PI Name: Ece Demir-Lira, PhD

Project Title: Identifying Relationships between Premature Birth, Parental Mental Health, Socioeconomic Status and Language Development in Children from Rural Iowa

Dept/College: Department of Psychological & Brain Sciences, College of Liberal Arts & Sciences, University of Iowa

Abstract: Rural children, who represent 12% of all children under the age of 6 in Iowa, are at a greater risk of falling behind in their
neurodevelopment compared to their urban peers. Prior literature examining mechanisms that underlie
neurodevelopmental gaps between children primarily focused on urban populations. This work identified significant
biological (e.g. prematurity) and environmental (e.g. maternal mental health and socioeconomic status) predicting child
outcomes. Little is known about the risk and protective factors predicting outcomes of rural children. The overall
objective of the current proposal is to characterize the relations between gestational age, SES, maternal mental health,
and early language skills in 3- to 5-year-old children living in rural counties of Iowa. Pinpointing aspects of rural children’s
early lives that increase or decrease risk for school readiness will inform early prevention and intervention efforts aimed
at improving rural children’s future life outcomes.

2017-2018 Pilot Awardee

PI Name: Nicole Novak, PhD

Project Title: Social and Structural Determinants of Latino Health and Health Behavior in Rural Iowa

Dept/College: Department of Community and Behavioral Health, College of Public Health, University of Iowa

Abstract: Acknowledging and understanding upstream influences on health and health behavior is important for effective intervention and prevention. A growing literature indicates that economic position, community integration, immigration policy and enforcement, and processes of racialization are important determinants of health and health behavior for immigrant and US-born Latinos, but there is little research on these dynamics in rural settings. This project will use oral histories, in-depth interviews and participant observation to build a richer understanding of the socio-structural determinants of health and health behavior for immigrant and US-born Latinos in Iowa. Findings from this project can inform the development of “structurally competent” interventions to help existing health and social services better meet the needs of Iowa’s Latino communities. It will also support the development of theoretical frameworks for future population health research on Latino health disparities in rural settings.

2015-2016 Pilot Awardee

PI Name: Anne Helene Skinstad, PhD

Project Title: Native American Health Innovations: A Return to Tradition

Dept/College: Department of Community and Behavioral Health, College of Public Health, University of Iowa

Abstract: Although prevalence rates among Native Americans are not public information, Native Americans have consistently higher rates of Type 2 Diabetes than the general population.  The National American Indian and Alaska Native ATTC seeks funding to conduct a needs assessment to learn about the Meskwaki community’s strengths and willingness to incorporate traditional produce and recipes. The needs assessment is the first step in a community-based participatory research project to assist the community in creating an intervention to encourage healthy eating into Type 2 Diabetes prevention and management.  Research suggests that implementing culturally-informed practices in Native communities is an effective way to treat and prevent Type 2 Diabetes in Native American communities.   In addition to the re-introduction of traditional foods for the purposes of increasing overall health, it is our hope that this project will also serve to create a greater sense of community and pride in reclaiming cultural traditions

2014-2015 Pilot Awardees

PI Names: Ellen Schafer, PhD

Project Title: Infant feeding experiences in Iowa: from breastfeeding initiation to cesssation

Dept. /College: Department of Community and Behavioral Health, College of Public Health, University of Iowa

Abstract: Breastfeeding helps reduce risks of adverse health outcomes for mothers and children.  Current recommendations suggest babies be fed only breast milk for the first six months of life with continued breastfeeding through one year.  While 82% of Iowa babies are ever breastfed, only 52% and 29% are breastfed for six and twelve months, respectively.  The gap between breastfeeding initiation and duration rates is posited to depend on mothers’ breastfeeding experience, including the influence of the social environment.  Research exploring experiences for the entire duration, from initiation to cessation, is needed yet lacking. In this project, retrospective interviews with first-time mothers and their significant others (e.g., spouse/partner, family, friends, and childcare providers) will be conducted to identify turning points, important events in the breastfeeding experience, and associated cognitions, behaviors, and social interactions.  Identifying key turning points and the interplay of these factors across the breastfeeding experience will help enhance current interventions.


PI Names: Jennifer Margrett, PhD and Sato Ashida, PhD

Project Title: Exploring care deserts: Evaluating formal and informal support in rural Iowa: relation to long-term support services and aging in place

Dept./College: Department of Gerontology, Iowa State University and Department of Community and Behavioral Health, College of Public Health, University of Iowa

Abstract: Iowa is one of the oldest states, particularly in regard to the oldest old (i.e., individuals aged 85+). Iowa is also highly rural, posing challenges to aging and independent living (e.g., transportation, resource knowledge and access). Iowa ranks second in the U.S. on the proportion of older adults receiving care in skilled nursing facilities and there are a disproportionately high number of residents classified as demonstrating low-care needs (fourth in nation). The objective of this proposal is to assess formal and informal community supports in rural Iowa communities which are at an increased risk of being located in “care deserts,” areas in which residents have limited access to resources that support healthy and independent living. Findings will help improve older Iowans’ access to home and community-based services (HCBS) which can decrease care cost, increase ability to live independently, and increase satisfaction. This project supports collaboration between Dr. Ashida (UI, PRC-RH) and Dr. Margrett (ISU, Gerontology).

2013-2014 Pilot Awardees

PI Names: Sato Ashida, PhD

Project Title: Familial and community-based social networks of older adults in rural Iowa

Dept. /College: Department of Community and Behavioral Health, College of Public Health, University of Iowa

Abstract: Older adults, especially those living in rural communities, are at increased risk for social isolation due to the increasing geographic dispersion among family members. As increasing numbers of older adults choose independent living, it becomes necessary to understand the characteristics of both familial and community-based social networks surrounding them so that interventions to enhance the social environment can consider all relevant relationships. In this pilot study, we will conduct a comprehensive assessment of familial and community social contexts among older residents in Ottumwa, IA, using systematic social network methodology. This approach will allow us to move beyond individuals and interview other important people including non-family network members (e.g., volunteers, adults from community-based agencies and groups) who may play important roles in older adults’ lives. Our long-term objective is to develop and test interventions that enhance the social environment of older adults to facilitate their overall wellbeing and quality of life.


PI Names: Barbara Baquero, PhD, MPH

Project Title: Exploring and understanding social networks of community-based organizations associated with healthy eating and active lifestyle among Latinos in Ottumwa, IA.

Dept. /College: Department of Community and Behavioral Health, College of Public Health, University of Iowa

Abstract: Iowa has seen one of the largest influxes of Latinos in the last decade. Latinos face many challenges when they immigrate to the US. Due partially to these challenges, Latinos suffer from serious obesity and chronic diseases health disparities compared to whites. Despite these challenges, Latinos continue to develop networks to interact socially and culturally and obtain the services that they need in their new communities. Incorporating existing connections individuals have with community-based organizations may contribute to intervention implementation, feasibility, efficacy and sustainability. This pilot study proposes to explore the social networks of community-based organizations that Latinos access in Ottumwa, Iowa and to demonstrate how these networks can be part of community-based interventions. This study is the first step in the research program that aims to develop a community wide intervention to support and promote healthy eating and active lifestyle behaviors for Latinos to prevent and control obesity.


PI Names: Natoshia M. Askelson, MPH, PhD and Disa Cornish, PhD

Project Title: Supporting rural school districts in achieving school meal reforms: Formative research for designing a Diffusion of Innovations-informed intervention

Dept. /College: College of Public Health, University of Iowa and University of Northern Iowa

Abstract: The goal of this proposal is to gather formative research for the development of an intervention which would facilitate healthier, locally-sourced school meals in rural schools. School meal programs have been the focus of attention because of the role school meals play in children’s overall nutrition and in preventing and addressing obesity. School meals are vital to rural children because of increased levels of poverty and limited access to nutritious foods. While the Healthy, Hunger-Free Kids Act of 2010 addressed nutritional changes and national reform efforts have focused on making school meals more appealing and locally-sourced, rural school districts have been struggling. Telephone surveys with food service directors will assess barriers, facilitators, best practices, and professional networks. The findings will be the basis for an intervention to use professional networks to facilitate the spread of best practices for creating healthier, sustainable school meals for rural students.