Research methodologies used in rural health research

By Sila Rogan

How can we define rural?

Determining what exactly defines a rural community is a tricky business. There are no clear definitions or guidelines for what constitutes an urban or rural area(1). Creating a strict definition is problematic as it disregards the diverse nature of rural communities as well as the multitude of factors that make a community rural. Strict definitions of rurality are of particular concern to health researchers as they often exclude communities that should be considered rural and include communities that should not be considered rural. It is often at the discretion of the researcher to define rural for the context of their project. Some researchers distinguish rural communities based on factors such as population size, others by distance from urban areas, culture, or resources available. Depending on the definition a researcher uses for a rural community, the population included in the research will vary(1). It is thus critical that rural health researchers use a definition of rural that best accounts for what they are trying to study.

To help determine what definition of rural your research group should use, check out the resources below. Please note that these definitions may not be a perfect fit for your research, but rather serve as examples of how other teams have defined rural.

StatsCan: Self-contained labour areas: A proposed delineation and classification by the degree of rurality.

This resource outlines how StatsCan defined rural in the 2006 Census.

StatsCan: Definitions of “Rural”

This resource explores 6 different definitions of rural that can be used by rural health researchers, with an emphasis on developing a definition for rural once the researchers know what they are trying to study.

StatsCan: Definitions of Rural – a Rural and Small Town Canada Analysis Bulletin

This resource outlines definitions of rural that can be used in Canadian Federal policy with an emphasis on developing the definition for rural once researchers know what they are trying to study.

Canadian Institute for Health Information: Rural health care in Canada

This resource provides researchers with the tools necessary for taking a systems approach to identifying the unique needs and characteristics of the rural communities.

What makes rural health research unique?

Rural health research is distinct from other forms of health research due to the unique health issues relevant to rural communities as well as the specific challenges rural health researchers face when researching rural populations. A large body of evidence suggests that rural communities face a disproportionately large burden of poor health outcomes relative to urban communities, such as an increased incidence of cancer, a shorter lifespan, a greater rate of disability, and elevated rates of chronic illness(2). Furthermore, the small population and remote geography of rural communities pose unique challenges to rural health researchers when collecting and analyzing data (2). To learn more about rural health research in Canada and what makes it unique, check out CIHR’s resource here.

You have your rural health research question– now what?

By generating a knowledge base that can be used to develop more effective interventions, research plays a critical role in improving human health, including the health of rural communities(3). Creating a study design that uses a methodology tailored to your research question can improve the quality of your research. In this blog post, we outline the basic research methodologies as well as some of the ways they might need to be modified for rural health research purposes.

Research methodology basics

A research methodology describes the steps researchers take to acquire information. Most methodologies fall into one of three categories: quantitative, qualitative, or mixed methods. Rural health researchers may need to modify some of these general research methodologies depending on the community they are working with(4). The core research methodologies:

Quantitative

Quantitative research methods involve collecting numerical measurements using statistical, computational, or mathematical techniques. This numerical data is used to answer the researcher’s questions(5). Quantitative approaches are good for rural health research projects that focus on describing phenomena more objectively.

Qualitative

Qualitative research involves collecting information that cannot be quantified, such as people’s experiences, or cultural concepts. Examples of qualitative data include text, video, or audio(6). Qualitative approaches are well suited for rural health research projects that aim to capture the experiences and/or cultures of rural communities.

Mixed

Mixed research methods use a combination of both quantitative and qualitative research methods for a single research project(7).

Why might rural health researchers need to use different methods?

Rural health researchers may be working in very different research environments than other researchers. Some challenges rural health researchers may face when collecting information include:

  • Small population sizes to sample from
  • Immense diversity between rural communities
  • Large geographic distance between researcher and community
  • Limited infrastructure, including unreliable internet access

Because of these challenges, many rural health researchers may need to modify their approach to gather information in a way that best represents rural communities.

Resources

Still trying to find the right methodology for your project? These resources might be a great place to start.

Journal: Research Methods in Medicine & Health Sciences

This journal publishes articles on cutting-edge health research methods.

Research Methods Knowledge 

Developed by a Professor in the Department of Policy Analysis and Management at Cornell University, this online textbook covers social research method basics, such as formulating a research question, developing a research design, and analyzing data.

Rural Health Research in the Canadian Institutes for Health Research

This is a great resource for understanding what rural health is in the Canadian context, as well as some of the unique considerations rural health researchers need to account for.

Canadian Institute for Health Information: Rural health care in Canada

This resource provides researchers with the tools necessary for taking a systems approach to identifying the unique needs and characteristics of the rural communities.

Examples of rural health research publications

UBC’s Centre for Rural Health Research Publications

Through rigorous research, UBC’s Centre for Rural Health Research generates an evidence base to inform decision-makers on health issues relevant to rural communities in British Columbia. They have released several publications on rural health issues.

BC Rural Health Network Publications

The BC Rural Health Network is a platform for rural residents in British Columbia to advocate for improvements in the quality of healthcare and healthcare delivery in British Columbia. Their wide range of publications contains valuable resources with an emphasis on community voice.

Rural Health Services Research Network of BC Publications

The Rural Health Services Research Network of BC aims to generate excellent rural health services by, for, and with rural communities, clinicians, and researchers. Our collection of publications includes prime examples of rural health research from a wide variety of sources.

References

1. Muilu T, Rusanen J. Rural Definitions and Short-Term Dynamics in Rural Areas of Finland in 1989–97. Environ Plan Econ Space. 2004 Aug 1;36(8):1499–516.
2. Government of Canada SC. Definitions of “Rural” – ARCHIVED [Internet]. 2021 [cited 2021 Feb 3]. Available from: https://www150.statcan.gc.ca/n1/pub/21-601-m/2002061/4224867-eng.pdf
3. Pong RW, Anne Marie Atkinson, Irvine A, Martha MacLeod, Minore B, Ann Pegoraro, et al. Rural Health Research in the Canadian Institutes for Health Research [Internet]. Canadian Institutes for Health Research; 1999. Available from: http://documents.cranhr.ca/pdf/cihr/CIHR.pdf
4. Pacific WHORO for the W. Health Research Methodology: A Guide for Training in Research Methods. World Health Organization; 2001. 246 p.
5. Research methods in rural studies: Qualitative, quantitative and mixed methods. J Rural Stud. 2020 Aug 1;78:262–70.
6. Mertler CA. Introduction to Educational Research. [book on the Internet]. SAGE Publication. 2020. Chapter 7: Quantitative research methods [cited 2021 Jan 20]. Available from: https://us.sagepub.com/sites/default/files/upm-binaries/70019_Mertler_Chapter_7.pdf
7. What is Qualitative Research? | Methods & Examples [Internet]. Scribbr. 2020 [cited 2021 Jan 21]. Available from: https://www.scribbr.com/methodology/qualitative-research/
8. Mixed Methods: Integrating Quantitative and Qualitative Data Collection and Analysis While Studying Patient-Centered Medical Home Models | PCMH Resource Center [Internet]. [cited 2021 Jan 20]. Available from: https://pcmh.ahrq.gov/page/mixed-methods-integrating-quantitative-and-qualitative-data-collection-and-analysis-while
9. Rural health care in Canada | CIHI [Internet]. [cited 2021 Feb 3]. Available from: https://www.cihi.ca/en/rural-health-care-in-canada

What rural health methodology does your research team use? Contact us to let us know!

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