Projects In Rural Communities Research Articles

Cancer Outcomes Research in a Rural Area: A Multi-Institution Partnership Model

Whereas, most cancer research data come from high-profile academic centers, little is known about the outcomes of cancer care in rural communities. We summarize the experience of building a multi-institution partnership to develop a cancer outcomes research infrastructure in Southwest Georgia (SWGA), a primarily rural 33-county area with over 700,000 residents. The partnership includes eight institutions: the Emory University in Atlanta, the Centers for Disease Control and Prevention (CDC), the Georgia Comprehensive Center Registry (the Registry), the Southwest Georgia Cancer Coalition (the Coalition), and the four community cancer centers located within the SWGA region. The practical application of the partnership model, its organizational structure, and lessons learned are presented using two specific examples: a study evaluating treatment decisions and quality of life among prostate cancer patients, and a study of treatment discontinuation among prostate, breast, lung, and colorectal cancer patients. Our partnership model allowed us to (1) use the Coalition as a link between Atlanta-based researchers and local community; (2) collaborate with the area cancer centers on day-to-day study activities; (3) involve the Registry personnel and resources to identify eligible cancer cases and to perform data collection; and (4) raise community awareness and sense of study ownership through media announcements organized by the Coalition. All of the above activities were performed in consultation with the funding institution (CDC) and its project directors who oversee several other studies addressing similar research questions throughout the country. Our partnership model may provide a useful framework for cancer outcomes research projects in rural communities.

Linking Small Farms to Rural Communities with Local Food: A Case Study of the Local Food Project in Fairbury, Illinois

The literature on sustainability and local food systems often takes for granted a positive impact on rural communities. This paper attempts to interrogate this notion through a systematic evaluation of a local food system project in Central Illinois, Using case studies and survey research, this paper focuses on an innovative relationship forged between farmers and a local independently owned supermarket in a small rural community, which created an “indoor farmers' market” inside the store. This growing group of farmers committed to providing their community with food grown using sustainable farming practices, while the grocery store owners committed to the project to support local farmers and as a competitive marketing strategy. Although one key measurement of the success of this business relationship is evident in the doubling of local produce sales within the store each year, benefits are accruing beyond the economic impacts. Based on the “Fairbury Local Food Project” we recommend nine key elements of success that can be used to measure impacts and evaluate the success of local food system projects in rural communities.

Using Strategic Risk Management: To Maximize the Benefit–Cost Ratio of Community Water Projects

Infrastructure projects in rural communities usually cost more and benefit fewer people than similar projects in urban or large communities. Because they have relatively low ratios of benefits to costs, small‐scale investments in water and sanitation infrastructure are difficult to justify by standard benefit‐cost ratio criteria. Strategic risk management (SRM) enhances standard cost‐benefit analysis by including economic, social, and environmental benefits and subtracting the value of volunteer labor from costs. When the life‐cycle benefits of small projects are factored in, their benefit‐cost ratio increases, as does their appeal as public investments. SRM was applied to a program in Virginia (Self‐Help Virginia [SHV]) that helps residents of small rural communities secure funding and implement solutions for local development problems. Since its establishment in 1998, SHV has helped small and low‐ to moderate‐income communities build water and sanitation infrastructure, spending just $3.1 million on projects conventionally estimated to cost $8.8 million. Program funds pay for the hardware required, and the community provides labor and other resources needed to complete the project, gaining skills, experience, and other benefits in the process. SRM is a perfect match for SHV programs because the risk‐based approach includes both these overlooked benefits as well as the hidden costs of risk avoidance when an infrastructure problem goes unresolved. For state‐level decision‐makers, the enhanced cost‐benefit analysis provided by SRM makes small‐scale projects more competitive and easier to justify. Utility managers can use SRM analysis to better evaluate competing projects and effectively leverage their investments.

Provision of agricultural information for development: a case study on crossing communication boundaries

Information provision appears to play a significant role in development projects in rural communities, despite the fact that it is not the sole concern of development agencies. Investigation of a successful training programme on maize production proved that integrating knowledge of the target group's information behaviour and their use of communication mechanisms into development strategies can help to effectively cross the boundaries between the modern information resource system and that of the indigenous knowledge system. It is argued that field workers operative at the interface between the developed world and the target groups in rural communities are ideally suited to the direct provision of information in a situation-specific context. However, field workers should be made aware of the value of information, as well as of the information behaviour of rural people used to handling information within an oral culture. The Merger Model depicts the way in which information from both the modern information resource system and the indigenous knowledge system can be harnessed for the transfer of information through development projects.

Nobody Tells You Who You Are

Summary In spite of many changes for girls and women, research indicates that between the ages of nine and twelve many girls begin to limit their expectations. This is often exacerbated in rural areas where girls have few opportunities. This paper provides the first notes about a rural community project for girls and women. It is a description of a community development process that not only addresses the needs of the girls and the adult women mentors who participate, but also of a network of activities and resources developed by and for the larger community.

Allied Health Education in Rural Health Professional Shortage Areas of the United States

SEVERAL recent studies1,2have highlighted gross deficiencies in the health status of those living in rural areas of the United States, as well as inequities in the distribution of health resources in such areas. Concerns about an adequate supply of primary care physicians and allied health personnel3,4in rural areas have catalyzed federal and state governments to action, including reinvigoration of the National Health Service Corps,5development of a new Federal Office of Rural Health Policy,6and design and implementation of interdisciplinary training demonstration projects in rural communities.7 Allied health professionals form a vital part of the health care infrastructure necessary to support ambulatory and institutional primary care and to provide the full spectrum of basic health care; yet definitive quantitative studies relating allied health training location and subsequent rural practice choice do not exist. Even basic data on the number and distribution of allied

Economic Development and Community Social Change

There is growing recognition that economic development in advanced industrial societies involves massive capital migration from one industrial sector to another, from one community to another, and even from one nation to another. Economic development is a continual process of opening new areas, spatially and sectorally, while closing others. Development projects in rural communities provide a timely and valuable laboratory in which to learn how the restructuring of advanced industrial societies affects local social structures. This chapter extracts and reviews what has been learned from studies of communities coping with rural industrialization and natural resource development, especially large-scale projects. Particular attention is given to changes in employment patterns, income, population, agriculture, local businesses, and public sector costs and revenues. The findings reveal an underlying tension between the free movement of capital, on the one hand, and community stability and worker welfare, on the other hand. The authors conclude that local social changesa re integral elements of external processes of economic development. They may be understood by directing attention to the spatial patterns of social, economic, and political inequality and to the mechanisms that generate and sustain unevenness.

BEHAVIORAL COMMUNITY PSYCHOLOGY: TRAINING A COMMUNITY BOARD TO PROBLEM SOLVE1

This study demonstrated the effect of training nine lower socio-economic adults participating as policy board members in a federally funded rural community project to make behaviorally defined statements to increase problem-solving behaviors in board meetings. A multiple-baseline design across subjects and skills was used to analyze the behavioral categories of: (1) stating the problem; (2) finding solutions to the problem, and (3) implementing the action to the solution. Problem-solving responses during board meetings increased for subjects following training and remained higher than baseline during follow-up.