Rural Community Members Research Articles

Exploring differences in perceived barriers and facilitators to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino communities in Southwest Florida

ABSTRACT Background: Identifying factors impacting vaccination and testing for COVID-19 is crucial to reduce health disparities, especially for rural/agricultural, low access and high poverty Latino communities disproportionately affected by the pandemic. This study examined differences in perceived barriers and facilitators (such as values, beliefs, and concerns) to COVID-19 vaccine uptake and testing intention by vaccination status and testing hesitancy among rural Latino community members in Southwest Florida. Methods: Rural Latino community members (N = 493) completed a cross-sectional survey in Spanish (86.0%) or English (14.0%) on perceived COVID-19 vaccine/testing barriers and facilitators, as well as demographics, mental health, medical history, health perceptions, and health literacy. Results: At the time of the survey, approximately 43% of participants were unvaccinated and 46.4% were testing hesitant. Significantly more vaccinated participants acknowledged keeping their family (d = .25), community (d = .27), and themselves (d = .22) safe as facilitators to vaccination (ps < .001). Among the unvaccinated participants, the most common concerns for getting vaccinated were side effects (d = −.53) and lack of knowledge about how the vaccine works (d = −.35, ps < .001). Testing hesitant participants reported concerns including not knowing where to get tested (d = −.25, p = 0.01) and less confidence in a positive test result (d = −.40, p < 0.001). Doctors and faith leaders were ranked as the most trusted information sources across groups. In logistic regression models, vaccination was linked to age, gender, education, and protecting others, while concerns about needles and side effects reduced odds; testing was driven by education, anxiety, hope, and safety concerns. Conclusion: Promoting family and community safety may be effective facilitators influencing vaccine and testing intention in rural Latino communities. Enhanced education by trusted information sources, such as doctors and faith leaders may alleviate associated concerns. Our findings may inform actions for future pandemics. Further studies should determine the generalizability of our findings across other rural migrant communities and other vaccines.

Building partnerships to improve clinical trial accrual in rural and Native American communities through community health educator interventions.

180 Background: Rural populations and racial minorities are often underrepresented in cancer clinical trials. The low representation is determined by multilevel factors, including lack of geographic access to facilities in rural locations and mistrust in the medical and scientific community. Presented here are partial results of an educational intervention to improve clinical trials-related knowledge among rural residents and racial minorities. Methods: The Center to Reduce Cancer Health Disparities (CRCHD) from the National Cancer Institute (NCI) developed the study materials, that were available in English or Spanish, to be utilized according to participants' preferences. The University of Wisconsin Carbone Cancer Center implemented this intervention in northern Wisconsin, which consisted of a baseline questionnaire, a recorded educational intervention, and a post-educational questionnaire. The chosen community is largely rural and Native. The questionnaires consisted of 11-knowledge- and 6-intention-related questions. After being screened by the rural Community Health Educator (CHE), subjects self-administered the intervention online or received the intervention from the CHE during tribal or other educational group events in rural communities. Results: Between January and May 2024, 62 participants started the intervention. Participants’ mean age was 45.1 (±15.36) years, 64.5% (40/62) were female, and 53.2% (33/62) self-identified as American Indian/ Alaska Native. All resided in rural community, defined as Rural-Urban Continuum Codes 7 or 8. Three participants did not respond to the post-educational questionnaire, and one skipped its intentions section. Although the two questions about informed consent presented the highest percent of correct answers post-intervention, the median total knowledge score pre and post-intervention remained the same (p&gt;0.05). Post-intervention, participants more often agreed it is important for minority groups to participate in clinical trials, reported being likely to search for a clinical trial they might be eligible for, join a clinical trial, and talk to family/friends about joining a clinical trial (p&lt;0.05). Conclusions: The CHE successfully engaged rural community members to participate in the intervention. In addition, the intervention facilitated building trust and partnerships for future cancer-related community driven work.

Abstract B086: Increasing clinical research participation and input from underserved communities: Results from community engagement studios inform clinical study design

Abstract Underrepresentation of marginalized racial and ethnic groups has been a consistent challenge in clinical trials. With an intent to increase trial accessibility for underserved communities, we conducted community engagement studios (CES) to understand the various cultures, values, worldviews, and lived experiences from different communities that might affect clinical trial participation. We report on the CES discussions and how they modified the design of an early cancer detection clinical study. CES were developed in partnership with an academic community engagement expert, OHSU and via the patient advocacy group, Touch4Life, which focuses on decreasing cancer disparities in the BIPOC (Black, Indigenous, and people of color) population. Four CES were conducted: 1 with members of Asian (n=11), 2 with members of African American (AA) (n=16), and 1 with members of rural (n=7) communities. One AA CES was conducted with members of the Touch4Life network, with whom we piloted a subsequent oral debrief session to review CES thematic results and relay the impact it had on clinical study implementation, the results of which led to a corollary CES to be initiated in this network (n=7) to evaluate recruitment messages in the BIPOC population. Common themes for clinical trial recruitment strategies included the importance of messaging from trusted sources. While clinicians were a shared trusted source, Asian CES members preferred a personal connection, rural CES members preferred non-profit foundations, and AA CES members highlighted community networks (church and patient advocacy groups with shared experiences). Asian CES participants were hesitant to engage with pharmacists for clinical study recruitment due to a lack of personal relationships, but rural and AA communities would be open to hearing about clinical studies at their pharmacy, combined with consultation with their doctor. All communities expressed shared barriers for trial participation (time commitment, transportation, cost) and unique barriers were also expressed: childcare and distrust in biopharma in the AA CES; language in the Asian CES. All CES expressed interest in receiving updates on clinical trial progress and outcomes. Themes from the CES have been used to inform changes to both our recruitment and education strategies and outreach efforts for this clinical study for the early detection of cancer. One such modification included adding recruitment channels focused on engaging participants through patient advocacy groups and specific clinical study sites. Following guidance from both CES participants and our CES partners, and by sharing the CES results with the Touch4Life community, we developed a bidirectional flow of information and fostered a joint mission to deepen our working relationship with the community. Our research demonstrated that early collaboration between industry-sponsored researchers, community experts, and patient advocacy groups is an ideal model for gaining insights into specific communities and fostering relationships that can improve access to clinical studies. Citation Format: Monique Gary, Laura Crandon, Tiffani L. Howard, Paul Bollinger, Natalie Bonilla, Jackilen Shannon, Shifra Krinshpun, Sarah Sawyer, Sara L. Bristow, Meenakshi Malhotra, Adham Jurdi, Alexey Aleshin, Breeana L. Mitchell. Increasing clinical research participation and input from underserved communities: Results from community engagement studios inform clinical study design [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B086.

Факторы социальной жизнестойкости арктических сельских сообществ в современной России (на материалах прибрежных и островных территорий Архангельской области)

The article focuses on the problem of factors ensuring social resilience of Arctic rural communities. Using the materials of island and coastal territories of the Primorskiy district of the Arkhangelsk Oblast, the author studies how the features of social organization and life activities of specific communities ensure their reproduction as local social systems, help them to remain resilient to external challenges of economic, environmental and other types, and allow them to adapt to the changes in the region. In order to solve these problems, the author took part in a field study on the territory of 14 rural settlements in three rural municipalities in the period from July to early September 2022. The main method of obtaining empirical data is in-depth interview. The analysis of the interviews made it possible to identify a set of key factors of resilience of the rural communities under consideration. The first factor is the ability of local residents to reorient to subsistence farming and traditional crafts in the conditions of degradation of those sectors of the local economy that imply permanent formal labor employment. The second factor is the high level of social capital of communities, which determines the normalization of mutual assistance practices. The third factor is the involvement of a part of the local population in grassroots activities: social and cultural initiatives of local residents make it possible to attract external resources to solve the problems of territorial development, as well as support the collective identity of rural community members and increase its cohesion. The fourth factor is the return of retired local natives who previously migrated from rural to urban areas.

Urban-Rural Differences in the Association of eHealth Literacy With Medication Adherence Among Older People With Frailty and Prefrailty: Cross-Sectional Study.

With advances in science and technology and improvements in health literacy, more studies have focused on frailty prevention by promoting medication adherence, emphasizing the role of eHealth literacy. However, the association between eHealth literacy and medication adherence in frail older adults has not been well studied, and it is unknown whether urban-rural differences exist in this relationship. This study aims to examine the relationship between eHealth literacy and medication adherence in older people with different frailty statuses, emphasizing variations between rural and urban areas. Between November and December 2020, a total of 4218 urban and rural community members (aged ≥60 years) in China were recruited as participants using a multistage random sampling method. A face-to-face structured questionnaire survey was conducted to collect information on demographic characteristics, eHealth literacy (consisting of application, evaluation, and decision dimensions), and medication adherence. eHealth literacy was assessed using the Chinese version of the eHealth Literacy Scale developed by Norman and Skinner, and medication adherence was measured using the 4-item Morisky scale. We used a general descriptive analysis and stratified logistic regression models to examine how eHealth literacy is linked to medication adherence and urban-rural differences. There were 4218 respondents, of which 2316 (54.9%) lived in urban areas and 1902 (45.1%) in rural areas, respectively. After adjusting for potential confounders, among participants with prefrailty, eHealth literacy was associated with medication adherence in urban areas in terms of less application (adjusted odds ratio [AOR] 1.16, 95% CI 0.82-1.63), less evaluation (AOR 1.29, 95% CI 0.92-1.81), and less decision ability (AOR 1.20, 95% CI 0.86-1.68); eHealth literacy was linked with medication adherence in the rural areas in terms of less application (AOR 1.10, 95% CI 0.56-2.13), less evaluation (AOR 1.05, 95% CI 0.61-1.79), and less decision ability (AOR 1.10, 95% CI 0.64-1.90). Among frail participants, less eHealth literacy (AOR 0.85, 95% CI 0.48-1.51), along with its dimensions, including less application (AOR 0.85, 95% CI 0.47-1.54), evaluation (AOR 0.89, 95% CI 0.50-1.57), and decision ability (AOR 0.99, 95% CI 0.55-1.76), were associated with medication adherence in urban areas; less eHealth literacy (AOR 0.89, 95% CI 0.48-1.65), along with its dimensions, including less application (AOR 1.23, 95% CI 0.62-2.44), evaluation (AOR 0.98, 95% CI 0.53-1.82), and decision ability (AOR 0.90, 95% CI 0.49-1.67), were associated with medication adherence in rural areas. The results of this study suggest that there is an association between eHealth literacy and medication adherence among older people with frailty and prefrailty. To promote medication adherence, eHealth literacy can be helpful in tailoring interventions.

Lessons Learned Implementing Syringe Services Programs at Rural Health Departments in Kentucky.

Until recently, most syringe services programs (SSPs) in the United States operated in metropolitan areas. This study explores how SSP implementers at rural health departments in Kentucky secured support for SSP operations. In late 2020, we conducted in-depth, semi-structured interviews with 18 people involved with rural SSP implementation in Kentucky. Participants were asked to reflect on their experiences building support for SSP operations among rural health department staff and community members. Participants reported that attitudes and beliefs about SSP implementation among rural health department staff shifted quickly following engagement in educational activities and interaction with SSP clients. Participants explained that successful SSP implementation at rural health departments required sustained educational activities among community members and authorizing authorities. Future work should explore how rural communities may advocate for low-threshold and evidence-based policies that support the provision of harm reduction services.

Examining community-level protection from Alaska Native suicide: An Indigenous knowledge-informed extension of the legacy of Michael Chandler and Christopher Lalonde.

Chandler and Lalonde broadened the scope of inquiry in suicide research by providing theoretical grounding and empirical support for the role of community, culture, and history in understanding Indigenous youth suicide and reimagining its prevention. Their work pushed the field to consider the intersectional process of individual and collective meaning-making in prevention of Indigenous suicide, together with the central role culture plays in bringing coherence to this process over time. Their innovation shifted the research focus to include the shared histories, contexts, and structures of meaning that shape individual lives and behaviors. We describe here a new generation of research extending their pathbreaking line of inquiry. Recent work aims to identify complex associations between community-level structures and suicidal behavior by collaborating with Alaska Native people from rural communities to describe how community protective factors function as preventative resources in their daily lives. Community engagement and knowledge co-production created a measure of community protection from suicide. Structured interviews with rural Alaska Native community members allowed use of this measure to produce relevant, accessible, and actionable knowledge. Ongoing investigations next seek to describe their mechanisms in shaping young people's lives through a multilevel, mixed-methods community-based study linking community-level protection to protection and well-being of individual youth. These efforts to understand the multiple culture-specific and culturally mediated pathways by which communities build on their strengths, resources, and practices to support Indigenous young people's development and reduce suicide risk are inspired by and expand on Chandler and Lalonde's remarkable legacy.

Governance for Sustainable Development in Peruvian High Andean Communities: Mediation of Attitude

Objective: The objective was to determine how governance explains sustainable development, mediated by attitude, in high Andean communities in Peru. Theoretical Framework: Few theories help to measure the levels of sustainable development at the community level, with little literature and evidence existing. The studies suggest applying transdisciplinarity and interdisciplinarity, incorporating uncertainty, adaptive governance processes. Method: Applying the quantitative approach, surveying 385 rural community members, with a 51-item Likert-type questionnaire. The results are presented in frequency tables, ordinal regression and simple mediation model in SPSS. Results and Discussion: The results for governance are perceived as high in 68.1% of cases, attitude to development at a medium level in 49.9% and sustainable development at a medium level by 80.3%. Governance explains 52.6% of sustainable development and 41.6% of attitude to development, and attitude to development explains 65.7% of sustainable development, all significant, values calculated with Nagelkerke's Pseudo R box. The mediating effect of attitude to development is 10.13% between governance and sustainable development. Research Implications: The research provides results that can be applied to the governance of rural communities, so that they achieve higher levels of development. Likewise, it allows investigators to continue deepening their understanding of sustainable development, a complex issue at the community level, as they are areas little addressed by the state. Originality/Value: It is a first work that measures the relationship of the three variables in communities, thus contributing to the sustainable development literature with empirical evidence for the implementation of development policies at the community level.

Evaluating Willingness to Sell Vegetation in the White Volta Basin in Northern Ghana

Concepts of ecosystem services have been developed to make explicit connections between human welfare and ecological sustainability for policy, development, and conservation initiatives. Economic concepts such as the distinction between prices and values, and the acknowledgment of their values are context-specific which may change across space and time. Contingent valuation is a survey-based economic technique for valuing non-market resources, such as vegetation. This method is often used to establish the amount people are willing to be compensated for maintaining the existence of an environmental feature such as a tree, shrub, or grass. The level of importance attached to provisioning services as well as cultural services and cultural heritage differ in the rural communities hence different cash values attached. It is often perceived that rural community members do not put monetary value on vegetation, the study is therefore aimed at establishing monetary value rural communities have value for vegetation. The study was conducted in two irrigated and two unirrigated landscapes consisting of about 54 communities and comprising 240 respondents. Participatory Rural Appraisal tools were used. Random Utility Theory was applied and used for the analysis. The willingness to sell vegetation was significant at a 5% confidence level concerning native, sex, age, education, and household head. Marital status was, however, not significant in all the landscapes. The price trend is observed to be across a landscape, from the catchment to the downstream ecosystem.

Rural physician-community engagement: Building, supporting and maintaining resilient health care strategies in three rural Canadian communities.

To explore rural physician-community engagement through three case studies in order to understand the role that these relationships can play in increasing community-level resilience to climate change and ecosystem disruption. Qualitative secondary case study analysis. Three Canadian rural communities (BC n = 2, Ontario n = 1). Rural family physicians and community members. Twenty-eight semi-structured virtual interviews, conducted between November 2021 and February 2022, were included. Communities were selected from the larger data set based on data availability, level of physician engagement and demographic factors. Thematic analysis was completed in NVivo using deductive coding. The presented qualitative case studies shed light on the strategies employed by physicians to establish and foster relationships within rural communities during challenging circumstances. In Community A, the implementation of a Primary Care Society (PCS) not only addressed physician shortages but also facilitated the development of strong continuity of care through proactive recruitment efforts. Community B showcased the adoption of an 'intentional physician community' model, emphasising collaboration and community consultation, resulting in effective communication of public health directives and innovative interdisciplinary action during the COVID-19 pandemic. In Community C, engaged physicians and community advocates are aligned to contribute to the long-term sustainability of the rural community, particularly in the context of food security and climate change vulnerabilities. These findings underscore the significance of trust building, transparent communication and collaboration in addressing health care challenges in rural areas and emphasise the need to recognise and support physicians as agents of change.

‘Old, weak, and confused’: A pilot study on perceptions of older adults and anxiety about aging among Kinh adults in rural Vietnam

ABSTRACT This study aims to explore Kinh Vietnamese adults’ perception of older adults, and examine their anxiety about ageing and its associated factors. Purposive sampling method was used to recruit rural community members who aged from 18 to 59 by the time of the study and self-identified with Kinh ethnicity, the major ethnicity in Vietnam. A total of 322 eligible participants completed face-to-face, semi-structured interviews conducted by research assistants. The survey consisted of both close-ended questions and open-ended questions to collect quantitative and qualitative data. The qualitative results from open-ended questions show that ‘older adults’ were perceived and described with overwhelmingly negative characteristics regarding their appearance (wrinkles, gray hair), physical and cognitive health conditions (weak, frail, confused), capacity (incapable of working), and personality and behavioral characteristics (being difficult and irritable). The quantitative findings show that contact with older adults, correct understanding of qualified age of older adults, and worry about getting dementia and caring for someone with dementia in the future were significantly associated with anxiety about aging. Stereotype and prejudice about older adults, as well as anxiety about aging are critical issues among Vietnamese adults. These results have their implications for educational programs and media campaigns to address ageist stereotypes and aging anxiety in community.

A Community Mental Health Integrated Disaster Preparedness Intervention for Bushfire Recovery in Rural Australian Communities: Protocol for a Multimethods Feasibility and Acceptability Pilot Study.

Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the "Black Summer Bushfires") resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety. This research aims to gain insight into rural Australian's recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community. Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions. This study has received institutional review board approval and commenced phase 1 recruitment in October 2022. The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context. DERR1-10.2196/53454.

Social and economic impact analysis of solar mini-grids in rural Africa: a cohort study from Kenya and Nigeria

This study presents the first comprehensive analysis of the social and economic effects of solar mini-grids in rural African settings, specifically in Kenya and Nigeria. A group of 2658 household heads and business owners connected to mini-grids over the last five years were interviewed both before and one year after their connection. These interviews focused on changes in gender equality, productivity, health, safety, and economic activity. The results show notable improvements in all areas. Economic activities and productivity increased significantly among the connected households and businesses. The median income of rural Kenyan community members quadrupled. Gender equality also improved, with women gaining more opportunities in decision making and business. Health and safety enhancements were linked to reduced use of hazardous energy sources like kerosene lamps. The introduction of solar mini-grids not only transformed the energy landscape but also led to broad socioeconomic benefits in these rural areas. The research highlights the substantial impact of decentralized renewable energy on the social and economic development of rural African communities. Its findings are crucial for policymakers, development agencies, and stakeholders focused on promoting sustainable energy and development in Africa.

Working From Within: The Rural Community Participatory Design Framework.

This article describes the development of the rural community-based participatory design framework to guide healthcare design teams in their integration of rural community and clinical voice during the planning, design, and construction of a healthcare facility. Rural communities are facing an alarming rate of healthcare facility closures, provider shortages, and dwindling resources, which are negatively impacting population health outcomes. A prioritized focus on rural care access and delivery requires design teams to have a deeper understanding of the contextual considerations necessary for a successful healthcare facility project, made possible through engagement and partnership with rural dwelling community members and healthcare teams. The rural community participatory design framework is adapted from the rural participatory research model, selected due to its capture of key concepts and characteristics of rural communities. Underpinning theories included rural nursing theory and theory of the built environment. The framework encompasses healthcare facility project phases, key translational concepts, and common traits across rural communities and cultures. As a middle-range theoretical framework, it is being tested in a current healthcare project with a Critical Access Hospital in Montana to facilitate design team and stakeholder collaboration. The rural community participatory design framework may be utilized by design teams as a means of familiarization with rural cultures, norms, values, and critical needs, which relate to meaningful design. The framework further enables design teams to critically appraise best practices of stakeholder engagement throughout the project lifecycle.

Safe water as empowerment, structural dilemma, and savior: conflicting discourses about arsenic groundwater contamination in West Bengal

ABSTRACT This essay explores the conflicting discourses circulated ‘on the ground’ in rural West Bengal regarding blame, water, and health. We take a culture-centered approach that builds on environmental health communication literature through qualitative research with health workers and rural community members living with arsenicosis. Local discourses about structural dilemmas and water as savior/medicine reveal important practical and cultural considerations to water contamination solutions in West Bengal. This study makes three key contributions. First, we illuminate how empowerment discourses reinforce neoliberal and lifestyle theories of health while concealing important realities connected to water contamination and water access. Second, we demonstrate how cultural discourses of water as a savior disrupt Eurocentric health narratives and argue for free, decommodified water. Third, we argue that the narratives based on people’s lived illness experiences could be used to foster solidarity with healthcare workers and should be the basis of practical solutions to create water access.

Sustainable futures: from causes of environmental degradation to solutions

The impacts of climate change, loss of biodiversity and pollution influence the living experiences of the various members of communities that rely on agriculture, shaping the adaptation responses to those phenomena and actions towards sustainable development. This study aims to understand how members of rural communities in Morocco perceive the causes of environmental degradation and the solutions meant to support the reduction of the vulnerabilities by applying a sustainable development lens. To achieve those objectives, this empirical study collects qualitative data by conducting semi-structured interviews on the local population's perceptions of environmental degradation causes and impacts, vulnerabilities, and solutions to adapt or cope with those impacts. The study includes a critical analysis of the proposals presented by the community members by addressing the economic, social, and environmental dimensions of their implications for development. The most common issue identified was water management, underscoring the water stress affecting several regions. However, several solutions presented would lead to further depletion of non-renewable water sources, which endangers the pursuit of genuinely sustainable development. The study's conclusions highlight the importance of contextualising the communication and adaptation responses that address local perceptions, namely the low prevalence of perceptions attributing anthropogenic causes to environmental degradation, leading to sentiments of helplessness among members of the rural communities.

Co-design of a personalised digital intervention to improve vegetable intake in adults living in Australian rural communities

Diets low in vegetables are a main contributor to the health burden experienced by Australians living in rural communities. Given the ubiquity of smartphones and access to the Internet, digital interventions may offer an accessible delivery model for a dietary intervention in rural communities. However, no digital interventions to address low vegetable intake have been co-designed with adults living in rural areas(1). This research aims to describe the co-design of a digital intervention to improve vegetable intake with rural community members and research partners. Active participants in the co-design process were adults ≥18 years living in three rural Australian communities (total n = 57) and research partners (n = 4) representing three local rural governments and one peak non-government health organisation. An iterative co-design process(2) was undertaken to understand the needs (pre-design phase) and ideas (generative phase) of the target population through eight online workshops and a 21-item online community survey between July and December 2021. Prioritisation methods were used to help workshop participants identify the ‘Must-have, Should-have, Could-have, and Won’t-have or will not have right now’ (MoSCoW) features and functions of the digital intervention. Workshops were transcribed and inductively analysed using NVivo. Convergent and divergent themes were identified between the workshops and community survey to identify how to implement the digital intervention in the community. Consensus was reached on a concept for a digital intervention that addressed individual and food environment barriers to vegetable intake, specific to rural communities. Implementation recommendations centred on i) food literacy approaches to improve skills via access to vegetable-rich recipes and healthy eating resources, ii) access to personalisation options and behaviour change support, and iii) improving the community food environment by providing information on and access to local food initiatives. Rural-dwelling adults expressed preferences for personalised intervention features that can enhance food literacy and engagement with community food environments. This co-design process will inform the development of a prototype (evaluation phase) and feasibility testing (post-design phase) of this intervention. The resulting intervention is anticipated to reduce barriers and support enablers, across individual and community levels, to facilitate higher consumption of vegetables among rural Australians. These outcomes have the potential to contribute to improved wellbeing in the short term and reduced chronic disease risk in the long term, decreasing public health inequities.

Fostering Economic Sustainability within Rural Families in South Africa through Visual Arts and Crafts

This paper investigated interventions that can restore the importance of visual arts and crafts in fostering economic sustainability within rural families, in particular, young rural community members. Prior to colonization, visual arts and crafts played a significant role in providing economic subsistence for many households in South Africa. During the inception of formal education, that practice was replaced by scholastic education, prioritizing theoretical knowledge over practical experiential learning, leading to a gradual decline in the subsistence lifestyle. Marxism Theory (1848), which underpins this study, posits that within a capitalist economic framework, workers are exploited whilst company owners amass additional money. Craft manufacturing has the potential to augment self-generated income, making a valuable contribution to economic growth whilst avoiding any form of exploitation. The qualitative convenient sample comprised fifteen school dropouts and graduates from both South Africans and foreign nationals and was studied through face-to-face and telephonically informal conversations. The findings revealed that insufficient application of traditional visual arts and crafts skills in elementary education; inadequate delivery of government services to promote visual arts and crafts entrepreneurship; and the divergent perspectives in defining the concept of “civilization and freedom” impede efforts to achieve economic sustainability. The study recommended that community members should not only rely on government support services but instead utilize government grants to acquire knowledge, develop skills, and adopt subsistence lifestyles that rely on natural resources for sustainable economic growth. The government should also support the establishment of training centres where skilled individuals can impart knowledge and skills to the younger generation and monitor the efficacy of non-governmental organizations. This study not only enhances the well-being of people and communities but also offers valuable material for academic research in several fields. It strengthens comprehension of cultural, economic, and social phenomena within the framework of sustainable development. Keywords: Visual Arts and Crafts, Economic Development, Skills Development, Rural Families

Collectivization in USSR: Practice and Ideology, Some Aspects of its Impact on Rural Society

The article provides a comprehensive overview of the main approaches developed in historiography to understand the process of collectivization in the USSR, which determined several specific features of the transition of the domestic society from an agrarian phase to an industrial one. Arguing for the viability of the New Economic Policy’s rural economy and the deadlock of Stalin’s version of its collectivization, the author relies on the inherent “sympractical” type of peasant culture. The historically developed worldview of rural community members formed the basis for high labor motivation. The destruction of this worldview during the process of collectivization became the cause of tragedy. The article presents the results of a comparative analysis of two stages of socialist transformation in the village. It examines the destructive impact of the expropriation of peasants on the economy in the first stage and explores the issues of crisis resolution in the second stage through the removal of certain restrictions on private farming. The article analyzes the factors of social degradation in the Soviet countryside in the 1930s and identifies their manifestation in interethnic relations. The novelty of the research lies in the author’s examination, based on the materials from the declassified “special file” of the Leningrad Regional Committee of the CPSU(B) in the 2000s, of peculiar manifestations of collectivization contradictions in the fate of the Finnish population in the Leningrad region.

Rural hospital contributions to community health: community perspectives from a New Zealand rural hospital.

Introduction Rural hospitals provide secondary care for much of the rural New Zealand population. Little is known about community perspectives of the health and social contribution. Aim This descriptive qualitative study aimed to explore community views on the role of their rural hospital in a low socioeconomic rural district with a high Māori and Pacific population. Methods Semi-structured individual and focus group interviews were conducted with rural community members about the perceived role of their rural hospital. Iterative thematic analysis was undertaken. Results In total, 22 participants were interviewed. Thematic analysis yielded four themes: (i) rural hospitals as a safety net - providing access to emergency care and mitigating limited primary care access; (ii) providing personalised, culturally aware care; (iii) facilitating family/whanau support; and (iv) doing the best with limited resources. The latter included pragmatism about resource constraints, but a preference for the hospital to remain open. Discussion Rural hospitals contribute to community safety by enhancing access to emergency care and mitigating difficulties in access to primary care. The local contextual knowledge of rural hospital providers allows personalised, family-centred and culturally-responsive care. Despite service centralisation, rural hospitals are wanted by their communities. Rural health planners should consider how to maximise the breadth of locally-provided services to reduce the impacts of travel and transfer for care.