Dr. Kristi Wick is a UC Foundation assistant professor and Vicky B. Gregg Chair in Gerontology. Photo by Angela Foster.
Older adults living in rural Tennessee counties are at a higher risk for developing chronic diseases, cognitive disorders and poor health outcomes due to a lack of access to health care, continuity of treatment and resources.
A grant awarded to the University of Tennessee at Chattanooga School of Nursing aims to mitigate those risks by delivering health care and social services professionals to rural communities.
The School of Nursing has been awarded $2.6 million from the Tennessee Department of Health (TDH) for a project titled ROAD MAP, an acronym for Rural Health and Older ADult Interprofessional Mobile HeAlth Program.
The grant is from TDH’s Healthcare Resiliency Program (HRP), which is making $119 million in funding available to 41 eligible applicants—including the School of Nursing’s ROAD MAP request. HRP funding was approved as part of the Tennessee Resiliency Plan, created in March 2022 by Tennessee’s Financial Stimulus Accountability Group.
ROAD MAP funding will enable the purchase of a mobile health vehicle that will regularly visit rural Southeast Tennessee senior centers offering education, health promotion, health screening, primary care and social services to older adults.
The initiative seeks to improve access to health care and raise awareness of chronic disease management. Long-term objectives include lowering caregiver stress, increasing community resource use, reducing emergency room visits and decreasing social isolation for older adults.
Dr. Kristi Wick, UC Foundation assistant professor and Vicky B. Gregg Chair in Gerontology, and Vice Provost Shewanee Howard-Baptiste are co-principal investigators on the grant-funded project, leading a ROAD MAP team that includes Dr. Sarah Treat (School of Nursing), Dr. Latisha Toney (School of Nursing), Dr. Amir Alakaam (Master of Public Health), Dr. Erin Melhorn (Occupational Therapy) and Dr. Cathy Scott (Social Work).
Wick said the mobile health vehicle would serve older adults and caregivers in the Southeast Tennessee Area Agency on Aging and Disability district—Bledsoe, Bradley, Grundy, Hamilton, Marion, McMinn, Meigs, Polk, Rhea and Sequatchie counties—by bringing interprofessional health care into underserved areas.
“Most of these counties are rural,” Wick said, “and they have older adults who don’t have access to a lot of the resources that we do. Some of the counties don’t have hospitals or emergency departments.
“The senior centers in these counties are a great point of contact for us. They have good relationships with the older adults in their community. This is a great opportunity for us to work alongside the staff and support their programs and services.”
According to a Tennessee Rural Health Care Task Force report released in June, 22 Tennessee counties do not have local hospitals—and 13 rural hospitals have closed since 2010.
Meanwhile, Tennessee placed 40th in the category ranking of healthiest states for older adults according to the United Health Foundation’s 2023 Senior Report, which provides a portrait of the health and well-being of older adults across the U.S.
“Being able to bring specific services for older adults to a rural community will be huge,” Wick said. “Even something as simple as providing information about home modifications—like the importance of a ramp or shower chairs to help prevent falls will allow people to stay safely in their homes longer.
“Getting out to those rural, vulnerable adults … there’s definitely a gap in services and there’s definitely plenty of opportunities to serve.”
Wick said there are steps to follow in procuring and contracting the mobile health unit. It will be customized to allow for specific services such as the ability to equip the mobile vehicle with telehealth so that people “may be able to use telehealth for their visits with their neurologist or different specialists—saving them from having to drive two hours to get to Hamilton County.”
The ROAD MAP project, she said, is to drive into rural communities weekly—and possibly more—during the school year. In the meantime, while the mobile vehicle is being acquired, plans are to establish a community advisory committee with stakeholders from each of those counties.
“Anytime we have the opportunity to learn from local residents and community organizations, we achieve far more than if we attempt to provide support on our own. We’ll visit those counties, and our goal will be to recruit local participants for an advisory committee and do all the listening and planning work right up front so that as soon as the mobile health vehicle is ready, we’ll be able to start moving,” she said.
“That does two things for us: It helps us establish what the actual needs are for each community and it helps build trusted collaborative relationships so that we can work together to engage the community.”
Wick fondly spoke about crisscrossing the state in rental vehicles and “getting whatever we can get in a car” while performing field work with programs such as COVID testing and her current engAGING Communities Tennessee initiative.
“Being able to take a bus where we could do a hearing evaluation or an eye exam or some memory testing with space for people to come in and sit down is just going to be awesome,” she said, “and as an added bonus, UTC’s information will be all over it to hopefully recruit people into our health programs, too.”
She said potential benefits also include increased interprofessional collaboration and workforce development through clinical placements.
“People are going to see us out in the community,” Wick said, “and we can do events or programs to demonstrate, in real time, what each profession does to serve others. I’m so excited about it. I think it’s going to be great.”
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