Increased autonomy can lead to better health behaviors and outcomes in rural communities, through improved motivation, supporting personal choice in health decisions, and maintaining trust in community-focused responses. However, public health initiatives often require rigorous, time-consuming methodologies, thus limiting timely assessment of health-related needs and concern and hindering autonomy support and educational program/resource response—particularly when urgency is required. PURPOSE: To evaluate a novel, brief qualitative assessment of immediate needs in rural communities across Texas. This project was a part of a program and resource development phase of a statewide project, Community Conversations on Health, in partnership with the Texas Department of State Health Services (DSHS). METHODS: From May 2022 to June 2023, a single-item, anonymous form was created, and distributed statewide for individual questions, needs, and concerns regarding chronic or infectious disease and/or a healthy lifestyle. A modified thematic analysis methodology was used to identify key themes to guide program and resource development. RESULTS: 217 responses across 34 communities were provided, but one “N/A” response was omitted. After analysis of the 216 responses, 12 themes were identified: (1) more favorable infrastructure, (2) clearer medical information, (3) accessible transportation, (4) increased health education, (5) access to mobile clinics, (6) greater understanding of vaccines, (7) resources for senior citizens, (8) veteran services, (9) increased access to dental care, (10) access to fresh food and water, (11) mental health counseling, and (12) improved financial assistance. The most prevalent responses emphasized infrastructure- and transportation-related concerns in the ability to have a quality healthy lifestyle, by decreasing the ability to obtain preventative care, engage in physical activity, and consume nutrient dense foods. Increasing access to health resources via in-person health clinics as well as by removing the barrier of not having transportation were identified as potential key contributors to increasing positive health behaviors. CONCLUSION: The present study provides preliminary support for the utility of a brief, assessment tool and thematic analysis methodology to confirm the wide variety of needs in rural communities. As a result, the findings successfully guided subsequent program and resource development. This evaluation also underscores the need for additional future questions on how to more rapidly and best meet the individual needs of each community, while supporting personal autonomy and maintaining trust.



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