Rural Health
Research Gateway

Jean Talbot, PhD, MPH

Maine Rural Health Research Center

Phone: 207.228.8480
Fax: 207.228.8138
Email: jean.talbot@maine.edu

University of Southern Maine
PO Box 9300
34 Bedford Street
Portland, ME 04104-9300

Current Projects - (3)

  • Rural-Urban Differences in Out-of-Pocket Prescription Drug Spending
    Using data from the 2014-17 Medical Expenditure Panel Survey, this study will examine rural-urban differences in out-of-pocket costs for prescription drugs. Additional analyses will examine rural-urban differences in out-of-pocket costs by type of medication and third party payer.
    Research center: Maine Rural Health Research Center
    Topics: Pharmacy and prescription drugs, Uninsured and underinsured
  • Rural-Urban Differences in the Prevalence and Impact of Chronic Pain
    Limited existing evidence suggests that chronic pain may be more widespread and disabling in rural than in urban populations, and that rural residents may lack access to adequate pain treatment resources. This study will explore rural-urban differences in chronic pain prevalence, impacts, and management, and inform policies to address any identified disparities.
    Research center: Maine Rural Health Research Center
    Topic: Chronic diseases and conditions
  • Use of Home and Community Based Services by Medicare Beneficiaries
    Using the Medicare Current Beneficiary Survey, we will examine rural-urban differences in the need for long term services and supports, rates of home and community-based services (HCBS) use, the use of different types of HCBS, and the impact of HCBS on subsequent use of emergent services such as hospitalizations and emergency department visits.
    Research center: Maine Rural Health Research Center
    Topics: Aging, Health services, Home health, Long-term care, Medicare

Completed Projects - (6)

  • Adverse Childhood Experiences and the Health Status of Rural Residents
    The proposed project will (1) assess the prevalence of adverse childhood experiences (ACEs) in rural populations and (2) examine associations of ACEs with health outcomes in rural versus urban settings.
    Research center: Maine Rural Health Research Center
    Topic: Children and adolescents
  • Impact of the Opioid Crisis on Rural Emergency Departments
    This study used data from the Nationwide Emergency Department Sample and information from a panel of rural emergency care experts to assess the impact of the opioid crisis on rural emergency departments. Findings informed policies designed to help rural healthcare systems and communities address the growing problem of opioid abuse.
    Research center: Maine Rural Health Research Center
    Topics: Emergency medical services (EMS) and trauma, Mental and behavioral health, Substance use and treatment
  • Rural Demography and Aging: The LTSS Imperative in Rural America
    The project created a current, broad-ranging, detailed profile of healthcare/LTSS needs and used patterns among rural and urban older adults through a literature review and analysis of data sets including the American Community Survey, the Area Health Resource File, and the Medicare Current Beneficiary Survey.
    Research center: Maine Rural Health Research Center
    Topics: Aging, Rural statistics and demographics
  • Rural Mental Health First Aid Evaluation
    This project is a mixed-methods case study that focuses on the Mental Health First Aid training program, with a view toward clarifying the rural reach, feasibility, impact, and appropriateness of the program for rural communities.
    Research center: Maine Rural Health Research Center
    Topic: Mental and behavioral health
  • Tobacco Treatment in Rural Primary Care
    This study used the National Ambulatory Medical Care Survey to compare rural and urban rates and predictors of tobacco counseling and tobacco treatment medication prescribing by primary care providers to their smoking patients.
    Research center: Maine Rural Health Research Center
    Topics: Physicians, Substance use and treatment
  • Understanding Differences in Rural and Urban Adolescent and Young Adult Substance Use
    Using National Survey of Drug Use and Health data, we'll examine rural-urban adolescent/young adult substance use differences. While substance use has declined among all adolescents in recent years, it's unclear whether the trends apply to rural adolescents/young adults who have historically higher substance use rates than their urban counterparts.
    Research center: Maine Rural Health Research Center
    Topic: Substance use and treatment

Publications - (12)

2021

  • Use of Electronic Health Records to Manage Tobacco Screening and Treatment in Rural Primary Care
    Journal Article
    Maine Rural Health Research Center
    Date: 09/2021
    This study compares the performance of rural and urban primary care providers in adhering to evidence-based smoking-related standards of care and assesses the degree to which electronic health record use was related to improved adherence to these standards in the practice of rural versus urban providers.
  • Opioid-Related Visits to Rural Emergency Departments
    Policy Brief
    Maine Rural Health Research Center
    Date: 02/2021
    The purpose of this project was to compare rural and urban opioid-related emergency department visits. Data from the Nationwide Emergency Department Sample were used to examine rural and urban opioid-related visits over time and to compare the outcomes of these visits.

2020

2019

  • Rural-Urban Differences in the Decline of Adolescent Cigarette Smoking
    Journal Article
    Maine Rural Health Research Center
    Date: 03/2019
    Comparing survey data from 2008-2010 with 2014-2016, we examined change over time in cigarette smoking among rural and urban adolescents. We found that both rural and urban rates declined, but the decrease was smaller in rural counties, which widened the rural-urban gap in adolescent smoking rates.
  • Long-Term Services and Supports Use Among Older Medicare Beneficiaries in Rural and Urban Areas
    Journal Article
    Maine Rural Health Research Center
    Date: 01/2019
    Analyzing the Medicare Current Beneficiary Survey, authors from the Maine Rural Health Research Center found that compared to their urban counterparts, rural Medicare beneficiaries had higher odds of nursing home use after controlling for beneficiary characteristics and contextual factors including nursing home bed supply.

2018

  • Patterns of Telehealth Use Among Rural Medicaid Beneficiaries
    Journal Article
    Rural Telehealth Research Center
    Date: 10/2018
    This study uses data from the 2011 Medicaid Analytic eXtract (MAX) to examine the prevalence of telehealth use among rural and urban Medicaid beneficiaries, characteristics of telehealth users, types of telehealth services provided, and diagnoses associated with telehealth use.
  • Residential Settings and Healthcare Use of the Rural "Oldest-Old" Medicare Population
    Policy Brief
    Maine Rural Health Research Center
    Date: 03/2018
    This study used Medicare Current Beneficiary Survey data to profile rural/urban Medicare beneficiaries ages 85 & older. Rural adults in this age group are more likely to be disabled and live alone in the community or in nursing homes and less likely to live in assisted living facilities. Findings highlight rural needs for community-based services.

2016

  • Adverse Childhood Experiences in Rural and Urban Contexts
    Policy Brief
    Maine Rural Health Research Center
    Date: 04/2016
    This study was designed to address the gap in the literature examining rural-urban differences in adults' exposure to adverse childhood experiences (ACEs) and to inform health system initiatives geared toward mitigating the impacts of ACEs on rural populations.
  • Mental Health First Aid in Rural Communities: Appropriateness and Outcomes
    Journal Article
    Maine Rural Health Research Center
    Date: 01/2016
    Mental Health First Aid (MHFA), an early intervention training program for general audiences, has been promoted as a means for improving population-level behavioral health in rural communities by encouraging treatment-seeking. This study examined MHFA's appropriateness and impacts in rural contexts.

2015

  • Implications of Rural Residence and Single Mother Status for Maternal Smoking Behaviors
    Policy Brief
    Maine Rural Health Research Center
    Date: 11/2015
    This study finds rural mothers are more likely than urban mothers to smoke. The authors suggest policymakers consider extending insurance for smoking cessation programs through the Affordable Care Act and Medicaid. Programs at the local, state, and national levels also could help reduce disparities in smoking-related morbidity and mortality.

2014