Perceptions of COVID-19 Mitigation Strategies between Rural and Non-Rural Adults in the US: How Public Health Nurses Can Fill the Gap.

Alan M. Beck,Amanda Gilbert,Amy J. Piontek,Eric M. Wiedenman

doi:10.3390/nursrep12010019

Alan M. Beck, Amanda Gilbert + Show 2 more

Open Access

https://doi.org/10.3390/nursrep12010019

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Abstract

The purpose of this study was to capture the perceptions of COVID-19 mitigations’ efficacy of rural and non-rural participants, using the health belief model (HBM), as well as to describe where public health nursing may be able to fill behavior gaps in rural communities. Rural and non-rural participants completed electronic surveys. Surveys collected demographic information and perceptions of various mitigation strategies’ effectiveness. Rurality was significantly associated with perceptions of the effectiveness of public health mitigation strategies including wearing facemasks, limiting time indoors, avoiding gatherings, non-essential business closure, and staying home. Our findings suggest people in rural areas perceive mitigations to be effective. Other researchers have consistently shown rural residents are least likely to partake in the same mitigations. Rural public health nurses on the front line serve as the key to closing the aforementioned gap. Understanding where their community’s perceptions lie is pivotal in creating educational programs to continue mitigation efforts as we embark on the second year of this pandemic.

Highlights

At the onset of the SARS-CoV-2 (COVID-19) pandemic in the United States (US), metropolitan areas were the most highly impacted by the infection [1]
When assessing participant perceptions for the effectiveness of public health measures to mitigate COVID-19 transmission, we found significant correlations between rurality and public health measures for guidelines recommending the wearing of facemasks (x2(2) = 16.486, p < 0.001), closing non-essential businesses (x2(2) = 14.324, p = 0.001), recommending people aged 70 and over or with a medical condition stay at home except for essential needs (x2(2) = 9.344, p = 0.009), and for non-essential workers to stay at home except to do basic shopping or because urgent medical care is required (x2(2) = 13.116, p = 0.001)
Public health professionals have relied on and continue to use the health belief model (HBM) to understand peoples’ health behaviors. Whether it is receiving the COVID-19 vaccine and booster or wearing a mask in public places, understanding the public’s view in their susceptibility of contracting the disease, the severity the disease will have on their personal lives, and the value placed on mitigation strategies, greatly assists public health nurses and health departments

Summary

Introduction

At the onset of the SARS-CoV-2 (COVID-19) pandemic in the United States (US), metropolitan areas were the most highly impacted by the infection [1]. Rural areas were thought to have some protection from the virus inherently due to their sparse nature. Over time, this perceived protection of rural areas dwindled, thereby becoming the US’s newest hot spot [1,2]. As has been the normal trajectory with COVID-19, by September 2020 death rates in rural areas surpassed those in urban areas [1,3]. Rural local health departments (LHD) are key resources in their respective communities. LHDs in rural areas are among the most understaffed and underfunded health departments in the nation [5,6]. Leadership at most LHDs in metropolitan areas tends to be someone with a formal degree in public health [6]; in contrast, rural LHDs are three times as likely to be led by someone with a nursing degree [12–14]. Prior to the COVID-19 pandemic, there was an estimated

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