AUTHOR]

Rural communities across the circumpolar region and worldwide perennially suffer from physician shortages despite decades of attempting targeted strategies for recruitment. Particularly in rural Canada, financial incentives have attracted but not retained a medical workforce. Although the importance of social connection or belonging is a long-established source of well-being, such information has not infiltrated the dialogue or action on physician retention in rural areas. A physician’s sense of belonging, arising from that emotional need for social connectedness, is built via bilateral active efforts at community engagement, reciprocity, social integration of family and workplace collegiality. Links between rural upbringing, rural training opportunities and subsequent rural practice likely rest upon fostering this sense of belonging. Policymakers and recruiters might consider how to help physicians adapt, “fit in”, and consider they have “come home” when they venture off to rural settings. Empowering the community to be involved in the recruitment and retention of rural physicians may also be effective. Perhaps this approach would better address the age-old battle to retain physicians in rural Canada and around the world. [ABSTRACT FROM AUTHOR]

Relatively little research has been carried out on the health and supportive care needs of rural women living with breast cancer. In this study, results from a Canadian focus group study are used to highlight issues of importance to rural women. A total of 276 rural women with breast cancer divided into 17 focus groups participated in the study conducted across Canada . A standardized protocol for discussion was employed. Issues of access to information, support and services were discussed, with women describing their experiences in trying to find appropriate programmes and services. The major theme identified through analysis of qualitative data was ‘becoming aware of and/or gaining access to health care information, support and services.’ Other major themes included: (1) dealing with isolation; (2) having to travel; (3) feeling the financial burden and (4) coping with changing work. Rural women with breast cancer have supportive care challenges related to their circumstances. A series of recommendations were generated through the consultation process which are contributing to the development of a national strategy focusing on the development and extension of programmes for rural women with breast cancer. Although the research on the project was not to specified standards, and suffered from less attention than community capacity building and advocacy, it proved to be of worth and revealed potential benefits from collaborations between researchers and community organizations . [ABSTRACT FROM AUTHOR]

The article discusses the needs and issues surrounding rural women in Canada regarding pharmacologic information and therapy. It examines the needs and issues regarding drug-related information and prescription and nonprescription pharmaceuticals. It applies a qualitative research of interpretive description using in-depth semistructured face-to-face interviews with 20 women aged 17-88 years who lived in rural southwestern Ontario.

Objectives: Although there has been a devolution of local rural maternity services across Canada in the past 10 years in favour of regional centralization, little is known about the health outcomes of women who must travel for care. The objective of this study was to compare intervention rates and outcomes between women who live adjacent to maternity service with specialist (surgical) services and women who have to travel for this care., Methods: The BC Perinatal Database Registry provided data for maternal and newborn outcomes by delivery hospital for 14 referral hospitals (selected across a range of 250-2500 annual deliveries) between 2000 and 2004. Three hospitals were selected for sub-analysis on the basis of almost complete capture of the satellite community population (greater than 90%) to avoid referral bias., Results: Women from outside the hospital local health area (LHA) had an increased rate of induction of labour compared with women who lived within the hospital LHA. Sub-analysis by parity demonstrated that multiparous women had increased rates of induction for logistical reasons., Conclusion: Rural parturient women who have to travel for care are 1.3 times more likely to undergo induction of labour than women who do not have to travel. Further research is required to determine why this is the case. If it is a strategy to mitigate stress incurred due to separation from home and community, either a clinical protocol to support geographic inductions or an alternative strategy to mitigate stress is needed.

This report is a review of studies that focus on rural breast cancer survivorship. It includes a total of 14 studies using large databases and 27 other studies using qualitative and quantitative methods. In our review of this literature, we identified four broad themes, including access to treatment and treatment type, medical providers and health information, psychosocial adjustment and coping, and social support and psychological support services. We review the findings of the rural breast cancer survivorship studies within each of these broad themes. A few of the findings of the review include that rural and urban women receive different primary treatments for breast cancer, that rural women may have greater difficulty negotiating their traditional gender roles during and after treatment, that rural women desire greater health-related information about their breast cancer, and that rural women have less access to mental health therapy. The review discusses the implications of these findings as well as the weakness in the literature., ((c) 2007 John Wiley & Sons, Ltd.)

Objective: To explore the impacts and implications of health reform/renewal for rural women in Saskatchewan and Manitoba, Canada. Design: The study was a multiple case study approach using mixed methods of focus groups, individual interviews, and trends/utilization analysis. Setting: Three rural communities – two in Saskatchewan; one in Manitoba. Participants: Rural women; non-health providers. Interventions: None. Outcome Measures: None. Results: This paper presents a four phase Integrated Community Policy Uptake Model which is derived from the experiences of rural women during the operationalizing of health reform policy. The model depicts a four phase integration of the health reform or renewal policy; specifically, ‘Taking In’, ‘Taking On’, ‘Taking Over’, and ‘Taking Beyond’. The Integrated Community Policy Uptake Model is firmly rooted in the perceptions and opinions of rural women, and is informed by their understanding of health policy. Conclusion: The involvement of rural women in the policy process is necessary. The model proposed potentially encourages women to become more directly engaged in future health policy making and planning. There is also significant potential for this model to inform decision makers of the perceptions, needs, and solutions offered by stakeholders such as rural women. [ABSTRACT FROM AUTHOR]

Research on family violence in rural communities in Australia and Canada has shown that women's experience of family violence is shaped by social and cultural factors. Concern for economic security and inheritance for children, closeness and belonging, and values of family unity and traditional gender roles are factors in rural communities that form the social and cultural context in which health and wellbeing are embedded. The findings presented in this paper show that rural women often place their needs second to those of their partners, children and families and, as a result, may minimize their own health concerns, especially in situations that involve family violence. Rural health care workers need to recognize the way social and cultural contexts specifically impact on rural women in order to provide appropriate prevention and treatment programs to address rural women's health issues. [ABSTRACT FROM AUTHOR]

The article discusses the findings of research which aims to compare risk factors for and consequences of intimate partner violence among urban and rural women in Canada. It examines the help-seeking behaviors of women living in rural and urban areas. The study indicates that women living in the rural area may be more vulnerable to partner violence than women living in urban settings. It mentions several characteristics of rural women that may put them at higher risk including lower education, higher unemployment, and social isolation. It reveals the association between low socioeconomic status and violence against women. Moreover, results of the study indicate that domestic violence is as big a problem in rural areas compared in urban settings.

Discusses peer support through audio teleconferencing technology for rural women with breast cancer in Newfoundland. Mention of the BREAST-CANCER ListServ and virtual support group for linking people through real-time discussion; The number of breast cancer cases diagnosed each year in the province; Newfoundland being home to the most extensive telemedicine and audio teleconferencing system in Canada as of August 1998; More.

Studies the history of rural women in Ontario, Canada. Differing emphasis on experience and representation; Social analysis of farm life; Effects of agricultural changes on role of women in farm production; Gender involvement in farm decision making.

Women living in a rural Canadian county were interviewed about how they locate health information. The experiences they described raise interesting questions about the efficacy of government sponsored e-health initiatives, particularly when such programs are intended to compensate individuals who live in remote communities for lack of access to health care services. Most of the women in the study undertake considerable health-related information gate-keeping for themselves and on behalf of family members and others in their personal networks. They seek and assess information from a wide variety of sources, some of which they locate via the Internet, and they balance what they learn against their experiences with the formal health system. The women's accounts focused repeatedly on the quality of their relationship with those to whom they turn for assistance, although the actual roles of helpers, whether physicians, friends, librarians, or staff in health food stores, often appeared to be incidental. Instead, helpers' perceived effectiveness seemed to depend largely on how well they express care when information is exchanged. Several women also reported that they had diagnosed and even treated themselves, sometimes on the basis of information gathered from the Internet. These and other findings are discussed with respect to public policy concerning consumer health information and the potential role of public libraries in the provision of health information programming in rural communities. [ABSTRACT FROM AUTHOR]

The article reviews the availability of and accessibility to health care services and resources in rural and remote areas of Canada, highlighting the pharmacological issues of women. The article reports that the health of rural residents are worse than their urban counterparts. The article cites several reasons for the limited access to health care including lack of transportation, distances to medical care facilities, the nature of rural physician practice, and local attitudes and beliefs.

A central premise of the first demographic transition theory is that demographic change would occur more slowly in rural than urban areas. Few studies, however, have investigated whether rural areas remain holdouts during the second demographic transition. To address this gap, this study (1) examines trends among rural and urban families in Canada and the United States over a 30-year period and (2) determines whether compositional differences in demographic, socioeconomic, and religious factors explain current differences between rural and urban families. We find that rural Canadian women continue to have, on average, 0.6 more children than urban women. However, rural families do not trail behind urban families on any other indicator of family change. In fact, rural women in both countries are now significantly more likely to cohabit and roughly 10 percentage points more likely to have children outside of marriage than urban women. These differences are largely explained by lower levels of education and income among rural American women and fewer immigrants in rural Canada. Examining family change through a rural–urban lens fills important empirical gaps and yields novel insights into current debates on the fundamental causes of ongoing family change in high-income countries. [ABSTRACT FROM AUTHOR]

Rural youths' outmigration is a well-documented phenomenon. However, very little is known about what makes some rural youths more mobile than others after they leave their parental home. The article offers a conceptual and empirical understanding of high mobility among rural women in the age range 25–34 years. Drawing upon the narratives of eight highly mobile women living in the province of Newfoundland and Labrador, Canada, the author shows that their migrations are more likely to be motivated by employment than education, and are often part of a tied migration linked to migration networks and systems. In a few cases, they were driven by the desire either to “get away” from the island of Newfoundland or to become autonomous of place. Highly mobile women were found to be risk takers and adventure seekers. In several cases, extensive mobility after finishing high school was a continuation of mobile biographies rooted in their childhoods. The article confirms that high mobility, particularly high mobility that involves multiple moves, is closely connected to insecure employment, contractual work, and local labour market insecurity. [ABSTRACT FROM PUBLISHER]

Purpose - To understand ageing well, one needs to study not only those who are ageing but also the places within and with which people are ageing. In the past, much ageing-well research has been focused on ensuring individuals have the "right" resources and are engaged in the "best" types of activities. However, recent theorizing has prompted the study of ageing well as a process of making sense of self amid later-life changes. Building on Rowles' attachment-to-place work, the purpose of this paper is to consider how the "thick concreteness" of place influences later-life meaning making. Design/methodology/approach - This is a theoretical paper on ageing. Findings - The paper draws on Casey's phenomenological conceptualization of places as imprinting themselves on bodies and selves, much as humans shape the places they inhabit. Data from interviews with older rural women in western Canada illustrates how this conceptualization can enhance understanding of ageing well relative to place as a physical, socio-cultural and temporal phenomenon, In a place that has been depicted as inhospitable, participants have chosen to stay even as practically invisible kin and community "keepers" on the "frontier". Originality/value - This original paper suggests that to age well is to age locally and to make sense not only for self about self and one's own ageing but also for ageing in mutually compatible ways in that place. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to examine the inverse association between site of locality and fertility from two competing perspectives: (1) the independent effect or subcultural hypothesis, and (2) the differential variable levels or micro-economic hypothesis. The data for the study are obtained from the 1971 Canadian Census One Per Cent Public Use Sample Tape. The unit of analysis is ever-married females 17 years of age and over, classified according to urban, rural farm and rural non-farm categories. The major technique employed in the analysis is a regression decomposition model developed by Coleman et al. (1972). The results indicate that, for the most part. the independent effect hypothesis is substantiated. When there is a deviation from this general finding (which occurred among young rural women), the explanation may be found in terms of anticipated migration to urban areas. Implications of these results are discussed. [ABSTRACT FROM AUTHOR]

Several studies have suggested that pre and/or postdiagnosis physical activity can reduce the risk of recurrence in breast cancer patients, however its effect according to follow-up time has not yet been investigated. We analyzed recurrence and mortality dynamics in randomized clinical trials (RCTs) from Australia and Canada. The combined Australian RCTs evaluated, at a median follow-up of 8.3 years, an 8-month pragmatic exercise intervention in 337 women with newly diagnosed breast cancer, while the Canadian RCT evaluated, at a median follow-up of 7.4 years, supervised aerobic or resistance exercise during chemotherapy in 242 patients. For each RCT, the control arm consisted of patients undergoing usual care. We estimated the event dynamics by the discrete hazard function, through flexible regression of yearly conditional event probabilities with generalized additive models. In the considered RCTs, the recurrence and mortality risk of patients enrolled in the physical activity arm were stably decreased at medium/long term after five year of follow-up. In the Australian RCTs where patients were recruited by urban versus rural area, the latter group did not display benefit from physical activity. Estimated odds ratios (95% confidence intervals) for disease-free survival (DFS) in urban women were 0.63 (0.22–1.85); 0.27 (0.079–0.90); 0.11 (0.013–0.96) at the 3rd, 5th and 7th year of follow-up, respectively. For rural women, DFS patterns were overlapping with odds ratios (ORs), approximating 1 at the different years of follow-up. Although not reaching statistical evidence, the estimates in the Canadian trial were in line with the results from the Australian urban women with ORs (95% CI) for DFS of 0.70 (0.33–1.50); 0.47 (0.19–1.18); 0.32 (0.077–1.29) at 3rd, 5th, 7th follow-up year, respectively. While we acknowledge that the analyzed RCTs were not designed for investigating disease recurrence over time, these results support the evidence that physical activity reduces the risk of developing medium-/long-term metastases. Additional translational research is needed to clarify the mechanisms underlying these observations. [ABSTRACT FROM AUTHOR]

Background: The relation between place of residence and risk of postpartum depression is uncertain. We evaluated the relation between place of residence and risk of postpartum depression in a population-based sample of Canadian women. Methods: Female postpartum respondents to the 2006 Canadian Maternity Experiences Survey (n = 6126) were classified as living in rural (< 1000 inhabitants or population density < 400/km²), semirural (nonrural but < 30 000 inhabitants), semiurban (30 000-499 999 inhabitants) or urban (≥ 500 000 inhabitants) areas. We further subdivided women living in rural areas based on the social and occupational connectivity of their community to larger urban centres. We compared the prevalence of postpartum depression (score of ≥ 13 on the Edinburgh Postnatal Depression Scale) across these groups and adjusted for the effect of known risk factors for postpartum depression. Results: The prevalence of postpartum depression was higher among women living in urban areas than among those living in rural, semirural or semiurban areas. The difference between semiurban and urban areas could not be fully explained by other measured risk factors for postpartum depression (adjusted odds ratio 0.60, 95% confidence interval 0.42-0.84). In rural areas, there was a nonsignificant gradient of risk: women with less connection to larger urban centres were at greater risk of postpartum depression than women in areas with greater connection. Interpretation: There are systematic differences in the distribution of risk factors for postpartum depression across geographic areas, resulting in an increased risk of depression among women living in large urban areas. Prevention programs directed at modifiable risk factors (e.g., social support) could specifically target women living in these areas to reduce the rates of postpartum depression. [ABSTRACT FROM AUTHOR]

While caregiving in northern, rural and remote communities takes place in the context of conditions unique to smaller communities, caregivers live with social policies that are shaped by urban norms rather than rural realities. In times of economic decline and government cuts rural issues of limited services and infrastructure as well as dependency on a single industry can lead to unemployment, community and family instability, and a decline in health and well-being. During these times caregivers face increased pressure to voluntarily fill the gaps left by service cuts. Research with women caregivers in four communities in northern British Columbia (BC), Canada explores the experiences of caring and the social, geographic, economic and political contexts within which the caregiving occurs. The discourse of economic efficiencies that speaks solely to the monetary value of care is contrasted with the human condition of connectedness and relationships. These two contradictory perspectives are uncovered during interviews with women caregivers and analyzed in the framework of Olena Hankivsky's discussion of an ethic of care. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Historical Review is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article analyzes the female rural-urban wage gap in Canada using longitudinal data from the Survey of Labour and Income Dynamics 1993–96. We estimate a two-step wage equation accounting for unobserved heterogeneity and sample selection. The results indicate that a statistically and economically significant rural-urban wage gap remains after controlling for observed and unobserved characteristics. Further, the results suggest this rural-urban wage difference is not simply induced by immobility between rural and urban markets. Rather, consistent with the effect of thinner rural labor markets, the evidence indicates that rural-urban differences in the impact of a number of explanatory variables are significant. [ABSTRACT FROM AUTHOR]

Canadian Aboriginal women have high rates of bone fractures, which is possibly due to low dietary intake of minerals or vitamin D. This study was undertaken to estimate dietary intake of calcium and vitamin D by designing a culturally appropriate dietary survey instrument and to determine whether disparities exist between Aboriginal and white women. After validation of a FFQ, 183 urban-dwelling and 26 rural-dwelling Aboriginal women and 146 urban white women completed the validated FFQ and had serum 25-hydroxyvitamin D [25(OH)D] measured. Urban Aboriginal women had lower (P=0.0004) intakes of total dietary calcium than urban white women; there was no difference in rural Aboriginal women. Only a minority of all women met the adequate intake (AI) for calcium intake. Ethnicity did not affect total vitamin D intake; however, rural Aboriginal women consumed all of their dietary vitamin D from food sources, which was more (P<0.03) than both urban Aboriginal and white women. Rural and urban Aboriginal women had lower (P<0.0004) serum 25(OH)D than urban white women. We found that 32% of rural Aboriginal, 30.4% of urban Aboriginal, and 18.6% of urban white women were vitamin D deficient, with serum 25(OH)D concentrations<37.5 nmol/L. The high prevalence of vitamin D deficiency among Aboriginal women, combined with lower dietary intake of calcium, especially in older women, likely contributes to the higher incidence of fracture in this population. [ABSTRACT FROM AUTHOR]

Documents the roles of Canadian farm women in the contemporary farm economy. Farm women's physical health and psychological well-being; Interaction and evaluation of the health care system; Lack of access to medical and counseling services; Perceived lack of understanding by policymakers and professionals.

In North America, the most common societal response to intimate partner violence (IPV) has been the establishment of women's shelters for temporary housing and security. Rurality further compounds the challenges women experiencing IPV face, with unique barriers from their urban counterparts. This study sought to explore the intersection of rural women's health care experiences within the context of IPV. Eight rural women living in Southwestern Ontario, who had experienced IPV, had used women's shelter services, and who had accessed health care services in the preceding 6 months were interviewed. Using a feminist, intersectional lens, we collected and analyzed qualitative data using an interpretive description approach. Findings demonstrated that women were able to identify strengths and opportunities from their experiences, but significant challenges also exist for rural women seeking health care who experience IPV. Our findings underscore the need for filling of policy gaps between health care and the services women use. We propose that further research is needed on alternative, integrated models of shelter services that address health care needs for women experiencing IPV. [ABSTRACT FROM AUTHOR]

Objective: This systematic review of the literature assesses congruency of findings from descriptive, qualitative, and association studies focusing on factors influencing smoking and smoking cessation with findings from smoking cessation interventions that included low‐income rural women. Design and Sample: Six databases relevant to the health and social sciences were searched in this systematic review using combinations of select keyword terms, specific inclusion criteria, and studies between 1997 and 2012. Results: Descriptive studies on this population of smokers provide economic, environmental, and social factors related to smoking patterns. Qualitative studies found social support received from an individual's social network was viewed as most beneficial when considering or maintaining smoking cessation while randomized controlled trials included in this review implemented social support through peripheral resources or resources with little personal connection to the sample and failed to produce significant results. Conclusions: Few studies have focused on the specific needs and difficulties of smoking cessation among rural low‐income women and interventions have not targeted the complex social network of this population. Incongruence in study findings supports the need for smoking assessment and cessation interventions that incorporates the unique social and cultural meanings of smoking in rural low‐income women. [ABSTRACT FROM AUTHOR]

Context: The influences of gender and geography are increasingly being acknowledged as central to a comprehensive understanding of health. Since little research on rural women's health has been conducted, an in-depth qualitative approach is necessary to gain a better initial understanding of this population. Purpose: To explore the determinants of health and their influence on rural women's health. Methods: From November 2004 to September 2005, 9 focus groups and 3 individual interviews were conducted in 7 rural southwestern Ontario communities. Sixty-five rural residents aged 26 years and older participated in the study. Semi-structured interview questions were used to elicit participants' perceptions regarding determinants of rural women's health. Findings: Four Health Canada determinants (employment, gender, health services, and social environments) and 3 new determinants (rural change, rural culture, and rural pride) emerged as key to rural women's health. Conclusions: Although health determinants affect both urban and rural people, this qualitative study revealed that rural women experience health determinants in unique ways and that rural residents may indeed have determinants of their health that are particular to them. More research is needed to explore the nature and effects of determinants of health for rural residents in general, and rural women in particular. [ABSTRACT FROM AUTHOR]

Interpersonal violence around pregnancy is of increasing global public health concern affecting both women themselves and their children. The primary aim of this study is to explore and identify potential correlates of such violence and to examine maternal and birth outcomes subsequent to that violence in a nationally representative sample of urban and rural women in Canada. The data are from the Maternity Experiences Survey (MES), a Canadian population-based postcensus survey administered to 6,421 Canadian mothers in 2006. Survey participants were 15 years and older and had given birth to a singleton and continued to live with their infant at the time of the survey. The survey response rate was 78%. Multivariable logistic regression analyses were used in the analysis with adjustments made for confounding variables. The study findings indicated that living in an urban environment was associated with an increased risk of interpersonal violence experience around the time of pregnancy (OR = 1.31, 95% CI: 1.03-1.66). In addition, being aboriginal, young, unmarried, economically disadvantaged, a nonimmigrant, and having more than four pregnancies, as well as cigarette smoking, alcohol drinking and drug use before the pregnancy were correlated with interpersonal violence around pregnancy. Maternal interpersonal violence experiences were also associated with postnatal depression and stressful life events among both urban and rural mothers. However, maternal interpersonal violence experiences were only associated with preterm birth among rural mothers but not among urban mothers. The present study highlights the need to implement effective interventions for women experiencing interpersonal violence around pregnancy due to its potential impact on maternal and newborn's physical and mental health. Screening and intervention should be targeted high-risk women particularly those who are indigenous, young, unmarried, nonimmigrants, of lower socioeconomic status, and manifesting high risk health behaviors. [ABSTRACT FROM AUTHOR]

The rural church may be an effective health resource for rural Canadian women who have compromised access to health resources. The purpose of this paper is to explore the relevance of the Christian church and faith community nurses in promoting the health of rural Canadian women in the evolving rural context. The findings from an extensive literature search reveal that religion and spirituality often influence the health beliefs, behaviors, and decisions of rural Canadian women. The church and faith community nurses may therefore be a significant health resource for rural Canadian women, although this phenomenon has been significantly understudied. [ABSTRACT FROM AUTHOR]

Background: Postpartum depression and anxiety are under-addressed public health problems with numerous treatment access barriers, including insufficiently available mental health specialist providers.Aims: To examine the effectiveness of nurse-delivered telephone interpersonal psychotherapy (IPT) for postpartum depression. Trial registration ISRCTN88987377.Method: Postpartum women (n = 241) with major depression (on the Structured Clinical Interview for DSM-IV (SCID-I)) from 36 Canadian public health regions in rural and urban settings were randomly assigned to 12 weekly 60 min nurse-delivered telephone-IPT sessions or standard locally available care. The primary outcome was the proportion of women clinically depressed at 12 weeks post-randomisation, with masked intention-to-treat analysis. Secondary outcomes examined included comorbid anxiety, self-reported attachment and partner relationship quality.Results: At 12 weeks, 10.6% of women in the IPT group (11/104) and 35% in the control group (35/100) remained depressed (OR = 0.22, 95% CI 0.10-0.46), with the IPT group 4.5 times less likely to be clinically depressed (SCID); 21.2% in the IPT group and 51% in the control group had an Edinburgh Postnatal Depression Scale (EPDS) score >12 (OR = 0.26, 95% CI 0.14-0.48), and attachment avoidance decreased more in the IPT group than in the control group (P = 0.02). Significant differences favoured the IPT group for comorbid anxiety and partner relationship quality at all time points, with no differences in health service or antidepressant use. None of the IPT responders relapsed by 36 weeks. Between-group SCID differences were sustained at 24 weeks, but not at 36 weeks.Conclusions: Nurse-delivered telephone IPT is an effective treatment for diverse urban and rural women with postpartum depression and anxiety that can improve treatment access disparities. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Rural Medicine (Joule Inc.) is the property of CMA Impact Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)