title: Rural and Urban/Suburban Families' Use of a Web-Based Mental Health Intervention.
abstract: Background/Introduction: Access to mental healthcare among rural residents is a national concern because unique barriers (e.g., fewer providers, distance to services) create significant challenges for the 60 million Americans who live in these settings. There is now a large body of literature demonstrating the efficacy of a wide range of Internet-based interventions. However, little is known about the extent to which individuals in rural settings will use these approaches and find them acceptable. Research with youths and their caregivers within this scope is particularly limited and, therefore, of great importance.
  
  
  
  We examined access and completion of a Web-based disaster mental health intervention in a population-based sample of 1,997 rural (n = 676) and urban/suburban (n = 1,321) adolescents and their caregivers who were affected by the Spring 2011 tornadoes that touched down in parts of Missouri and Alabama.
  
  
  
  Results indicated no differences in the rate of access or completion of Web-based modules based on geographical location. Furthermore, for those who did not access the Web-based resource, no differences were observed with respect to reasons for not accessing modules based on geographical location.
  
  
  
  These data have promising implications for the reach of Web-based resources to both rural and urban/suburban communities, as well as the willingness of adolescents and their caregivers to access and complete such resources, regardless of geographical location.
authors.affiliation: 1 Department of Nursing, Medical University of South Carolina , Charleston, South Carolina.|2 Ralph H. Johnson VA Medical Center , Charleston, South Carolina.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Bunnell
authors.affiliation: 1 Department of Nursing, Medical University of South Carolina , Charleston, South Carolina.|2 Ralph H. Johnson VA Medical Center , Charleston, South Carolina.
authors.forename: Tatiana M
authors.initials: TM
authors.lastname: Davidson
authors.affiliation: 2 Ralph H. Johnson VA Medical Center , Charleston, South Carolina.
authors.forename: Daniel
authors.initials: D
authors.lastname: Dewey
authors.affiliation: 3 Department of Psychology, University of Vermont , Burlington, Vermont.
authors.forename: Matthew
authors.initials: M
authors.lastname: Price
authors.affiliation: 1 Department of Nursing, Medical University of South Carolina , Charleston, South Carolina.|2 Ralph H. Johnson VA Medical Center , Charleston, South Carolina.
authors.forename: Kenneth J
authors.initials: KJ
authors.lastname: Ruggiero
mesh_terms: D000293:Adolescent; D000328:Adult; D000407:Alabama; D004190:Disasters; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D020407:Internet; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D008923:Missouri; D019035:Rural Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data; D013383:Suburban Population / Q000706:statistics & numerical data; D017216:Telemedicine / Q000458:organization & administration* / Q000706:statistics & numerical data; D055869:Tornadoes; D014505:Urban Population / Q000706:statistics & numerical data; D055815:Young Adult
keywords: behavioral health; disaster medicine; e-health; technology