Rural-specific identity and associations with lifestyle behaviors and well-being among rural cancer survivors.

BACKGROUND: Disparities in rural cancer survivors' health outcomes are well-documented, yet the role of sociocultural aspects of rurality, such as rural identity, attitudes toward rurality, and social standing on health beliefs and behaviors remain unclear. This study aimed to address these gaps. METHODS: Rural cancer survivors (N = 188) completed a mailed/online survey. Regression analyses identified relationships among rural identity, negative attitudes toward rurality, and social standing with health outcomes, quality of life, cancer fatalism, and cancer information overload. RESULTS: Higher rural identity was associated with believing everything causes cancer (OR = 1.58, p = 0.048), believing "there's not much you can do to lower your chances of getting cancer" (OR = 2.22, p = 0.002), and higher odds of being overloaded with cancer information (OR = 2.05, p  = 0.008). Negative attitudes toward rurality was linked with higher levels of perceived stress (B = 0.83, p = 0.001), and chronic pain (OR = 1.47, p = 0.039). Higher subjective social status was associated with perceived social support (B = 0.09, p = 0.016), better overall health (B = 0.13, p < 0.001), lower levels of perceived stress (B = -0.38, p = 0.007), and chronic pain (OR = 0.80, p = 0.027). CONCLUSION: Sociocultural factors of rurality were associated with indicators of quality of life, cancer fatalism, and information overload. Further exploration of the underlying mechanisms that drive these associations can help improve intervention targets for rural cancer survivors.

Perceptions of Palliative Care: Demographics and Health Status Among the General Population in Florida and the United States.

BACKGROUND: Palliative care (PC) helps maintain quality of life for seriously ill patients, yet, many Americans lack knowledge of PC. AIM: To explore the relationships between knowledge of PC of individuals living in north-central Florida and throughout the United States. DESIGN: This cross-sectional survey with three sampling approaches, one was a community-engaged sample and two were panel respondent samples. Respondents and setting: Respondents of the Florida sample (n1 = 329) and the community-engaged sample (n2 = 100), were representative of the 23 Florida county general population. Respondents of the national sample (n = 1800) were adult members of a panel owned by a cloud-based survey platform. RESULTS: Young adults compared with adults (OR 1.62, 95% CI 1.14-2.28, P .007), middle-adults (OR 2.47, 95% CI 1.58-3.92, P < .001) and older-adults (OR 3.75, 95% CI 2.50-5.67, P < .001) were less likely to agree that the goal of PC is to help friends and family cope with a patient's illness, and that the goal of PC is to manage pain and other physical symptoms compared with adults (OR 1.67, 95% CI 1.20-2.30, P .002) middle-adults (OR 2.58, 95% CI 1.71-3.95, P < .001) and older-adults (OR 7.19, 95% CI 4.68-11.2, P < .001). Participants with greater rural identity (OR 1.39, 95% CI 1.31-1.48, P < .001) were more likely to agree that accepting PC means giving up. CONCLUSIONS: Increased knowledge of PC might be influenced through targeting educational interventions and educating the general population through social media use.

Rural Identity as a Contributing Factor to Anti-Intellectualism in the U.S.

Anti-intellectualism-a distrust of intellectuals and experts-has had a significant political presence in the U.S. and globally, especially in recent years. Anti-intellectualism drives support for phenomena such as populism, a rejection of scientific consensus, and health and science misinformation endorsement. Therefore, discovering what drives someone to be more anti-intellectual is highly important in understanding contemporary public opinion and political behavior. Here, I argue that a significant and overlooked factor contributing to anti-intellectualism is rural social identification-a psychological attachment to being from a rural area or small town-because rural identity in particular views experts and intellectuals as an out-group. Using 2019 ANES pilot data (N = 3000), original survey data (N = 811) and a separate original survey experiment, I find that rural social identification significantly predicts greater anti-intellectualism. Conversely, anti-intellectualism is not significantly associated with rural residency alone, as theoretically speaking, simply living in a rural area does not capture the affective dimension of rural psychological attachment. These findings have implications for health and science attitudes, populist support, and other relevant political matters. They also have implications for what it means to hold a rural identity beyond anti-urban sentiment, and for understanding the urban-rural divide. Supplementary Information: The online version contains supplementary material available at 10.1007/s11109-022-09770-w.

The rural identity scale: Development and validation.

PURPOSE: The purpose of this study was to conduct a psychometric evaluation of a new 35-item survey developed in the United States to measure rural identity. METHODS: Factor structure, reliability, convergent validity, and incremental validity of the Rural Identity Scale (RIS) were examined using two datasets. Study 1 examined RIS psychometric properties using survey data collected from substance use treatment counselors in a southeastern state (n = 145), while Study 2 used data collected from women incarcerated in rural jails (n = 400). FINDINGS: A one-factor structure containing 15 items was identified in the RIS, with acceptable internal reliability (α = .72-.83). In Study 1, participants from rural counties had significantly higher RIS scores than their urban counterparts. In both studies, convergent validity was evaluated and the RIS scores were significantly associated with other measures relevant to identity and rurality at the bivariate level. Incremental validity was supported in multivariable models as the RIS scores were significantly and uniquely associated with primary rural place variables in each sample. CONCLUSIONS: This study is an initial step toward a reliable, valid scale measuring rural identity. RIS may be especially beneficial to health research as a methodological tool that can contextualize health behaviors among rural populations and highlight potential interventions to promote health equity.

Feel Good? The Dialectical Integration of International Immigrants in Rural Communities: The Case of the Canadian Prairie Provinces.

The increasing influx of international immigrants settling in rural communities, where their landing is expected to revitalize communities, has triggered concerns about international immigrants' adaptation and well-being. In this article, we specifically focus on international immigrants' economic integration as a part of their socialization in communities. This article integrates the results of two independent studies, respectively, focusing on rural employers' motivations to hire immigrants and immigrants' integration in rural communities, both taking place in the Canadian Prairie provinces. Based on a survey of 112 employers and 36 in-depth interviews with international immigrants and organizations promoting their integration, we explore the impact of mediating organizations on the well-being of international immigrants. The results highlight that mediating organizations facilitate the sharing of meanings between rural communities' stakeholders, which is key to success for both employers and employees in formalized organizations such as businesses. The results suggest that international immigrants' well-being is facilitated by mediating organizations that foster a dialectical transformation of rural communities where both hosts and immigrants understand each other.

Correlates of Rural, Appalachian, and Community Identity in the CITIES Cohort.

PURPOSE: To determine correlates of rural, Appalachian, and community identity among a cohort of participants in the Community Initiative Towards Improving Equity and Health Status (CITIES) project. METHODS: Mixed linear and logistic regression effects models were utilized to determine correlates of 3 outcomes: 1) community identity, 2) rural identity, and 3) Appalachian identity among participants in the Ohio CITIES project. FINDINGS: Distinct demographic characteristics were found to be associated with each of the outcomes. For community identity, while no differences were found for rural or urban participants, those who were single or never married (P < .0001) as well as those who graduated from college (P = .0005) reported significantly lower community identity scores than married individuals with less than a college education. Those who resided in an Appalachian county reported higher community identity scores (P = .0009) than non-Appalachian residents. For rural identity, those who did not identify as Christian (P = .018) as well as those who identified as Democrat (P = .027) reported significantly lower rural identity scores than others. Lastly, for Appalachian identity, county-level percentage of families in poverty (P = .06), as well as gender (P = .05), were associated with self-reported Appalachian identity, but these effects were only marginally significant. CONCLUSIONS: Although community, rural, and Appalachian identity may be viewed as similar due to their measure of attachment to a place, results from this study suggest that there are distinct individual and area-level correlates associated with community, rural, and Appalachian identity.

Rethinking registrar attributes for Australian rural general practice training.

OBJECTIVE: Despite increases in Commonwealth funded general practice (GP) Registrar training positions, workforce trends continue to show geographical maldistribution. This study aimed to identify Registrar attributes which describe a cohort choosing to work in rural practice. DESIGN: Cross-sectional self-report questionnaire for socio-demographics, prior training, current training pathway, measures of personality and resilience. PARTICIPANTS AND SETTING: GP Registrars (N = 452) training in either the general or rural pathways of three Registered Training Providers in three states, or training through the Australian College of Rural and Remote Medicine's independent pathway. MAIN OUTCOME MEASURE: Ordinal logistic regression tested the impact of key variables on the likelihood that Registrars would settle in rural practice. Univariate analysis explored differences between groups and effects of variables. RESULTS: A significantly increased interest in rural practice was to found to exist among registrars who were male, identified themselves as being rural, had a partner who identified as being rural, were enrolled in a rural training pathway and had high levels of Cooperativeness. CONCLUSION: We present a discriminating model combining socio-demographics, prior training and personality variables which challenges Australia to rethink Registrar attributes when training for rural general practice. With significant changes about to occur to GP training in Australia, this paper highlights the need for a more holistic approach which considers personal attributes such as Cooperativeness, rural identity and provision of geographically focused rural training pipelines to encourage Registrars to bond to individual rural communities and further develop their personal connectedness to country life and rural medical practice.

Social Representations and Rural Sociability Among Farmers of a Rural Community / Representações Sociais e Sociabilidade Rural entre Camponeses de uma Comunidade Rural / Representaciones Sociales y Sociabilidad Rural entre Campesinos de una Comunidad Rural

Guided by the Social Representation Theory, this study aims at investigating rural social representations among farmers in State of Espírito Santo - Brazil by analyzing the semantic field associated to the representational object "rural person"; the organizational principles of individual attitude in face of shared content; and the anchoring processes. Two hundred (200) residents, aged between 7 and 81, belonging to four generations of a rural community participated in individual interviews in this study. The results analyzed using software SPAD-T showed that rural sociability is represented from the positive association to the agricultural and community spheres, as well as from the negative comparison between country and city life, which causes feeling of depreciation and critical evaluation about the poor investments in rural areas. It also identified that personal and community values strengthen the positive image of rural identity, showing strategies to maintain the country way of life among diferente generations in this community.(AU)

Orientado pela Teoria das Representações Sociais, o estudo teve como objetivo investigar as representações sociais de ruralidade entre camponeses do estado do Espírito Santo, através da análise do campo semântico associado ao objeto representacional "pessoas do meio rural", dos princípios organizadores dos posicionamentos individuais frente ao conteúdo compartilhado e dos processos de ancoragem. Por meio de entrevistas individuais, participaram do estudo 200 moradores de quatro gerações de uma comunidade rural, com idades entre 07 e 81 anos. Os resultados, analisados com auxílio do software SPAD-T, indicaram que a sociabilidade rural é representada a partir da associação positiva às esferas agrícola e comunitária, bem como da comparação negativa entre campo-cidade, esta gerando sentimento de desvalorização e avaliação crítica sobre a falta de investimento na zona rural. Identificou-se ainda que valores pessoais e comunitários atuam reforçando a imagem positiva da identidade rural, evidenciando estratégias de manutenção do modo de vida camponês entre as diferentes gerações da comunidade.(AU)

Orientado por la Teoría de Representaciones Sociales, el estudio tuvo como objetivo investigar las representaciones sociales y rurales entre campesinos del estado de Espírito Santo - Brasil, a través de análisis de campo semántico asociado al objeto representativo 'persona del medio rural'; investigar también los principios organizadores de ubicación individual frente al contenido compartido y de los procesos de anclaje. Se realizaron entrevistas individuales con 200 habitantes de cuatro generaciones de una comunidad rural, con edades entre 7 a 81 años. Los resultados analizados con auxilio del software SPAD-T, indicaron que la sociabilidad rural está representada a partir de la asociación positiva con las esferas agrícolas y comunitarias, y también la comparación negativa entre campo-ciudad, está generando sentimientos de desvalorización y evaluación crítica sobre la falta de inversión en la zona rural. Se identificó además que valores personales y comunitarios refuerzan la imagen positiva de la identidade rural, evidenciando estrategias para mantener el modo de vida campesino entre las diferentes generaciones de la comunidad.(AU)