Research Publications

  • Home is Where the Heart Is: Insights on the Coordination and Delivery of Home Health Services in Rural America
    Access to home health in rural areas is an important public policy concern, particularly with the growing number of older adults residing in rural America. This qualitative study seeks to better understand how home health services are provided in rural areas, and identifies facilitators and barriers to providing care.
    Author(s): Knudson, A., Anderson, B., Schueler, K., Arsen, E.
    Date: August 2017
    Type: Policy Brief
  • Use of the Emergency Department for Mental Health and Substance Abuse among Women
    A study by the Rural Health Reform Research Center shows that women with mental health (MH) and substance abuse (SA) issues are putting a strain on emergency departments (EDs). This study helps identify trends among women in rural and urban communities who utilize the ED for MH/SA. The information can be used to help communities provide more relevant, appropriate, and less costly care.
    Author(s): Schroeder, S., Peterson, M., Jaeger, J.
    Date: July 2017
    Type: Fact Sheet
  • Rural and Urban Utilization of the Emergency Department for Mental Health and Substance Abuse
    Utilizes data from the Healthcare Cost and Utilization Project’s (HCUP’s) State Emergency Department Databases (SEDD) for seven states. Researchers explore, and describe in this brief, the use of the Emergency Department for mental health and substance abuse among Urban, Large Rural, Small Rural, and Isolated Small Rural residents.
    Author(s): Schroeder, S., Peterson, M.
    Date: June 2017
    Type: Policy Brief
  • Oral Health among North Dakota Medicaid Recipients
    Examines dental care utilization among Medicaid recipients in North Dakota.
    Author(s): Schroeder, S.
    Date: October 2016
    Type: Fact Sheet
  • Oral Health Programs in North Dakota
    Policy Brief detailing current oral health initiatives in North Dakota.
    Author(s): Schroeder, S., Fix, N.
    Date: October 2016
    Type: Policy Brief
  • Where did North Dakota Primary Care Physicians Graduate from Medical School and Where Have North Dakota Medical School Graduates Gone?
    Examines where physicians practicing in North Dakota attended medical school and where North Dakota medical school students currently practice.
    Author(s): Hart, G., Peterson, M., Ahmed, A.
    Publication: North Dakota Health Workforce Fact Sheet Series, Number 23
    Date: September 2016
    Type: Fact Sheet
  • Dentists Providing Oral Healthcare to Long Term Care Residents: Survey Chartbook & Four North Dakota Case Studies
    The survey was to assist in identifying providers for case study, and to identify barriers to providing care in long term care facilities.
    Author(s): Schroeder, S., Bright, P.
    Date: July 2016
    Type: Report
  • Oral Healthcare in North Dakota Long Term Care Facilities
    Examines survey results of oral healthcare in long term care facilities throughout North Dakota.
    Author(s): Schroeder, S.
    Date: June 2016
    Type: Fact Sheet
  • Dental Workforce in Rural and Urban North Dakota
    Examines dental health workforce in both rural and urban North Dakota.
    Author(s): Schroeder, S.
    Date: June 2016
    Type: Fact Sheet
  • Oral Health Services and Barriers to Care in North Dakota Long Term Care Facilities: Chartbook
    Long term care facility staff completed a survey to identify current oral health practices, and barriers to providing oral healthcare to facility residents in North Dakota.
    Author(s): Schroeder, S., Bright, P.
    Date: March 2016
    Type: Report
  • Exploring Rural and Urban Mortality
    Exploring Rural and Urban Mortality Differences examines the impact of rurality on mortality and explores regional differences in mortality rates. This study used a quantitative analysis approach drawing upon the data available from the National Vital Statistics System (NVSS) at CDC WONDER. Exploring Rural and Urban Mortality Differences contains visual aids which displays indicators of mortality rates by cause of death (multiple cause of death), age group, rural-urban status, region, and sex for populations 15 years of age and older cross-referenced to tables and statistical results.
    Author(s): Knudson, A., Meit, M., Tanenbaum, E., Brady, J., Gilbert, T., Klug, M., Arsen, E., Popat, S., Schroeder, S.
    Date: February 2016
    Type: Report
  • American Indian Health Research Conference
    North Dakota Medicine, Volume 40, Issue 4. The annual AIHRC provides a forum for culturally appropriate research.
    Author(s): Massmann, N.
    Date: December 2015
    Type: Magazine
  • Assessment of Anxiety Among Northern Plains Indians
    Article examines the reliability and validity of the Beck Anxiety Inventory by comparing scores among three different diagnostic categories.
    Author(s): Gray, J., McCullagh, J., Petros, T.
    Publication: American Journal of Orthopsychiatry
    Date: November 2015
    Type: Journal Article
  • Brushing Up on Dental Care in North Dakota
    North Dakota Medicine, Vol. 40, Issue 1. The Center for Rural Health makes recommendations based on a study of ways to improve North Dakotans’ oral health.
    Author(s): Massmann, N.
    Date: March 2015
    Type: Magazine
  • Perspectives of Rural Hospice Directors
    Examines hospice care within a rural context, including issues regarding regulations, finance/reimbursement, workforce, general rural issues, relationships with other organizations, and technology. Identifies concerns of hospice directors in rural settings.
    Author(s): Gibbens, B., Schroeder, S., Knudson, A. and Hart, G.
    Date: March 2015
    Type: Policy Brief
  • Intra Rural and Urban Primary Care Physician Findings: AAMC 2009 Physician Survey of Primary Care Chartbook
    This publication was produced for the U.S. Department of Health and Human Services, Health Resources and Services Administration, Office of Rural Health Policy by Gary Hart Associated under HRSA contract. The report utilizes primary care physician (PCP) survey data, collected by the Association of American Medical Colleges (AAMC) in 2009/2010 shortly before the Affordable Care Act was made law to preserve a baseline from which to compare future post Affordable Care Act implementation surveys.
    Author(s): Hart, G.
    Date: February 2015
    Type: Report
  • Policy Brief: Use and Performance Variations in U.S. Rural Emergency Departments: Implications for Improving Care Quality and Reducing Costs
    Rural areas have a higher prevalence of subpopulations (younger, low income, and uninsured) that use the Emergency Department (ED) for non-emergent purposes than urban areas. ZIP Code areas with fewer than five primary care physicians per 10,000 had populations that were more likely to use those EDs for non-emergent conditions.
    Author(s): Jonk, Y., Klug, M., & Hart, G.
    Date: February 2015
    Type: Policy Brief
  • Conducting Community Health Needs Assessments in Rural Communities
    Article addresses the lessons learned in conducting community health needs assessments and discusses the Rural Community Group Model for conducting assessments.
    Author(s): Becker, Karin L.
    Publication: Health Promotion Practice, 16(1), 15-19
    Date: January 2015
    Type: Journal Article
  • North Dakota Oral Health Report: Needs and Proposed Models, 2014
    Needs, outcomes, findings, and stakeholder recommendations from the 2014 assessment of oral health need and policy recommendations for North Dakota.
    Author(s): Schroeder, S., Jonk, Y., Schuller, K., Hall, K., Hart, G., Gibbens, B.
    Date: December 2014
    Type: Report
  • North Dakota Oral Health Report: Needs and Proposed Models, 2014 Executive Summary
    Executive Summary for the full North Dakota Oral Health Report. Reviews the findings from the 2014 assessment of oral health in North Dakota.
    Author(s): Schroeder, S., Jonk, Y., Schuller, K., Hall, K., Hart, G., & Gibbens, B.
    Date: December 2014
    Type: Report
  • Policy Brief: Rural-Urban Disparities in Heart Disease
    Heart disease is the leading cause of death in the United States, claiming about 600,000 lives annually. This policy brief highlights rural-urban disparities in heart disease and focuses on three measures: 1) death rates for ischemic heart disease (IHD) among persons 20 years of age and older, 2) obesity among persons 18 years of age and older, and 3) physical inactivity during leisure time among persons 18 years of age and older.
    Author(s): Knudson, A., Meit, M., & Popat, S.
    Date: October 2014
    Type: Policy Brief
  • Assessment of the North Dakota Dementia Care Services Program
    Discusses the North Dakota Dementia Care Services Program which works to increase caregiver knowledge about dementia, caregiving, and decrease caregiver stress.
    Author(s): Klug, M. G., Peterson, M.
    Date: July 2013
    Type: Report
  • Care Consultation Distances to Potential Caregivers: Weighted Population Estimates
    Discusses the North Dakota Dementia Care Services Program which works to increase caregiver knowledge about dementia, caregiving, and decrease caregiver stress.
    Author(s): Klug, M. G., Peterson, M.
    Date: July 2013
    Type: Report
  • Reducing Healthcare Costs for Dementia Patients: Estimating Savings from a Caregiver Support Program
    Provides information on estimated cost savings based on limited healthcare events within a short time span for a dementia care program.
    Author(s): Klug, M.G., Muus, K., Volkov, B. & Halaas, G.W.
    Date: December 2012
    Type: Journal Article
  • North Dakota Dementia Care Services Program (DCSP): Caregivers’ Attributes and Service Use
    Discusses the North Dakota Dementia Care Services Program which works to increase caregiver knowledge about dementia and caregiving, and decrease caregiver stress. Number 2 in a four-part series.
    Author(s): Klug, M., & Muus, K.
    Date: October 2012
    Type: Fact Sheet
  • North Dakota Dementia Care Services Program (DCSP): Characteristics of Persons with Dementia
    Discusses the North Dakota Dementia Care Services Program which works to increase caregiver knowledge about dementia and caregiving, and decrease caregiver stress. Number 3 in a four-part series.
    Author(s): Klug, M., & Muus, K.
    Date: October 2012
    Type: Fact Sheet
  • North Dakota Dementia Care Services Program (DCSP): Impact on Caregiver Support and Estimated Health/Long-Term Care Cost Savings
    Discusses the North Dakota Dementia Care Services Program which works to increase caregiver knowledge about dementia and caregiving, and decrease caregiver stress. Number 4 in a four-part series.
    Author(s): Klug, M., & Muus, K.
    Date: October 2012
    Type: Fact Sheet
  • North Dakota Dementia Care Services Program (DCSP): Utilization Increases Over Time
    The intent of the DCSP is to increase caregiver knowledge about dementia and caregiving, decrease caregiver stress, and coincide with estimated health and long-term care cost savings.
    Author(s): Klug, M., & Muus, K.
    Date: October 2012
    Type: Fact Sheet
  • Deciding When to Put Grandma in the Nursing Home: Measuring Inclinations to Place Persons with Dementia
    For caregivers of persons with dementia, estimating when that person should be placed in long-term care is difficult. Healthcare providers also find it hard to give an exact time as to when the person should be placed. Using data from 197 caregivers working with the Dementia Care Services Project in North Dakota, we show that asking the caregiver about their inclination to place can be equated to asking them for a specific time to place (k = .616). Using the probability density function of time to place we were able to translate it into inclination. This inclination is easier information for the caregiver to provide and places fewer burdens on the caregiver and patient. It also provides the healthcare provider with a measure of time to help advise caregivers and recommend interventions and provide service organizations with measures of cost savings to support the impact of outreach and intervention. The final, definitive version of this paper has been published in the American Journal of Alzheimer's Disease and Other Dementias, Vol 27/Issue 4, June 2012 by SAGE Publications Ltd./SAGE Publications, Inc., All rights reserved.
    Author(s): Klug, M.G., Volkov, B., Muus, K., & Halaas, G.W.
    Date: June 2012
    Type: Journal Article
  • Projection of North Dakota Physicians: 2010-2040
    Describes a projection of both the population of North Dakota and physicians in North Dakota. Includes projection models, graphs, and tables.
    Author(s): Peterson, M., Klug, M., & Hart, G.
    Date: April 2012
    Type: Report
  • Effect of Outpatient Visits and Discharge Destination on Potentially Preventable Readmissions for Congestive Heart Failure and Bacterial Pneumonia
    Emphasizes the importance of receiving timely post-discharge outpatient care and appropriate discharge destination for reducing preventable hospital readmissions, especially but not exclusively among rural-based patients. Full report.
    Author(s): Klug, M., & Muus, K.
    Date: March 2012
    Type: Policy Brief
  • Growing Our Own: Building a Native Research Team
    This article highlights the team growth, increasing structure, student needs and the faculty and staff involved. It further addresses the support and educational aspects of growing an ongoing, multidisciplinary research team committed to ethical research in Native communities.
    Author(s): Gray, J.S., & Carter, P.M.
    Publication: Journal of Psychoactive Drugs, 44(2), 160-165
    Date: 2012
    Type: Journal Article
  • Dementia Care Services Project: Continued Progress in Providing Assistance to Caregivers
    Provides information regarding the continued progress in providing assistance to caregivers of participates in the dementia care services project.
    Author(s): Volkov, B., Muus, K., & Klug MG.
    Date: September 2011
    Type: Policy Brief
  • North Dakota Dementia Care Services Project: Contributing to Health Cost Savings
    Author(s): Volkov, B., Muus, K., & Klug, MG.
    Date: September 2011
    Type: Fact Sheet
  • Physical Activity and Cervical Cancer Testing Among American Indian Women
    This study examined Pap screening prevalence and assessed whether physical activity was associated with screening adherence among AI women from 2 culturally distinct regions in the Northern Plains and the Southwest.
    Author(s): Muus, K., Baker-Demaray, T., Bogart, A., Duncan, G., Jacobsen, C., Buchwald, D., & Henderson, J.
    Publication: The Journal of Rural Health, 28(3), 320-326
    Date: September 2011
    Type: Journal Article
  • Rural Mental Health Research White Paper for National Institute of Mental Health
    This report focused on the nature of rural mental health research, issues in rural mental health, and future areas for research addressing the needs and disparities in rural mental health. These topics are focused on four general areas — Access, Quality, Healthcare Reform, and Disparities.
    Author(s): Gray, J.
    Date: September 2011
    Type: Report
  • Setting Research Roots
    Dr. Jacque Gray cultivates the growth of American Indian researchers.
    Author(s): Morin, K.
    Publication: North Dakota Medicine, 36(3), 23-24
    Date: September 2011
    Type: Magazine
  • Dementia Care Services Project Benefiting Veterans in North Dakota
    Provides information regarding which veterans in North Dakota have benefited from the dementia care services project.
    Author(s): Muus, K., Volkov, B., & Klug, M.G.
    Date: April 2011
    Type: Fact Sheet
  • Dementia Care Services Project’s Positive Impact on Caregiving and Cost Savings in North Dakota
    Provides information on how the dementia care services (DCS) project has had a positive impact on caregiving and cost savings in North Dakota. Covers estimated median long term care cost avoidance and total quarterly savings on hospital, ambulance, and 911 calls from participates in the DCS program. In addition, shows the percentage of caregivers who had taken healthcare actions following six months of program participation.
    Author(s): Muus, K., Volkov, B., Klug, M.G., & Mueller, J.
    Date: April 2011
    Type: Fact Sheet
  • Charting a New Course
    North Dakota Medicine, Vol. 35, Issue 5. Dr. L. Gary Hart is the The Center for Rural Health’s new director. Hart is a nationally recognized expert in rural healthcare delivery and healthcare workforce, and the CRH is excited to have him on board.
    Author(s): Hart, G.
    Date: December 2010
    Type: Magazine
  • Dementia Care Services Project Benefiting North Dakotans
    Provides information on how North Dakotans have benefited from the dementia care services project including the percentage of individuals that completed care-related action steps and the likelihood to place individuals with dementia in a long term care facility (LTC).
    Author(s): Volkov, B., Muus, K., Klug, M.G., Mueller J., & Haley-Franklin, H.
    Date: December 2010
    Type: Fact Sheet
  • Dementia Care Services Project: Supporting Caregivers in North Dakota
    Author(s): Muus, K., Volkov, B., Klug, M., Mueller, J., & Haley-Franklin, H.
    Date: December 2010
    Type: Policy Brief
  • Geographic Differences in Potentially Preventable Readmission Rates in Rural and Urban Hospitals
    Presents a study that estimated Potentially Preventable Hospital Readmissions (PPRs) in three types of acute care hospitals: urban prospective payment system (PPS) hospitals, rural PPS hospitals, and Critical Access Hospitals (CAHs).
    Author(s): Klug, M., Knudson, A., & Muus, K.
    Date: November 2010
    Type: Policy Brief
  • Circles of Strength: A Case Description of Culturally Integrated Suicide Prevention
    This article presents a case description of an American Indian female at high risk for suicide in effort to document the potential effectiveness of a college student suicide prevention program designed for Northern Plains American Indian students.
    Author(s): Gray, J.S., & Muehlenkamp, J.J.
    Publication: Archives of Suicide Research, 14, 182-191
    Date: 2010
    Type: Journal Article
  • Potentially Preventable Readmissions in Rural Hospitals
    Examines potentially preventable readmission rates for rural and urban hospitals, and discusses the rural implications of policy initiatives to reduce readmission rates.
    Author(s): Klug, M., Muus, K., Casey, M., Moscovice, I.
    Date: August 2009
    Type: Policy Brief
  • A College Suicide Prevention Model for American Indian Students
    This article outlines the model developed for the American Indian Support Team from funding through the Garrett Lee Smith Campus Suicide Prevention Grant funded by the Substance Abuse and Mental Health Services Administration to focus on reducing suicide risk of American Indian students at the University of North Dakota.
    Author(s): Muehlenkamp, J.J., Marrone, S., Gray, J.S., & Brown, D.
    Publication: Professional Psychology: Research and Practice , 40(2), 134-140
    Date: 2009
    Type: Journal Article
  • Health Insurance Coverage and Access to Healthcare for American Indian and Alaska Native Elders
    Reports findings from a study assessing health insurance coverage and access to healthcare among American Indian and Alaska Native elders (Native elders), using data from a national survey that included more than 8,300 Native elders.
    Author(s): Knudson, A.
    Date: October 2007
    Type: Policy Brief
  • Alcohol, Tobacco, and Illicit Drug Consumption and Consequences in North Dakota: The North Dakota Epidemiological Profile, 2007
    The report examines the prevalence and patterns of substance (alcohol, tobacco and other drug) use and consequences in North Dakota.
    Author(s): Muus, K., Gray, J., & the State Epidemiological Outcomes Workgroup
    Date: March 2007
    Type: Report
  • Zinc Affects Cognition and Psychosocial Function of Middle-School Children
    This study investigated the effects of dietary zinc intakes on cognition and psychosocial function in young adolescents. Zinc nutrition has been related to motor, cognitive and psychosocial function in very young children and adults, but there have been no studies of older children who may be at risk of zinc deficiency while undergoing rapid growth during puberty.
    Author(s): Penland, J.G., Lukaski, H.C., & Gray, J.S.
    Publication: The FASEB Journal, 19(5), A973
    Date: March 2005
    Type: Journal Article
  • Depression in Northern Plains Indians is Associated with Physical Health and Fitness, Dietary Intakes, Food Insecurity and Cultural Identification
    This study examined the relationships between depression and physical health and fitness, dietary intakes, food insecurity and cultural identification among Northern Plains American Indians.
    Author(s): Penland, J.G., Gray, J.S., Lambert, P., Gonzalez, J., Wilson, E.L., & Lukaski, H.C.
    Publication: The FASEB Journal, 18(4), A516
    Date: March 2004
    Type: Journal Article