{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:29:30Z","timestamp":1788823770901,"version":"build-2803163510"},"reference-count":23,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T00:00:00Z","timestamp":1765411200000},"content-version":"vor","delay-in-days":101,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To assess the impact of a structured educational curriculum Ostomy Self\u2010Management Telehealth (OSMT) treatment among cancer survivors residing in rural areas of the United States on selected measures of health care utilization, cost, and employment status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a multi\u2010site randomized controlled trial comparing OSMT treatment group against a control group receiving usual care (UC) in rural populations. OSMT treatment consisted of virtual group sessions led by trained peer ostomates delivered once a week over a 5\u2010week period via video conferencing platforms. Surveys related to health care utilization were administered up to four times: baseline, post\u2010session, 3\u2010month and 6\u2010month follow\u2010up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Compared to the UC group, the OSMT group was associated with lower frequencies of in\u2010person nurse (\u201357.2%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.015) and physician (\u201376.1%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.024) visits in the post\u2010session follow\u2010up survey; no significant differences were observed in the subsequent follow\u2010up surveys. Moreover, the OSMT treatment group was also associated with lower ostomy\u2010related emergency department visits (\u201388.3%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.119), lower direct out\u2010of\u2010pocket health care (\u201325.8%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.405) and travel costs (\u201347.7%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.105), as well as higher probability of full\u2010time employment (18.9%\u00a0vs. 12.3%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.179) and lower probability of claiming disability (14.3%\u00a0vs. 18.9%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.459) in the 6\u2010month follow\u2010up; these differences, however, were not statistically significant.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>While not all statistically significant, the OSMT treatment was associated with some notable changes in the patterns of health care utilization and selected economic outcomes among ostomates residing in rural communities. This suggests that the OSMT treatment likely contributes to more efficient and cost\u2010effective care in the target population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Synopsis<\/jats:title>\n                    <jats:p>Ostomy Self\u2010Management Telehealth (OSMT) program seeks to reduce barriers to care and improve self\u2010management skills especially among ostomates residing in rural communities. This study reports that OSMT was associated with lower in\u2010person health care provider visits, suggesting OSMT may lead to more efficient and cost\u2010effective care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jrh.70096","type":"journal-article","created":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T07:25:05Z","timestamp":1765524305000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Impact of Ostomy Self\u2010Management Telehealth training for rural cancer survivors on health care utilization and economic outcomes in the United States"],"prefix":"10.1111","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1867-6629","authenticated-orcid":false,"given":"Daniel","family":"Maeng","sequence":"first","affiliation":[{"name":"Department of Psychiatry University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Population Sciences Division of Nursing Research and Education City of Hope  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Nielsen","sequence":"additional","affiliation":[{"name":"Department of Urology School of Medicine University of North Carolina at Chapel Hill  Chapel Hill North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca L.","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Division of Colorectal Surgery Geisinger Medical Center Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2679-7460","authenticated-orcid":false,"given":"Tullika","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Urology Penn State Health Milton S. Hershey Medical Center Hershey Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah M.","family":"Popek","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Surgical Oncology University of New Mexico Albuquerque New Mexico USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert P.","family":"Sticca","sequence":"additional","affiliation":[{"name":"Department of Surgery University of North Dakota\u2014Sanford Health Fargo North Dakota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison A.","family":"Aka","sequence":"additional","affiliation":[{"name":"Division of Colon and Rectal Surgery Loma Linda University Health Loma Linda California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walid M.","family":"Hesham","sequence":"additional","affiliation":[{"name":"Division of General Surgery Lancaster General Hospital Lancaster Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia","family":"Grant","sequence":"additional","affiliation":[{"name":"Department of Population Sciences Division of Nursing Research and Education City of Hope  Duarte California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Holcomb","sequence":"additional","affiliation":[{"name":"Arizona Telemedicine Program University of Arizona  Tucson Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert S.","family":"Krouse","sequence":"additional","affiliation":[{"name":"Corporal Michael J. Crescenz Veterans Affairs Medical Center and Perelman School of Medicine University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,12,11]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.15840"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0b013e318259c441"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010015\u20101050\u20103"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/WON.0000000000000922"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JOP.2013.001311"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102354.2000.00225.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/10810730590934217"},{"issue":"10","key":"e_1_2_8_9_1","first-page":"34","article-title":"The prevalence of ostomy\u2010related complications 1 year after ostomy surgery: a prospective, descriptive, clinical study","volume":"62","author":"Carlsson E","year":"2016","journal-title":"Ostomy Wound Manage"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcpo.2024.100534"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000000246"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.43562"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13187\u2010012\u20100433\u20101"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.4078"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.34126"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.16153"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.13666"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-1765(03)00032-6"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.2196\/29575"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/ASW.0000000000000300"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.25270\/wmp.2021.1.1217"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11491"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.35091"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0000000000002142"}],"container-title":["The Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.70096","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jrh.70096","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.70096","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T12:19:08Z","timestamp":1779538748000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jrh.70096"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":23,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["10.1111\/jrh.70096"],"URL":"https:\/\/doi.org\/10.1111\/jrh.70096","archive":["Portico"],"relation":{},"ISSN":["0890-765X","1748-0361"],"issn-type":[{"value":"0890-765X","type":"print"},{"value":"1748-0361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-04-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-11","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70096"}}