All Maine Rural Health Research Center Publications | Maine Rural Health Research Center (MRHRC) | University of Southern Maine

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The Maine Rural Health Research Center focuses on barriers to health access for rural residents and related topics, including insurance coverage, Medicaid, behavioral health, long term services & supports, and challenges faced by rural providers (rural health clinics & critical access hospitals) in delivering and sustaining services. For over 20 years, the Maine Rural Health Research Center’s research agenda has focused on some of the most intractable health access problems facing rural residents, especially those with mental health and substance abuse issues and those facing financial barriers due to lack of insurance and under-insurance. That body of research has helped reveal the effects of policy and health system organization and financing on rural health access. The Center is committed to enhancing policy making and improving the access, delivery and financing of rural health services by effectively linking its research to the policy development process through appropriate dissemination strategies.

2020 2020

Substance Use among Rural and Urban Youth and Young Adults, Jennifer D. Lenardson MHS, Nathan Paluso MPH, and Erika C. Ziller PhD

Telehealth Use in a Rural State: A Mixed-Methods Study Using Maine's All-Payer Claims Database., Yvonne Jonk PhD, Amanda Burgess MPPM, Martha Elbaum Williamson MPA, Deborah Thayer MBA, Jennifer A. MacKenzie, Catherine McGuire BS, Kimberley S Fox MPA, and Andrew F. Coburn PhD

Implementation of Flex EMS Supplemental Funding Projects: Year One Activities, Karen B. Pearson MLIS, MA; John A. Gale MS; and Sara Kahn-Troster MPH

Supporting Critical Access Hospitals (CAHs) during the COVID-19 Pandemic: Summary Results of a Survey of State Flex Coordinators, John Gale MS; Zachariah T. Croll MPH; Yvonne Jonk PhD; Sara Kahn-Troster MPH; and Karen Pearson MLIS, MA

Supporting CAHs during the COVID-19 Pandemic: Results of a Survey of State Flex Coordinators, John Gale MS; Zachariah T. Croll MPH; Yvonne Jonk PhD; Sara Kahn-Troster MPH; and Karen Pearson MLIS, MA

Rebuilding the Foundation of Rural Community Health after COVID-19, John A. Gale MS, Alana Knudson, and Shena Popat

A Century Later: Rural Public Health's Enduring Challenges and Opportunities., Erika C. Ziller PhD and Carly Milkowski MPH

Pent-Up Demand for Care among Dual-Eligible Victims of Elder Financial Exploitation in Maine, Yvonne Jonk PhD, Kimberly I. Snow MHSA, Deborah Thayer MBA, Catherine McGuire BS, Stuart Bratesman MPP, Charles A. Smith PhD, and Erika C. Ziller PhD

Telebehavioral health (TBH) use among rural medicaid beneficiaries: Relationships with telehealth policies, Jean A. Talbot PhD, Yvonne Jonk PhD, Amanda Burgess MPPM, Deborah Thayer, Nathan Paluso MPH, and Andrew F. Coburn PhD

Addressing Opioid Use in Rural Communities: Examples from Critical Access Hospitals, John A. Gale MS; Sara Kahn-Troster MPH; Karen B. Pearson MLIS, MA; and Nathan First LCSW, MSW, MA

Virtually possible: using telehealth to bring reproductive health care to women with opioid use disorder in rural Maine, Terri-Ann Thompson, Katherine A. Ahrens PhD, and Leah Coplon

Engaging Critical Access Hospitals in Addressing Rural Substance Use, John A. Gale MS; Sara Kahn-Troster MPH; Zachariah T. Croll MPH; and Nathan L. First LCSW, MSW, MA

Provision of Mental Health Services by Critical Access Hospital-Based Rural Health Clinics, John A. Gale MS; Zachariah T. Croll MPH; Nathan First LCSW, MSW, MA; and Sara Kahn-Troster MPH

Rural-Urban Residence and Mortality among Three Cohorts of U.S. Adults, Erika C. Ziller PhD; Jennifer D. Lenardson MHS; and Katherine A. Ahrens MPH, PhD

Process of Identifying Measures and Data Elements for the HRSA School-Based Telehealth Network Grant Program, Marcia M. Ward PhD; Kimberley Fox MPA; Kimberly Merchant; Amanda Burgess MPPM, MPH; Fred Ullrich; Karen Pearson MLIS, MA; George Shaler MPH; Christopher Shea; Steve North; and Carlos Mena

Exploring State Data Sources to Monitor Rural Emergency Medical Services Performance Improvement, John A. Gale MS; Karen B. Pearson MLIS, MA; and Yvonne Jonk PhD

Maternal opioid use disorder at delivery hospitalization in a rural state: Maine, 2009-2018., Sarah M.B. Gabrielson, Jenny L. Carwile, A. B. O'Connor, and Katherine A. Ahrens PhD

Rural-Urban Differences in Hospitalizations for Opioid Use-Associated Infective Endocarditis in the United States, 2003-2016., E. Katherine Nenninger, Jenny L. Carwile, Katherine Ahrens PhD, Brett Armstrong, and Kinna Thakarar

Health Care Use and Access among Rural and Urban Nonelderly Adult Medicare Beneficiaries, Erika C. Ziller PhD, Amanda Burgess MPPM, and Deborah Thayer MBA

2019 2019

Behavioral Health in Rural America: Challenges and Opportunities, John A. Gale MS; Jaclyn Janis BSN, RN; Andrew F. Coburn PhD; and Hanna Rochford MPH

What Is Rural? Challenges and Implications of Definitions that Inadequately Encompass Rural People and Places., Kevin J Bennett PhD; Tyrone F Borders PhD; George M. Holmes PhD; Katy Backes Kozhimannil PhD, MPA; and Erika C. Ziller PhD

Behavioral Health in Rural America: Challenges and Opportunities [EXECUTIVE SUMMARY], John A. Gale MS; Jaclyn Janis BSN, RN; and Andrew F. Coburn PhD

Rural Health Clinic Costs and Medicare Reimbursement, John A. Gale MS, Zachariah T. Croll MPH, and Andrew F. Coburn PhD

What to Expect with MaineCare Expansion [OpEd], Zachariah T. Croll BA

Association Between Rurality and Lung Cancer Treatment Characteristics and Timeliness, Kathleen M Fairfield MD, MPH, DrPH; Adam W. Black; F. Lee Lucas PhD; Kimberly Murray MPP; Erika C. Ziller PhD; Neil Korsen MDMS; Leo B. Waterston MA; and Paul K. J. Han MD, MA, MPH

Sustainable Public-Private Strategies to Improve Population Health in Maine: Annotated Bibliography, Zachariah Croll MPH

Rural Health in Maine and America vs. the World, Erika C. Ziller PhD and Yvonne Jonk PhD

Growing Up Rural [Podcast], Erika C. Ziller PhD and Yvonne Jonk PhD

Sociodemographic and Health Status Characteristics of Maine's Newly Eligible Medicaid Beneficiaries [Data Brief], Zachariah T. Croll MPH, Erika C. Ziller PhD, and Barbara Leonard MPH

How Did We Get Here? Rural Health Challenges in America [Podcast], Erika C. Ziller PhD and Yvonne Jonk PhD

Female Age at First Sexual Intercourse by Rural-Urban Residence and Birth Cohort., Jaclyn A. Janis BSN, RN, MPH; Katherine A. Ahrens PhD; and Erika C. Ziller PhD

Community Impact and Benefit Activities of Critical Access, Other Rural, and Urban Hospitals, 2017, Zach T. Croll MPH, John A. Gale MS, and Jeremy Zuckero

The Health Care Costs of Financial Exploitation in Maine, Kimberly I. Snow MHSA, Yvonne Jonk PhD, Deborah Thayer MBA, Catherine McGuire BS, Stuart Bratesman MPP, Charles A. Smith PhD, and Erika C. Ziller PhD

Preventive Health Service Use among Rural Women, Erika C. Ziller PhD; Jennifer D. Lenardson MHS; Nathan Paluso MPH; and Jaclyn Janis BSN, RN

Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking., Erika C. Ziller PhD, Jennifer D. Lenardson MHS, Nathan Paluso MPH, Jean A. Talbot PhD, and Angela Daley PhD

Implementation of the Flex Program's Innovative Models Program Area: Final Evaluation Report, John A. Gale MS, Sara Kahn-Troster MPH, and Andrew F. Coburn PhD

Implementation and Early Results of the Flex Program's Innovative Models Program Area (Briefing Paper #42), John A. Gale MS, Sara Kahn-Troster MPH, and Andrew F. Coburn PhD

Advancing Tobacco Prevention and Control in Rural America, Jean A. Talbot PhD; Martha Elbaum Williamson MPA; Karen B. Pearson MLIS, MA; Jennifer D. Lenardson MHS; Erika C. Ziller PhD; Frances Jimenez; Nathan Paluso MPH; Louisa Munk; Jaclyn Janis BSN, RN; and Paula F. Clayton MS, RDN, LD

Advancing Tobacco Prevention and Control in Rural America: Executive Summary, Jean A. Talbot PhD; Martha Elbaum Williamson MPA; Karen B. Pearson MLIS, MA; Jennifer D. Lenardson MHS; Erika C. Ziller PhD; Frances Jimenez; Nathan Paluso MPH; Louisa Munk; Jaclyn Janis BSN, RN; and Paula F. Clayton MS, RDN, LD

Long-Term Services and Supports Use Among Older Medicare Beneficiaries in Rural and Urban Areas, Andrew F. Coburn PhD; Erika C. Ziller PhD; Nathan Paluso MPH; Deborah Thayer MBA; and Jean A. Talbot PhD, MPH

Improving Rural Systems of Care for Time Critical Diagnoses (Briefing Paper #41), John A. Gale MS and Karen B. Pearson MLIS, MA

Health Status and Access to Care among Maine's Low-Income Childless Adults: Implications for State Medicaid Expansion, Zachariah T. Croll MPH and Erika C. Ziller PhD

2018 2018

Assessing the Unintended Consequences of Health Policy on Rural Populations and Places, Keith J. Mueller PhD; Charles Alfero MA; Andrew F. Coburn PhD; Jennifer P. Lundblad PhD, MBA; A. Clinton MacKinney MD, MS; Timothy D. McBride PhD; and Paula Weigel PhD

Access to Health Care Services for Adults in Maine [Policy Brief], Erika C. Ziller PhD, Barbara Leonard MPH, Amanda Burgess MPPM, and Nathan Paluso MPH

Patterns of Telehealth Use Among Rural Medicaid Beneficiaries, Jean A. Talbot PhD, Amanda Burgess MPPM, Deborah Thayer MBA, Lily Parenteau, Nathan Paluso MPH, and Andrew F. Coburn PhD

CAHs' Community Health Needs Assessments and Implementation Plans: How Do They Align? (FMT Briefing Paper #39), John A. Gale MS, Zach T. Croll BA, Lauren Zoll MPH, and Andrew F. Coburn PhD

Medicaid Income Eligibility Transitions Among Rural Adults, Erika C. Ziller PhD, Deborah Thayer, and Jennifer D. Lenardson MHS

Rural Health Clinic Participation in the Merit-Based Incentive System and Other Quality Reporting Initiatives: Challenges and Opportunities, John A. Gale MS, Zachariah T. Croll MPH, and Andrew F. Coburn PhD

Health Equity Challenges in Rural America, Erika C. Ziller PhD and Andrew F. Coburn PhD

Low-Income, Uninsured Mainers Face Substantial Challenges Getting Health Care, Erika C. Ziller PhD, Amanda Burgess MPPM, and Barbara Leonard MPH