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Graduation Term
Fall 2025
Degree Name
Doctor of Philosophy (PhD)
Department
Mennonite College of Nursing
Committee Chair
Theresa Adelman-Mullally
Committee Co-Chair
Michele Shropshire
Committee Member
Cherrill Stockman
Committee Member
Wendy Woith
Abstract
This dissertation comprises three manuscripts intended for publication, each exploring harm reduction interventions in rural areas for people who use substances (PWUS). The first manuscript presents a literature review on current research regarding the implementation of harm reduction interventions in rural areas. The review highlights that harm reduction interventions are affected by interpersonal relationships, accessibility, and buy-in from the community and PWUS. This review concludes with the importance of hearing from rural PWUS to design impactful interventions for the rural community.
The second manuscript reports on a narrative inquiry study investigating the experiences, barriers, and access of harm reduction programs in rural areas. Guided by the Health Promotion Model, this study utilized this framework as it was developed to promote overall health behaviors, not just focus on the absence of disease. Narrative inquiry allowed centering on the perceptions and stories of rural PWUS. Themes such as addiction, isolation, reasons for using substances, support from family, friends, and professionals, discrimination by professionals, acceptance, discrimination by others, and access were all found to be part of these patients stories surrounding substance use and harm reduction programs.
The third manuscript discusses the challenges experienced in recruitment of rural PWUS, as well as suggested opportunities to increase recruitment in future studies. Authenticity of online respondents, in person recruitment, and study commitment were all challenges that can be affected by careful planning and preparation. Opportunities for future researchers included building community partnerships, educating rural communities, and planning for future research through diverse research teams and extended timeframes. This paper contributes to the science by encouraging recruitment and retention of rural PWUS in research to help design impactful, long-lasting interventions.
Access Type
Dissertation-ISU Access Only
Recommended Citation
Rosecrans, Kelly, "Utilization of Harm Reduction Services for People Who Use Substances in Rural Illinois" (2025). Theses and Dissertations. 2248.
https://ir.library.illinoisstate.edu/etd/2248