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This chapter explores differences in fringe, distant, and remote rural public library assets for asset-based community development (ABCD) and the relationships of those assets to geographic regions, governance structures, and demographics.

The author analyzes 2013 data from the Institute of Museum and Library Services (IMLS) and U.S. Department of Agriculture using nonparametric statistics and data mining random forest supervised classification algorithms.

There are statistically significant differences between fringe, distant, and remote library assets. Unexpectedly, median per capita outlets (along with service hours and staff) increase as distances from urban areas increase. The Southeast region ranks high in unemployment and poverty and low in median household income, which aligns with the Southeast’s low median per capita library expenditures, staff, hours, inventory, and programs. However, the Southeast’s relatively high percentage of rural libraries with at least one staff member with a Master of Library and Information Science promises future asset growth in those libraries. State and federal contributions to Alaska libraries propelled the remote Far West to the number one ranking in median per capita staff, inventory, and programs.

This study is based on IMLS library system-wide data and does not include rural library branches operated by nonrural central libraries.

State and federal contributions to rural libraries increase economic, cultural, and social capital creation in the most remote communities. On a per capita basis, economic capital from state and federal agencies assists small, remote rural libraries in providing infrastructure and services that are more closely aligned with libraries in more populated areas and increases library assets available for ABCD initiatives in otherwise underserved communities.

Even the smallest rural library can contribute to ABCD initiatives by connecting their communities to outside resources and creating new economic, cultural, and social assets.

Analyzing rural public library assets within their geographic, political, and demographic contexts highlights their potential contributions to ABCD initiatives.

The purpose of this study is to explore the sustainability of innovations introduced during the coronavirus disease 2019 (Covid-19) pandemic in remote and rural primary care advanced clinical practice.

The methodology includes an exploratory qualitative study of eight key stakeholders from Scottish remote and rural primary care advanced practice (three policymakers and five advanced practitioners). Data were collected using semi-structured interviews during 2022 and analysed thematically.

Advanced practice in remote and rural primary care is characterised by a shortage of doctors, close-knit communities and a broad scope of practice. Covid-19 catalysed changes in the delivery of healthcare. Innovations which participants wanted to sustain include hybrid working, triage, online training and development, and increased inter-professional support networks.

Findings provide valuable insights into how best to support remote and rural advanced practice which may have implications for retaining healthcare professionals. They also identified useful innovations which could benefit from further investment.

Given current healthcare workforce pressures, identifying and sustaining innovations which will support and retain staff are imperative. Hybrid consultations and online access to training, development and support should be sustained to support the remote and rural advanced practice workforce. Further research should explore the sustainability of innovations introduced during the Covid-19 pandemic in other care contexts.

This paper seeks to present findings from a study soliciting the perspectives of child and youth mental health clinicians practising in rural/remote settings in British Columbia, Canada. Satisfaction is assessed in four areas: lifestyle, practice, preparation for practice, and fit of organizational standards.

An online survey using a variety of closed and open‐ended questions was administered to clinicians practising in four distinct settings: small rural, large rural, small remote, and large remote. Closed questions were analyzed using SPSS 17.0 while open ended questions were analyzed using manual open and axial coding.

Findings indicate moderate to high levels of satisfaction in all areas. Satisfaction with rural lifestyle and professional practice was strongest for clinicians recruited from within the community. However, clinicians from small remote communities indicated much lower levels of satisfaction in all four areas.

The study underscores the importance of understanding the diversity of rural practice settings in mental health workforce development. In particular it highlights the need for greater attention to evidence based approaches to support mental health practitioners in small remote settings.

This chapter examines the relationship between health service restructuring and the health care experiences of women from rural and remote areas of Canada. Data were collected from 34 focus groups (237 women), 15 telephone interviews and 346 responses from an online survey. Access to services, care quality and satisfaction are salient themes in these data. Problems include: travel, shortage of providers, turnover in personnel, delays associated in accessing care, lack of knowledge of women's health issues and patronizing attitudes of some health care providers. Health care service restructuring has led to deterioration in service availability and quality. Key areas for policy development need to address health care access and quality improvement issues, including increasing access to more (particularly female) providers who are sensitive to women's health issues.

This chapter contributes to addressing the gap in the literature on entrepreneurs and enterprise in island and remote rural environments.

The research, policy and practice literature on island enterprises and entrepreneurs is reviewed, taking Scotland as a focus within wider international contexts. Islands – as spaces and cultural places – are recognised in terms of ‘otherness’ and difference, not least in respect of tourism and culture. The importance of distance, isolation and peripherality is discussed as social constructions – myths and narratives – as well as in their mainstream measured equivalences. Agencies and policies are introduced at different levels and given significance reflecting their particular relevance in remote and isolated communities. The significance of the dominant paradigm founded on agglomeration, clusters, connectivity, proximity and competitiveness in the peripheralisation of those establishing and running businesses on islands is explored critically. This is contrasted with experiences from comparative northern European locations of smart specialisation, innovation and resilience, and the underpinning key roles of social capital, relationships and cultural values and norms are identified. Sectoral case studies and enterprise are offered to examine these issues in context.

As this is an exploratory study, results are neither comprehensive nor definitive. However, they are indicative of how forces and obstacles apply in island and remote rural environments.

The study confirms the need to recognise social relations locally, and for policies and strategies to be proofed for locational differences.

Retention of medical doctors and nurses in remote and rural areas is a key issue in India. The purpose of this paper is to assess the relevant policies and provisions with respect to health care professionals, aiming to develop feasible retention strategies in rural areas of Odisha state of India.

The study employed documentary review and key informant interviews with policy elites (health planners, policy maker, researchers, etc.). The document review included published and unpublished reports, policy notifications and articles on human resources for health (HRH) in Odisha and similar settings. Throughout the study, the authors adapted World Health Organization’s framework to study policies relevant to HRH retention in rural areas. The adapted framework comprised of the four policy domains, education, regulation, financial incentives, professional and personal support, and 16 recommendations.

In Odisha, the district quota system for admission is not practiced; however, students from special tribal and caste (Scheduled Tribe and Scheduled Caste) communities, Socially and Educationally Backward Classes of citizens, and Persons with Disabilities have some allocated quota to study medicine and nursing. Medical education has a provision of community placement in rural hospitals. In government jobs, the newly recruited medical doctors serve a minimum of three years in rural areas. Doctors are given with location-based incentives to work in remote and difficult areas. The government has career development, deployment, and promotion avenues for doctors and nurses; however, these provisions are not implemented effectively.

The government could address the rural retention problems, as illustrated in the study and put in place the most effective policies and provisions toward recruitment, deployment and attraction of HRH in remote and rural areas. At the same time, implementation HRH strategies and activities must be rigorously monitored and evaluated effectively.

The purpose of this study is shed light on the underlying forces behind entrepreneurship within a regional innovation system (RIS) in a remote rural region. The authors examine the following questions: Which are the main underlying forces behind the entrepreneurial process in a rural RIS characterized by traditionally low-tech, small-scale businesses? How can the development of a low-tech regional innovation system be conceptualized?

The design of the study is based on entrepreneurship theory. Data analysis followed practices used in phenomenography, a research approach used to analyse and identify commonalities and variations in populations' perceptions of a certain phenomenon. Data are composed using semi-structured interviews and a database composed of company information of all firms in the population.

A proactive mobilization of regional stakeholders and resources can be an important driving force behind the entrepreneurial process and generation of a rural RIS. Innovation can be generated within low-tech industries turning the rural context into an asset. An RIS in a remote rural context can be initiated and orchestrated by regional authorities, but knowledge brokering and orchestration can also be managed by networks of small-scale businesses brought together by mutual benefit and common interests.

Regional innovation systems theory is most often used to study high-tech industries. But by combining regional innovation systems with rural entrepreneurship and entrepreneurship context theory is a fruitful avenue to understand the role of rural entrepreneurship in regional development, even in remote and peripheral regions. Innovation does not need to entail high-tech international environments; it can appear as the result of efforts in low-tech industries in rural and remote environments. The authors’ findings need to be scrutinized; therefore, the authors call for more research on regional innovation systems in rural environments.

It is possible for regional authorities to orchestrate a development process through the actions of a strong regional agent but also by supporting the creation of networks of small businesses that are built on trust and common interests.

This study contributes to the literature with a new perspective to the study of entrepreneurship and of regional innovation systems. Entrepreneurship research with focus on rural contexts most often highlight limits to entrepreneurship and see entrepreneurship as “just running a business”. A perspective that starts from innovation and innovative behaviour, despite the rural context and embedded resources, helps to generate new knowledge that can enrich the understanding of entrepreneurship and also be the foundation for more precise business development policies in rural settings.

Some of Australia’s most severe and protracted workforce shortages are in public sector community mental health (CMH) services. Research identifying the factors affecting staff turnover of this workforce has been limited. The purpose of this paper is to identify work factors negatively affecting the job satisfaction of early career health professionals working in rural Australia’s public sector CMH services.

In total, 25 health professionals working in rural and remote CMH services in New South Wales (NSW), Australia, for NSW Health participated in in-depth, semi-structured interviews.

The study identified five work-related challenges negatively affecting job satisfaction: developing a profession-specific identity; providing quality multidisciplinary care; working in a resource-constrained service environment; working with a demanding client group; and managing personal and professional boundaries.

These findings highlight the need to provide time-critical supports to address the challenges facing rural-based CMH professionals in their early career years in order to maximise job satisfaction and reduce avoidable turnover.

Overall, the study found that the factors negatively affecting the job satisfaction of early career rural-based CMH professionals affects all professionals working in rural CMH, and these negative effects increase with service remoteness. For those in early career, having to simultaneously deal with significant rural health and sector-specific constraints and professional challenges has a negative multiplier effect on their job satisfaction. It is this phenomenon that likely explains the high levels of job dissatisfaction and turnover found among Australia’s rural-based early career CMH professionals. By understanding these multiple and simultaneous pressures on rural-based early career CMH professionals, public health services and governments involved in addressing rural mental health workforce issues will be better able to identify and implement time-critical supports for this cohort of workers. These findings and proposed strategies potentially have relevance beyond Australia’s rural CMH workforce to Australia’s broader early career nursing and allied health rural workforce as well as internationally for other countries that have a similar physical geography and health system.

In the decades since World War II, Australia has moved from a vibrant, universalist welfare system, based on the rights of citizens to receive income support, to a residualist system that is highly targeted, based on harsh and increasingly punitive eligibility requirements and which re-defines recipients as ‘clients’. These developments have happened slowly, some would say insidiously, as Australia moved from a supportive environment where the notion of collective responsibility for the vulnerable was accepted and, indeed, embraced. More recently collectivism has been replaced by the notion of individualism in what McDonald (2006, p. 10) refers to as ‘a silent surrender of public responsibility’. Individuals and/or their families are expected to absorb their own welfare needs as much as possible, while those that fall to the public purse are treated with some suspicion, particularly if they fall into categories of the ‘undeserving’ poor. In Australia the ranks of the ‘undeserving’ appear to be widening beyond single parents and the unemployed to include those with disabilities and young people.

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.