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In Rural Wyoming, This Program Is Designed To Help Patients Manage Medical Needs


When you live in a rural place, the doctor's office or emergency room can be hard to get to. For people living with chronic conditions, that makes life complicated. Wyoming Public Radio's Maggie Mullen reports on one program designed to help rural patients manage their medical needs.

MAGGIE MULLEN, BYLINE: Gary and Celeste Havener live 40 miles outside of Laramie in southeast Wyoming. They spend a lot of their time growing vegetables and riding horses across the prairie.

GARY HAVENER: And any time you get on a horse, anything can happen.

MULLEN: A few weeks ago, Celeste fell off her horse.

CELESTE HAVENER: Had a very ungraceful dismount and tweaked my knee pretty good.

MULLEN: Afterwards, she laid on the ground for a while, trying to figure out how hurt she was, but also wondering if a visit to the doctor was worth it.

C. HAVENER: After it didn't get better, I did go to town.

MULLEN: This kind of decision-making is something she and her husband do often since they both have other health issues. Gary deals with pain from injuries working as a carpenter, and Celeste just recently wrapped up radiation treatment for breast cancer.

C. HAVENER: I think most rural people choose Dr. Denial as their first choice. Dr. Google is their second choice.

MULLEN: In a recent poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health, 26% of rural Americans say there's been a time the past few years when they needed health care, but did not get it. A majority of them say it was because financial barriers kept them from seeing a doctor, but almost a quarter of them say it was because health care was too far or difficult to get to. That's where Janet Korpela comes in.

JANET KORPELA: In a rural area, if someone can manage their own health better and go to the doctor less often, then that's a win for everybody.

MULLEN: Today, she's running a leader training with eight volunteers for a program called Healthy U.


MULLEN: They arrange tables in a circle so participants can all face one another. The people from this training will go back into their communities to teach patients living with chronic conditions how to better manage their health. These leaders don't need a medical background. Korpela says, they just need to be willing to do the 40 hours of free training.

KORPELA: This curriculum is really designed to be led by pure leaders, which means that the leaders should be equivalent or equal to the people who will eventually be taking the workshops.

MULLEN: One of the things volunteers do in the training is role-play. Korpela is in the role of patient.

KORPELA: My action plan was to take my prescribed medication daily, on time, as prescribed. And I did not do that. And actually...

MULLEN: Volunteers learn to brainstorm solutions. Melanie Pearce and Dawn Garrison have a few ideas.

MELANIE PEARCE: Take your medicine with a regular activity.

DAWN GARRISON: I said, put it by the toothpaste so when you brush your teeth in the morning, you take it first thing in the morning. I'm assuming that you brush your teeth every morning.


MULLEN: This is called action planning, and studies show it's effective at improving quality of life and reducing the number of doctor visits or hospitalization.

ANNA D'HOOGE: I mean, I think we tend to think of it as a medical issue in the sense of disease management - like, you just need to go to the doctor or take your medication.

MULLEN: That's Anna D'Hooge. She's one of 62 people in Wyoming to complete the leader training. She's a nutritionist at a hospital in Cheyenne, and the majority of her patients deal with a chronic condition.

D'HOOGE: Hopefully, people will realize, oh, well, I'm not a health care doctor. I'm not a nurse, but I do have these skills, so I can help my friend with chronic disease by doing this.

MULLEN: For D'Hooge, she decided to do the training as a way to make her community a healthier place to live. For NPR News, I'm Maggie Mullen in Laramie. Transcript provided by NPR, Copyright NPR.

Maggie Mullen