Due to COVID-19, CRH will continue working remotely until further notice.
2018 Presentations & Handouts
To access handouts for the sessions, click on the title of the session. If there are multiple handouts, they
will be listed under the abstract. If there is not a handout available, it means the presenter has not provided
the handout to be posted online. "No Handout" has been indicated for presentations where the presenter has
notified us that there will not be a handout to post online.
ABSTRACT: This presentation will focus on national and federal policy issues
affecting rural providers and include an overview of key focus areas for the Federal Office of Rural Health
Policy. The session will highlight key national rural health policy issues and identify resources available to
assist rural communities in enhancing healthcare delivery.
ABSTRACT: The University of North Dakota, Center for Rural Health will discuss
findings from their evaluation of the North Dakota State Targeted Response to the Opioid Crisis (Opioid STR) as
well as the impact of project ECHO, an online medical education delivery system used to train providers
participating in the Opioid STR.
ABSTRACT: In this session you will learn about how a unique network of community
and clinical partners are working together to prevent type 2 diabetes in North Dakota. With the current
prevalence and predicted future burden of diabetes across the U.S., these partners are applying an
evidence-based strategy that works, the National Diabetes Prevention Program. Attend this session to learn about
the partners, plans, process, access and outcomes; and to find out how you can get involved today.
ABSTRACT: Interested in enriching an afterschool program to promote healthy
behaviors? How about empowering teen leaders with the most recent guidance? NDSU Extension will share how the
“On the Move to Better Health Afterschool Toolkit” can enhance afterschool programs and/or recreational groups
with nutrition and physical activity education as well as policy, systems, and environmental changes.
Session 4: Poster
Presentations: Provider Confidence and Satisfaction
with Communication Strategies to Address Vaccine Hesitancy Kylie Hall, MPH, Project Coordinator, NDSU Center for Immunization Research
and Education (CIRE) Lauren Dybsand, MPH
ABSTRACT: Researchers at NDSU CIRE worked with a group of pediatric providers to
assess communication strategies that have been recommended to address vaccine hesitancy. Providers were trained
on vaccine safety and efficacy, licensure, how to refute common myths, and the use of two communication
strategies. Confidence in addressing vaccine hesitancy and satisfaction with the strategies were assessed.
The Health Implications of Daily Smoking, Lack of Exercise, and Inability to Afford Medical Care on
North Dakota Residents Nathan Fix, BS, MPH, Research Specialist, Center for Rural Health,
University of North Dakota Sonja Bauman, MS, Research Specialist, Center for Rural Health, University of North
ABSTRACT: This presentation focuses on daily smokers in North Dakota, and
investigates the association between the cost of consulting a doctor and exercising over the duration of one
month. This presentation also explores how these factors affect a smoker's overall health. Data specific to
North Dakota was selected from the Behavioral Risk Factor Surveillance System (2016), for adults 18 and older,
which included 14% (596) daily smokers.
Evaluation of Breastfeeding Rates, Durations, and Support in North Dakota Amir Alakaam, PhD, MS, LN, MBChB, Assistant Professor, University of North
ABSTRACT: North Dakota has seen a steady increase in breastfeeding rates and
durations over the last years. The aim of this research is to describe the current situation regarding
breastfeeding, rates, durations, and support in North Dakota, explore maternity and breastfeeding practices in
North Dakota health facilities, and provide a strategy to evaluate and improve breastfeeding support in this
Supporting Access to Health in Rural Areas Kristen Staloch, MArch, MS, EDAC, Associate, HGA Architects and
ABSTRACT: Learn research that impacts healthcare buildings with the methods and
processes of health delivery and staff space configurations. This session reviews the context for care in rural
areas increases the pressures to provide greater access to better care in facilities that promote best practice
ABSTRACT: The perceived likelihood and impact of behavioral health workforce
solutions identified by North Dakota stakeholders will be presented, as well as the role public health can play
in each intervention. Peer support specialist as a new behavioral health provider will be discussed, including
state credentialing, reimbursement, and how this provider can be used to provide care in high-need communities.
ABSTRACT: The North Dakota public health and medical emergency preparedness and
response system has multiple core capabilities that are implemented within the state for emergency responses
that exceed normal day to day local operations. When these types of emergencies occur, well defined core
response systems are implemented jointly at the state and local levels including all functions or public health
and medical providers. These core response systems include but are not limited to Medical Facility Evacuation,
Vulnerable Population Evacuation, Medical Sheltering, Pre-Hospital Patient Staging and Stabilization, Public
Health and Medical Tactical Communications, Mass Fatality Response, Communicable Disease Outbreak Response,
Patient Tracking, Cold Chain Preservation and staffing through the North Dakota Medical Reserve Corp. The public
health and medical assets are provided through the State Medical Cache which contains about $15 million of
medical and public health equipment, pharmaceuticals, medical transportation, cargo transportation, mobile
emergency department, generators, and other assets.
ABSTRACT: Despite telehealth's potential to improve delivery of rural public
health services, telehealth still has not been fully utilized in the public health arena. Various legal barriers
have slowed wider adoption of telehealth practices among public health departments. In this session, presenters
will share lessons learned and best practices for utilizing telehealth in the rural public health context.
Session 8: Poster
Presentations: Rural Mental Health: The Relationship Between Social Support and Depression in Farmers Andrea Bjornestad, PhD, LPC, NCC, Assistant Professor and South Dakota State
University Extension Mental Health Specialist, South Dakota State University
ABSTRACT: With high depression and suicide rates, the mental health of farmers
has become an international concern. Little is known about the effects of social support on the mental health of
farmers. This study examined the relationship between social support and depression in 185 farmers residing in
the Midwest. The results and implications for rural health will be discussed.
Managing Depression Among Patients with Comorbid Diabetes: The Comprehensive Diabetes and Depression
Program Abby Wilder, BS, Clinical Assistant, Family Healthcare Sarah Schmidt, PharmD, Pharmacy Manager, Thrifty White Pharmacy Brody Maack, PharmD, BCACP, CTTS, Assistant Professor of Practice, North Dakota State
University Mark Strand, PhD, MS, CPH, Professor, North Dakota State University
ABSTRACT: With increasing responsibility of mental health management falling to
primary care, how can we address and adequately treat depression when the primary focus is commonly on diabetes?
The Comprehensive Diabetes and Depression Program aims to discuss the link between both diseases in high-risk
and underserved populations, along with identifying health care gaps and discussing interventional points.
Attitude Changes of Pharmacists After Participating
in an Opioid Misuse Prevention Training Siri Burck, BS, Student, School of Pharmacy, North Dakota State
University Mark Strand, PhD, Professor, North Dakota State University Heidi Eukel, PharmD, Associate Professor of Practice, North Dakota State University
ABSTRACT: This poster presentation is based on the Opioid Misuse Prevention
project designed by faculty and students from North Dakota State University. This poster will describe the
process of creating an attitudinal survey, the results of the survey, and a model for how attitudes of
healthcare professionals inform their behaviors.
Efforts to Improve Patient Access to Care in a Rural Primary Care Clinic with the Development and
Implementation of a Panel Managed Preventative Health Services Protocol Kara Falk, MSN, DNP, FNP, Assistant Professor, North Dakota State University
ABSTRACT: The lack of primary care providers is a national problem, especially
evident in rural areas leading to compromised patient access to healthcare. The development and implementation
of a panel managed preventative health services protocol in a rural family practice clinic was trialled in
efforts to improve patient access to care.
ABSTRACT: Health in All Policies (HiAP) is a framework for improving community
health by ensuring that policies are sustainable, promote equity, and include a consideration of health in the
decision-making process. In this session, attendees will learn about Health in All Policies and developing an
initiative "from scratch", including strategies to bring HiAP to your own organization or community. Learn about
directly engaging one-on-one with elected officials, educating agency staff and executive boards, and utilizing
Health Impact Assessments and other pilot projects as entry points to more sustainable policy change. This
session will focus on implementation at the local level, and will cover points including addressing health
equity in a conservative political environment, identifying opportunities for internal and external alignment,
and building partnerships with non-public health partners to improve health equity.
9:15 – 10:15 AM
A buzz session consists of dividing an audience into small groups to discuss a specific topic.
The session provides a unique opportunity to listen, learn, and share information. You will select three topics
to attend (a horn will sound and you will switch to a different table). Each hot topic table will have a
facilitator to give guidance and keep everyone on point.
ABSTRACT: FirstLink, in collaboration with the Substance Abuse and Mental Health
Services Administration (SAMHSA) and the North Dakota Department of Health is offering the Suicide Follow-up
Call Program to referring agencies or individuals.
ABSTRACT: Cancer disproportionately impacts American Indian/Alaska Native
(AI/AN) populations. While nearly every other population is experiencing a decrease in rates of cancer diagnoses
and death, cancer rates are still increasing for AI/AN populations. The American Indian Cancer Foundation
(AICAF) is committed to change the cancer story by working with tribes and partner organizations to address
health inequities. Broad and comprehensive approaches are needed to sustain tribal public health as a national
priority. The presenter will share information and data on the AI/AN cancer burden and review why cancer rates
are higher among AI/ANs. Strategies that AICAF employs to support implementation of innovative programming will
be shared. Culturally tailored cancer prevention and screening resources will be discussed in detail and shared
with participants for use within their own communities and organizations.
ABSTRACT: The presentation will look at the roles providers, partners (business
associates), human resources, administration, and board members play in protecting health information. We will
discuss the resources needed to address the most common issues in terms of time, talent, and money.
ABSTRACT: This effort is to empower Native Elders to "age in place" through an
effective system of "Long-Term Services & Supports" (LTSS). Since 2016, the LTSS system at Spirit Lake has
been under development, progressively building a network of partners, who collaborate in offering a wide range
of community-based health and social support services for Spirit Lake Elders in their homes.
ABSTRACT: Palliative care is an extra layer of support for patients facing
serious or chronic illness & their families. It maximizes quality of life; delivered by an interdisciplinary
team. Palliative care includes seven core skills: communication, decision making, managing issues of disease,
symptoms, psychosocial/spiritual care, care of the dying, and care coordination. These reflect good healthcare
practice. Primary palliative care can be offered in every setting.
ABSTRACT: This presentation will cover a brief state of affairs in regards to
the Opioid Crisis in the U.S., the general model of evidence-based treatment, and a review of the latest
evidence for Medication Assisted Treatment (MAT). The Continuum of Care necessary to treat Opioid Use Disorder
(OUD) and how it might be applied in rural areas will be discussed, including innovations that could be
applicable such as telehealth/tele-consults.
ABSTRACT: This presentation will introduce healthcare providers to the
education, behavioral interventions, and medication assisted treatment options imperative for addressing
Substance Use Disorder (SUD) in pregnant women and preparing for neonatal abstinence syndrome in the newborn.
Healthcare providers are encouraged to take an interdisciplinary proactive approach to addressing SUDs in women,
especially during their reproductive years.
ABSTRACT: This panel will focus on the challenges and success within each entity
as well as the links and relationships between them. The panelists will each share from their perspective for
about the first hour. The second hour will be a facilitated discussion based on the information presented by the
ABSTRACT: Offering training at your local community healthcare facility or
hospital can sometimes be a daunting task. Is it worth the time and effort? What do we get out of it? In this
intensive session, hear from Dr. David Schmitz and Stacy Kusler about why every community should be a teaching
community, and what the eventual payoff of having a great workforce development and recruitment plan in place
could be. We will discuss multiple programs being offered through UND SMHS to facilitate learning in rural and
underserved communities, as well as projects that help the students understand the importance and impact of
ABSTRACT: In 2015, the Health Profession Opportunity Grants (HPOG) Program
funded five tribal grantees to develop programs that provide low-income individuals with the opportunity to
obtain training for occupations in the healthcare field. Tribal HPOG 2.0 grantees will share lessons learned
from program implementation and the evaluation team will share findings from the first year of the evaluation.
ABSTRACT: This is an update on the latest activities of the Spirit Lake Special
Diabetes Program for Indians. The presentation is related to their culturally innovative, evidence-based, and
effective approach to prevent diabetes in an economically disadvantaged rural community.
ABSTRACT: Half of all American deaths can be connected back to preventable
behaviors. Growing evidence is showing that prevention and treatment for chronic disease requires addressing
multiple behavioral and lifestyle risks. Using a Lifestyle Medicine approach will position the healthcare
organization to be most successful in health outcomes and cost reduction.
Intensive 4b: Promotion of Healthy Lifestyles:
Stepping On Sarah Gailfus, RN, Clinic Coordinator, Presentation Medical Center Wade Burgess, DPT, Director of Physical Therapy, Presentation Medical Center Karen Armstrong, BS, EFNP, North Dakota State University Extension Office Rolette County
ABSTRACT: An overview and review of the program will show how it has given
confidence to people who have participated to continue living at home. It also addresses how this program has
been excellent fit for the Rolla community and has provided an opportunity to collaborate with others in the
community. Finally, balance and strength exercises to help reduce the potential of falls will be reviewed.
Health Policy Panel: North Dakota Legislative Interim Committee Update Representative Kathy Hogan, MS, North Dakota State Legislature, District
21 Representative George Keiser, PhD, North Dakota State Legislature, District 47 Senator Howard Anderson, Jr., RPh, North Dakota State Legislature, District 8
ABSTRACT: Three North Dakota legislators will discuss the 2017 legislative
session and the outcomes related to healthcare.
ABSTRACT: Dr. John Maxwell states that in order to lead others and lead leaders,
we must first learn to lead ourselves. In a world where our business and healthcare leaders are accustomed to
developing missions, visions, and strategic plans for their organizations, it is uncommon that leaders have ever
taken time to write a vision for their own lives. In a culture that increasing values a faster pace and is
leading to higher burn out, greater stress, and ultimately chronic disease, it is important that we get clear on
our personal values and why we do what we do. Having a vision for our own life is the key to overcoming
overwhelm, decreasing over commitment, and increasing joy and productivity both in our own lives and in the
people that we lead.
ABSTRACT: Specialty care for children with orthopaedic conditions can be
difficult to access in rural communities. To locate specialty services, many families may be forced to drive
hundreds or thousands of miles taking a toll on them financially. Outreach clinics bring specialty healthcare to
families with rural North Dakota providing cast removal, surgery follow-up exams, and bracing check-ups.
ABSTRACT: Strategic partnerships and coalitions are an integral part of public
health practice. This presentation aims to outline and describe Grand Forks Public Health's policy-driven health
initiative "Partners for a Healthy Community". The initiative is primarily a worksite wellness-based initiative
focused on workplace policies. Implementation strategies, partnerships formed, and outcomes achieved will all be
discussed to provide the learner with the necessary tools to begin an initiative in their own communities/areas.
An overview of policy, systems, and environmental change will be provided with examples of how Grand Forks
Public Health has promoted this concept in the community and among health partners.
ABSTRACT: The No Excuses Program is a public/private partnership program with
Central Valley Health District (Women's Way), Jamestown Regional Medical Center (JRMC) and the JRMC Foundation
for 3D mammography. It targets females between 40 and 80 who experience barriers to screening services like lack
of insurance payment, time for appointments or even simple understanding of the process to be screened.
Session 16: Opioid Use Disorder in North Dakota:
Where Are We At? Project ECHO and Beyond Dave Schmitz, MD, Department of Family and Community Medicine Chair,
University of North Dakota School of Medicine & Health Sciences Bryan Delage, MD, Assistant Professor Family and Community Medicine, University of North
Dakota School of Medicine & Health Sciences Kamille Sherman, MD, FAAFP, Co-Director, Family Medicine Clerkship & Rural Opportunities i
n Medical Education, University of North Dakota School of Medicine & Health Sciences Quinci Paine, MS II, University of North Dakota School of Medicine & Health Sciences
ABSTRACT: Public awareness of the opioid crisis in America has recently
increased, and there are multiple initiatives underway to address the complex issues involved. Project Echo is
one way the Center for Rural Health at UND SMHS is working to address this crisis. While the impact is being
felt significantly in both rural areas and urban areas, rural providers face unique challenges with regard to
resources and treatment in a rural context. With the rise in deaths in North Dakota from opiate overdose
increasing over the last five years and continuing to rise, solutions that work for rural North Dakota are
critically important. This interactive session will provide an opportunity to discuss what is being done to
approach this problem and hear feedback and suggestions on what more we can all be doing together.
ABSTRACT: This presentation will discuss the importance of oral health for
nursing home residents while sharing a standardized oral health assessment to be utilized for all residents upon
admission. Learn how North Dakota has become a model for other states through provider collaboration, and the
implementation of the standard assessment.
Session 18: Parents Lead Jessica Rudnick, BS, MPA, Community Prevention Specialist, North Dakota
Department of Health, Behavioral Health Division
ABSTRACT: Prevention science has continually shown it is more effective to
target parents than it is to provide messages aimed at youth directly. In fact, youth themselves rank their
parents as being the most prevailing factor in determining whether or not to drink alcohol or engage in risky
behaviors. The core principles of Parents Lead are designed to support parents in not only preventing their
child from underage drinking, but also in preventing other risky behaviors and behavioral health issues such as
depression or anxiety. This presentation will address the various shared risk and protective factors associated
with underage drinking and other issues, detail the four core principles making up the foundation of the Parents
Lead program, and describe the many ways Parents Lead can be utilized and accessed by parents, professionals,
and communities across the state.
ABSTRACT: Public health professionals need to understand how to leverage
health-related data to communicate to the public in order to motivate behavior and policy changes. This session
will address social math use by public health professionals to communicate complicated information to the
public, including determining the focus of the data, crafting effective associations, and creating