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The purpose of this paper is to increase the understanding regarding how managers attempt to make purposeful use of innovation management self-assessments (IMSA) and performance information (PI).

An interpretative perspective on purposeful use is used as an analytical framework, and the paper is based on empirical material from two research projects exploring the use of IMSA and PI in three case companies. Based on the empirical data, consisting of interviews and observations of workshops and project meetings, qualitative content analysis has been conducted.

The findings of this paper indicate that how managers achieve a purposeful use of PI is related to their approach toward how to use the specific PI at hand, and two basic approaches are analytically separated: a rule-based approach and a reflective approach. Consequently, whether or not the right thing is being measured also becomes a question of how the PI is actually being interpreted and used. Thus, the extensive focus on what to measure and how to measure it becomes edgeless unless equal attention is given to how managers are able to use the PI to make knowledgeable decisions regarding what actions to take to achieve the desired changes.

Given the results, it comes with a managerial responsibility to make sure that all managers who are supposed to be engaged in using the PI are given roles in the self-assessments that are aligned with the level of knowledge they possess, or can access.

How managers purposefully use PI is a key to understand the potential impact of self-assessments.

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.