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Paper

Cluster, Multi-site and Multi-level Evaluations

Rural Health Impacts: Leveraging the TSBM Model to Capture Larger Research Consortium Trends

Stream: Multi-Level and Complex Evaluations

Wednesday, October 23, 2024
4:15 PM - 5:15 PM PST
Abstract Information: Studies in Social Determinants of Health identify rural communities as a nexus of opportunity to address challenges in healthcare access and resources by leveraging innate community-driven research values. Rural communities often experience disparities in access and outcomes to specialized care, preventative medicine, and evidence-based innovation in clinical practice. The Consortium of Rural States (CORES) operates as a research institute consortium with a shared mission to impact rural health, and is associated with clinical and translational research initiatives. CORES consists of National Institutes of Health-funded Clinical and Translational Science Awards (CTSAs) sites (University of Utah, University of Kansas Medical Center, University of New Mexico, University of Arkansas for Medical Sciences, University of Kentucky, University of Iowa, Penn State University, and Dartmouth) that serve states with significant rural populations and settings. CORES was formed to facilitate collaborations that will produce new opportunities for advancing translational science through community engagement, scaling emerging technologies, supporting multicenter pilot research, developing integrated education and workforce development plans that benefit rural communities. The purpose of this project is to identify, evaluate rural-focused programs and initiatives using the Translational Science Benefits Model (TSBM), and assess the degree to which the TSBM captures rural health impacts. The TSBM identifies four socially-conscious impact domains: Clinical; Community; Economic; and Policy with 30 sub-categories of impacts associated with translational science research. The result of a modified Delphi approach, the TSBM is well positioned as a common outcomes framework for identifying research impacts at the nexus of specific communities across CORES institutes.

Methods: The evaluation leads from each institution co-created an inventory of all rural-focused activities, projects, and initiatives currently operating at each site. Variables included program area; activity type and description; target population; activity status; metrics/outputs; and short-term outcomes. The group then mapped site outcomes according to the four TSBM domains and 30 subcategories.

Results: Over 50 rural-focused initiatives, pilot projects, and programs were identified across eight sites. All rural-focused efforts produced Community and Clinical impacts, with >60% focusing on Community impacts. The majority of rural efforts are ongoing, and their impacts continue to be developed. These results suggest an opportunity gap in tying Economic and Policy-level objectives to our collective rural-focused initiatives.

Discussion: NIH report that over 20% of Americans live in rural areas, and rural health disparities in access and outcomes persist despite innovations like telehealth. This project provides a novel way to map current rural-focused initiatives to an existing translational outcomes framework. As CORES recommends widening rural projects’ impacts to include Economic and Policy-level impacts, the research team is also evaluating the degree to which the TSBM is able to capture the diverse benefits to rural communities and if gaps are identified, propose additional refinements for rural project applications. These recommendations can be used by other CTSAs and institutions with a rural footprint to adapt their own efforts for measuring impact within the context of unique considerations for rurality.