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Introduction: The impact of opioid use disorder (OUD) on children is of increasing concern to providers and communities and is yet to be fully understood. Children and families in rural areas are particularly vulnerable due to decreased access to care, lower socioeconomic status, and lower rates of health insurance coverage. This qualitative secondary data analysis of transcripts from interviews with community stakeholders specifically examined responses when asked how parental OUD impacted children in their rural communities. Methods and Materials: As part of a larger community assessment, 11 focus group and three individual interviews with a variety of stakeholders most likely to encounter those with or at risk for substance use disorder from a predominately rural region of Texas were held in October of 2019. During one-hour sessions a scripted interview guide was used to ask open-ended questions to identify the prevalence and impact of OUD within the community. Transcripts of recorded interviews were coded by three researchers using conventional content analysis focusing on discussion of how parental OUD impacted children in their rural communities. Codes were classified into themes based on consensus. Results: Identified themes were (1) Community Concern for Families; (2) Impaired Parents, Neglected Children, and (3) Intergenerational Normalization of Substance Misuse. Conclusions: The impact of parental OUD and SUD was a concern for participants. Findings have implications for strategies to prevent and mitigate adverse outcomes for children and families in rural areas. [ABSTRACT FROM AUTHOR]

Abstract: Sexual assault is prevalent in the Unites States. Many areas of the country lack access to sexual assault nurse examiners (SANEs), especially in rural areas. The U.S. Health Resources and Services Administration Advanced Nursing Education-Sexual Assault Nurse Examiner educational grant provided an opportunity to improve equity and reduce disparity in rural and underserved communities by offering education and simulation experiences in the care of sexual assault patients. Through the Texas A&M Health Center of Excellence in Forensic Nursing, Texas A&M University College of Nursing developed an innovative program using simulated medical forensic examinations and mock testimony education. Rapid cycle quality improvement was utilized to adapt quickly to feedback and meet overarching goals. This article describes development and adaptation of the program using rapid cycle quality improvement processes and progress in recruitment, retention, and certification of nurses to provide sexual assault care in rural and underserved areas of Texas., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 International Association of Forensic Nurses.)