Rural Context Research Articles

Artificial Intelligence as an opportunity or a curriculum trajectory in the 21st century? Towards embracing unfamiliar discourses

This theoretical paper contributes to the ongoing debate on Artificial Intelligence (AI) in relation to curriculum and implementation in post-colonial South Africa. We contend that AI, as perceived, conceived, and implemented within the curriculum space, presents an ambivalent terrain marked by fear, uncertainty, and anxiety among stakeholders, as its presence has interfered with the everyday work of educational practitioners. Cognizant of this problem, we locate our theorisation within the framework of Sustainable Learning Environments and address two questions: (1) What are the opportunities of AI in relation to the curriculum in post-colonial South Africa? (2) What challenges are faced in the implementation of AI, especially in rural contexts where technological opportunities are not equivalent to those in urban areas? In this paper, we highlight that while AI tools like ChatGPT may appear daunting for integration into teaching and learning—potentially undermining educators' authority and raising ethical concerns—there is an urgent need to rethink and restructure teacher education. This restructuring should align with the evolving demands of an AI-enhanced curriculum and address the shifting expectations in educational contexts.

The 2023 State of Nebraska Families: State Priorities and Key Areas of Promise

Nebraska is often referred to as “the good life” by state residents. In 2022, Nebraska was comprised of over 800,000 family households and had a population nearing two million. Nebraska is the only state in the U.S. with a unicameral legislature and is comprised of both rural and urban contexts over a diverse geography. Like other states, in the past decade, there have been changes in the demographic makeup of the population, due in part to immigration, an aging population, and out migration. Given this context, we focus our review of Nebraska families on state priorities identified in a Nebraska Cooperative Extension needs assessment that include attracting and retaining a skilled workforce, and enhancing economic vitality, health, and wellbeing. We describe the state geography, demographics, and government contexts. We then describe where current policy programming, and resources stand in addressing relevant family-focused needs and issues of the key working age population. We end with recommendations focused on the strengths of Nebraska, given its relatively small population and community-oriented nature that can be leveraged to support innovations in policies and programs to create a healthy environment for families, that ultimately enhance the economic vitality of the state.

Knowledge, Influence and Accountability: A Study of Political‒Administrative Relations and Civil Servant Influence on Two Rural Swedish Citizen Dialogues

One of the current challenges of democracy is the increasing complexity of governing and, consequently, increasing civil servant influence at the expense of elected representatives. This is also affected by what politician–civil servant relations look like and by contextual aspects, although knowledge about the extent and impact of this influence is selective. Thus, this paper examines civil servants’ influence in evidently complex and resource-intensive processes by conducting a study of citizen dialogues in two rural Swedish municipalities. Expectedly, traits of this context can be recognised throughout the results. The findings point to the position of the involved civil servants as important to the level of civil servant influence in these processes. They further suggest that process complexity may contribute to amplifying already high civil servant influence. However, they also confirm expectations about civil servants’ dispositions towards political legitimate processes, which appeared to dampen the impact of the skewed influence. I conclude that, with these contextual preconditions, the studied form of process can potentially increase civil servant influence. I also argue that, given the size and form of this study, this highlights the need for further studies in local rural contexts and local politician–civil servant relations.

A longitudinal study on the predictors of early grades learning attainments in low-and-middle-income countries: Evidence from Tanzania

Strands of evidence from high-income countries has consistently indicated that early learning attainments predict later learning achievements. However, less are known about these issues from low-and-middle-income countries, particularly from the sub-Saharan region. This longitudinal study examined the extent to which children’s school-entry (N = 597; mean age = 6.34 years) early reading and early math skills predicted their later learning achievement in a low-income country, Tanzania. Further, given the existing disparities of quality of educational services, families’ income, and early learning achievements, the sample included children and families from both rural and urban contexts. Data were collected using Measure of Early Learning Environments (MELE) for controlling of school quality, Early Grade Reading Assessment (EGRA) and Early Grade Math Assessment (EGMA) for children’s tests, and parents’ questionnaire for home-related variables. Controlling for family socioeconomic status, intervention status, urbanicity settings, and parental education, findings indicated that school-entry math skills were significantly predictive of children’s end of Grade 2 reading and math achievement. However, while school-entry early reading skills predicted end of Grade 2 reading achievement, it did not predict later math achievements. This article extends research on links between elements of transition to school and later achievement across countries, thus, its implications are discussed.

Transit Safety of Women in Rural-Urban Contexts

Sexual harassment and other forms of transit crime are everyday occurrences for women and girls around the world. The absence of safety hampers the ability of numerous women to engage freely in school, employment, and public activities without being alert. This research explores women’s safety experiences, particularly focusing on young women in diverse rural and urban environments. We utilized chi-square analysis and regression models to analyze data obtained from a survey distributed to railway passengers in 2022 across neighboring municipalities in southern central Sweden. Findings show that being young makes women more likely to be victimized. Although rural women feel safer than their urban counterparts, they are more often willing to take precautionary measures before taking a trip (e.g., more often traveling with someone in the evening or avoiding certain stations). These findings call for gender-age-sensitive mobility policies, taking into account the intersectionality of transit safety, and reflecting women’s and girls’ safety needs in particular rural contexts.

Constraining Factors to Rural Women's Empowerment: A Perspective from the Specialized Literature

This study analyzes the constraining factors of women's empowerment in rural contexts, focusing on socioeconomic and sociocultural factors. It examines the limited access to economic resources, employment opportunities, gender roles, social norms, and access to education as segregating elements, restricting empowerment. From this perspective, the purpose of this research is to review the specialized literature to analyze these factors and determine guidelines to strengthen empowerment in rural communities. With a qualitative approach, the research is also descriptive and reviews studies and specialized sources. The findings show that the main obstacles are limited access to economic resources and employment opportunities, along with traditional gender roles and lack of education, which in turn limit the economic participation and influence of rural women in the community, leading to the conclusion that it is necessary to address these elements comprehensively, promoting policies and programs that improve access to resources, education and gender equality, facilitating an environment that empowers rural women and allows them to fully contribute to their communities.

Women entrepreneurs in rural Nigeria: formal versus informal credit schemes

PurposeThis study examines why low-wealth women entrepreneurs forgo mobile enabled money services and government supported micro finance for informal, community-based revolving loans in rural Nigeria.Design/methodology/approachThematic analysis of 25 interviews with women in rural, south-west Nigeria. Entrepreneurial ecosystem theory, in the gendered context of micro finance and community-based lending, is employed.FindingsThis study explains the paradox of forgoing seemingly accessible mobile enabled credit, and formal credit schemes (e.g. micro-finance programs) for informal, one-on-one borrowing. Convenience and trust-based relationships with respected community members ease the burden of time scarcity and vulnerability associated with formal capital. Flexible terms, autonomy, self-reliance and knowing who one is dealing with make Esusu a preferred source of finance. Findings are discussed in the context of gendered entrepreneurial ecosystems in which participants conduct business.Research limitations/implicationsThe sample is not representative of women entrepreneurs in rural Nigeria. Survivorship bias is acknowledged. Further research is needed on the psychological risks of informal capital and the benefits of community-based lending.Practical implicationsMeasures to scale mobile enabled credit, without commensurate interventions to address time management and other structural issues that confront women traders, limit their utility and impacts. Power differentials between women traders and lenders must also be considered in the design of lending products. Training of women traders and formal lenders should incorporate curricula about gender gaps in capital markets and systematic gender challenges to support entrepreneurs who seek to grow beyond subsistence enterprises.Originality/valueThis study documents decision criteria that motivate informal rural women traders to employ community-based revolving credit or Esusu. Findings inform measures to increase women entrepreneurs' access to capital in a rural sub-Saharan Africa contexts.

Adapting Child Development Assessment Tools to the Rural Indian Context.

Child development assessment tests serve many purposes, including educational placement, identifying cognitive weaknesses, and initiating early interventions. Much of the research associated with developmental testing has been conducted in high-income countries, offering limited guidance on adapting these tests to other settings. As part of the first phase of a study exploring the impact of childhood vaccines on cognition and school attainment, we aimed to assess the feasibility of enrolling children from the community, documenting immunization, and conducting child development assessments for children between 18 months and 8 years of age in a rural setting in Haryana, India. To ensure assessments are optimally tailored to the context, child development assessment tests require valid translation and cultural adaptation. This report describes the rigorous seven-step adaptation process we designed for the contextually appropriate adaptation of the following three child development assessment tests: the Bayley Scales of Infant Development-IV, the Stanford Binet Intelligence Scale Fifth Ed. for Early Childhood, and the Wechsler Intelligence Scale for Children IV. This process involved translating tests into the local language, back-translating them for accuracy, adapting them to the rural context via several iterations, and field-testing to refine and validate adaptation quality. This adaptation process may be beneficial for other researchers involved in adapting child development assessment tests to other settings. Further, this adaptation process may inform other researchers involved in adapting tests for diverse settings.

Experiences of Rural-Dwelling Children Wearing Physical Activity Trackers: An Exploratory Study.

Although there is a need for evidence-based physical activity programs in rural communities, evaluating such programs is often challenging due to access-related barriers and measurement tools that are not designed for rural contexts. This study aimed to explore and better understand the day-to-day experiences of rural-dwelling children using wrist-worn PA trackers as part of a study to develop a health promotion program. Ten caregivers and child dyads were enrolled (n = 20). The children wore accelerometers pre- and post-intervention. Semi-structured interviews were completed post-intervention and were audio recorded, transcribed, and summary reports were generated based on recurring themes. The children had a mean age of 8.7 (SD = 1.4) years and the majority were male (80%). The caregivers were female, white, and had a mean age of 43.6 (SD = 8.5) years, with an annual income of ≥USD 40,000. Factors contributing to device wear times included low caregiver burden, device functioning as a watch, and device interactivity. The children reported that the devices were acceptable, but may have changed their physical activity behaviors, with children regularly checking their step count. The caregivers preferred devices that monitored the children's activity levels without sharing location data. Identifying acceptable and feasible strategies to measure physical activity is vital to developing effective health promotion efforts. The lessons learned may help develop evaluation plans for implementing rural physical activity programming.

Linguistic variation in urban vernaculars and rural and urban youth language in South Africa

Abstract This article describes and attempts to differentiate varieties of spoken isiXhosa in South Africa – including variations of the isiXhosa-based stylect commonly referred to as Tsotsitaal (plural tsotsitaals), and the urban vernacular form of isiXhosa. The article introduces some new Tsotsitaal data from a rural context and unpacks whether a comparison with both standard and urban forms of isiXhosa is a useful analysis, and whether we can look at these different practices as varieties, or alternatively as a continuum of isiXhosa. The comparison highlights what may be features of the lexicon and morphosyntax of isiXhosa-based tsotsitaals compared to urban and standard isiXhosa, and points to possible differences between rural and urban tsotsitaals. Ultimately, the article concludes that the inherent variability in stylistic practice within youth and urban varieties demands larger datasets if we are to argue that different varieties are at play, rather than simply stylistic variation in interactional contexts.

Prostate Cancer Care in Rural Primary Care Contexts: A Narrative Review.

Prostate cancer is highly prevalent among older men and poses significant health challenges, particularly in rural areas where access to specialized care is limited. This narrative review aims to evaluate the quality of prostate cancer care in rural primary care settings, identify gaps, and suggest strategies for improvement. A comprehensive narrative review was conducted using PubMed to identify relevant studies published between April 2000 and August 2024. The search focused on articles discussing prostate cancer management in rural primary care, including challenges, outcomes, and collaborative practices. Thirteen studies met the inclusion criteria and were analyzed to assess the quality of care and potential areas for enhancement. The review highlighted significant disparities in prostate cancer care in rural areas, including limited access to urologists, variability in PSA testing practices, and socioeconomic and geographic barriers. Innovative models like telehealth and 'One Stop' Prostate Clinics(OSPCs) showed promise in addressing these challenges. However, gaps in long-term symptom management and follow-up care persist, emphasizing the need for comprehensive survivorship plans and targeted educational interventions for primary care physicians. Rural primary care settings face unique challenges in managing prostate cancer, necessitating tailored strategies to improve care quality. Enhancing collaboration between primary care physicians and urologists, expanding access to innovative care models, and addressing socioeconomic and geographic disparities are critical to improving outcomes for prostate cancer patients in rural areas. Future research should focus on developing and evaluating these strategies to ensure equitable care for all patients.

Teaching the Teachers: Technological Proficiency and Professional Growth in Rural Education

Preparing teachers in small rural schools to effectively integrate technology into their teaching practices is vital for fostering 21st-century skills in students, despite the unique challenges these settings present. To explore the specific challenges and opportunities related to the professional development of teachers in small rural schools, in the context of increasing digitalisation of education. This study employs a systematic review as its research method, aiming to identify, critically evaluate, and synthesize relevant studies that shed light on this context. Teacher education programmes that adeptly incorporate technology, such as mobile devices, into their curricula offer a critical support system not just for urban educators, but importantly for rural teacher candidates who may have limited access to higher education resources. Smartphones and tablets, for instance, can serve as valuable tools for these teachers, allowing them constant and remote access to professional development materials and effective learning resources. The technology also presents an opportunity for iterative learning, where immediate feedback can guide improvements in teaching strategies. Examples include the use of virtual avatars as teaching aids instead of in-person instruction. As the push for digitalisation continues, it is incumbent upon educational institutions to articulate the benefits and returns of such investments, especially in the context of small rural schools where resources may be limited and the challenges distinct. This articulation must be framed in terms that resonate with educators, students, communities, and potential educational funders in these rural contexts.

A cross-sectional survey exploring organizational readiness to implement community pharmacy-based opioid counseling and naloxone services in rural versus urban settings in Alabama

BackgroundRural US regions experience lower naloxone dispensing rates compared to urban counterparts, particularly in Alabama. In light of this, strategies to enhance opioid counseling and naloxone services (OCN) in rural community pharmacies are critical. However, organizational readiness to implement OCN in rural versus urban contexts where resource networks may differ is not well understood. ObjectivesThe purpose of this study was to explore organizational readiness and identify factors associated with implementation of OCN in rural versus urban Alabama community pharmacies. MethodsAlabama community pharmacists and technicians were recruited to participate in an anonymous online cross-sectional survey via email. The survey instrument was adapted from the Organizational Readiness to Change Assessment (ORCA). Primary outcome measures included 3 overarching ORCA domains (Evidence, Context, and Facilitation) with 19 subscales regarding OCN implementation readiness, measured via 5-point Likert-type scales (1 = strongly disagree, 5 = strongly agree). Secondarily, pharmacy OCN implementation status (implementer, non-implementer, or in-development) was measured via multiple-choice (1-item). Differences in mean domain and subscale scores between rural and urban pharmacies were evaluated using Mann-Whitney U tests and influential factors affecting OCN implementation status were assessed via logistic regression (alpha = 0.05). ResultsOf 171 respondents, the majority were pharmacists (78.6 %) in urban locations (57.1 %). Mean[SD] clinical experience evidence (Evidence) (3.98[0.69] vs 3.74[0.71]; p = 0.029), staff culture (Context) (4.04[0.66] vs 3.85[0.76]; p = 0.047), service measurement goals (Context) (3.92[0.77] vs 3.66[0.79]; p = 0.034), and senior management characteristics (Facilitation) (3.87[0.72] vs 3.71[0.66]; p = 0.045) subscales were higher in urban versus rural pharmacies. Notably, 66.7 % of pharmacies were current OCN implementers, and pharmacies with higher ORCA context domain scores had 3.230 greater odds of implementing or being in the process of developing OCN (95 % CI = 1.116–9.350; p = 0.031). ConclusionOrganizational readiness to implement OCN was higher among urban versus rural pharmacies in terms of perceived strength of clinical evidence, staff culture, service measurement goals, and senior management characteristics. Future research may leverage key contextual factors to enhance OCN implementation.

Emergency care via video consultation: interviews on patient experiences from rural community hospitals in northern Sweden

BackgroundDelivering emergency care in rural areas can be challenging, but video consultation (VC) offers opportunities to make healthcare more accessible. The communication and relationship between professionals and patients have a significant impact on the patient’s experience of safety and inclusion. Understanding the patient perspective is crucial to developing good quality healthcare, but little is known about patient experiences of emergency care via VC in a rural context. The aim of this study was to explore patient experiences of emergency care via VC in northern rural Sweden.MethodsUsing a qualitative approach, semi- structured interviews (n = 12) were conducted with individuals aged 18—89 who had received emergency care with a registered nurse (RN) on site and VC with a general practitioner (GP). The interviews were conducted between October 2021 and March 2023 at community hospitals (n = 7) in Västerbotten County, Sweden. Interviews were analysed with content analysis.ResultsThe analysis resulted in main categories (n = 2), categories (n = 5) and subcategories (n = 20). In the main category, “We were a team of three”, patients described a sense of inclusion and ability to contribute. The patients perceived the interaction between the GP and RN to function well despite being geographically dispersed. Patients highly valued the opportunity to speak directly to the GP. In the main category, “VC was a two-sided coin”, some experienced the emergency care through VC to be effective and smooth, while some felt that they received a lower quality of care and preferred face-to-face consultation with the GP. The quality of the VC was highly dependent on the RN’s ability to function as the hub in the emergency room.ConclusionPatients in rural areas perceived being included in 'the team' during VC, however they experienced disadvantages with the system on individual basis. The nursing profession plays an important role, and a proper educational background is crucial to support RNs in their role as the hub of the visit. The GP’s presence via VC was seen as important, but to fully enable them to fulfil their commitments as medical professionals, VC needs to be further improved with education and support from technical devices.

Environmental education within the right to education framework

The incorporation of environmental education (EE) into the framework of the right to education that has been established is being more recognized as being of utmost importance in light of the growing environmental issues. The purpose of this study is to address the important need to align environmental education (EE) with present educational demands. This will ensure that environmental awareness and sustainability are intrinsic components of educational curriculum all over the world. The purpose of this study is to investigate the manner in which EE is currently included into the framework of the right to education, with the intention of determining both the areas of strength and those that require development. The research makes use of a mixed-methods methodology, which blends qualitative insights acquired from interviews with educators and policy makers with quantitative data obtained from a survey of educational institutions located in a variety of locales. There are considerable discrepancies between urban and rural contexts in terms of resource allocation, curriculum creation, and teacher training, according to the analysis, which demonstrates that the implementation of EE takes place in a diverse terrain. A significant discovery is that even while EE is technically acknowledged in educational regulations, its actual implementation continues to be inconsistent. This is frequently reliant on the resources available in the local community as well as the dedication of the institution. Following the conclusion of the study, recommendations are provided for educational practitioners and policymakers, with an emphasis placed on the requirement for an approach to EE that is both more structured and accessible to all individuals. These findings provide a contribution to the larger conversation on sustainable education and bring to light the critical need for coordinated strategies that guarantee every kid has access to quality environmental education as part of their fundamental right to get an education.

Facilitators and barriers of technology adoption and social connectedness among rural older adults: a qualitative study

ABSTRACT Background Social disconnection is a public health concern among rural Australian older adults. While research suggests technology can enhance social wellbeing and protect against social disconnection, many older adults are not digitally literate, and little is known as to why and how technology adoption could be promoted in rural contexts. This study aimed to (1) explore the barriers and facilitators of technology adoption among rural older adults and (2) determine the potential utility of technology to promote social connectedness in the aged population. The Theoretical Domains Framework and the Behaviour Change Wheel (BCW) were employed to gain a comprehensive understanding of the digital and social behaviours of rural Australian older adults. Methods Semi-structured interviews were conducted with a convenience sample of 33 rural older adults aged between 65 and 87 years. Interviews were conducted over the phone, audio-recorded, and transcribed. Interview transcripts were coded and analysed using thematic analysis and the BCW. Results Numerous barriers and facilitators of technology adoption were identified, with the most prominent being knowledge, perceived value, perceived self-efficacy, and social support. Findings suggest that older adults’ technology adoption is not simply a technical matter, but influenced by various individual, social, and environmental contexts. Consideration of these factors during development, marketing, training and implementation may facilitate technology adoption among older adults. With regard to social connectedness, several rural barriers emerged, including low population density, geographic isolation, limited community opportunities and poor public transport infrastructure. Conclusion Technology was consistently identified as a facilitator of the social experience, indicating that technology is a promising tool to enhance social connectedness among older adults, particularly those living in rural areas. Future research should focus on enhancing the capability, opportunity and motivation of older adults in technology adoption, with reference to the rural contexts.

Association between Built Environment and Bus Usage among Older Adults: Urban–Rural Differences in the Nonlinearities

Public transport improves mobility and well-being for the rapidly aging population. However, few planning interventions have addressed the urban–rural disparity in bus usage among older adults. Using data from Zhongshan, China, this study adopts the eXtreme Gradient Boosting (XGBoost) model to examine urban–rural differences in the nonlinear relationship between built environment and daily bus usage among elderly adults. The results indicate nonlinearities across all built environment variables and stronger effects of the built environment in rural areas. Distance to transit contributes the most in urban neighborhoods but least in rural ones. Furthermore, dwelling unit density and green space accessibility play the biggest roles in the rural context. Additionally, the most effective ranges of intersection density, land use mixture, and CBD accessibility are greater in rural areas. The findings facilitate fine-grained and diversified planning interventions to facilitate bus usage among older adults in both urban and rural areas.

How to enhance the entrepreneurial intentions of the young population in rural areas: An approach from personal values and the socioeconomic environment

This study investigates the determinants of entrepreneurial intentions among university students in the rural region of Comarca Sierra Sur, Andalusia, Spain. Using the Theory of Planned Behavior, the analysis reveals that attitudes toward entrepreneurship and perceived behavioral control are significant predictors of entrepreneurial intentions. Positive attitudes and a strong sense of control are closely associated with entrepreneurial intentions, while subjective norms show no significant effect, suggesting that social expectations may function differently in rural areas. Additionally, personal values such as openness to change and self-enhancement positively influence entrepreneurial intentions, whereas conservatism is negatively associated. This research fills a gap in the literature by extending the Theory of Planned Behavior to a rural context, where prior studies have been limited. The findings highlight the need to tailor entrepreneurship policies to the unique characteristics of rural areas and emphasize the importance of personal values and perceived control in fostering entrepreneurship. These insights are particularly relevant for policymakers aiming to stimulate economic development and entrepreneurship in rural regions.

The interplay between social environment and opportunities for physical activity within the built environment: a scoping review

BackgroundThe association between social and built environments plays a crucial role in influencing physical activity levels. However, a thorough understanding of their combined impact remains unclear. This scoping review seeks to clarify the interplay between social environments and opportunities for physical activity within different built environments, with a particular focus on the implications of socioeconomic status and urban planning on physical activity participation.MethodsWe conducted a systematic literature search across several databases to identify studies exploring the associations between social factors, built environment characteristics, and physical activity levels. The inclusion criteria were studies published in English between 2000 and 2022, encompassing urban, suburban, and rural contexts. Thematic analysis was employed to categorise studies based on the specific aspects of the built environment they investigated (walking infrastructure, cycling infrastructure, parks and open spaces, and sports facilities) and the social determinants they examined.ResultsA total of 72 studies were included in the review, illustrating a multifaceted relationship between access to physical activity opportunities and social determinants such as socioeconomic status, community engagement, and urban design. The findings highlight the significant role of socioeconomic factors and the quality of PA infrastructure in promoting or hindering PA across communities. Effective urban planning was identified as crucial in providing expanded physical activity opportunities, notably through more pedestrian-friendly environments, comprehensive cycling infrastructure, and accessible green spaces and sports facilities.ConclusionsThis review emphasises the significant impact of socioeconomic status and urban planning on access to physical activity opportunities. This underscores the necessity for urban planning policies to adopt an inclusive approach, considering the varied needs of different population groups to ensure equitable access to physical activity resources. Such strategies are crucial for public health initiatives aimed at enhancing physical activity levels across diverse community sectors, offering a potential avenue to alleviate health disparities associated with inactivity.

Rethinking rural: Public health advocates' views on ENDS cessation for young adults in rural areas.

Electronic nicotine delivery systems (ENDS, commonly referred to as e-cigarettes), have become popular among young adults (YAs, 18-24 years) in the United States. YAs in rural areas increasingly consume more ENDS than those in urban areas. However, there is a knowledge gap regarding the perspectives of public health advocates (PHAs) on ENDS use and cessation among YAs in rural areas. The objectives of the study are to describe the perspectives of PHAs and identify strategies to strengthen the capacity for promoting the cessation of ENDS among YAs in rural communities. A qualitative study and interpretive description were used with semi-structured interviews. The content analysis was used to analyze the data. Twenty-two PHAs, including public health officers, nurses, and tobacco-free educators, from Wisconsin, Minnesota, and North Dakota, were invited to the semi-structured interviews. Four themes emerged: (a) Perceived ENDS use and cessation; (b) rural contexts and infrastructure influencing ENDS use; (c) essential public health responsibilities controlling ENDS use in rural areas; and (d) regulating ENDS use: Policies and law. PHAs stressed the importance of increased awareness of ENDS use in YAs, improved regulation, and tailored policies to tackle rural communities' distinct challenges. The study emphasizes the urgency for specialized programs to aid YAs in quitting ENDS in rural areas. A comprehensive strategy is needed to effectively address ENDS use among YAs in rural areas, involving education, policy adjustments, and community-based initiatives.