Brief Summary of Minutes of Annual Meeting

Please see the attachment.

The overall objectives of this project are:

Objective 1: To conduct extensive higher order analyses in all waves of quantitative and qualitative data to further explore factors that create barriers or enhance the physical and mental health of diverse rural low-income families.

Objective 2: To understand the impact of the Affordable Care Act (ACA) on rural low-income families.

Objective 3: To disseminate findings, based on the proposed analyses, in order to further the empirical knowledge base and increase understanding among family serving professionals and policy makers regarding factors that contribute to or create barriers to the physical and mental health of diverse rural low-income families.

To achieve the objectives above, we set our milestones in each year. The 2015 milestones and their activities, outputs, and short-term outcomes are described below:

2015 milestones:

Objective 1: Develop comprehensive historical data set of compatible health and well-being variables from parallel populations collected at different points in time. Provide input into case study protocols.

• The Executive Board committee assigned a contact person who takes a leadership role to achieve this goal. After consulting a statistical consultants, we found that merging different datasets is not practical for our project. According to Tom Scoffield at Iowa State who looked at the datasets, we do not have a critical mass of data to construct a meaningful combined dataset. The only way to do this would be census tract data (i.e., addresses). However, due to change in group membership this is not possible. His opinion was that we were better off running parallel analyses in data sets from two time points to effectively address questions about time. This decision was not made lightly.

Objective 2: Purposely select rural, low-income families and stakeholders for case studies. Develop interview protocol, finalize strategies and other procedures for case study interviews.

• The Case Study committee was formed at the 2014 annual meeting which identified the impact of the ACA on rural, low-income families as a topic that needed to be assessed. The committee recommended the target populations, sampling method, and potential interview questions. Based on the recommendations, we further created case study sub-committee which developed draft of interview protocol for rural, low-income mothers, and draft of survey for community healthcare providers. At the 2015 meeting, however, the group decided to focus on collecting information from individual mothers by postponing the survey for community healthcare providers. Currently, the group is finalizing the interview protocol and pilot tests of the protocol is been conducted.

Objective 3: For this objective, we have 2 milestones;

1. a) Assemble welfare policies for each state. Compile multi-state findings and policy points of interest for the similarities and differences, and
2. b) Peer-reviewed publications and presentations representing multiple disciplines targeting diverse audiences (practitioners, researchers, policy makers).

To achieve Objective 3-a), a project member completed a databook which lists health-related information of our participating counties.

Mammen, S., Shepherd, A. & Miccio, E. (2015). A Guide to the Affordable Care Act (ACA) Coverage In RFSH States. Unpublished document.

Additionally, policy briefs about the impact of ACA on rural, low-income families are published to inform policymakers and community stakeholders. The titles of the briefs can be found under “Publication” section.

In addition of various journal articles, conference proceedings, book chapters, and other outputs, we also submitted two grant proposals to secure findings: 1) NCFR innovative grant proposal submitted by Dr. Kimberly Greder, Iowa State University, in order to conduct additional interviews with Latina mothers in Iowa, and 2) Robert Wood John Foundation grant by Dr. Doris Tirado-Cancel, Western Oregon University, to analyze NC1171 data more in depth.

Finally, the NC1171 data were used to enhance undergraduate students’ learning outcomes. Dr. Suzanne Smith, Washington State University Vancouver, used case studies in her conflict management class; and Dr. Sheila Mammen, University of Massachusetts, used local level data in her economics class.

The 2016 milestones are set as follows:

Objective 1: Analyze health and well-being of rural low-income families based on two waves of qualitative and quantitative data from the NC1171 project. Examine changes and stabilities of families and communities based on the historical data set created in Year 1.

Objective 2: Collect, code and clean data from selected case study families. Collect, code, and clean data from community stakeholders.

Objective 3: Distribution of selected policy briefs. Peer-reviewed publications and presentations representing multiple disciplines targeting diverse audiences (practitioners, researchers, policy makers). Begin development of educational materials for elected officials, program administrators, students, consumers.

The list below only shows published work and publications in preparation are not included in the list.

Peer reviewed manuscripts--Published:

Mammen, S., Dolan, E., & Seiling, S.B. (2015) Explaining the poverty dynamics of rural families using an economic well-being continuum.  Journal of Family and Economic Issues. doi: 10.1007/s10834-014-9405-4.

Manoogian, M. M., Jurich, J., Sano, Y., & Ko Ju-Lien. (2015). “My kids are more important than money:” Parenting expectations and commitment among Appalachian, low-income mothers. Journal of Family Issues. 36(3), 326-350. doi: 10.1177/0192513X13490402.

Valluri, S., Mammen, S., & Lass, D. (2015) Health care use among rural, low-income women and children: Results from a 2-stage negative binomial model.  Journal of Family and Economic Issues, 36:154-164. Doi: 10.0007/s10834-014-9424-1.

Peer reviewed manuscripts—Under Review:

Barnett, M., Yancura, L.A., Wilmoth, J., & Sano, Y. (under review). Wellbeing Among Rural Grandfamilies in Two Multigenerational Household Structures. Submitted to Grandfamilies: The Contemporary Journal of Research, Practice, and Policy.

Greder, K., Doudna, K., and Sarver, S. (under review). Food Insecurity, Maternal Depression, and Child Behaviors in Rural, Low-income Families”. Submitted to Family Relations.

Izenstark, D., Oswald, R.F., Holman, E.G., Mendez, S.N, and Greder, K. (under review). Rural, Low-Income Mothers’ Use of Family-Based Nature Activities to Promote Family Health. Submitted to Journal of Leisure Research.

Mammen, S., Sano, Y. & Gay, M (under review). Degree of privation among rural, low-income families: Differences by race and ethnicity. Submitted to Journal of Rural Sociology.

Reina, A. and Greder, K. (under review). Meanings and strategies for good health: Perspectives of Latina immigrant mothers in the rural Midwest”. Submitted to Hispanic Journal of Behavioral Sciences.

Yancura, L. Sano, Y., & Ontai, L. (under review). The association between multigenerational household structure and overweight and obesity in rural families. Submitted to Child: Care, Health & Development.

Book Chapters

Downey, J. and Greder, K. (2014) “Depressive Symptomology among rural low-income Latina and non-Latina White mothers”. In Blair, S.L. and McCormick, J.H. (Eds.), Family and Health: Evolving Needs, Responsibilities, and Experiences (Contemporary Perspectives in Family Research, Volume 8B. (pp.247 – 269). Emerald Group Publishing Limited.

Greder, K., Ihmels, M., Burney, J., Doudna, K. (2014). Obesity in Rural America. In J. Warren and B. K. Smalley (Eds.). In Rural Public Health: Best Practices and Preventive Models. Springer Publishing Company. 

Technical Report

Mammen, S., Shepherd, A. & Miccio, E. (2015). A Guide to the Affordable Care Act (ACA) Coverage In RFSH States. Unpublished document.

Policy Briefs

Byrne, M. and Greder, K. (2014). Obesity Risks for Latino Immigrant Families in Rural Iowa. Iowa State University Extension and Outreach Research Brief, HS 0012, Iowa State University. [Available online]. http://store.extension.iastate.edu/Product/HS12

Byrne, M., Greder, K., and Routh, B. (2014). Healthcare Literacy, Access, and Resources in Iowa’s Rural Latino Communities. Iowa State University Extension and Outreach Research Brief, HS 0013, Iowa State University. [Available online]. http://store.extension.iastate.edu/Product/HS13

Conference Presentations

Bao, J., and Greder, K. (2015) “Relationship Between Family Routines and Rural Latino Child Health.” Poster at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Burney, J., Routh, B., Greder, K., and Greer, B. (2015) “Associations between Maternal Depression and Family Eating and Physical Activity Behaviors.” Poster Symposium at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Dyk, P., Routh, B., Katras, M., Greder, K., Mammen, S., and Alvarez, S. (2015) “Barriers and Enablers to Good Health Experienced by Low-Income Rural Mothers.” Poster Symposium at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Greder, K., Katras, M.J., and Routh, B. (2015). “Rural Low-Income Mothers Using Internet for Health Information”. Workshop presentation at the 20th Rural Multiracial and Multicultural Health Conference, Philadelphia, PA.

Greder, K., Sano, Y., Mammen, S. and Doudna, K. (2015). “Relationship between health and rural low-income mothers’ Internet use.” Poster Symposium at the National Council on Family Relations 76^th Annual Conference, Baltimore, Maryland.

Izenstark, D., Oswald, R.F., Holman, E.G., Mendez, S.N., and Greder, K. (2015). “Using Family-Based Nature Activities to Promote Rural, Low-income Families' Health", Paper presentation at the National Recreation and Park Association (NRPA) Research Conference, Las Vegas, NV. Awarded Pillars of NRPA Award for Best Research Abstract in Health and Wellness, National Recreation and Park Association.

Mammen, Berry, Bird, & Burney. (2015) Empowering Marginalized Rural Families through Health Security ”  Poster Symposium at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Mammen, Varcoe, & Lawrence. (2015) Impact of EITC status of RFSH Mothers. The annual meeting on the American Council for Consumer Interests, Clearwater Beach, FL.

Ontai, L., Sano, Y., Greder, K., McGuire, J., Radunovich, H., and Barnett, M. (2015) “Relationship Between Negative Family Dynamics and Child Health.” Paper at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Radunovich, H., & Smith, S.R. (July-August 2015). NC 1171 Research Collaborative: Mental Health Results for Poor, Rural Families. National Association for Rural Mental Health, Honolulu, Hawaii.

Rodriguez, G. and Greder, K. (2015). “Relationship Between Families’ Health Insurance Status and Children’s Dental Health”. Poster presentation at the Annual Cambio de Colores (Change of Colors) Conference, Kansas City, MO.

Routh, B., Doudna, K., and Greder, K. (2015) “Maternal Depression and BMI among Rural Low-Income Latina Immigrant Mothers.” Paper Symposium at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Routh, B., Doudna, K., and Greder, K. (2015). Parenting Alliance and Health Behaviors among Rural Latinos. Poster presentation at the 38th Annual Rural Health Conference, Philadelphia, PA.

Sano, Y., Greder, K., and McGuire (2015) “Relationship between Food Insecurity and Child Behavior Among Rural Families.” Poster Symposium at the National Council on Family Relations 77^th Annual Conference, Vancouver, BC.

Non-refereed Manuscripts for Professional Organization Bulletins and Newsletters

Routh, B. and Greder, K. (2014). Health Disparities Facing Latinos in Rural Iowa. Public Health Matters, Iowa Public Health Association.[Available online]. http://www.iowapha.org/Resources/Documents/IPHA%20PHM-Winter2014.pdf