Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA.
Department of Psychological and Brain Sciences, University of Iowa, Iowa City, Iowa, USA.
J Rural Health. 2022 Sep;38(4):932-944. doi: 10.1111/jrh.12667. Epub 2022 Apr 24.
The objective of this study was to assess perceptions, health behaviors, and disruptions related to the COVID-19 pandemic in a largely rural, Midwestern state, and to examine differences between rural and urban respondents.
A questionnaire was mailed August 2020 to a sample of 10,009 registered voters in Iowa ages 18-100 years, with oversampling from 6 select rural counties. Previously validated and tested items assessed COVID-19 precautions, health care disruptions, emotional reactions, health behavior changes, telehealth and experiences with the internet, and demographic characteristics.
There were 4,048 respondents (40% response rate); 65% were rural and 35% were urban residents. The average age of respondents was 58.3 years and 45% of respondents identified as female. Rural respondents reported less concern about COVID-19 in their community (29% vs 40%, P<.001) and lower perceived importance of social distancing (51% vs 64%, P<.001). Urban respondents more often reported experiencing disruption to daily living, stronger negative emotional reactions, and displayed more pronounced behavior change compared to their rural counterparts. For example, urban respondents reported more pandemic-related job losses (6% vs 4%, P = .05), disruptions to daily activities (48% vs 35%, P<.001), and use of telehealth services during the pandemic (24% vs 16%, P<.001).
The majority of respondents reported disruptions to normal activities, medical appointment cancellations, and emotional distress during the first 6 months of the pandemic. The impact of the pandemic on urban residents appeared to be greater than for rural respondents. Timing of pandemic spread and varying beliefs are potential explanations.
本研究旨在评估在一个以农村为主的中西部州，与 COVID-19 大流行相关的认知、健康行为和干扰情况，并比较农村和城市受访者之间的差异。
2020 年 8 月，向爱荷华州年龄在 18-100 岁的 10009 名登记选民邮寄了一份调查问卷，对 6 个选定的农村县进行了抽样调查。先前经过验证和测试的项目评估了 COVID-19 预防措施、医疗保健中断、情绪反应、健康行为改变、远程医疗和互联网体验以及人口统计学特征。
共有 4048 名受访者（40%的回应率）；65%为农村居民，35%为城市居民。受访者的平均年龄为 58.3 岁，45%的受访者为女性。农村受访者表示对社区内 COVID-19 的担忧较少（29%比 40%，P<.001），对社交距离的重要性认知较低（51%比 64%，P<.001）。与农村受访者相比，城市受访者更常报告日常生活受到干扰、负面情绪反应更强烈，行为改变更明显。例如，城市受访者报告更多与大流行相关的失业（6%比 4%，P =.05）、日常活动中断（48%比 35%，P<.001）和大流行期间使用远程医疗服务（24%比 16%，P<.001）。
大多数受访者报告称，在大流行的前 6 个月内，正常活动、医疗预约取消和情绪困扰受到干扰。大流行对城市居民的影响似乎大于对农村居民的影响。大流行的传播时间和不同的信念可能是潜在的解释。
