Telemedicine use surged during COVID-19, and a significant amount of recent research has relied solely on online surveys to assess patient perceptions. However, these surveys may be biased since they require an internet connection and digital literacy skills. We compare local perceptions of telemedicine visits in rural areas across two methods of data collection: online-only vs. paper surveys. We collected 100 paper and 108 online surveys in two rural counties with a total population of 10,000. The results show that significant differences exist in the demographics of people completing each type of survey and in the perceptions of telemedicine, with paper-based respondents generally demonstrating a higher degree of confidence in telemedicine. Ordered logistic regressions controlling for potentially influential underlying demographic characteristics (income, hours worked, and presence of children) show that paper-based respondents tend to have higher opinions of telemedicine, but that overall levels of comfort are similar across survey types.

As broadband Internet access becomes more common, researchers have focused on the ways that it might improve society. As part of this effort, we seek to determine whether increasing levels of broadband adoption have impacted actual health outcomes by assessing changes in aggregate health measures over time. We use data from 92 metropolitan/micropolitan statistical areas in the USA over the time period 2002–2009 and incorporate a first-differenced approach to uncover the relationship between levels of broadband adoption and various self-reported health outcomes. The results show that higher rates of broadband adoption play a statistically significant role in explaining changes in 9 of the 24 health measures considered. In some cases, higher levels of online activity are related to improved health outcomes. This suggests that policies to increase broadband adoption rates may have significant externalities related to health.

Small and home-based businesses have long been identified by Extension educators as an important component of economic development, particularly in rural areas. The services available to these businesses can take many forms, including management training, accessibility of local funding, providing incubation facilities, or setting up mentoring relationships. Extension educators wanting to promote certain services should be aware of historical rates of use of these programs and their impacts on various success measures for small businesses. State-level survey results of small business owners are used to discuss the services used, different measures of success, and statistical relationships between the two.

Many rural communities are adopting entrepreneurship and small business development services as components of their economic development programs. As rural communities face declining tax bases (due to out-migration) and recession-related fiscal stress, knowing which of these programs best utilizes scarce funds is critical. A partial answer to this question comes by understanding which services small business owners utilize and which contributed to their success. Using data collected from a random sample of 1,200 Oklahoma households via a telephone survey, we identify which locally provided services (mentoring, small business management training, locally-provided funds – including state and federal subsidized loans, incubator) small business owners in Oklahoma used, and we assess the correlation between the use of services and the business owners’ perceived success across three measures: overall business success, employment growth, and financial success.

Purpose: This paper takes an empirical approach to determining the effect that a critical access hospital (CAH) has on local retail activity. Previous research on the relationship between hospitals and economic development has primarily focused on single-case, multiplier-oriented analysis. However, as the efficacy of federal and state-level rural health subsidies come under increasing scrutiny, more comprehensive investigations can provide support for continued funding.Methods: Data from 105 rural Oklahoma communities are used to explore whether the presence of a CAH impacts several measures of retail activity. The measures are: total retail sales, total number of retail establishments, and number of micro and small retail establishments. Ordinary least squares regression is used to evaluate the impact of a CAH after controlling for a host of other factors influencing retail activity such as local demographics, unemployment rates, and the presence of a Wal-Mart.Findings: The presence of a CAH has a positive and significant influence on each measure of retail activity. The parameter estimates suggest that a CAH has a similar influence on rural retail sales as a Wal-Mart, increasing total retail sales by approximately 28% over towns without a CAH. Other model results indicate that a CAH presence significantly increases the number of total retail establishments and the number of micro and small business establishments.Conclusions: The positive results provide additional evidence on the far-reaching economic development impacts of CAHs. The results also emphasize the importance of continued support for these rural institutions, including federal and state subsidies.

This paper studies “entrepreneurial communities” using both quantitative and qualitative data from the state of Oklahoma. Household-level survey data and community-specific characteristics are used to determine what factors affect whether a rural community operates in an entrepreneurial manner. Case studies from successful rural communities provide a more qualitative viewpoint of the factors that lead to entrepreneurial activity.