Rural Communities Research Articles

Rancang Bangun Sistem Informasi Warga Berbasis Mobile pada RW 006 Kelurahan Cipinang Jatinegara Jakarta Timur

Rukun Tetangga/Community Association, hereinafter abbreviated as RT/RW, is an institution formed through RT/RW deliberations which has an important role in maintaining and preserving community values based on cooperation and kinship; expediting the implementation of government duties in the field of rural or urban and community development, as well as empowering all government organizations and the business world to improve community welfare. Therefore, RT/RW must provide good services to their citizens to create a conducive society. People need services at any time, but these services can only be provided to residents in the afternoon or on holidays because RT/RW administrators have personal interests. Currently, the quality of public services provided by government institutions is still not optimal, services to the community are not running optimally. This problem can be overcome by building a mobile-based citizen information system that is capable of being a communication medium between residents and RT/RW administrators. Through the use of mobile technology, citizen information systems enable citizens to quickly access information related to community activities, important announcements, and public services available around them. This application also makes it easier for residents to report problems or community needs directly through an integrated reporting feature. Thus, it is hoped that the adoption of this technology can have a positive impact in improving the quality of life and strengthening the social ties of local communities. This application aims to make it easier to get information about activities/events or other necessary information, as well as make it easier to make reports or complaints in the form of a mobile application.

Service Provider Perspectives on Advance Care Planning Use in Rural Dementia Patients and Caregivers: A Qualitative Study

ABSTRACT Advanced care planning (ACP) utilization remains very limited in rural communities compared to urban areas. ACP earlier in the disease trajectory is particularly important for people with dementia (PWD) due to its progressive nature affecting their decision-making ability. Considering the well-documented benefits of ACP in improving the quality of end-of-life (EOL) care, the rural vs. urban disparity may indicate poorer EOL quality for rural PWD. This study aimed to explore barriers and current resources for ACP of PWD from the perspectives of health or social service providers serving rural communities. Using a qualitative approach, semi-structured face-to-face interviews were conducted with 11 health or social service professionals serving older adults and their caregivers in rural Alabama. Thematic analysis revealed three major barriers: (1) lack of knowledge, (2) psychosocial barriers, and (3) limited access to healthcare. Participants also showed misconception that a lawyer or a notary is required for ACP. Two themes arose in the participants’ recommendations to address the barriers: (1) providing ACP-relevant information and (2) addressing psychosocial stressors about ACP. This study highlighted an urgent need for social policy in ACP education for caregivers and service providers in rural settings.

Migrants’ Inclusion in Rural Communities

This thematic issue examines migrants’ inclusion in rural communities, contributing to a deeper understanding of the complex realities informing migrant experiences and processes of inclusion and exclusion in rural localities. The studies presented apply different theoretical approaches, all using various qualitative methods, to shed light on daily life experiences and views in rural locations. This editorial discusses the questions raised in the studies and outlines the main arguments of the different contributions assembled in this thematic issue.

Don’t look like lesbian when you walk through the village, lesbians, gays, and transgenders in rural communities

This study explores the coping practices of lesbians, gays, and trans (LG&T) people, living in rural communities, as they experience hardships originating from their surroundings in small rural communities in Israel. The research findings based on in-depth interviews with 24 gay, lesbian, and trans subjects, suggest that those who live in rural communities feel that their lifestyle is subjected to prejudice and scrutiny and monitoring. This anachronistic homophobic attitude is still prevalent in smaller communities in Israel. Subjects report that this causes distress and discomfort thus affecting their well-being and sense of belonging to the community, that is their home. The study reveals two approaches utilized to deal with the social control applied to them: the practice of resistance that contributes to the sense of relaxation and resilience of LGBTQ+ people in their surroundings, and the practice of avoidance that allows them to live their lives undisturbed. The findings show the importance of creating unique social services suitable for this minority living in rural communities.

Physical activity to address mental health in a remote Australian community: community readiness assessment

Purpose The mental and physical health of those residing in Australian rural and remote communities is poorer compared to major cities. Physical health comorbidities contribute to almost 80% of premature mortality for people living with mental illness. Leisure time physical activity (LTPA) is a well-established intervention to improve physical and mental health. To address the physical and mental health of rural and remote communities through LTPA, the community’s level of readiness should be first determined. This study aims to use the community readiness model (CRM) to explore community readiness in a remote Australian community to address mental health through LTPA. Design/methodology/approach Individual semi-structured interviews were conducted using the CRM on LTPA to address mental health. Quantitative outcomes scored the community’s stage of readiness for LTPA programmes to address mental health using the CRM categories of one (no awareness) to nine (high level of community ownership). Qualitative outcomes were thematically analysed, guided by Braun and Clark. Findings The community scored six (initiation) for community efforts and knowledge of LTPA programmes and seven (stabilisation) for leadership. The community’s attitude towards LTPA and resources for programmes scored four (pre-planning), and knowledge of LTPA scored three (vague awareness). Originality/value To the best of the authors’ knowledge, this is the first Australian study to use CRM to examine community readiness to use LTPA to improve mental health in a remote community. The CRM was shown to be a useful tool to identify factors for intervention design that might optimise community empowerment in using LTPA to improve mental health at the community level.

Blooming social impact: Growing Appalachian Botanical Company’s resource partnerships in a rural ecosystem

Research methodology This case is based on primary and secondary data collection. ABCo’s Founder, Jocelyn Sheppard, sat down with the author for a 75-min recorded interview in July 2022, and she provided follow-up information via email. Interview data was supplemented with secondary data from publicly available sources to fill in portions on the founder, the company’s history and its location; and triangulate the collected interview data (Creswell and Poth, 2018). There are no conflicts of interest that the author needs to disclose related to the founder or company. The case was piloted at one institution in the Fall 2022, Spring 2023 and Fall 2023 semesters, with 59 undergraduates in an in-person social entrepreneurship course and 165 undergraduates and 33 graduate students in an online asynchronous social entrepreneurship course. All students worked through the case in groups, and as a requirement of their corresponding assignment submission, they provided feedback that was de-identified. In total, 60 groups reported their feedback, which was considered during the subsequent drafts of the case and instructors’ manual IM. According to the anonymized feedback, the protagonist, product line, desired social impact and experienced challenges of ABCo were all said to be interesting, approachable and relatable for students, and the case piqued the interest of students coming from different majors (e.g. business, environmental issues, human services and criminal justice). Students from rural areas, or those who have family in rural areas, felt the case was particularly interesting; a handful of the students in the asynchronous online class who were unfamiliar with such settings suggested providing students with some additional contextualization of rural environments, either through class discussion with other students who had experience in those environments or additional media or text-based supports. Further adjustments also included removing a reading and a corresponding question and revising elements within the Teaching Approaches section of the IM to support the additions they suggested within the feedback (i.e. spending time to define and walk through the provided model and highlight the differences of rural entrepreneurship and entrepreneurship in the rural as a class before engaging in the related write-ups for that question). Case overview/synopsis Jocelyn Sheppard, Founder of Appalachian Botanical Company (“ABCo”), had built her company not just on a vision of revitalizing reclaimed coal mine land through planting and producing products with lavender, but also to have a social impact on the rural town of Ashford and its greater region of Boone County in West Virginia, USA. While she understood that hiring workers in need of a second chance would present its challenges, she was shocked by the depth of social need her new employees presented, which contributed to many employees’ disruptive behaviors and turnover. To approach the problem at hand, Sheppard needed to reflect on the resources around her, namely, other entities and organizations who might be able to support her efforts to improve how ABCo delivers on its social mission and, thus, helps to improve the local community and its economy. The case draws upon literature and models within rural entrepreneurship and community development to have students advise Sheppard on what she should do next to improve the social outcomes for ABCo and its employees. Complexity academic level This case is geared for both upper-level undergraduate and graduate courses in entrepreneurship, including in social, environmental and rural entrepreneurship courses and course modules. The case introduces students to a social enterprise struggling to get its footing in a rural context. The case would be suitable for both introductory and advanced courses, especially when placemaking/place-based entrepreneurship or ecosystem building are discussed.

Development Planning in Rural Communities in Bolivia: A Study in the Department of Oruro

This research aims to determine the most important elements that contribute to the development planning processes in the rural communities of the department of Oruro, Bolivia; It is based on the proposition that democracy in Latin America is in a situation characterized by advances in political rights and deficiencies in the civil and social rights of citizens, rural communities are where the most acute indicators of political, social, cultural and economic exclusion occur. Therefore, the effective membership of rural communities emerges as a peremptory task for the consolidation of their development based on community development planning. It assumes a quantitative qualitative approach, and is of a correlational descriptive type, which seeks the association and relationship of the variables that intervene and influence the community planning processes. A survey is applied to 384 people who live in communities in rural areas, among them the actors in the development of the localities are considered, such as community leaders and heads of households. For the statistical analysis, descriptive statistics and a multiple regression model are incorporated. The research establishes that community participation, ancestral knowledge, along with natural resources are the most important elements that contribute to the planning of the development of rural communities.   Received: 16 February 2024 / Accepted: 8 April 2024 / Published: 5 May 2024

ANALYSIS OF PERCEPTION AND THE LEVEL OF USE OF IMPROVED PROCESSING AND STORAGE FACILITIES AMONG RURAL WOMEN IN KWARA STATE, NIGERIA.

This research was carried out to assess the perception and the level of use of improved processing and storage facilities among rural women in Kwara State. Specifically, the study described socio-economic characteristics of rural women, assessed the frequency of use and ascertained perception of women on the use of improved processing and storage facilities. A three stage sampling procedure was used to select 160 rural women from who data was collected using structured interview schedule. Data collected were analyzed using frequency counts, percentages, mean and Pearson Product Moment Correlation (PPMC). Findings revealed that 60.6% were aged above 50years, 79.4% were married, 48.8% had no formal education while 62.5% were non-member of cooperative society. PPMC analysis between socio-economic characteristics and the use of improved processing/storage facilities among rural women indicated that level of formal education (p=0.002, r=0.240) and membership of agricultural society (p=003, r=0.237) showed positive significant relationship while age (p=0.000, r=-0.299) and marital status (p=0.000, r=-0.308) showed negative significant relationship at p<0.05 level of significance. The study concluded that women in the study area were low users of improved processing and storage facilities despite having favourable perception towards using them. It was therefore recommended that extension service should engage in training women and dissemination of affordable processing and storage technologies to the rural communities.

Catch me if you can: informal tourism employment of locals in scenic-oriented rural communities

ABSTRACT The expansion of the tourism industry has generated a plethora of informal job opportunities. However, existing literature has not thoroughly explored the extensive involvement of local residents in rural areas in informal tourism employment. This study focuses on the Fujian Tulou villages in China and employs the fieldwork method to investigate the phenomenon of informal tourism employment among local residents in scenic-oriented rural communities. The findings indicate that the dearth of employment prospects in rural areas, coupled with China’s distinctive rural land ownership system and the support from the rural social network, are the primary drivers motivating locals to participate in informal tourism employment. Locals employ tactics such as camouflage, tacit collusion, lurking, and covert actions to engage in informal tourism employment while navigating the regulations imposed by scenic area management. In efforts to standardize management within scenic areas, both local governments and tourism management companies are implementing measures such as offering formal employment opportunities and profit-sharing arrangements to incentivize the regularization of local employment in the tourism sector.

Assessing the Economic Impact of Coffee Farming on Rural Communities in Colombia

Purpose: The aim of the study was assessing the economic impact of coffee farming on rural communities in Colombia Methodology: This study adopted a desk methodology. A desk study research design is commonly known as secondary data collection. This is basically collecting data from existing resources preferably because of its low cost advantage as compared to a field research. Our current study looked into already published studies and reports as the data was easily accessed through online journals and libraries. Findings: Assessing the economic impact of coffee farming on rural communities in Colombia reveals significant findings. Coffee farming is a major source of employment and a primary contributor to household income in these areas, supporting the economic stability of numerous families. Moreover, the coffee industry’s demand for labor not only boosts local employment rates but also contributes to regional economic development through the generation of export revenues. Unique Contribution to Theory, Practice and Policy: Dependency theory, livelihoods approach & dual economy model may be used to anchor future studies on assessing the economic impact of coffee farming on rural communities in Colombia. Implement CBPR methods to involve coffee farmers in the research process, ensuring that their firsthand experiences and insights inform the study. Advocate for policies that support fair trade practices.

Tracking antimicrobial resistance transmission in urban and rural communities in Bangladesh: a One Health study of genomic diversity of ESBL-producing and carbapenem-resistant Escherichia coli.

Our study underscores that wastewater discharged from households and wet markets carries antibiotic-resistant organisms from both human and animal sources. Thus, direct disposal of wastewater into the environment not only threatens human health but also endangers food safety by facilitating the spread of antimicrobial resistance (AMR) to surface water, crops, vegetables, and subsequently to food-producing animals. In regions with intensive poultry production heavily reliant on the prophylactic use of antibiotics, compounded by inadequate waste management systems, such as Bangladesh, the ramifications are particularly pronounced. Wastewater serves as a pivotal juncture for the dissemination of antibiotic-resistant organisms and functions as a pathway through which strains of human and animal origin can infiltrate the environment and potentially colonize new hosts. Further research is needed to thoroughly characterize wastewater isolates/populations and understand their potential impact on interconnected environments, communities, and wildlife.

Influence of childhood trauma and traumatic stress on a woman's risk of having a child with a fetal alcohol spectrum disorder.

Maternal risk factors for having a child diagnosed on the fetal alcohol spectrum disorders (FASD) continuum are complex and include not only the quantity, frequency, and timing of alcohol use but also a woman's physical stature, socio-economic status, and pregnancy-related factors. Exposure to trauma may predispose women to a range of physiological and mental disorders. A woman's mental and physical health may in turn influence her probability of having a child with FASD. This study investigated the role of maternal childhood trauma and lifetime traumatic stress on prenatal alcohol consumption and on the risk of having a child with FASD. A nested, case-control study was conducted for maternal risk assessment. Study participants were mothers of first-grade learners from five rural communities in the Western Cape Province of South Africa who were assessed for FASD. Face-to-face surveys were conducted, which included mental health and trauma assessment questionnaires. In logistic regression analyses, higher maternal childhood trauma scores were associated with an increased likelihood of having a child diagnosed with FASD, although the increase in risk was modest (OR = 1.014, p = 0.015). In addition, structural equation modeling investigated relationships between maternal drinking, childhood trauma, traumatic stress, and a child's FASD diagnosis. Traumatic stress and drinking during pregnancy, but not lifetime alcohol use, were associated with maternal childhood trauma. Lifetime alcohol use influenced drinking during pregnancy, which in turn was significantly associated with having a child diagnosed on the continuum of FASD. No direct influence of maternal childhood trauma on FASD diagnosis could be demonstrated. However, maternal trauma may indirectly contribute to the risk of having a child diagnosed with FASD.

Prevalence and distribution of transmissible venereal tumor in dogs from a rural community of Mexico

Objective: The aim of this work was to determine the rates of prevalence and recurrence of TVT infection in owned dogs, as well as the distribution of the disease, in Cuajinicuilapa, Guerrero, Mexico. Methods: This work was an observational, descriptive, longitudinal study. A TVT diagnosis was performed in all dogs in the community based on clinical records, a physical examination, and a cytological evaluation, and further confirmed by histopathology. Tissue samples were surgically obtained for histopathological analysis and, when required, to remove tumors and give treatment with vincristine; a GPS system was used to identify possible spatial groupings. All cases were re-evaluated one year after. Results: A prevalence of 5.15% was found in 1047 dogs (512 females and 535 males; 25 positive females and 29 positive males). TVT infection was more frequent in 2–3-years-old dogs. A spatial aggregation pattern was observed in the local cases. One year after, no lesions were found in the 29 animals treated. Conclusion: TVT is a common disease, and its distribution suggests its aggregation in certain areas of the locality. Further studies on the dynamics of dog populations in small cities are required.

Development of a Low-Cost Banana Fiber Extractor

Banana fiber is an underutilized natural resource with potential for industrial applications and value addition at the smallholder farm level. Traditional manual methods for extracting fibers from banana plant wastes are inefficient and labour-intensive. This limits opportunities for rural communities in Africa to commercialize banana cultivation. The study aimed to address this challenge by developing an affordable and effective mechanized solution for extracting banana fibers tailored to small farms. Key design considerations included ease of operation, portability, durability, and optimization for a single operator. Fabrication using basic workshop tools demonstrated technical feasibility. Structural analysis validated structural integrity. Performance testing showed 85% extraction efficiency at 5.36kg/sec, outpacing manual methods. Results confirm the potential of the machine to promote higher fiber yields. With further refinement, the developed technology can stimulate enterprise and industry centered on banana production, contributing to improved rural livelihoods on the continent.

Repeated clearing as a mechanism for savanna recovery following bush encroachment

Abstract Many savannas are experiencing increased cover of trees and shrubs, resulting in reduced herbaceous productivity, shifts in savanna functional structure and potential reductions in ecotourism. Clearing woody plants has been suggested as an effective management strategy to mitigate these effects and restore these systems to an open state with higher rates of grass production and herbivory. This study investigated the effectiveness of repeated shrub clearing as a tool to mitigate bush encroachment in a semi‐arid savanna in southern Africa. We present data from a 7‐year experiment in the Mthimkhulu Game Reserve bordering Kruger National Park, South Africa. Colophospermum mopane stems and resprouting shoots were basally cut 2–3 times per year (2015–2022) in three pairs of treatment and control plots of 60 × 60 m. We monitored changes in soil moisture, grass biomass and herbivore activity via dung counts. We assessed C. mopane physiological responses to repeated cutting using non‐structural carbohydrates and stable water isotopes to infer changes to energy storage and functional rooting depth, respectively. The cleared treatment had higher soil moisture and grass biomass than the control treatment. Dung counts showed impala and buffalo visited the cleared treatment more frequently than the control treatment. Repeated cutting had limited effects on C. mopane survival in the first 2–3 years after initial clearing, but 80% of individuals were dead after 7 years. Repeatedly cut C. mopane had lower belowground starch concentrations and used water from shallower soil depths than C. mopane in control plots. Synthesis and applications. Repeated cutting increased soil moisture availability and grass biomass, and attracted charismatic grazing herbivores. While more costly than once‐off clearing methods, this practice created more employment opportunities for a neighbouring rural community. Transforming portions of the ecosystem to a grass‐dominated state may increase ecotourism potential through improved game viewing in open systems.

A protocol of a pilot randomised trial (Action-RESPOND) to support rural and regional communities with implementing community-based systems thinking obesity prevention initiatives.

Over a quarter of children aged 2-17 years living in Australia are overweight or obese, with a higher prevalence reported in regional and remote communities. Systems thinking approaches that seek to support communities to generate and implement locally appropriate solutions targeting intertwined environmental, political, sociocultural, and individual determinants of obesity have the potential to ameliorate this. There have however been reported challenges with implementation of such initiatives, which may be strengthened by incorporating implementation science methods. This pilot randomised controlled trial protocol outlines the development and proposed evaluation of a multicomponent implementation strategy (Action-RESPOND). to increase the implementation of community-based systems thinking child obesity prevention initiatives The target of this intervention is ten rural and regional communities (or local government areas as the unit of allocation) within Northeast Victoria who were participants in a whole-of-systems intervention (RESPOND). Action-RESPOND builds on this intervention by assessing the impact of offering additional implementation strategies to five communities relative to usual care. The development of the multicomponent implementation strategy was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework and consists of seven implementation strategies primarily delivered via 'facilitation' methods. Implementation strategies aimed to ensure initiatives implemented are i) evidence-based, ii) address community's specific needs and iii) are suitable for local context. Strategies also aimed to increase the community's capacity to implement, through iv) improving the health promotion team's implementation knowledge and skills, fostering v) leadership, vi) physical resources and vii) community culture to drive implementation. The feasibility, acceptability, potential impact, and cost of the strategy will be assessed at baseline and follow up using surveys administered to key representatives within the community and internal records maintained by the research team. By leveraging an existing community-based whole-of-systems intervention, Action-RESPOND offers a unique opportunity to collect pilot feasibility and early empirical data on how to apply implementation and systems science approaches to support obesity prevention in rural and regional communities in Victoria.

Implication of Institutional Frameworks Governing Land Tenure Security in Social-Economic Dynamics: Experience from Iringa District in Tanzania

Purpose: The study aimed to examine the implication of institutional frameworks governing land tenure security in socioeconomic dynamics in the Iringa district. The study used the case of the Iringa district to investigate the institutional framework that provides implications for the governance of land tenure security in Tanzania. Methodology: The study employed phenomenography by collecting primary data from 16 key informants selected from village and district levels. Data from key informants were complemented by documentary review with perception considered deductively.   Findings: Findings confirmed the existence of two principal institutional frameworks; the Land Act No. 5 of 1999 and the Village Land Act No. 4 of 1999. Nonetheless, bureaucracy, inadequate policy dissemination, and poverty emerged as primary causes of deviations in land policy implementation in the study area. This study concludes that the successful implementation of Tanzania's land policy in the Iringa District Council has significantly facilitated land tenure security through the issuance of a Certificate of Customary Right of Occupancy. Establishing a robust institutional framework and clear land use rules has been central to this success. However, challenges such as complex Certificate of Customary Right of Occupancy acquisition procedures, bureaucracy, inadequate policy dissemination, and prevalent poverty in rural areas have been identified as impediments. Unique Contribution to Theory, Practice and Policy: The study was guided by Institutional Theory which describes the interaction of human beings with existing natural resources, the institution involves the regulation of formal rules from constitutions, status laws, and other legal frameworks controlling the interaction and relationship of human behavior. The study contributed to the theory by establishing the relationship between the organization and enforcement of policy and regulatory framework that governs land tenure. Also, the study recommends expanding the Certificate of Customary Right of Occupancy issuance, strengthening local land administration, simplifying land use regulations, facilitating easier access to Certificate of Customary Right of Occupancy especially for impoverished households, and implementing strategies to reduce bureaucracy and enhancing policy understanding at the grassroots level. These measures aim to enhance land tenure security and support sustainable development in rural communities.

Abstract PO1-08-04: Universal Germline Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision Making

Abstract Background: Prior work from our group has shown a high rate of familial breast cancer (BC) among rural BC patients (pts), with 33% reporting > 1 first-degree family members with BC and 55% meeting NCCN germline genetic testing (GGT) criteria (Shelton CH et al. NC Med. J; 2022). In 2018, we increased GGT to include all BC pts and observed: 1) many pts were out-of-criteria per NCCN guidelines but had actionable pathogenic germline variants (PGVs) and 2) knowledge of GGT factored significantly into shared decision making by providers and patients, including for positive and negative results. Beginning in 2019, concurrent with the recommendation from the American Society of Breast Surgeons, we expanded this model of universal GGT to an IRB-approved study to measure the impact of prospective testing on shared decision-making. Herein we report the real-world implementation of universal GGT for patients with BC and genetics-informed treatment decision-making in a rural community practice. Methods: From 2019-2022 all BC pts at a small, rural community hospital were offered GGT. Demographics, clinical features, and GGT results were collected along with clinician-reported clinical recommendations for treatment based on GGT results. Descriptive statistics and two-tailed Fisher’s exact test were employed and significance was set at p< 0.05. Results: 210 BC pts were offered GGT and 192 (91%) underwent testing [97% female, 95% non-Hispanic White, mean age at diagnosis of 62, 75% Stage I], with all but 7 pts completing GGT before primary treatment decisions. 104 (54%) of patients were in-criteria (IC) and 88 (46%) out-of-criteria (OOC) with NCCN GGT guidelines. PGVs were identified in 25 pts (13%) and 15 genes, most commonly BRCA1/2 (5 pts), PALB2 (3), monoallelic MUTYH (3) and ATM, BARD1, CHEK2 (2 pts each). PGV frequencies were 15% in IC and 11% in OOC patients (p=0.495). 46 (24%) pts had only a variant of uncertain significance (VUS) results. 70% of patients had > 1 clinical management change based on their GGT results. Changes in breast surgery, uptake of risk-reducing bilateral salpingo-oophorectomy, surveillance and clinical follow-up were significantly higher in patients with PGV compared to those with VUS/negative results (p < 0.0001). Compared to those with negative results, patients with PGVs in BRCA1 and BRCA2 were significantly more likely to undergo bilateral mastectomy (BLM) while those with PGVs in other genes or with VUS were not significantly more likely to elect for BLM than those with negative results. Clinicians reported that return of GGT reinforced their recommendation for 73/138 (53%) of patients who underwent breast-conserving therapy. GGT results aided in radiation therapy strategy for 54% of pts, most often resulting in dose de-escalation (accelerated fractionation) for negative/VUS pts (Table). Conclusions: Universal GGT for patients with BC was successfully implemented in a rural community practice with >90% uptake. Treatment was enhanced in those with clinically actionable PGVs and de-escalated in those without PGVs. Universal GGT for patients with BC is feasible to implement as the standard of practice within rural populations, enabling optimization of clinical care to patients’ genetic profile and may reduce unnecessary healthcare resource utilization. Universal Germline Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision Making Changes in Radiation Therapy Strategy based on GGT Citation Format: Charles Shelton, Sarah Nielsen, Antonio Ruiz, Lauren Shelton, Karen Freas, Sarah Poll, Brandie Heald, Daniel Pineda-Alvarez, Edward Esplin, Rachel Ellsworth, Hannah Montgomery. Universal Germline Genetic Testing for Breast Cancer: Implementation in a Rural Practice and Impact on Shared Decision Making [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-08-04.

Bridging Horizons: Exploring STEM Students’ Perspectives on Service-Learning and Storytelling Activities for Community Engagement and Gender Equality

This study explores STEM students’ perspectives on service-learning and story-telling activities to enhance community engagement and advance gender equality, investigating their impact on students’ perceptions, experiences, and understanding of gender dynamics within rural communities. Through qualitative analysis of interviews, reflective journals, and participatory videos, this study explores the transformative potential of service-learning and storytelling initiatives in empowering rural women, challenging traditional societal roles, and advocating for equal opportunities, particularly in STEM disciplines. Findings reveal the multifaceted benefits of these activities, including the development of empathy, cultural awareness, leadership skills, and a commitment to social justice among participating students. This study highlights the importance of integrating service-learning and storytelling into STEM education to cultivate inclusive practices, promote community development, and advance gender equality in rural settings.

Abstract PO3-27-08: Geographic Distribution and Accessibility of Clinical Trials for Advanced-Stage Breast Cancer in the United States: A Focus on Rural and Minority Health Disparities

Abstract Background: Our research examines the geographical distribution and accessibility of clinical trials for metastatic breast cancer patients in the U.S., spotlighting the challenges faced by rural communities and minority groups. Prior research indicated nearly half of these patients would have to commute over an hour to reach a trial site. [1] Our study provides a refreshed perspective on this issue, offering a more comprehensive analysis. Methods: Utilizing the ClinicalTrials.gov portal, we identified active interventional clinical trials for metastatic breast cancer patients as of November 25, 2022. We obtained distinct zip codes linked to these trials and, using 2020 census data, estimated the proportion of the U.S. populace residing within specific distances from these sites. Our analysis encompassed ethnicity, and other socio-economic parameters. Using GIS software, we also developed illustrative maps to visually represent the U.S. clinical trial accessibility landscape. Results: The majority of Americans diagnosed with metastatic breast cancer have clinical trials within their reach. A significant 81.8% of the U.S. populace resides within a 30-mile radius of a relevant clinical trial site. However, there is significant variation among ethnic groups, especially among American Indians, where 56.5% live within 30 miles of a clinical trial site. Conclusions: While a commendable 81.8% of the U.S. population resides within 30 miles of a metastatic breast cancer clinical trial site, our data underscores the uneven geographical spread of these trials. Our findings underscore the need for strategic initiatives to ensure clinical trials are within reach for every individual, irrespective of their location or background. Reference: 1. Galsky MD, Stensland KD, McBride RB, Latif A, Moshier E, Oh WK, Wisnivesky J. Geographic accessibility to clinical trials for advanced cancer in the United States. JAMA Intern Med. 2015 Feb;175(2):293-5. PMID: 25437434. Map of 30-, 60-, and 120-mile buffers from clinical trial sites open to patients with metastatic breast cancer. The U.S. Population living withing 30-, 60-, and 120-miles of an open clinical trial site for patients with metastatic breast cancer. Citation Format: Emily Westergard, Abigail Swenson, Zachary Schroeder, Wade Swenson. Geographic Distribution and Accessibility of Clinical Trials for Advanced-Stage Breast Cancer in the United States: A Focus on Rural and Minority Health Disparities [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-27-08.