Purpose: This review explores the important role that Family Nurse Practitioners (FNPs) play in addressing mild to moderate anxiety and depression in rural primary care settings. With limited to no access to psychiatric providers, rural communities often rely on FNPs to bridge critical gaps. This paper highlights practical, evidence-based approaches tailored to the unique challenges of rural healthcare, including provider shortages, stigma, and geographic location. Methods: A review of clinical guidelines and peer-reviewed literature published between 2020 and 2025 was conducted. The focus was on tools and strategies that support FNPs in assessing and managing anxiety and depression rural settings. Findings: In many rural areas FNPs often serve as the primary, and sometimes only, mental health providers. Their role includes early screening, diagnosis, treatment planning, and ongoing management. Validated tools such as the PHQ-9 andGAD-7 help guide clinical decision-making and track progress over time. First-line treatments typically include selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). When access to medication is limited, nonpharmacologic interventions such as cognitive behavioral therapy (CBT), behavioral activation, lifestyle changes, and community-based support become even more valuable. Telehealth and collaborative care models are increasingly used to improve access, reduce barriers and support continuity of care in rural areas. Discussion: FNPs are well positioned to respond to mental health needs in rural communities. By combining practical tools, evidence-based treatments, and flexible care delivery models-including telehealth., FNPs can expand access to care and help reduce mental health disparities. Their unique position in primary care allows them to build trust, deliver holistic care, and make a meaningful impact on the mental well-being of underserved rural populations.
Purpose: To explore the emerging role of artificial intelligence (AI) in improving pharmacologic decision-making for nurse practitioners (NPs) in rural primary care, highlighting clinical support, workflow integration, and ethical and legal responsibilities. Methods: This narrative review examines recent literature, case studies, and AI-enhanced tools to evaluate AI’s impact on prescribing safety and efficiency in rural health settings. Findings: AI-driven tools, such as clinical decision support systems and predictive analytics, are increasingly available to assist nurse practitioners (NPs) in prescribing practices. In rural settings, where providers face unique challenges such as workforce shortages, patient complexity, and limited specialist access, AI offers promising solutions. Case studies demonstrate AI’s ability to support pharmacologic decisions for chronic conditions such as diabetes and atrial fibrillation. However, ethical concerns—including bias, transparency, and informed consent—must be proactively addressed. Conclusions: NPs practicing in rural environments are well-positioned to lead the ethical and effective integration of AI into pharmacologic practice. By maintaining clinical accountability, ensuring patient understanding, and evaluating tools for rural relevance, NPs can use AI to improve medication safety and access while protecting patient trust.
Background: Rural communities face persistent challenges pertaining to healthcare access, workforce shortages, and geographic isolation. To address these issues, the Rural Ready Nurse Practitioner (RRNP) Program was established through Health Resources and Services Administration (HRSA) Advanced Nursing Education and Workforce (ANEW) funding (Award # T94HP32889) to prepare nurse practitioners (NPs) for practice in rural and underserved areas. Purpose: The paper describes the development, implementation, and outcomes of our RRNP Program, emphasizing theoretical grounding in Rural Nursing Theory and integration of the Three R’s of Rural Readiness: Relationships, Resources, and Reinforcement. Methods: Program design involved multi-level strategies, including partnerships with rural clinical sites, integration of telehealth-based interprofessional education, and expansion of the Caring for Our Own Program (COOP) to support Indigenous graduate students. Data were drawn from HRSA tracking metrics and graduate self-reports. Results: From 2021 to 2025, 31 RRNP Scholars completed the program, with 89% of graduates employed in rural and 93% employed in underserved areas. Key educational elements included annual in person Clinical Skills Days, customized medical kits, and Area Health Education Center (AHEC) Scholars Program. Implications: The RRNP model demonstrates an evidence-based framework for preparing rural-ready nurse practitioners capable of meeting healthcare needs in (State)’s frontier and tribal communities.
Objective: To answer the following questions: (1) What is the existing evidence on rural maternity care and shared decision making, and (2) what are the knowledge gaps and directions for future research? Methods: The review was guided by Whittemore and Knafl. Included studies were appraised using the Mixed Methods Appraisal tool. Data Sources: With librarian support, searches were conducted in PubMed, CINAHL, PsycINFO, and ProQuest. Filters limited results to English-language, full-text publications from January 2019 to January 2026. Study Selection: The search identified 1,186 research studies. After removing duplicates, the citation mining of six articles and screening, 54 full texts were reviewed; 29 were excluded, leaving 25 studies included in the review. Data Extraction: Of the 25 studies, 20 (75%) used quantitative, 2 (8%) qualitative, and 3 (12%) mixed methods. Major themes included maternity care deserts, hospital closures, distance to maternity care, insurance, telehealth, social determinants of health, severe maternal morbidity and mortality (SMMM), and shared decision making (SDM) or relational care. Data Synthesis: Barriers such as hospital closures, maternity care deserts, and travel distances worsened maternal outcomes. Insurance instability, under-reimbursement, and workforce shortages further limited access. Telehealth showed promise but was constrained by broadband gaps. Social drivers compounded risks, with rural Black, Indigenous, and People of Color (BIPOC) experiencing the poorest outcomes. Studies addressed SDM, though continuity of care, relationships, and communication were emphasized. Conclusions: Improving rural maternal patients’ access to high-quality care is necessary to decrease the risk of SMMM. Nurses promote patient-centered communication, evidence-based interventions, and address social drivers of health through education and advocacy. Expanding the SDM evidence base in rural maternity care will strengthen nursing’s role in engagement, empowerment, and health equity.
urpose: To examine the outcomes of a mindfulness-based intervention for the prevention of mental health disorders among rural dwelling Native American youth ages 10-12. Sample: Native American student participant sample (N=20) was recruited from schools from one rural Native American tribe in the Midwestern United States. The county where the study was conducted is officially designated as a nonmetropolitan county, and it is classified as rural according to the county-level system. Methods: This cross-sectional descriptive study measured mental health outcomes that included stress, anxiety, depression, substance use (alcohol and drugs) and commercial tobacco use. All participants were Native American who resided in rural tribal communities. Findings: Study sample was both female (N-10) and male (N-10), with a mean age of 11.37. Participants self-reported significant decreases in mental health disorders of stress, anxiety, depression, substance use (alcohol and drugs) and commercial tobacco use from baseline pre-intervention to 3-months post intervention. Native Reliance (cultural identity) significantly increased from baseline pre-intervention to 3-months post-intervention. Conclusion: Findings from this pilot study support the use of a mindfulness approach delivered in a cultural based Talking Circle intervention for the prevention of mental health disorders among rural dwelling Native American youth
