RURAL: Risk Underlying Rural Areas Longitudinal Cohort Study

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ABSTRACT Historically, rural communities have been difficult to study compared to their urban counterparts. This can be attributed to them feeling marginalized from economic growth and technological advances, as they witness the closure of rural hospitals, churches, and schools. Reaching and recruiting the rural vulnerable people in the Appalachia and Mississippi Delta (AMD) regions is challenged by their remote locations, worsened by a digital divide, a potential mistrust of outsiders, a paradoxical high self-rated health, their skeptical view of medical tests, and a hesitancy to prioritize time solely for research. To further examine these challenges, the aims of this study is to 1) identify the facilitators and barriers to participation in research in rural communities by comparing and contrasting the community engagement practices of the Mississippi core of the rural study with principles of community engagement. 2) document the reach and effectiveness of community engagement activities implemented to date by the Mississippi core of the RURAL Study using the re-aim (reach, effectiveness, adoption, implementation, maintenance) framework. Documenting features of the Mississippi counties and approaches used to contribute to the successes to date will enable the Mississippi core to use the results to continue community engagement throughout the six-year cycle of the RURAL Study. Documentation of successful strategies and lessons learned by the Mississippi core during year one of the study may provide guidance for Louisiana and Kentucky which will be ready to escalate their presence in their respective communities during project years three and four. The publication anticipated, as a result of this proposed research, may also benefit investigators of similar studies who are seeking approaches for research participation with populations in rural communities.