Rural Communities Research Articles

Healthcare Information Technology: Bridging the healthcare access gap in underserved communities

This comprehensive article explores the transformative impact of Healthcare Information Technology (HIT) in addressing global healthcare access disparities, particularly in underserved and rural communities. The article examines various aspects of digital health interventions, including telemedicine implementation, mobile health applications, electronic health records integration, and virtual clinical trials. The article highlights how these technological advancements have revolutionized healthcare delivery by improving patient access, reducing costs, enhancing clinical outcomes, and enabling more efficient care coordination. Special attention is given to the role of emerging technologies such as artificial intelligence and blockchain in shaping the future of healthcare delivery, demonstrating their potential to further bridge the healthcare access gap and improve patient care quality across diverse populations.

The Impact of Tele pharmacy in Rural Healthcare

In many nations, the rapid expansion of information and telecommunication technology use has a significant impact on healthcare delivery. Geographical and demographic characteristics, however, frequently make it difficult for rural areas and residents to access healthcare services. Telepharmacy, a relatively new term for pharmaceutical services, allows a qualified pharmacist to provide healthcare services, including medication reviews, patient counseling, and prescription verification, to patients who live far from a hospital, pharmacy, or healthcare facility. Economic benefits, patient satisfaction due to medication access and information in rural areas, easy access to healthcare services in remote and rural locations, effective patient counseling, and a lack of local pharmacists and pharmacy services are just a few of the well-known advantages of telepharmacy. Although telepharmacy is an excellent idea, its implementation can occasionally be difficult. There are hazards and legal issues that come with implementing these techniques that must be resolved. Significant time, money, and effort are required for the technology, software, connectivity, and operational costs associated with telepharmacy startup. One of the main obstacles to telepharmacy services for rural hospitals with fewer patients seems to be cost.Furthermore, there are still issues with the execution and uniformity of the telepharmacy law. A properly-designed system, however, has the power to transform pharmacy practice in ways that benefit rural communities as well as the hospitals or retail pharmacies that provide these services.

Addressing healthcare disparities and improving osteoporosis management in rural communities: a cluster randomized control trial.

Rural communities face limited healthcare access, financial constraints, and transportation barriers leading to health disparities. This study examined interventions that reduced health disparities in increasing the outpatient attendance and treatment rate of anti-osteoporosis medication (AOM), while identifying factors contributing to therapy refusal in rural communities. A total of 567 patients were randomized at the community level into three groups: multicomponent integrated care (MIC), osteoporosis care only (OC), and usual care (UC). Fracture Risk Assessment Tool and dual-energy X-ray absorptiometry scans were used to evaluate the osteoporosis and osteoporotic fracture risk. High- and moderate-risk patients were advised to pursue further hospital-based assessments and treatment. Both the MIC and OC groups received five interventions to address rural barriers, including specialist access, disease education, overcoming transportation barriers, peer support, and dedicated case managers. However, UC excluded transportation assistance, peer support, and case management. Outcomes measured included outpatient attendance, AOM treatment rates, and factors affecting hospital assessment refusal, analyzed via multivariable logistic modeling. In the MIC group, 73.3% of patients attended the outpatient clinic and 58.6% received AOM. In the OC group, 81% patients attended and 69.3% received AOM. Conversely, in the UC group, only 4.1% attended and received AOM. Significant differences in attendance and AOM rates were found between the MIC and UC groups and between the OC and UC groups (p < .001 for both). Common barriers included beliefs that treatment was unnecessary and lack of hospital access. Risk factors hindering outpatient attendance include male sex, low education, low budget, multiple disabilities, and osteopenia diagnosis. Addressing transportation barriers and implementing dedicated case management are crucial for improving healthcare access among rural patients. ClinicalTrials.gov NCT05104034.

The People and the Fire Tree: Co-Designing a Bushfire Early Warning System to Meet the Sustainable Development Goals

Australian rural communities face significant climate challenges including catastrophic bushfires. In line with the UN sustainable development goals (SDGs), to build resilience in the face of bushfire threats, communities need to increase adaptive capacity while maintaining the community’s integrity. To build community resilience, they should harness the hybridity between digital technology and non-technological practices. Building community resilience is gaining attention in rural human–computer interaction to ensure those who are vulnerable to disasters strengthen their ability to address adversity even in the absence of formal government assistance. How they apply digital technology into practice to ensure it meets their needs is crucial. We outline a case study of a rural Australian bushfire-impacted community. A series of co-design workshops was conducted to understand local bushfire preparation activities and the role of digital technologies in these activities. Three creative participatory design activities supported the co-design of an early-warning bushfire system. The workshop participants co-designed and merged two solutions: first The Fire Tree, a conceptual map of a preventative information system fed and validated by the community itself; second, The People System identifies and harnesses government resources to feed and generate a rich, dynamic, and constantly updated information environment. The final solution based on the two concepts is Bushwire, a communication facilitator designed and used by participants in workshops four and five. Bushwire is a co-designed web-based collective platform that leverages citizen-science behaviours, enabling them to share local knowledge and prepare for bushfire threats. The system became a communication facilitator, a space to share detailed local information and connect; fed by locally produced elements including digital technologies, weather/road conditions, and on-the-ground instructions. This case study explores how Bushwire responds to a range of UN SDGs by seeking to build sustainable communities (SDG11), to address climate action (SDG13) for this rural Australian bush-fire-prone community, and harmonises life on land (SDG15) through multi-stakeholder partnerships (SDG17). We envisage that urban planners may derive value from listening and responding to messages from nature, and from citizen-scientists embedded in rural communities as depicted in this case study.

Enhancing Social Participation in Rural Communities: Analyzing International Experiences and Practical Strategies for Afghanistan

Social participation is a cornerstone of sustainable rural development, particularly in fragile states like Afghanistan. This study investigates the challenges and opportunities of fostering social participation in rural Afghan communities by analyzing successful international models and proposing practical strategies tailored to the local context. Drawing from global experiences in countries such as India, Bangladesh, and South Korea, the research highlights key factors such as policy frameworks, decentralized governance, inclusion of marginalized groups, and capacity building. The study employs a qualitative methodology, integrating secondary data analysis and expert consultations to identify actionable recommendations. Findings reveal that while Afghanistan’s traditional governance structures, like shuras and jirgas, provide a foundation for participation, significant barriers such as gender inequality, limited decentralization, and inadequate resources persist. The proposed strategies emphasize integrating traditional and modern participatory approaches, leveraging digital tools, and enhancing collaboration between government institutions and NGOs. This research contributes to the broader discourse on participatory rural development, offering insights into building resilient, inclusive communities in fragile contexts.

Impact of Video Assisted Sinterventional Program on Knowledge about Child Abuse among Mothers of under Five Children in Selected Rural Community, West Bengal

Impact of Video Assisted Sinterventional Program on Knowledge about Child Abuse among Mothers of under Five Children in Selected Rural Community, West Bengal

A study on sustainable neem seed collection and utilization practices in selected cluster of Tamil Nadu

Neem (Azadirachta indica), often referred to as the "miracle tree" of India, has attracted considerable interest due to its commercial and therapeutic benefits, evolving from local utilization to global markets, especially in the United States and Australia. Currently, more than 30 neem-based pesticides are produced domestically, highlighting neem's extensive potential across various applications, including neem oil and azadirachtin for pest control. This tree is vital to India's ecosystem, particularly in regions such as Uttar Pradesh, Tamil Nadu and Karnataka, where it yields an average of 35 kg of fruit per tree annually. The seeds of the neem tree are economically significant for their oil and medicinal attributes, yielding essential components like azadirachtin and neem cake. This research investigates sustainable practices for neem seed collection, highlighting the importance of appropriate timing, harvesting techniques and training for rural communities to promote ecological sustainability and economic viability. Implementing sustainable methods not only protects the health of neem trees but also establishes reliable income streams for rural residents. The study gathered primary data through interviews with 160 individuals in a designated district of Tamil Nadu, India. Factor analysis was utilized to identify the socio-economic and market factors that affect neem seed collection.

Evaluating Community-Based Development in Rural Afghanistan: a Comprehensive Analysis of The National Solidarity Program And Citizens

This study evaluates the effectiveness of community-based development (CBD) initiatives in rural Afghanistan, focusing on the National Solidarity Program (NSP) and the Citizens' Charter National Priority Program (CCNPP). These programs, designed to empower rural communities through participatory decision-making and infrastructure development, have played a critical role in post-conflict reconstruction. Using a mixed-methods approach, this research combines quantitative data from surveys and program reports with qualitative insights from interviews and focus groups to assess the programs' impacts, challenges, and sustainability. Key findings reveal that while the NSP and CCNPP have significantly improved access to basic services and fostered community participation, they face persistent challenges such as fragmented social structures, security constraints, and gender disparities. The study highlights the importance of context-specific approaches, enhanced local governance capacities, and greater gender inclusion to ensure equitable and sustainable outcomes. Additionally, the study addresses the implications of recent political changes, including the Taliban's return to power, on the future of CBD initiatives in Afghanistan. By providing a comprehensive analysis of the NSP and CCNPP, this research contributes to the broader understanding of CBD in conflict-affected settings and offers actionable recommendations for policymakers and development practitioners. The findings underscore the need for adaptive strategies that address Afghanistan's unique socio-political dynamics, ensuring that future CBD programs are more inclusive, resilient, and effective.

Social Determinants of Health and Access to Care: A Cross - Sectional Study in Marginalized Rural Communities

Social Determinants of Health and Access to Care: A Cross - Sectional Study in Marginalized Rural Communities

Determinants of attitude toward African wild dog (Lycaon pictus) and other large carnivores in rural communities adjacent to the Mid-Zambezi Wildlife Area, Zimbabwe

ABSTRACT Understanding psychological and sociological factors affecting human attitudes toward carnivores assists in promoting co-existence. We interviewed respondents in rural communities adjacent to Zimbabwe’s Mid-Zambezi Wildlife Area to determine which demographic, regional and human–wildlife conflict-related variables affect attitudes toward African wild dog and other large carnivores. Variables determining attitude varied per species, however; women held less positive views of carnivores. Attitudes toward African wild dog were positively related to knowledge level and conservation support. Attitudes were most negative toward species which caused considerable conflict (spotted hyaena, lion, leopard). Age and being part of CAMPFIRE had a positive impact, while distance from the protected area negatively affected attitudes toward those conflict prone species. Overall, perceived threat to livestock and human life were main reasons to dislike carnivores, even when conflict was minimal or absent. Respondents used conventional mitigation methods during nighttime, but hardly used daytime herding to prevent depredation of livestock.

Status and prospects of research on new rural communities in China based on CiteSpace analysis

ABSTRACT New rural communities, as a model of rural residence, play a crucial role in rural development. This study utilizes the CNKI database and employs keyword analysis in CiteSpace to examine research on new rural communities in the 21st century. Findings reveal that: (1) The current research focuses on the necessity and promotion of national policies, identifying deficiencies in the policy system and improving. It also examines community planning systems, construction mode classifications, and performance evaluation methods, as well as governance models, stakeholders, and challenges. These areas are interconnected over time. (2) Time can be divided into three phases: the first phase, research focused on single elements such as health care, political construction, education, etc. with slow progress. The second stage, diversified explorations began, and policy research and practical reflection were coupled and developed. The third stage emphasizes more on the concern for humans, and the emphasis of the research is expanded from the material level to spiritual. (3) Present research has yielded significant outcomes, transitioning from empirical studies to profound theoretical analyzes. However, challenges persist, such as the absence of a comprehensive theoretical framework and methodological innovation. Future research should emphasize systematic exploration of policies, prioritize localized construction models, and drive research methodology innovation.

The elusive ‘promised land’: South Africa’s rural community struggles after thirty years of democracy

This study highlights the struggles of Black South Africans in rural communities, which define inequalities and socio-economic conditions thirty years after the first democratic elections in 1994, regardless of the ANC's promise of “a better life for all.” The purpose of discussing these challenges was to explore selected areas relevant to these issues as a delimitation. A closer look at the socio-economic history of a people reveals factors and circumstances that either promote, sustain, or challenge the livelihoods of a society or community, as in South Africa, race and geographical location define social status and quality of life. Such circumstances have particularly affected Black South African rural communities, who continue to experience abject poverty and destitution. This points to a departure from the Batho Pele Principles, which aimed to focus on socio-economic development programmes. The data used was ‘desktop’ from secondary sources, reports, and policy papers deemed relevant to the study and related to the experiences and struggles of rural communities against inadequate education, sustainable livelihoods, water and sanitation, and health, among others. The study concluded that, despite the gains of democracy, more needs to be done. An Afrocentric perspective was preferred because it is suitable for conceptualising, operationalising, and understanding social human problems such as rural community struggles outside the confines of Eurocentric knowledge ‘paternalism’. An Afrocentric method was used to present the findings of the study, based on the identified subtopics.

The Behaviors and Habits of Young Drivers Living in Small Urban Cities

While studies have typically examined the driving habits of young drivers living in large urban cities, few have examined the habits of young drivers living in smaller cities with large rural surrounding areas. Three surveys were disseminated to 193 young drivers, 65 police officers, and 62 driving instructors to examine the driving habits and challenging driving situations young drivers experience. Almost a fifth (18.1%) reported consuming alcohol prior to driving; alcohol consumption prior to driving was significantly associated with eating food/drinking beverages while driving, cellphone use, and speeding. The most challenging situations young drivers reported were night driving, encountering wild animals on the road, and driving in extreme weather conditions (e.g., ice, snow). Driving instructors reported that young drivers had challenges with lane positioning, speed control, and navigating traffic signs and signals. Additionally, police officers reported issuing tickets to young drivers primarily for failure to stop, distracted driving, impaired driving, and speeding. Young drivers living in smaller cities and rural communities have unique challenges, including interactions with wildlife, driving on gravel roads, and driving in poor weather and road conditions (e.g., ice, snow). Opportunities for young drivers to be exposed to these scenarios during driver training are critical for increasing awareness of these conditions and reducing crash risk.

Closing Tobacco Treatment Gaps for Rural Populations: The Role of Clinic-Based Pharmacists at a Federally Qualified Health Center

Pharmacists are often the first point of contact for healthcare advice in rural communities, where access to healthcare is limited. Tobacco cessation rates improve with counseling from a pharmacist, and in many states, pharmacists can now prescribe medications for quitting. This study aimed to explore smoking behavior and cessation motivations among patients at a Federally Qualified Health Center (FQHC) clinic in rural Wyoming, estimate the prevalence of tobacco-related interventions by clinic staff, and assess patients’ interest in engaging in pharmacist-led cessation programs. A cross-sectional survey was administered over three months to clinic patients who self-identified as current tobacco users. Survey items assessed sociodemographics, tobacco use and vaping behaviors, previous cessation advice from pharmacists, and interest in pharmacist-led support for quitting. Of 63 respondents, 57 (90.5%) reported current tobacco use. Most were ready to quit within the next month (43.9%) or the next six months (33.3%), and 26.3% had previously received advice about quitting from a pharmacist. Most (59.6%) expressed interest in establishing care with a pharmacist for cessation support, and 45.3% requested to be contacted by a pharmacist for assistance with quitting. Interest did not differ by gender or age. The results indicate that rural patients are interested in engaging with pharmacists for quitting. Further research is needed to determine how pharmacy-led programs can complement existing healthcare resources to improve access to cessation support in underserved areas.

Sexual identity, sexual behavior, and drug use behaviors among people who use drugs in the rural U.S.

People who use drugs (PWUD) are at risk of HIV infection, but the frequency and distribution of transmission-associated behaviors within rural communities is not well understood. Further, while interventions designed to more explicitly affirm individuals' sexual orientation and behaviors may be more effective, descriptions of behavior variability by orientation are lacking. We sought to describe how disease transmission behaviors and overdose risk vary by sexual orientation and activity among rural PWUD. From 01/2018-03/2020, rural PWUD participating in the Rural Opioid Initiative were surveyed across 8 sites. Collected data included: demographics; experiences with drug use, overdose, and healthcare; stigma; gender identity; and sexual orientation and partners. Participants were categorized as: monosexual by orientation and behavior (Mono-only), monosexual by orientation but behaviorally bisexual (Mono/Bi), and bisexual by orientation (Bi+). Analyses included descriptive summaries, bivariate examination (chi-square), and logistic regression (relative risk [RR] and 95 % confidence interval [CI]). The 1455 participants were 84.8 % Mono-only, 3.2 % Mono/Bi, and 12.0 % Bi+. Compared to Mono-only men, Mono/Bi and Bi+ men had greater risk of transactional sex (RR = 9.71, CI = 6.66-14.2 and RR = 5.09, CI = 2.79-9.27, respectively) and sharing syringes for injection (RR = 1.58, CI = 1.06-2.35 and RR = 1.85, CI = 1.38-2.47). Compared to Mono-only women, Mono-Bi and Bi+ women had greater risk of transactional sex (RR = 4.47, CI = 2.68-7.47 and RR = 2.63, CI = 1.81-3.81); and Bi+ women had greater risk of sharing syringes for injection (RR = 1.49, CI = 1.23-1.81), sharing syringes to mix drugs (RR = 1.44, CI = 1.23-1.69), and experiencing an overdose (RR = 1.32, CI = 1.12-1.56). Bi+ men and women both more frequently reported selling sex as a source of income (versus Mono-only, both p < 0.050) and measures of perceived stigma (all p < 0.050). Rural PWUD who are bisexual by orientation or behavior are significantly more likely to engage in behaviors associated with infectious disease transmission and to experience stigma and drug overdose. Given the growing recognition of bisexuality as a distinct orientation that warrants individualized consideration, interventions that are specifically acknowledging and affirming to the circumstances of this group are needed.

Gender differences in cognitive impairment among the elderly in rural West Texas counties.

The prevalence of Alzheimer's disease or dementia in the elderly population has been increasing both nationally and globally. Males and females are impacted differently when it comes to cognitive health, and this can be influenced by various risk factors. This study highlights the sociodemographic, chronic disease, and genetic biomarker risk factors associated with gender differences and cognitive impairments in the elderly population living in Cochran, Parmer, and Bailey counties of rural West Texas. Cross tabulation, Pearson's chi-squared, two sample proportions, binary logistic regression, and multinomial logistic regression were utilized to analyze data. SPSS software was used to detect significant risk factors. Using a bivariate logistic regression, the age group 70 and above of males and females for the Cochran and Parmer counties was found significantly associated with cognitive impairment. Anxiety, depression, diabetes, and cardiovascular disease were found to be significantly associated with an increased risk of cognitive impairment in females in Parmer County. Gender differences were observed in Cochran County for smoking but females in Bailey County were found to be more tobacco-dependent compared to other counties. However, in Cochran County the prevalence of cognitive impairment with rates of 66% for males and 70% for females was observed to be significantly lower in hypertensive group who consumed modified diet. Gender-based disparities in cognitive impairment are essential for gaining more insights into Alzheimer's disease or dementia prevention and advancement of healthcare and medical approaches in the underserved rural communities of West Texas.

Understanding rural adaptation to smoke from wildfires and forest management: insights for aligning approaches with community contexts

Background Rural communities are increasingly impacted by smoke produced by wildfires and forest management activties. Understanding local influences on smoke adaptation and mitigation is critical to social adaptation as fire risk continues to rise. Aims We sought to determine the role of local social context in smoke adaptation and gauge interest in adaptation strategies that might reduce exposure. Methods We conducted 46 semi-structured interviews with 56 residents and professionals in Parks, Arizona, USA, a rural community adjacent to public lands regularly affected by smoke. Key results Rural residents think of smoke as an acceptable risk. Efforts to adapt to potential health impacts are minimal, though inaction is driven by diverse reasoning and tradeoffs. Local social context – particularly elements related to government distrust, forest management, and independence – heavily influences interest in uptake of different adaptation strategies as well as affecting access to, and interpretation of, information about smoke risks. Conclusions Rural approaches to, and understandings of, smoke adaptation vary spatially and temporally. Public interest in broader forest management efforts can be leveraged to engage residents in conversations about proactive smoke adaptation. Implications Smoke adaptation strategies in rural communities must meld evidence of their effectiveness with community preferences grounded in local context to overcome inaction.

Thirsting for solutions: Unpacking inadequate water provision in rural communities

Background: In South Africa, access to water is not equally spread across the population. As a result, 19% of those living in rural areas lack access to a dependable water source and 33% lack basic sanitation services.Aim: This study aimed to identify obstacles municipalities face in delivering water services to rural communities and challenges surrounding water scarcity.Setting: This study focused on the rural areas of the Amathole District Municipality in the Eastern Cape province, South Africa.Methods: A qualitative research approach was employed, with a case study design and an interpretivism paradigm. The data collection process utilised semi-structured interviews and a thematic analysis to interpret the findings comprehensively.Results: Findings reveal that ageing infrastructure, ineffective governance structures, limited financial resources, and uneven distribution of water resources exacerbate the problem.Conclusion: Part of the recommendations is that significant investment is needed in upgrading water infrastructure, particularly in rural areas, and governance structures should be strengthened to ensure effective management and equitable distribution of water resources.Contribution: Through delineating strategic recommendations, this study identified the root causes behind insufficient water provision within rural communities. This contributes to the direction of policymaking efforts and expands its impact on future researchers within the field of public administration. Moreover, to bridge the gap between ensuring adequate water provision and promoting efficient water utilisation, it makes strategic proposals for improving water management and distribution, which will affect policymaking and future public administration research.

Community-Engaged Approach to Improve Food Access and Consumption of Fruits and Vegetables in a Rural Appalachian Community

Background/Objectives: Community–academic partnerships offer unique opportunities to leverage expertise and resources to modify structural factors that address community priorities. However, few in-depth examples of successful partnerships in rural communities to improve food security are available. This manuscript describes the process of building a partnership to reduce food insecurity in a rural Kentucky community. Methods: The research team worked with Cooperative Extension to form a community advisory board (CAB) representative of diverse sectors of the community who had interest in food security, agriculture, and/or nutrition. The CAB convened regularly, in-person or virtually, to review community assessment information and identify, select, and adapt relevant multi-level interventions. CAB members were invited to complete two surveys and participate in a listening session to provide feedback on working with academic partners. Results: Over the first two years of the project, 17 people served on the CAB. Early in the project, the CAB prioritized interventions for working families, relatives raising children, and lower income households. Some ideas were able to come to fruition (e.g., family cooking social classes, raised garden beds), while others were explored but were unable to gain momentum (e.g., mobile market) due to challenges with feasibility, organizational capacity, and/or interest. CAB members reported high engagement and strong communication between community and academic partners. Conclusions: Full exploration of potential solutions suggested by CABs may build trust between community and academic partners and could provide a strategic selection process for multi-level, evidence-based interventions deemed feasible for addressing complex issues such as food insecurity and nutritional health outcomes.

Effects of Investments From the Centers for Disease Control and Prevention's COVID-19 Health Disparities Grant on Health Departments' Capacity to Address Public Health Emergencies.

The COVID-19 pandemic magnified long-standing health disparities, showing that certain populations are at higher risk for effects of public health emergencies than others. The pandemic response also put demands on the nation's health departments and stretched their limited resources. In 2021, the Centers for Disease Control and Prevention launched the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities (hereinafter, COVID-19 Health Disparities Grant) to reduce COVID-19 health disparities and advance health equity. Health departments in all 50 states, 50 localities, 5 territories, and 3 freely associated states were recipients of approximately $2.25 billion. This study explored the extent to which investments from the COVID-19 Health Disparities Grant, through the allocation of funds across 5 strategies, correspond to reported changes in recipient health departments' capacity to address the COVID-19 public health emergency and future emergencies as measured in the Health Department and Jurisdiction Capacity Survey in 2023. The survey measured capacity along 4 domains: workforce and human resources, interorganizational relationships, data and informational resources, and governance and planning. In total, 70 of 75 recipients who responded to the survey reported that they began with low capacity in at least 1 capacity domain and advanced their capacity during grant implementation. This study demonstrated the reported value of investments in health departments to build capacity and infrastructure to address health disparities and advance health equity to respond to future public health emergencies.