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Background: As rural hospitals in Kentucky face insolvency, stakeholders must assess the value of rural hospitals as well as alternatives such as rural clinics and private physician offices. Objective: To identify the value of attributes of healthcare facilities based on Kentucky’s rural residents’ willingness-to-pay (WTP). Methods: A survey instrument was created and distributed to ten counties in rural Kentucky. A conditional logit model was used to obtain baseline values and then a mixed logit model was used to address heterogeneity among consumers in estimating WTP. WTP values incorporated respondents’ demographic characteristics and their health status from self-reported frequency of use of medical services and distance from these services. Results: The results indicate that on average respondents were willing to pay $69.90 each year for the attribute of a facility that treats patients whether they have health insurance or not, compared to a facility that only accepts patients with private health insurance. Uninsured residents were willing to pay $81.15 for this attribute level. Conclusion: The study suggests that uninsured residents value this attribute level of a facility that grants them access to care. Stakeholders may justify such welfare benefit amounts in support of the establishment or maintenance of such a facility.

Self-injury (SI) is a growing concern for professionals working in educational settings who desire more information on SI and express a lack of confidence in working with youth who self injure (Carlson, DeGreer, Deur, & Fenton, 2005; Heath, Toste, & Beettam, 2008). A sample of 263 teachers from a small, rural Kentucky county completed a survey (response rate of 45.5%) designed to address educators’ knowledge of SI, training needs, and knowledge of school response plans for working with youth who self-injure. A 20-item measure developed by Jeffery and Warm (2002) assessed SI knowledge. Educators evidenced significantly lower scores on the knowledge measure than school psychologists (Beld, 2007), and professionals working in a medical setting (Jeffrey & Warm, 2002) with the exception of psychiatrists. Analysis of the response patterns of the educators on the knowledge measure indicated 11 out of 20 items evidenced serious inaccurate understandings of basic fact and myths, prevalence, relationship of SI to psychopathology and suicide, and media influences. There were no gender differences when comparing self-rated knowledge of SI; however, female educators evidenced greater mean scores on the knowledge measure. Females evidence significantly greater knowledge of SI than males. There is no relation between knowledge of SI and the amount of experience working with youth who self-injure for this sample. Knowledge of SI and amount of experience working with students who SI was not correlated. Further, educators who report knowledge of school plans did not report higher confidence in helping students. Descriptive information regarding knowledge of SI and school response plans, confidence, and training indicate the majority of educators in this sample do not have any experience working with youth who self-injure. Further, most lacked knowledge of a school response plan and did not know the existence of or steps included in the district’s school response plan. A majority of participants indicated never attending in-service training on SI; however, they did indicate an interest in receiving more information on SI. Results support the need for districts to educate staff on school response plans and/or to develop a specific school response plan for dealing with youth who engage in SI. Also supported are training needs regarding the school plan, basic knowledge of SI, and extended areas of SI such as media and suicide. Lastly, follows the discussion of practical implications, limitations, and suggestions for future research in relation to results.

This study investigates the reasons for apparent differences in entrepreneurship rates in rural and urban areas using a Survey of Rural Kentucky Residents (SRKR) and the Panel Study of Entrepreneurial Dynamics (PSED) data. We estimate the determinants of dissimilar characteristics for rural and urban areas in two aspects: one is individual and contextual resources; the other is cultural tendencies of resources. The results of the analysis suggest that the difference in available individual, economic, and social support resources does not explain the observed difference in entrepreneurship rate. The results also indicate that gender, ethnicity, income, and number of children in the family have different effects on entrepreneurial intentions in rural and urban settings. The results suggest that policy makers need to account for cultural or geographical differences when designing entrepreneurial educational and support programs in order to enhance the establishment of new business between rural and urban areas.

The purpose of this study was to establish a deeper understanding of the educational needs of rural-based learners within the context of online learning opportunities. I hoped to ascertain whether rural learners' needs differ in terms of learning choices from that of their urban counterparts. This study was particularly focused on establishing a baseline for understanding community online readiness and identifying factors for how rural adults decide whether to participate in online-based learning.The participants in this study were selected from adults in established adult education courses, local churches, rural development clubs, and miscellaneous other civic organizations. Each participant was asked to complete a questionnaire that was a modified McVay Online Readiness Questionnaire (McVay, 2000). In addition, 4 local community leaders were selected for interviews. The selected interviewees were the County Judge-Executive, the mayor of the county seat, the Superintendent of Schools, and the director of adult and community education for the county. These leaders were asked questions designed to assess their understanding of current technological infrastructure to support broadband Internet, as well as, their willingness to encourage the support required for community transformation. Interview questions focused on how well leaders understand both the technological and the sociocultural dimensions of their community.The results were the identification of 7 interrelated themes that help explain the online readiness behaviors of rural adults in the selected county. The themes are: the Importance of Broadband Internet, the Attraction of Professionals to the Area, the "Missing Generation," Common Solutions and Working Together, Lack of Vision for Online Learning, Changing Cultures and Demographics, State and Local Government's Role and Regulatory Policy. Questionnaire responses are presented in this study as descriptive statistics and are representative of the county studied. The data collected from these questionnaires were used in collaboration with interview findings to arrive at conclusions. Key recommendations include: provisions for tax credits and other financial incentives to encourage Internet providers to increase coverage into rural areas; and improved collaboration between public and private stakeholders in an effort to address the digital divide. / Department of Educational Studies