Rural Prejudice-Urban Bias: The Stories and Structures That Oppress Rural Communities

Mohatt, Nathaniel V.; Mohatt, Dennis F.

doi:10.1007/978-3-030-35517-3_23

Cited by 6 publications

(5 citation statements)

References 35 publications

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“…Clinicians caring for rural survivors may need to be aware if they hold any negative perception of or implicit bias toward rural culture. Current approaches toward improving access to care have been developed in the context of an urban health care delivery system [ 54 ]. For example, rather than viewing aspects of rural culture through a deficit lens (ie, stigma and self-reliance as barriers to access), we should strive to develop culturally appropriate interventions that leverage the considerable strengths of the rural setting (ie, resilience, strong community networks) to design effective interventions that connect rural survivors with care [ 55 ].…”

Section: Discussionmentioning

confidence: 99%

Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study

DeGuzman¹,

Vogel²,

Bernacchi³

et al. 2022

JMIR Form Res

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Background Even when technology allows rural cancer survivors to connect with supportive care providers from a distance, uptake of psychosocial referrals is low. Fewer than one-third of participants in a telemedicine intervention for identifying rural survivors with high distress and connecting them with care accepted psychosocial referral. Objective The purpose of this research was to examine the reasons for which rural cancer survivors did not accept a psychosocial referral. Methods We utilized a qualitative design to address the research purpose. We interviewed participants who had been offered psychosocial referral. Semistructured interviews were conducted 6 weeks later (n=14), and structured interviews were conducted 9 months later (n=6). Data were analyzed descriptively using an inductive approach. Results Ultimately, none of the rural cancer survivors (0/14, 0%) engaged with a psychosocial care provider, including those who had originally accepted referrals (0/4, 0%) for further psychosocial care. When explaining their decisions, survivors minimized their distress, emphasizing their self-reliance and the need to handle distress on their own. They expressed a preference for dealing with distress via informal support networks, which was often limited to close family members. No survivors endorsed public stigma as a barrier to accepting psychosocial help, but several suggested that self-stigma associated with not being able to handle their own distress was a reason for not seeking care. Conclusions Rural cancer survivors’ willingness to accept a psychosocial referral may be mediated by the rural cultural norm of self-reliance and by self-stigma. Interventions to address referral uptake may benefit from further illumination of these relationships as well as a strength-based approach that emphasizes positive aspects of the rural community and individual self-affirmation.

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Section: Discussionmentioning

confidence: 99%

Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study

DeGuzman¹,

Vogel²,

Bernacchi³

et al. 2022

JMIR Form Res

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“…Researchers who use intersectionality in their studies are concerned with "identifying, discussing, and addressing the ways that systems of inequality, including sexism, racism, and class bias, intersect to produce complex relations of power and (dis) advantage" (Nichols & Stahl, 2019, p. 1255. Although a sense of place or context is not traditionally part of intersectionality, there is prejudice against people who live in rural areas, and rural residents are often overlooked, underserved, and portrayed through negative stereotypes (Mohatt & Mohatt, 2020). Low-income white people from rural areas are often portrayed as 'white trash' (Drinkard, 2014).…”

Section: Theoretical Framework: Intersectionality Of Class and Ruralitymentioning

confidence: 99%

‘White Trash’ in the Academy: Working-class Women Professors Discuss their Backgrounds and Education

Hayes,

Locke

2024

AM J QUALITATIVE RES

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Women from rural, low-income backgrounds holding positions within the academy are the exception and not the rule. Most women faculty in the academy are from urban/suburban areas and middle-and upper-income family backgrounds. As women faculty who do not represent this norm, our primary goal with this article is to focus on the unique barriers we experienced as girls from rural, low-income areas in K-12 schools that influenced the possibilities for successfully transitioning to and engaging with higher education. We employed a qualitative duoethnographic and narrative research design to respond to the research questions, and we generated our data through semi-structured, critical, ethnographic dialogic conversations. Our duoethnographicnarrative analyses revealed six major themes: (1) independence and other benefits of having a working-class mom; (2) crashing into middle-class norms and expectations; (3) lucking and falling into college; (4) fish out of water; (5) overcompensating, playing middle class, walking on eggshells, and pushing back; and (6) transitioning from a working-class kid to a working class academic, which we discuss in relation to our own educational attainment.

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“…Further, the psychologist should critically evaluate their own cultural background and rooted beliefs, and how they could present or be interpreted by the patient, influencing the telehealth services. This notion is believed to be especially important given consistent findings that the dominant urban culture often portrays rural individuals with negative stereotypes that can exacerbate preexisting mental health challenges and impact the quality of the care patients receive if they feel misunderstood, or worse, disrespected (Mohatt & Mohatt, 2020). Creating further challenge, these biases are often unconscious and result in the devaluation of rural knowledge and conventions without a psychologist's awareness (Fors, 2018).…”

Section: Establishing Patient Appropriatenessmentioning

confidence: 99%

A Canadian psychologist’s primer to telehealth practice.

Perle,

Stolte,

Janzen

et al. 2024

Canadian Psychology / Psychologie canadienne

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Mental health-related concerns are a frequently cited reason for health service attendance throughout Canada. Despite the prevalence, numerous barriers limit consistent attendance for in-person care, especially among those living in rural and northern areas of Canadian provinces and territories. The expansion of telehealth has allowed psychologists to reach these historically underserved Canadians. While adoption has been rapid in response to the COVID-19 pandemic, psychologists remain underprepared for the use of technology-delivered practices. Fragmentation of telehealth-related information, combined with unique or absent guidance across the different provincial and territorial jurisdictions, creates further challenge for those seeking evidence-informed information to guide their work. To assist psychologists, the current discussion acts as an applied primer for ethical and legal considerations when practicing psychology via telehealth throughout Canada. Licensure and jurisdiction considerations, methods of establishing patient appropriateness, informed consent processes, safety planning, and data security are outlined. Practice across province/territory, as well as practice to patients travelling outside of Canada, is also reviewed. Public Significance StatementTelehealth provides a viable means of reaching Canadians experiencing mental health-related challenges across provinces and territories. To ensure an ethical, legal, evidence-informed, and safe telehealth practice, psychologists must be knowledgeable of telehealth-unique factors that differ from traditional in-person methodologies.

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Rural Prejudice-Urban Bias: The Stories and Structures That Oppress Rural Communities

Cited by 6 publications

References 35 publications

Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study

Self-reliance, Social Norms, and Self-stigma as Barriers to Psychosocial Help-Seeking Among Rural Cancer Survivors With Cancer-Related Distress: Qualitative Interview Study

‘White Trash’ in the Academy: Working-class Women Professors Discuss their Backgrounds and Education

A Canadian psychologist’s primer to telehealth practice.

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