Rural Users Research Articles

Assessment of the content, usability, and benefits of the WeChat-based programme for dog bite victims in China: A prospective observation study.

WeChat in China has been used for public health education and the prevention of diseases. This study introduced a WeChat-based program for rabies prevention and evaluated the users’ satisfaction with the program using the technology acceptance model.An online satisfaction questionnaire was used to survey 315 users who had followed the WeChat official account in China, and their satisfaction scores were assessed and analyzed.The users were generally satisfied with the WeChat-based program as an educational and instructional tool with the mean satisfaction score for each item ranging from 3.9 to 4.6 out of a maximum of 5.0 and the total mean satisfaction score of 41.5 out of a maximum of 50.0 (SD = 4.3). Urban users showed more satisfaction than rural users (P = .03). Users who were satisfied also reported that they intended to recommend WeChat to others (P = .00).Findings from the present study indicated that WeChat was considered a useful educational and instructional tool for dog-bite victims among young and urban population. This model of a WeChat-based program for rabies prevention should be expanded to other areas in China.

Reading interest and reading pattern of rural library users in a low literacy rate area

The rural library generates knowledgeable and up-to-date communities through the inculcation of positive lifestyles. The purpose of the study is to investigate reading interest and reading patterns among rural communities in the low literacy rate areas in Malaysia. The quantitative study employs a multi-stage cluster and simple random sampling, whereby 400 respondents from 16 rural libraries at Sabah, Sarawak, Kedah, and Kelantan were selected. This investigation shows that rural library users interested in the reading activity. Most of the users are female, read 2 to 5 books in a week, and prefer to read printed materials in Malay. There is no significant difference in reading interest and gender. Findings suggested that more library needs to be established in rural areas to foster reading culture. Librarians and community leaders play a role in promoting library facilities for the community. More research needs to be conducted to assess the impact of the rural library on the community, especially in the low literacy rate areas. Keywords: literacy rate, reading interest, reading pattern, rural community, rural library

Risk factors, incidence, and prevalence of diabetes among rural farm and non-farm residents of Saskatchewan, Canada; a population-based longitudinal cohort study.

Saskatchewan has a high prevalence of diabetes. It is the largest, rurally populated, predominantly agricultural province in Canada. This research aims to determine the risk factors associated with the incidence and longitudinal changes in the prevalence of diabetes among Saskatchewan's adult rural farm and non-farm residents. The Saskatchewan Rural Health Study (SRHS) is a prospective cohort study conducted in two phases: a baseline survey (2010, 8261 participants) and a follow-up survey (2014, 4867 participants). Generalized estimation equations and survival analysis techniques were used to determine diabetes prevalence and incidence risk factors, respectively. Incidence of diabetes among rural residents was 2.75%. Positive family history, high BMI, sleep apnea and an abnormal Epworth Sleepiness Score (ESS) were significant predictors for diabetes incidence. A substantial increase (1.98%) of diabetes prevalence was observed after four years of follow-up. Risk factors of diabetes prevalence were increasing age, male, low income, positive family history, high BMI, hypertension and heart attack. A mix of individual and contextual factors interacting in complex pathways were responsible for the high incidence and prevalence of diabetes among rural residents. The most original finding of that study was a positive association of sleep apnea, and ESS with incident diabetes warrants further research to identify a causal linkage. Increased diabetes risk among rural male insecticide users indicates an adverse consequence of unprotected chemical exposures in the agricultural field. Urgent population-based preventive measures should initiate to slow the increasing trend of diabetes prevalence among rural residents.

Utilization of prehospital emergency medical services in Saudi Arabia: An urban versus rural comparison

Background: There is limited research outside the USA, Europe, or Australia on the capacity, efficiency, and development of prehospital emergency medicine services (EMS) between urban and rural areas. This study aimed to examine the usage of prehospital EMS across rural and urban areas in Riyadh region in the Kingdom of Saudi Arabia. Methods: A random sample of 800 (400 urban and 400 rural) emergency patient records from the Saudi Red Crescent Authority EMS was collected. The following variables were analyzed: patient demographics, clinical characteristics, length of hospital stay, and length of intensive care unit (ICU) stay. Results: A skewed distribution was noted with respect to sex, i.e., 559 men versus 241 women. Rural patients were younger (42.75 vs. 39.72 years) and had significantly longer hospital (15 days versus 9 days) and ICU (5 days versus 2 days) stays than urban patients following transportation. All injury types were comparable, except for head injury, which was higher in the rural group than in the urban group. Advanced treatment and trauma transport were more often used in rural areas than in urban areas. Conclusions: In this study, rural EMS users were more likely to experience trauma-related incidents that necessitate EMS transportation, while medical reasons were more common among urban EMS users. Moreover, men used EMS at much higher rates than women and were more likely to be transported to the hospital following a call-out.

Shifting to Remotely Delivered Mental Health Care: Quality Improvement in the COVID-19 Pandemic

This paper presents an organizational (ambulatory) case study of shifting mental health care from in-person to remote service delivery due to the current (COVID-19) pandemic as a rapid quality improvement initiative. Remotely delivered mental health care, particularly using synchronous video and phone, has been shown to be cost-effective, especially for rural service users. Our provincial specialized mental health clinic rapidly shifted to such remote delivery during the current pandemic. We report on processes and outputs of this rapid quality improvement initiative, which serves a purpose beyond pandemic circumstances, such as improving access to such specialized mental health care for rural and other service users at any time. In conclusion, shifting specialized mental health care from in-person to remotely delivered services as much as possible could be beneficial beyond the current pandemic. More research is needed to optimize the implementation of such a shift.

Medicinal herbs in community forests of Darchula District, Nepal: a boon of employment and income generation for rural users

Medicinal herbs in community forests of Darchula District, Nepal: a boon of employment and income generation for rural users

Recent trends in the rural-urban suicide disparity among veterans using VA health care.

There is an elevated risk of suicide among people living in rural areas, and the rural-urban disparity in death by suicide is growing in the general United States population. The department of Veterans Affairs (VA) implemented programs targeting rural health in 2007 and suicide prevention in 2008. Rural-urban differences in suicide rates among VA users have not been examined since 2010. We sought to understand whether the rural-urban disparity in suicide risk among VA users decreased during a time of contemporaneous VA efforts to improve access to mental health care for rural Veterans and to improve the effectiveness of mental health services at preventing suicide. We performed a retrospective cohort study examining differences in the raw and adjusted annual suicide rate among rural and urban VA users between 2003 and 2017. All VHA users 2003-2017. Descriptive statistics are presented for all VHA users in 2017. This includes 6,120,355 unique VA users, 32.0% (n = 1,955,935) of whom lived at a rural address. Raw rates of death by suicide were higher in rural VA users than urban VA users overall (33.3 vs. 29.1 deaths per 100,000 population) and across years, but the age, sex, and race-adjusted rates converged in 2005. White VA users had over triple the rate of death by suicide as black VA users, and lived disproportionally in rural areas. The rural-urban suicide disparity among VA users persists. However, the disparity appears to be driven by differences in the racial composition of rural and urban patients, which were not accounted for in prior studies.

The quality of primary care in community health centers: comparison among urban, suburban and rural users in Shanghai, China

ObjectiveFollowing World Health Organization’s initiatives to advance primary care, China put forth forceful policies including the Personal Family Doctor Contract to ensure that every family sign up with a qualified doctor in a community health center (CHC) ever since its 2009 New Health Reform. We used the Johns Hopkins-designed Primary Care Assessment Tool (PCAT) to assess primary care quality experienced by the contracted residents and compare this across different socioeconomic regions.MethodsUsing a multistage sampling method, four CHCs each were randomly selected from urban, suburban and rural districts of Shanghai, a metropolitan with 24 million residents. ANOVA and Multivariate analyses were used to assess the association between location of CHC and the quality of primary care experience.FindingsA total of 2404 CHC users completed our survey. Except for the domain of coordination (information systems), users from suburban CHCs reported best primary care experiences in all other domains, followed by users of rural CHCs. After controlling for covariates, suburban CHC users were more likely to report higher total PCAT scores (ß = 1.57, P < 0.001) compared with those from urban CHCs.ConclusionThat contracted residents from suburban CHCs reporting better primary care experience than those from urban CHCs demonstrates the unique value of CHCs in relatively medical-underserved areas. In particular, urban CHCs could further strengthen first contact (utilization), first contact (accessibility), coordination (referral system), comprehensiveness (available), and community orientation aspects of primary care performance. However, all CHCs could improve coordination (information system).

A Qualitative Evaluation of Tobacco Consumption in the Rural Context

Objectives: Understanding what rural adult tobacco users think about tobacco use, tobacco control policies and health may help create acceptable policies and interventions. Methods: We completed 8 focus groups in rural Michigan from winter 2016 through summer 2018. Interviews were transcribed and an iterative thematic analysis was completed during fall 2018. Results: Although our primary themes of Independence, Respect, Social Context, Economic Calculus, and Policy with an underlying theme of health were similar to themes that typically arise in tobacco control research, their application and social context appear to be unique in rural communities. Issues of respect for tobacco users, and well as third-party individuals affected by tobacco use, were paramount for participants. They viewed tobacco use as an individual choice and not a structural or policy-relevant issue, although they accepted restrictions on tobacco use in most settings where non-smokers are present. Conclusions: Participants understood that smoking is problematic and seem to be open to anti-smoking messaging and policies when correctly framed. Participants blame themselves for their smoking (ignoring industry responsibility) and used language that can be found in tobacco marketing. Framing tobacco control as a way to protect children while respecting smokers as people may be successful.

4045 A TL1 Team Approach to Identify Factors Affecting Rural Tobacco Users’ Participation in Research and Quitting Tobacco Use

OBJECTIVES/GOALS: Guided by the health belief model and social identity theory, we aim to identify socio-cultural and psychological factors that influence rural tobacco users a) participation in research and b) quitting tobacco use. We also explore how citizen scientists are perceived as disseminators of messages. METHODS/STUDY POPULATION: In Phase I of this multi-stage project, we are conducting in-depth interviews with approximately 30 tobacco users. Interviews are on-going, and have been conducted with 16 participants thus far from four rural counties in Florida. The interview consists of semi-structured questions and multiple validated questionnaires. Specifically, we ask a series of questions about participants’ barriers to participating in research, tobacco use history, and internet use and message preferences. Additionally, we include questionnaires on participants’ substance use, nicotine dependence, motivation to quit, and willingness to participate in research studies. RESULTS/ANTICIPATED RESULTS: Initial findings suggest that rural tobacco users have an overall positive perception of research, and many choose to participate in research for altruistic reasons (i.e. they want to help others). Further, participants noted described feeling stigmatized due to their tobacco use. Although most began smoking to fit in with their community, many now feel on the outs. Participants also reported logistical barriers to participating in research, including lack of transportation. DISCUSSION/SIGNIFICANCE OF IMPACT: Findings can inform the development of recruitment materials to resonate with rural adults, including by emphasizing the collective potential to help by participating. This interdisciplinary highlights areas for collaboration to enhance the reach of health education and public health messages.

Informal rural transport in a typical minor municipality in northeastern Brazil: Evaluation and regulation proposals

In many parts of the developing world, informal rural transport, although precarious, is the only type of transport available for urban–rural connectivity. In this context, this article aims to evaluate the level of user satisfaction, as well as to understand their main difficulties and how to improve this kind of transportation. To do that, a research was conducted among transport users, seeking to perform quantitative and qualitative analyses. Adult women represent the majority of users, but, despite the female predominance, satisfaction assessment does not depend on gender. On the other hand, the place of residence affects the perception of service quality, as rural users – perhaps more resilient – are less unsatisfied than urban residents. 78% of respondents use Toyota vans modified for passenger transportation, which they evaluate poorly. 15% use motorcycle taxi and are more satisfied, due to its adequacy in meeting individual demands. Delays and slow travel represent the main problems reported. It was also evidenced that pricing, although not regulated, was the better evaluated criterion. As a conclusion, it is proposed the development of regulation guidelines for operational purposes.

Psychological factors and genetic characteristics of rural cannabis users.

Marijuana is one of the most widely used psychoactive substance. There is evidence of genetic predisposition for addiction. The aim of the study is to evaluate personality traits measured by the NEO Five-Factor Inventory and State-Trait Anxiety Inventory, combined with analysis of Tag1B rs1079597 and Tag1D rs1800498 located in the DRD2 gene. The study group consisted of 214 rural cannabinoid users and 301 controls. The same psychometric test and real-time PCR genotyping were performed in both studied groups. The values of Anxiety state, Anxiety trait, NEO FFI: Neuroticism and Openness in the rural cannabis using group were significantly higher than in the control group. On the other hand, lower values were observed among rural people using cannabis compared to the control group for NEO FFI: Extraversion, Agreeability and Conscientiousness. In the Anxiety trait subscale, a 2% association with the polymorphism DRD2 Tag1B rs1079597 was detected in subjects using cannabis. However, for the DRD2 Tag1D rs1800498, there was no effect on the differences in personality traits between rural cannabis users and the control group. The study shows differences in personality traits between the cannabis using group and controls. Interaction between genetic factors and personality traits was also detected. The association showing the combination of psychological characteristics and genetic variants can bring us closer to the overall picture of the issue of marijuana addiction.

Feasibility of a text-based reduction intervention in helping rural and underserved smokeless tobacco users quit

IntroductionSmokeless tobacco (ST) use significantly affects morbidity and mortality and remains disproportionally prevalent in rural and medically underserved communities. Few programs exist for rural smokeless tobacco users. Text-based interventions may increase the reach of cessation interventions; yet, none has tested them in ST users. We evaluated the feasibility, acceptability, and preliminary efficacy of a text-based Scheduled Gradual Reduction (SGR) intervention in rural and underserved ST users. MethodsST users were randomized in 2:1 fashion to the SGR group (N = 65), a text-based reduction program plus text-based support counseling messages or text-based support messages only group (N = 33). We surveyed participants at 30-days post intervention initiation to assess feasibility and acceptability and examined self-report 7-day point prevalence cessation at 30-days and 6-months post intervention initiation in the two arms. ResultsWe achieved benchmarks for feasibility and acceptability. Among the SGR participants 51% (n = 48) reported that intervention was useful in helping them quit, 83% (n = 48) indicated that they would recommend the intervention to a friend. Over 95% (n = 39) of SGR participants said that they read all alert texts. The SGR participants had a higher quit rate at 30-days compared to support messages alone (SGR = 21.5%, Control = 9.1%, p = 0.1627, Cohen’s d equivalent = 0.56, medium effect). However, the quit rate at 6-months was 21% (p = 0.9703) for both groups. ConclusionsA text-based intervention was feasible and acceptable among underserved ST users. SGR helped promote short-term cessation. The text-based interventions both had long-term efficacy. Given that text-based interventions have the potential to increase reach in underserved ST users, further testing is warranted.

The 11th Australian Rural and Remote Mental Health Symposium Communiqué.

The 11th Australian Rural and Remote Mental Health Symposium Communiqué.

A Case for Large Cells for Affordable Rural Cellular Coverage

In most developing countries across the world, cellular rural users are predominantly pedestrian and indoor users within village homes, and much less from vehicles, let alone fast-moving ones. Specifically, in India, 85% of the villages in the plains are spaced 2–3 km apart uniformly in every direction. The base station required for providing coverage in rural areas is starkly different from the base station along highways to provide coverage for fast-moving vehicles. Till IMT-2020, ITU did not have a rural use case suited to rural needs of developing countries. Hence, the IMT advanced technology development (such as 4G LTE) did not meet the rural requirements in countries like India. To avoid such a situation for 5G, a new test case requirement, named low-mobility large cell (LMLC) was included as a mandatory use case with performance requirements that must be met by every specification that is approved as an IMT-2020 compliant standard. In this paper, we describe the reasons why such a test case requirement is crucial by taking a case study from the Indian rural setting. In addition, we also describe various technical solutions that can be considered to satisfy such stringent requirements. In particular, we look at a new waveform with low peak-to-average power ratio that has been introduced in 5G for coverage enhancement.

Comparing attitudes towards adoption of e-government between urban users and rural users: an empirical study in Chongqing municipality, China

ABSTRACT Urban–rural divide becomes an obstacle to the development of e-government in China. This research devotes to promoting the adoption of e-government in China. It investigates the attitudes of urban residents versus rural residents toward e-government use in Chongqing, one of most important municipalities of China which is fraught with a serious urban–rural divide. A research model is created to assess the differences between urban and rural residents according to previous literatures and theories. A Structural Equation Model approach is employed to examine the research model. The survey data were collected from 596 urban residents and 477 rural residents in Chongqing. The results reveal that there are differences between urban and rural groups. Many enabling factors and inhibiting factors in previous studies, such as perceived behavioural control and resistance to change, can positively influence rural residents’ intentions to use but fail to exert great effects on urban residents’ motivations. Thus, it is necessary for government agencies in China to take actions based on those significant enabling factors and inhibiting factors to promote e-government acceptance. In addition, it is also necessary to conduct deeper research on e-government acceptance of urban residents in China.

Conservation from the inside‐out: Winning space and a place for wildlife in working landscapes

Abstract Protected areas fall far short of securing the space needed to sustain biodiversity and ecosystem function at a global scale and in the face of climate change. The prospects of conserving biodiversity in working landscapes help buffer the insularization effects of protected areas and hold great potential for biodiversity conservation on a landscape scale but depend on finding adequate space and a meaningful place in the lives of rural land users. Using a case study in southern Kenya, we show that the conservation of large open landscapes, biodiversity and the coexistence between wildlife and livestock can be achieved indirectly by reinforcing pastoral practices that depend on open space, mobility, social networks and institutional arrangements governing common‐pool resources. Pastoral practices and wildlife both depend on large multiscale interactions within interlinked social and ecological systems, which are threatened by land fragmentation, alienation and degradation. We show that large open spaces can be maintained by using a conservation approach starting from within community aspirations that emphasize the links between livelihoods, productivity, efficiency and resilience in pastoral economies and the secondary benefits of wildlife enterprises. Scaling up from an ecosystem to multi‐scale approach benefits pastoral communities by building resilience and new economic opportunities. In the process, the expanded scale conserves regional biodiversity and large free‐ranging herbivore and carnivore populations underpinning ecosystem function and the nationally important tourism industry centered on the Kenya–Tanzania boundary. The ‘inside‐out’ approach to the conservation of wildlife and biodiversity is place‐based, draws on local knowledge and informal governance arrangements and avoids the stigma of wildlife conservation driven by outside agencies. The human‐centered approach reinforces land health and spatial connectivity and encourages multi‐level and distributed governance arrangements embedded in large regional and national jurisdictions.

Telecenters and the expansion of human capabilities among rural women

PurposeThis study aims to assess the contribution of telecenters in expanding the capabilities of rural women to achieve their development outcomes in three rural districts in Tanzania.Design/methodology/approachThe study conducted 12 focus group discussions with 37 rural women users and 36 rural women non-users of telecenters and semi-structured interviews with telecenter managers in the selected districts. The framework for the study is based on Sen’s capability approach.FindingsThe study noted that telecenters may enable rural women to build some capabilities (social, financial, human and political capabilities), and inhibit others, resulting in diverse development outcomes, based on the choices made and conversion factors. These conversion factors included institutional factors (inadequate computers, space and personnel, unreliable electrical power and slow internet connectivity) and individual factors (multiple responsibilities, status, low-level of education, language barrier, lack of information and communication technology (ICT) skills and technology efficacy and inability to afford ICT short courses). Other conversion factors (e.g. availability of affordable ICTs) enabled rural women to build their capabilities.Originality/valueThis is a comprehensive study that provides findings for rural telecenters to plan and allow rural women to expand their capabilities and achieve their development goals in Tanzania or other settings with similar conditions.

Lessening barriers to healthcare in rural Ghana: providers and users\u2019 perspectives on the role of mHealth technology. A qualitative exploration

BackgroundKey barriers to healthcare use in rural Ghana include those of economic, social, cultural and institutional. Amid this, though rarely recognised in Ghanaian healthcare settings, mHealth technology has emerged as a viable tool for lessening most healthcare barriers in rural areas due to the high mobile phone penetration and possession rate. This qualitative study provides an exploratory assessment of the role of mHealth in reducing healthcare barriers in rural areas from the perspective of healthcare users and providers.MethodSemi-structured interviews were conducted with 30 conveniently selected healthcare users and 15 purposively selected healthcare providers within the Birim South District in the Eastern Region of Ghana between June 2017 and April 2018. Data were thematically analysed and normative standpoints of participants were presented as quotations.ResultsThe main findings were that all the healthcare users had functioning mobile phones, however, their knowledge and awareness about mHealth was low. Meanwhile, rural health care users and providers were willing to use mHealth services involving phone call in the future as they perceived the technology to play an important role in lessening healthcare barriers. Nevertheless, factors such as illiteracy, language barrier, trust, quality of care, and mobile network connectivity were perceived as barriers associated with using mHealth in rural Ghana.ConclusionThe support for mHealth service is an opportunity for the development of synergistic relationship between health policy planners and mobile network companies in Ghana to design efficient communication and connectivity networks, accessible, localised, user-friendly and cost-effective mobile phone-based health programmes to assist in reducing healthcare barriers in rural Ghana.

Impact of ICTs-in-Agriculture on Rural Resilience in Developing Countries

Agriculture remains the dominant sector for rural areas in developing countries. However, short-term shocks (e.g. conflict, economic crisis) and long-term trends (e.g. climate change) hamper and can even reverse attempted gains in agricultural productivity and related rural development outcomes. Influenced by the current sustainable development paradigm, it is increasingly acknowledged that, to address this, rural households and communities must strengthen their resilience. Given their growing role in rural livelihoods, information and communication technologies (ICTs) will be a key part of resilience-building. Yet we currently know very little about this. To address this knowledge gap, a systematic literature review was undertaken to establish two things. First, the extent to which use of ICTs-in-agriculture (ICT4Ag) is weakening or strengthening the resilience of rural households and communities in developing countries. Second, an explanation of why the observed impacts are occurring. Measuring resilience using the RABIT (Resilience Assessment Benchmarking and Impact Toolkit) framework, current reported evidence suggests ICTs are strengthening rural resilience far more than weakening it. However, the impact is highly uneven. Household resilience is built far more than community resilience, and there is a strong differential impact across different resilience attributes: equality in particular is reported as being undermined almost as much as enhanced. A new conceptual model is inductively created to explain some of these outcomes. It highlights the importance of individual user motivations, complementary resources required to make ICT4Ag systems support resilience, and the role of wider systemic factors such as institutions and structural relations. The paper draws policy/practice conclusions: more equal focus on both household- and community-level resilience, more attention to the resilience-weakening potential of ICTs, ensuring perceived utility of digital applications among rural users, encouraging use of more complex ICT4Ag systems, and looking beyond the technology to make parallel, complementary changes in resource provision and development of rural institutions and social structures. Conclusions are also drawn about the conceptualisation of resilience: better incorporation of agency and power, and greater clarity on resilience system boundaries and indicators. Overall, we contribute new frameworks, new evidence, new practical guidance and a research agenda for those seeking to strengthen rural resilience through use of ICTs.