Rural Communities Research Articles

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.

Nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State, Southwest Nigeria.

Nutritional imbalance is an underlying cause of 2.6million death annually and a third of child's death globally. This study assessed and compared the nutritional status of primary school children and their caregiver's knowledge on malnutrition in rural and urban communities of Ekiti State. This is a cross-sectional comparative study carried out among 983 urban and rural primary school children in Ekiti State (495 in urban and 488 in rural) using interviewer-administered semi-structured questionnaire. A multi-stage sampling technique was used and data collected was analyzed using SPSS 23 with level of statistical significance set at p < 0.05. Underweight and stunting were relatively higher in rural (6.5% and 22.7% respectively) than in urban (6.3% and 19.4% respectively) and these differences are not statistically significant (p = 0.898, p = 0.197). However, wasting, overweight and obesity were higher in urban (12.7%, 6.1% and 7.7% respectively) than rural (11.5%, 3.7% and 7.5% respectively) but the difference is not statistically significant. (p = 0.242). Majority of the caregivers in both settings had good knowledge of malnutrition though higher in urban mothers (89.5%) with statistical significance than their rural counterparts (71.5%). However, there is no significant association between caregiver's knowledge and malnutrition in this study. Being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver were the common predictors of malnutrition among the school children in both community settings. Generally, the prevalence of malnutrition was high in both urban and rural primary school children in this study. However, while underweight and stunting were more prevalent among the children in the rural communities, wasting, overweight and obesity were more prevalent in the urban. The caregivers in both communities had good knowledge of malnutrition (better in the urban) but this is not good enough to bring a significant relationship with the occurrence of malnutrition in the children. Common predictors of malnutrition in both community settings are being in lower primary school class, relationship with caregiver, educational status of caregiver and occupation of caregiver. It is therefore recommended that regular continuous public enlightenment, nutritional education programmes and other programmes targeted at improving the economic power of the caregivers are measures that will improve the nutritional status of the primary school children.

An "integration" of professional identity formation among rural physicians experiencing an interplay between their professional and personal identities.

The present understanding of professional identity formation is problematic since it underrepresents minority physicians and potentially excludes their professional identity formation experiences. Rural physicians are expected to have similar underrepresented aspects as minority physicians because of their specific sociocultural contexts and consequent private-professional intersection, which lead to ethical complexities. Therefore, to bridge this research gap, we interviewed 12 early- to mid-career Japanese physicians working in rural areas and explored their experiences. Through a narrative analysis guided by Figured Worlds theory, we analysed the data by focusing on the vocabulary, expressions, and metaphors participants used to describe their experiences. A central theme emerged concerning how the rural physicians configurated their personal versus professional participation in their local communities. Further, their identity narratives varied regarding how they constructed their identities, rural communities, and relationships as well as their identity formation ideals and strategies to achieve them. Informed by 'Big Questions' concerning worldview framework, we delineated four identity narratives as prototypes to describe how they participated in their communities. These identity narratives provide a preliminary understanding of how diverse identity formation is for rural physicians. In addition, our findings exposed the current professional identity formation framework as potentially biased towards single forms of participation in monolithic communities, overlooking complicated forms of participation in multiple communities. We argue that applying frameworks and concepts to capture these multiple forms of participation as well as revisiting the 'discourse of integration' are necessary steps to overcome the limitation of the current understanding of professional identity formation.

Differences in Rural Versus Urban Patients With Prostate Cancer in Diagnosis and Treatment: An Analysis of a Population-Based Cohort.

Patients living in rural communities have greater barriers to cancer care and poorer outcomes. We hypothesized that rural patients with prostate cancer have less access and receive different treatments compared with urban patients. We used a population-based prospective cohort, the North Carolina Prostate Cancer Comparative Effectiveness and Survivorship Study, to compare differences in prostate cancer diagnosis, access to care, and treatment in patients by geographic residence. The 2013 rural-urban continuum code (RUCC) was used to determine urban (RUCC 1-3) versus rural (RUCC 4-9) location of residence. Patients with rural residence comprised 25% of the cohort (364 of 1,444); they were less likely to be White race and had lower income and educational attainment. Rural patients were more likely to have <12 cores on biopsy (47.1% v 35.7%; P < .001) and less likely (40.8% v 47.6%; P = .04) to receive multidisciplinary consultation. We observed significant differences in treatment between urban and rural patients, including rural patients receiving less active surveillance or observation (22.6% v 28.7%), especially in low-risk cancer (33.2% v 40.7%). On multivariable analysis that adjusted for patient and diagnostic factors, rural residence was associated with less use of active surveillance or observation over radical treatment (ie, surgery or radiation therapy; odds ratio, 0.49 v urban; P < .001) in patients with low-risk cancer. Patients with prostate cancer who live in rural versus urban areas experience several differences in care that are likely clinically meaningful, including fewer cores in the diagnostic biopsy, less utilization of multidisciplinary consultation, less use of active surveillance, or observation for low-risk disease. Future studies are needed to assess the efficacy of interventions in mitigating these disparities.

Face-to-face and virtual mathematics enrichment for rural schools:

In this paper the authors report on the University of Southern Queensland’s (USQ) Mathematics Rural and Regional Communities (MRRC) project. This project is an extension to the Mathematics Enrichment Program (MEP), which has been running since 2007. Since the MEP’s inception, more than 500 students, 29 schools, 15 pre-service teachers (who are involved to gain practical teaching experience) and many volunteer university lecturers and other mathematics and education professionals have been involved. The MRRC project builds on USQ’s MEP to offer content in an online or virtual format. Through an interactive virtual environment, the MRRC project connects regional high schools to USQ’s two campuses to build the capacity of the teachers and students involved. The authors describe the overall aim and structure of the MRRC program, preliminary evaluations of the program, analysis of the virtual space and future plans for the program.

Elections, governance, and polarization in Indonesian villages

ABSTRACT This article explores the deepening of affective polarization in rural Indonesia after the Village Law. The 2014 Village Law was envisioned as an essential way for promoting rural decentralization to fostering collaborative governance. Nevertheless, this article finds that there has been a deepening of polarization in rural communities after Village Law. Through an everyday political approach, the study employs qualitative research to provide a more tangible picture of the depth of polarization. This article examines three ways of affective polarization in rural communities: intense political competition, disaggregated voting patterns, and selective handing out of government benefits. We conclude that the dynamics of the village head election, built on ethnic and religious lines, generate an intense political competition and segregated voting patterns. Furthermore, affective polarization ultimately affects the selective distribution of government benefits. This article offers new insights into the aftermath of the Village Law dynamics from village head elections to village governance, focusing on how polarization in rural Indonesia is deepening.

Decolonising research and folk media: a methodology for Exploring narratives of HIV and AIDS in rural Malawi

ABSTRACT Background In Malawi, well-meaning HIV and AIDS interventions imagined in the “Global North” continue to ignore how local people construct the world. This paper explores how folk media can be used to enable research on HIV and AIDS to be positioned within localised cultural paradigms. Methods Drawing on Chewa epistemology, I used folk media methods supported by participant observation. The research was conducted in three phases over 15 days in two rural communities and captured the workshop processes, participants’ process reviews, verbal journals and creative outputs through pictures, audio and video recordings, field notes and reflections. Data was analysed thematically. Finding Folk media can be used to structure research, to facilitate a conducive environment for research practice, as data and as a method for the generation of data/knowledge. Conclusions Folk media can be a strong, replicable, culturally grounded, decolonizing research methodology that promotes collaboration and the deconstruction of power relations.

“Sex Out of Boredom”: Key Stakeholders’ Perspectives on Teen Pregnancy Prevention in Emerging Immigrant Latino Rural Communities

Abstract Introduction Teen pregnancy (TP) rates are 1.5 times higher among Latina youth than the United States national average and one-third times higher in rural counties. The Socio-Ecological framework recognizes the myriad of issues that impact TP, including four bidirectional levels of influence on teenagers’ behaviors: macro, community, institutional, and interpersonal levels. We aim to fill critical knowledge gaps regarding the influence of key community stakeholders living in rural, Latino-majority communities shaping Latino/a, immigrant adolescents’ TP-related environments. Methods A purposive sample of 48 key stakeholders was drawn from three rural counties (Finney, Ford, and Seward) in southwestern Kansas from 2016 to 2017; participants completed a brief demographic survey and a semi-structured qualitative interview. Qualitative data analysis followed grounded theory within a Socio-Ecological framework, and we used descriptive statistics to analyze survey data. Results Respondents (N = 48) included 5 public health department staff, 8 community health workers, 8 healthcare workers, 9 community members, and 18 high school/college administrators. The mean age was 43 years (SD = 15.5) and 50% self-identified as Latino/a. Recommendations included developing TP prevention education programs for parents, utilizing ongoing events and familiar venues, and keeping content consistent with local culture and norms. Conclusions Key stakeholders’ perceptions regarding TP are often unaccounted for but play a role in shaping youth’s decision-making environments. Policy Implications This information could inform the development of culturally specific TP prevention interventions, especially considering the controversial politics centered on immigration to the U.S. and its negative impact on the overall health of Immigrant Latinos living in the U.S.

Gaushala Safety – Automation of Cattle Livestock

Automation of Cattle Livestock is a ground-breaking initiative aimed at transforming cattle care and management. In a nation where cattle play a pivotal role in rural economies, the absence of accessible veterinary care, delayed vaccinations, and disease outbreaks pose significant threats to cattle health and the livelihoods of dependent communities. This project offers a comprehensive solution by harnessing cutting-edge technology. It includes a robust cattle information management system, utilizing speech recognition for data input to accommodate diverse user literacy levels..The core feature is an intelligent vaccination scheduler, creating personalized vaccination plans based on individual cattle profiles, and sending timely reminders to owners. Additionally, it employs advanced image processing to detect early signs of disease. The project ensures accessibility through voice-enabled interaction and simplifies the registration of new cattle and along with that it includes the cattle tracker and shed cleaning. By enhancing cattle health, increasing accessibility, and promoting sustainable cattle rearing, Automation of Cattle Livestock seeks to empower farmers, protect livestock, and drive rural community development. This project represents a pioneering step toward a brighter future for both cattle and their caretakers in India.

Extension-Clinical Approach to COVID-19 Testing and Vaccination

Vaccination rates against COVID-19 are lower in rural areas across the country, including SC. This paper highlights the work conducted by Clemson Cooperative Extension Service in SC to increase rural access to COVID-19 testing and vaccine services. Extension Agents engaged in clinical and community partnerships to coordinate COVID-19 vaccine and testing clinics in rural and underserved communities. Agents established 204 test clinics and 220 vaccination clinics. The total number of people tested and vaccinated was 9,331 and 2,037, respectively. The success of this project shows Extension agents can be instrumental in bridging the gap between clinical resources and rural communities.

A Predefined Rule-Based Multi-Factor Risk Stratification Is Associated With Improved Outcomes at a Rural Primary Care Practice.

This study built a predefined rule-based risk stratification paradigm using 19 factors in a primary care setting that works with rural communities. The factors include medical and nonmedical variables. The nonmedical variables represent 3 demographic attributes and one other factor represents transportation availability. Medical variables represent major clinical variables such as blood pressure and BMI. Many risk stratification models are found in the literature but few integrate medical and nonmedical variables, and to our knowledge, no such model is designed specifically for rural communities. The data used in this study contain the associated variables of all medical visits in 2021. Data from 2022 were used to evaluate the model. After our risk stratification model and several interventions were adopted in 2022, the percentage of patients with high or medium risk of deteriorating health outcomes dropped from 34.9% to 24.4%, which is a reduction of 30%. The medium-complex patient population size, which had been 29% of all patients, decreased by about 4% to 5.7%. According to the analysis, the total risk score showed a strong correlation with 3 risk factors: dual diagnoses, the number of seen providers, and PHQ9 (0.63, 0.54, and 0.45 correlation coefficients, respectively).

A Study on Rural Entrepreneurial Behaviour and Strategies of College Students in the Context of Shared Prosperity

Rural entrepreneurship serves as a concrete manifestation of college students&amp;apos; active engagement in youth-building actions. Vigorously fostering a group of ambitious, dedicated, adaptable, and sustainable rural talents is not only a crucial initiative for advancing &amp;quot;mass entrepreneurship and innovation&amp;quot; but also an effective pathway for promoting the growth and success of university students, enabling them to realize their life values. Additionally, it provides substantial support for the achievement of shared prosperity. Therefore, while meeting the developmental needs of college students, attracting young individuals to actively participate in rural practices and transitioning from being &amp;quot;attracted&amp;quot; to &amp;quot;settling down&amp;quot; is an essential strategy for alleviating employment pressures and addressing the weaknesses in rural development. This study analyzes the challenges and influencing factors in the rural entrepreneurial journey of college students, delving into the behavioral logic and implementation pathways that lead to their engagement. It also proposes corresponding strategies for enhancing the &amp;quot;coupling degree&amp;quot; between college students and rural development, providing recommendations for the latter part of the discourse on college students&amp;apos; rural entrepreneurship. Rural areas should enhance their service capabilities, collaboratively empower and consolidate resources, and strive to provide efficient and high-quality service support for college students engaged in rural innovation and entrepreneurship. A comprehensive support system for college student rural entrepreneurship, consisting of a tripartite collaboration among the government, universities, and rural communities, and encompassing educational guidance, policy support, financial assistance, and service guarantees, should be constructed. This multi-faceted approach will foster a positive atmosphere encouraging college students to actively participate in rural innovation and entrepreneurship initiatives.

National Overview of Nonprofit Hospitals' Community Benefit Programs to Address Housing.

Housing is a critical social determinant of health that can be addressed through hospital-supported community benefit programming. To explore the prevalence of hospital-based programs that address housing-related needs, categorize the specific actions taken to address housing, and determine organizational and community-level factors associated with investing in housing. This retrospective, cross-sectional study examined a nationally representative dataset of administrative documents from nonprofit hospitals that addressed social determinants of health in their federally mandated community benefit implementation plans. We conducted descriptive statistics and bivariate analyses to examine hospital and community characteristics associated with whether a hospital invested in housing programs. Using an inductive approach, we categorized housing investments into distinct categories. The main outcome measure was a dichotomous variable representing whether a hospital invested in one or more housing programs in their community. Twenty percent of hospitals invested in one or more housing programs. Hospitals that addressed housing in their implementation strategies were larger on average, less likely to be in rural communities, and more likely to be serving populations with greater housing needs. Housing programs fell into 1 of 7 categories: community partner collaboration (34%), social determinants of health screening (9%), medical respite centers (4%), community social determinants of health liaison (11%), addressing specific needs of homeless populations (16%), financial assistance (21%), and targeting high-risk populations (5%). Currently, a small subset of hospitals nationally are addressing housing. Hospitals may need additional policy support, external partnerships, and technical assistance to address housing in their communities.

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.

Neutrality and impartiality in Midwestern U.S. newspapers: community-oriented newspaper journalists reporting of environmental water problems in agricultural and ranching states

ABSTRACT Background U.S. journalists embedded in rural and agricultural communities could adversely affect the health of residents if they avoid alerting and engaging their readers – farmers, ranchers, and community members – on environmental and health issues. We expected reporters would maintain community status quo and inaction by framing local water pollution and quality issues neutrally deemphasizing threats and solutions to maintain their own credibility as unbiased informational sources. Method In a content analysis of local water quality newspaper articles from five farming and cattle ranching states in the west central U.S. Midwest, we employed seven variables to investigate whether journalists practiced neutral, detached forms of journalism (i.e. dissemination versus interpretative role enactment, government-frame) as well as whether they deemphasized water pollution as a concerning issue (i.e. problem, threat), water pollution solutions, and readers’ efficaciousness. Results The results showed these journalists relied heavily on government-driven narratives presenting water quality issues from an impartial, straight reporting lens in which they primarily followed the journalistic dissemination role enactment, while neglecting to provide readers with interpretative, threat, efficacy, or solution’s information. Conclusions The study seeks to help communicators understand the information diet people living in this part of the country likely receive on environmental and health risks in the context of water pollution. Communicators seeking to reach and affect audiences in this region should understand local information practices to navigate how to craft culturally specific public health messages.

Agricultural Thought and Humanism of Rabindranath

This article describes Rabindranath Tagore's profound insights on rural development and agricultural reform, highlighting his vision for uplifting village communities through modern science and technology. Tagore's humanistic perspective emphasized the pivotal role of agriculture in societal progress, advocating for the adoption of innovative farming techniques to alleviate rural poverty and empower farmers. Through his observations and initiatives, Rabindranath sought to transform the traditional farming landscape, promoting education, economic independence, and sustainable development in rural Bengal. is writings reflect a deep understanding of the challenges faced by rural communities and underscore the urgent need for holistic approaches to village revitalization.

Techno-economic analysis of a hybrid photovoltaic-wind-biomass-battery system for off-grid power in rural Guatemala

Guatemala has made significant progress in improving its electrical infrastructure in recent years. However, most studies and efforts have focused on developing policies that directly benefit the national electrical market, which may cause a lack of attention toward solutions that cater to low-consumption cases, such as residential and rural communities. Therefore, it is vital to consider the needs of these communities while developing policies and solutions to ensure that they also have access to reliable and affordable sources of electricity. This study analyzes the cost-effectiveness and technical performance of a hybrid renewable energy system (HRES) that can meet the power needs of low electricity-consuming households in a rural region of Guatemala. The proposed HRES comprises a hybrid photovoltaic-wind turbine-bio generator coupled to battery storage, which caters to the energy needs of a typical household in Alta Verapaz, a rural area in Guatemala with limited electricity access (64.61%). The research considers three scenarios: I) basic electricity needs for the household, II) increased electricity needs for cooking and water heating, and III) future electricity demand in 2050, considering the role of the renewable energy market. Based on Scenario I, the cost-effective solution is a PV system with a capacity of 5.39 kW and 29 kWh battery capacity, with a cost of energy (COE) of 0.893 $/kWh. In Scenario II, a hybrid solution consisting of a 2.46 kW PV system, a 2.20 kW bio-generator, and 16 kWh battery capacity o, results in a COE of 0.605 $/kWh. Scenario III suggests a hybrid system, including 7.90 kW of PV, 3.30 kW bio-generator, and 14 kWh battery to meet the expected energy demand in 2050. COE for this solution is estimated to be 0.297 $/kWh. Considering the declining costs of renewable energy technologies by 2050, the findings highlight that the proposed HRES can be an affordable solution for low-consumption scenarios such as off-grid areas in Guatemala.

Unveiling Social Dynamics in People's Perception of Raptors to Guide Effective Conservation Strategies

Ethnoscientific approaches offer valuable tools for exploring human–nature relationships, making them useful for developing effective conservation strategies. Raptors, which are birds of prey, face significant conservation threats worldwide, with human persecution being a leading factor in their population decline. Urgent conservation strategies are needed, particularly in regions of high raptor diversity like the tropical Andes. In this study, we employed semistructured questionnaires and logistic models to investigate how demographic factors, economic activity, and traditional knowledge shape people's perceptions of raptors in rural communities of the Ecuadorian Andes. These communities have historically experienced poverty and inequality, and our approach takes into account their local realities to provide conservation recommendations. Our findings reveal that traditional ecological knowledge provides a broad understanding of human–raptor relations, and that raptors are viewed as both providers of ecosystem services and disservices. Additionally, social demographics, such as gender and educational level, can influence people's perception of raptors. Based on these results, we can promote conservation actions from a local to global level. Ethnoecological approaches offer diverse conservation opportunities that can vary based on different local contexts. In addition to conventional measures such as environmental education programs, poultry management, and landscape preservation, it is essential to consider the political ecology of specific sites, particularly in regions of the Global South where poverty and inequality are closely intertwined with social and environmental injustices. As such, policy making to alleviate poverty and inequality in rural communities in Ecuador and other Andean countries; and science decolonization to make conservation more inclusive are crucial for human well-being and successful and lasting conservation actions for raptors and biodiversity.

The usefulness of the Model of Occupational Self Efficacy (MOOSE) in returning stroke survivors to work in a rural community in Cape Town, South Africa

BACKGROUND: Individuals diagnosed with stroke have a poor return to work rate, particularly in rural communities. OBJECTIVE: The aim of the study is to describe the experiences and perceptions of individuals diagnosed with stroke about the usefulness of the Model of Occupational Self Efficacy (MOOSE) in assisting them in returning to their worker role. METHODS: The study utilized an explorative, descriptive, qualitative research design, furthermore the data was analyzed using thematic analysis, resulting in three themes. Seven stroke survivors and one key informant participated in the study. RESULTS: Theme one: Obstacles that affect the return to work of stroke survivors in a rural community. Theme two: Re-establishing a strong belief in functional ability through participation in occupation. Finally, theme three: The MOOSE enables transition to the worker role in a rural context. CONCLUSION: The findings indicate that the MOOSE is a useful model in facilitating the return to work of individuals diagnosed with a stroke. The participants struggled to return to work not only due to their loss of abilities but also their lack of knowledge with regard to how to return to work and their diagnosis of a stroke.

Resilience of communal water management in La Gomera (Canary Islands): discussing with Hardin and Ostrom

ABSTRACT We analyse the main keys of the traditional agroecosystem of the palm grove (Phoenix canariensis) in irrigated terraces in Valle de Arriba in the municipality of Valle Gran Rey (La Gomera, Canary Islands, Spain). Here, irrigation water is not only associated with the land but is also being managed as a communal resource by the inhabitants. The change in the economic model from agriculture to tourism is putting the survival of this traditional agrarian system at risk (agricultural exit, population ageing and economic touristification). The need for preservation is then suggested, but the question that leads us to a re-edition of the so-called “Tragedy of the Commons” arises again: What actors should carry out this preservation? Private agents or the State, as suggested by Hardin, or the rural community, as maintained by Ostrom? We conclude that for the case studied of La Gomera, the rural community has kept managing the communal water resource but at the expense of the secular class struggles won by the farming community against the privatisation of water by private agents and/or the State.