Survivors of traumatic injury who live in rural America face many challenges to recovery due to limited access to specialized services, geographic barriers, and socioeconomic factors including lower baseline income levels and higher rates of uninsurance.

While nearly 20% of the U.S. population lives in areas defined as rural, rural patients are substantially underrepresented in studies of trauma survivorship. In a new project funded through a Patient-Centered Outcomes Research Institute (PCORI) Engagement Grant, Marta McCrum, MD, trauma surgeon-scientist at the University of Utah, seeks to address the disparities in post-trauma recovery that plague those who live outside metropolitan and suburban areas.

“Utah is a major trauma center that serves a large five-state catchment area,” said Dr. McCrum, who grew up in northern Alberta, Canada and knows something about access to care issues. “We appreciate our patients’ struggles with accessing trauma care and high-level post-discharge care. This project will help us understand our patients’ perspectives with respect to their recovery and identify ways we can help improve their experience.”

Chelsi Gearty was severely injured in a farming accident on her ranch more than 40 miles east of San Antonio, TX, and faced many of the obstacles that Dr. McCrum describes. Left paralyzed after a 1,200 lb. bale of hay fell on her back, once she was discharged from an in-patient facility, the single mother had no way to get to and from physical therapy appointments. “It was like getting injured all over again, having to navigate a distant healthcare system with no support,” she said. Gearty—already a member of CNTR’s Injury Research Engagement Panel—will be a participant in Dr. McCrum’s project. “I’m hoping that this project makes everyone more aware of what the true needs are in rural communities.”

The project, titled “Building Capacity for PCOR/CER by Engaging Rural Trauma Survivors and their Recovery Communities,” will first convene a diverse community of stakeholders to include rural trauma survivors and their families, surgeons and physicians involved in trauma patient care, therapists, social workers and advocacy groups. Following training in patient-centered outcomes and comparative effectiveness research, the group will systematically identify gaps in existing research and then prioritize these topics for future research proposals.

Dr. McCrum plans to create community-based research models and to foster partnerships with rural healthcare facilities, national research organizations such as the Coalition for National Trauma Research, and trauma survivor advocacy organizations to ensure sustainability of rural trauma research. “The research agenda we develop will be made available to the greater trauma community and will be a resource for other trauma programs and investigators who want to work on this,” she said.

Dr. McCrum first discovered CNTR when she attended the Summit to Advance Focused Equity Research in Trauma (SAFER-Trauma) and found that CNTR’s commitment to addressing disparities matched her own. “I walked out of that conference wanting to do this project,” she said. CNTR’s role is to assist with patient and family recruitment and engagement throughout the course of the project.

If you are a trauma surgeon, nurse or other trauma care provider who serves those in rural settings, please download the recruitment flyer to share with your patients: HERE