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Development and application of a rubric to compare strategies for improving access to health care in rural communities in the United States
•This rubric can be used by key stakeholders in rural areas to standardize and prioritize strategies to improve access to care in their communities.•Use of the rubric can inform decision making processes by providing evidence-based, comparable results pertaining to the impact and feasibility of pert...
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| Published in: | Evaluation and program planning 2019-06, Vol.74, p.61-68 |
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| Main Authors: | , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
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| Summary: | •This rubric can be used by key stakeholders in rural areas to standardize and prioritize strategies to improve access to care in their communities.•Use of the rubric can inform decision making processes by providing evidence-based, comparable results pertaining to the impact and feasibility of pertinent access to care improvement strategies.•The rubric can be further modified to meet the specific population and/or health needs of each community.•In the long-term, this rubric could facilitate discussions of strategy implementation successes and opportunities for improvement between rural communities.
Rural areas are underserved in terms of the availability of and access to health care services. According to Healthy People 2020, access to health care continues to be the most frequently identified rural health priority in the United States.
The purpose was to develop an efficient approach for standardizing and prioritizing strategies to improve access to health care in rural areas across the United States. The rubric provides a quantitative metric of the effectiveness of each strategy in terms of impact and feasibility and allows community health departments and other access to care groups to compare strategies and facilitate discussion of various strategies’ ability to meet the needs of diverse communities.
The Plan, Do, Check, Act (PDCA) cycle was used to create the rubric. The research team constructed a plan for creating a rubric to measure each strategy’s impact and feasibility. We checked the rubric by applying it to selected access to care improvement strategies evaluated by the Robert Wood Johnson Foundation (RWJF). Members of a rural community Access to Care Workgroup applied the rubric to several RWJF What Works for Health strategies. The final step was to compare the results of the application phase through facilitated conversations with the goal of determining which strategy or strategies would best meet the needs of the rural community.
A rubric is a valuable tool to facilitate assessment and discussion and for assisting community members in determining access to care priorities. After applying the rubric in a community setting, we identified two important tactics: 1) the rubric is best applied to strategies when they are summarized consistently and cohesively; and 2) it is important to involve community stakeholders early in the process of identifying strategies for evaluation. The next step is to apply the rubric to similar strategies in other |
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| ISSN: | 0149-7189 1873-7870 |
| DOI: | 10.1016/j.evalprogplan.2019.02.013 |