Delivering care to rural HIV/AIDS patients.

With HIV/AIDS on the rise in rural areas, health care providers must find ways of delivering care with little or no increase in resource support. This paper examines the evolution of a rural HIV/AIDS alliance using a life cycle model to identify each stage of the alliance development and the specific issues associated with each stage. The data were collected through structured interviews and by review of background materials, including budgets, grant proposals, and program reports. The findings identify alliance strategies that can be used in other rural communities facing the challenge of serving an increasing number of HIV/AIDS patients with limited resources. Differing from other models, this rural HIV/AIDS alliance emerged from local government and community support into an independent, nonprofit organization operating through a network of interorganizational relationships.

Health promotion and disease prevention: a survey of rural family physicians.

Family and general practice physicians deliver comprehensive health care over time and are well suited to promote health and prevent disease. Prior studies of preventive medicine routines have tended to address a limited number of the recommended practices. The purpose of this study was to: (1) estimate the level of primary care physician compliance with the wide range of physician recommendations in Healthy People 2000: National Health Promotion and Disease Prevention Objectives for the Year 2000 and (2) identify practice characteristics associated with performance of preventive health care. Full-time family and general practice physicians, located in rural Mississippi towns of 5,000 to 10,000, were selected for the study. Of 94 eligible physicians, 81 were surveyed (73 surveys completed on site and 8 surveys returned by mail). The physicians treated a mean of 35 patients per day, with a disproportionate number of elderly patients. Limited physician time was ranked by physicians as the greatest obstacle to preventive medicine. Physicians were found to practice more preventive medicine in the adult and elderly patients than in the children and adolescents. Cancer, cardiovascular, and infectious disease risks were well addressed, with little attention directed toward occupational and environmental (e.g., lead, firearm, automobile) risks. Two practice characteristics were consistently associated with higher preventive medicine scores: an assigned preventive medicine staff member and preventive medicine flow charts. This information, obtained in a medically underserved area, may be used to assist physicians in meeting the Healthy People 2000 objectives. More research is needed to identify effective approaches for health risks that were not well addressed in physician offices.

Essential health education for deployment in underdeveloped countries.

Educating personnel regarding issues related to health and foreign travel has always been an important deployment concern. This article provides general health education guidelines pertinent to any deployment, but especially foreign deployment. The report is intended as a vehicle for initiating the health education process of nonmedical personnel prior to deployment.