Perceptions of COVID-19 Mitigation Strategies between Rural and Non-Rural Adults in the US: How Public Health Nurses Can Fill the Gap

Abstract

The purpose of this study was to capture the perceptions of COVID-19 mitigations’ efficacy of rural and non-rural participants, using the health belief model (HBM), as well as to describe where public health nursing may be able to fill behavior gaps in rural communities. Rural and non-rural participants completed electronic surveys. Surveys collected demographic information and perceptions of various mitigation strategies’ effectiveness. Rurality was significantly associated with perceptions of the effectiveness of public health mitigation strategies including wearing facemasks, limiting time indoors, avoiding gatherings, non-essential business closure, and staying home. Our findings suggest people in rural areas perceive mitigations to be effective. Other researchers have consistently shown rural residents are least likely to partake in the same mitigations. Rural public health nurses on the front line serve as the key to closing the aforementioned gap. Understanding where their community’s perceptions lie is pivotal in creating educational programs to continue mitigation efforts as we embark on the second year of this pandemic.

Eliciting Opinions on Health Messaging During the COVID-19 Pandemic: Qualitative Survey Study

“…Potentially owing to our sampling methods, our results differ from other findings of rural populations' hesitance and distrust toward behavioral recommendations related to COVID-19 [10,11]. However, our findings may still resonate with other studies that document that even though rural populations are less likely to participate in preventive health behaviors related to COVID-19, they may still highly believe in the efficacy of public health measures and the threat of the pandemic to their community and be open to receiving health messages from trusted local health officials [59,60]. Our findings may also indicate that it is important that researchers not homogenize rural populations' approaches to the pandemic and instead dedicate more resources to addressing how rural populations understand their health.…”

Public Health Nurses’ Proficiencies and Training Needs in an Emergency Response: A Cross-Sectional Observational Study

“…This speaks to an urgent need to understand reasons for these continued gaps and how they can be addressed, both in nursing education and PHN workforce development. As engaging the community, being inclusive, and building partnerships have been found to be areas in which PHNs tend to excel,13,14,23 our findings regarding training needs in engaging the community in program implementation, collaborating with public health staff across the agency and system, and engaging community assets and resources were unexpected. One possible explanation may be that nurse respondents were underestimating their skills, as has been found in other research 41.…”

“…Addressing these root causes was especially needed during the COVID-19 pandemic, which sorely tested the depleted public health workforce and further exposed and worsened inequities in the United States 19-22. While few LHDs in the United States, if any, were prepared for this pandemic, health departments with more nurses may have had greater “surge capacity” in being able to respond more quickly and effectively during the pandemic,23 perhaps given PHNs’ understanding of both clinical approaches to disease response and prevention, as well as health equity and collaboration. Research focused on nurse directors of LHDs provides some insight—these studies found that the presence of a nurse-trained health department director was associated with reduced Black-White mortality disparities in the community; in addition, nurse-trained health directors were more likely to emphasize policy activities focused on the social determinants of health and credited their nursing education and experience with their ability to be inclusive in their leadership, to use systems thinking in their work, and to build and maintain strong community partnerships 12,13,24.…”

Stressor Factors for Spanish Nursing Students in a Pandemic Context: An Observational Pilot Survey

“…Another limitation was that the reasons for early non-engagement in the health care system were not collected, so other possible personal variables, such as coping skills, emotional response to stress, and unknown family or environmental issues, which could intensify existing stressors, must be taken into account. It should also be noted that the impact of pandemic in the Terres de l’Ebre (Catalonia, Spain) non-urban health region was less than in other regions in the country, perhaps due to its geographical dispersion, as it reduced transmission by contact [ 39 , 40 ]. Lastly, we collected the data through a self-administered survey.…”