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A quick search of the headlines of major newspapers reveals a treasure trove of technology procurement gone wrong. While the private sector seems to adopt and implement new technology seamlessly and quickly to deliver for customers, the government struggles to accomplish technology purchases and integrations with the same ease. As governments in the United States are looking to retain their current workforce and attract the next generation of workers, the technological capabilities and ethos of governments will be paramount. With nearly every industry being transformed by technology and Generation T being the first generation to have an ingrained “technology first” mindset, the ability of governments to attract these workers depends, in large part, on the ability to transform their government technology culture, policies, and practices.

In this chapter, the authors examine the administrative branch and observe two key components at the root of most technology failures: poor organizational structure in the bureaucracy and the lack of an empowered Chief Information/Technology Officer. Building upon case studies from Massachusetts and California, this chapter looks at the factors related to failure or success to understand the technology procurement culture. The chapter concludes by presenting four key “best practice” principles of public policy and administration that can be implemented by almost any governmental entity to improve their acquisition and implementation of technology.

The disparities of COVID-19 vaccination rates between the rural and urban areas have become apparent during this pandemic. There is a need to understand the root causes of vaccine hesitancy demonstrated by the rural population to increase coverage and to contain the disease spread throughout the United States. This study aimed to explore other factors influencing vaccine hesitancy among rural dwellers besides the geography-related barriers such as poor health care access and individuals having no or suboptimal insurance coverage.

By reviewing existing data and literature about vaccination, health literacy, and behaviors, and prevailing ideologies, we discuss the potential causes of vaccine hesitancy in rural areas that could create barriers for successful public health efforts related to vaccine coverage and provide suggestions to ameliorate the situation.

Geography-related barriers, health literacy, and preconceived notions are key determinants of adopting healthy behaviors and complying with public health authorities' recommendations among rural individuals during a public-health crisis. We argue that ideology, which is much deeper than preconception or misconception on vaccination, should be incorporated as a key factor to redefine the term “vulnerable populations” in public health research.

The limitation of our study is that we have not found an effective way to encourage the populations who hold conservative religious and political ideologies to join the efforts for public health. Even though geography-related barriers may strongly impact the rural dwellers in achieving optimal health, the various forms of ideologies they have toward certain health behaviors cannot be discounted to understand and address vaccine-related disparities in rural areas. There is a need to redefine the term “vulnerable population” particularly as it relates to rural areas in the United States. During large-scale public health disasters, scholars and public health authorities should consider the ideologies of individuals, in addition to other factors such as race/ethnicity, area of residence (rural vs. urban), and socioeconomic factors influencing the existing vulnerabilities and health disparities.