DP24-004, PRC, Core: University of Iowa Prevention Research Center for Rural Health

University Of Iowa, Iowa City IA

Investigators

Abstract

The Prevention Research Center for Rural Health (PRC-RH) mission is to address disparities in and across Midwestern communities to promote well-being. Among many social, structural, and environmental determinants of health, place matters. In the US, 97% of land is considered rural, and 19% of the population live in these places. Rural residents are more likely to die from each of the ten leading causes of death; yet rural health programs are underfunded. Place also intersects with other important social identities, including sexual and gender identity, frequently referred to as LGBTQIA+ (Lesbian, Gay, Bisexual, Transgender, Queer, Questioning, Intersex, Asexual and additional aspects of sexual/gender identity). LGBTQIA+ individuals are at elevated risk of cancer, chronic obstructive pulmonary disease, and cardiovascular disease than their heterosexual and cisgender peers. Less is known about LGBTQIA+ lives in rural areas. Many socio-ecologic factors influence these outcomes including experiences of stigma and discrimination. These experiences also drive risk behaviors including tobacco use. Tobacco use is significantly higher among LGBTQIA+ young adults (YA) than their heterosexual and cisgender peers. Evidence-based cessation strategies, such as Tobacco Quitlines (QL) are available, but YA significantly underutilize them. QL offer free, convenient, confidential cessation services that can address barriers in access to treatment. There is a clear implementation gap in evidence about what works to increase uptake of QL for rural LGBTQIA+ YA who use commercial tobacco products. Community-engaged research with these YA is necessary to center their narratives, to understand unique barriers to uptake of the QL; and to design sustainable, culturally relevant, and scalable implementation strategies to increase uptake of the QL. The PRC-RH focuses on micropolitan communities (n=15) in Iowa (IA); rural communities with populations sized 10,000-<50,000 that are growing in diversity, and serve as hubs for education, employment, economic and health activities, and are frequented by residents of smaller rural communities. Our specific aims are: • Aim 1: Promote health equity in IA’s micropolitan communities. Our approach relies on strengthening capacity to conduct prevention research; providing training and technical assistance, and infrastructure to support Aim 2, and communicating, disseminating and translating evidence-based interventions. • Aim 2: Enhance Quitline uptake and smoking cessation among LGBTQIA+ young adults in Iowa’s micropolitan communities. This project will pilot test implementation strategies in two micropolitan communities, develop an Implementation Playbook, scale up the intervention across Iowa, and share lessons learned and translation products with partners across Region G. • Aim 3: Collaborate with other PRCs in the network and other external partners to co-learn, synergize, share successes, and disseminate and translate products for collective health equity impact.