The integrated musical is a vehicle for the creation and communication of a national identity, created through the use of coded performances of gender and, at times, rural settings conceptualized as essentially “American.” There is, however, little research about the ways in which gender operates in rural settings in musical theatre, or the ways in which rural gender identities are utilized to communicate nationalist ideologies. This thesis seeks to address this gap in research by examining three contemporary American musicals – Carrie, Violet, and The Spitfire Grill – in light of both American musical theatre conventions surrounding gender performance and contemporary theory around gender, rurality, and intersectional rural gender identities. This thesis ultimately suggests that an approach to rural gender in musical theatre grounded in a specific physical and cultural moment and location is best equipped to both honor the narratives of rural communities and propagate appropriately complex narratives of national identity.

Master of Arts / Department of Sociology, Anthropology, and Social Work / Laszlo Kulcsar / Commercial trucking by its nature is a transient occupation, and those involved with commercial trucking can find themselves on the road and away from their homes for extended periods of time. Given the occupation’s transitory nature, why have some commercial drivers chosen to call rural America home when any place near a highway should suffice? Through the use of semi-structured interviews, this thesis attempts to explore whether rural truck drivers have any historical or geographical ties to the rural areas that they have chosen to live in. Using qualitative interview approach this thesis endeavored to find whether there are connections to the loss of agricultural or rural manufacturing jobs in a rural driver’s community and their decision to enter the occupation of trucking. In this way this thesis has attempted to discern to what extent structural changes in the rural economy over the last 40 years, may have played a role in a person’s decision to enter the occupation of trucking. This thesis has also attempted to elicit a phenomenological understanding of how they rural truck drivers understand themselves in relation to the larger American society through the work they perform.

Il s'agit ici de comprendre comment un paysan pourrait avoir du pouvoir sur sa propre activité, sa propre vie. Le Plateau de Millevaches où fleurissent de nombreuses initiatives et alternatives à la société de consommation peut donner certaines pistes. Les paysans sont abordés par le biais d'entretiens non directifs. Le choix quant à sa façon d’être paysan, celui de privilégier une identité de filière, professionnelle, ou bien celui d’affirmer son identité locale est lié à diverses manières de concevoir et d’utiliser le pouvoir. En effet, le pouvoir ne se résume pas à la domination, propres aux relations hiérarchiques dans lesquelles sont plongés les paysans suivant un modèle institutionnel, mais il se compose aussi de l’influence ou de la création qu’utilisent des paysans qui revendiquent leur appartenance locale. A travers le pouvoir, c’est notre liberté et nos choix éthiques de vie qui sont mis ici à l’épreuve. / How a farmer can have some power on his activity, on his life? To find several levels of power used by farmers, I'm travelling the "Plateau de Millevaches"(Limousin, France) where are growing several original initiatives. Farmers are approached by qualitative interviews. Concerning the way of being farmer, there’s a choice: to privilege a sectorial and professional identity, or to affirm a local one; and this choice is link to several way to conceive and use power. Indeed, power is not restricted to domination, proper to hierarchical relations in which farmers, following an institutional model, are plunged, but power also consists in influence or creation, used by farmers who claim their local ownership.Through power, liberty and our ethical choices are challenged

En France comme dans l’ensemble des pays industrialisés, la ruralité, entendue comme construction sociale du monde, se transforme. La mobilité croissante des individus, l’installation de nouvelles populations, l’urbanisation des esprits, setraduisent par de nouvelles manières d’habiter la campagne. Cette thèse apporte sa contribution à l’analyse de la ruralité contemporaine à travers l’étude des pratiques des cafés en interrogeant le déclin et les formes de résistance des cafés dans les espaces ruraux bretons.D’un point de vue général, notre questionnement est double : il porte d’une part sur l’évolution des campagnes et la construction des ruralités contemporaines et, d’autre part, sur les modes d’habiter des ruraux, plus exactement sur la pratique des cafés au sein de ces modes d’habiter. L’un, regard surplombant, et l’autre, regard de terrain, se soutenant mutuellement. Dans un premier temps, nous interrogeons les profils et les stratégies des cafetiers face à la crise des cafés. Cette analyse débouche sur une typologie des cafés ruraux fondée sur les activités et services proposés et met en évidence l’émergence de cafés alternatifs. Dans un second temps, ce sont les pratiques spatiales ordinaires des clients qui sontmises à l’épreuve de cette diversité des cafés ruraux. Les choix des cafés effectués par les clients apparaissent comme dictés par une volonté de différenciation sociale dans l’espace local. / In France, as in all industrialized countries, rurality, defined as social construction of the world, evolves. Mobilities of people, newcomers in rural spaces and urbanization of minds result in new ways of living in countryside. This thesis wants to analyse today rurality by studying drinking establishments practices. It questions decline and forms of renewal in drinking establishments in rural spaces of Brittany. The methods combine interviews with owners and patrons, ethnographic materials and a survey. So we can study profiles and strategies of drinking establishment owners. We propose a typology of drinking establishments in rural Brittany based on activities and products and we highlight the emergence of “alternative” bars. Then, we study the diversity of drinking establishment practices. Patrons’ choices of their bars appear to be related tosocial differentiations in the rural space.

O processo de urbanização contemporânea tem transformado significativamente espaços rurais e urbanos, sobretudo os localizados em territórios metropolitanizados. Nesse processo novas configurações físico-espaciais e relações socioeconômicas se intensificam tanto pela diversificação quanto pelo deslocamento de funções entre campo e cidade, resultando em um espaço complexo e distinto, onde esses espaços encontram-se a tal ponto imbricados que se tornou difícil estabelecer limites entre eles. É objetivo desvendar os espaços rurais inter-metropolitanos no território da Macrometrópole Paulista (MMP), composta de cinco regiões metropolitanas do Estado de São Paulo, identificando-os por meio da análise de seus aspectos sociodemográficos e físico-territoriais e das transformações decorrentes de dinâmicas produtivas estabelecidas, confrontando-os com a classificação oficial do território em rural e urbano no Brasil, adotada pelo Instituto Brasileiro de Geografia e Estatística (IBGE). Como método de trabalho apoia-se na construção de uma cartografia temática que revela as características intrínsecas às categorias mencionadas, definem-se critérios de ruralidade circunscritos ao contexto da MMP e com base neles se elabora uma indicação de ruralidade que é apresentada em um mapa-síntese, o qual é objeto de cotejamento com a classificação do IBGE. Esse cotejamento revela discrepâncias entre um e outro entendimento dos rurais e urbanos desse território. O estudo mostra que em meio à complexidade da urbanização contemporânea a separação do território em rural e urbano tornou-se diluída, dinâmica e resiliente e que a distinção entre esses territórios requer a conjugação de diversas variáveis e parâmetros conforme elaborado, sendo insuficiente a delimitação rural/urbano praticada. Espera-se que os resultados obtidos mediante esse estudo possam orientar a formulação de políticas públicas que contemplem espaços rurais e urbanos fornecendo dimensões mais realistas no território da MMP. / The contemporary urbanization process has significantly transformed rural and urban spaces, especially in metropolitan areas. In this process, new spatial configurations and socioeconomic relations are intensified by diversification and displacement of functions between countryside and city, resulting in complex and distinct space, where these spaces are so intertwined that it has become difficult to establish limits between they. The objective of this study is to uncover the inter-metropolitan rural spaces in the territory of the Paulista Macrometropole (MMP), composed of five metropolitan regions of the State of São Paulo, analyzing their social-demographic and physical-territorial aspects and the transformations resulting from productive dynamics, confronting them with the official classification of the territory in rural and urban in Brazil, adopted by the Brazilian Institute of Geography and Statistics (IBGE). As a working method it is based on the construction of a thematic cartography that reveals the characteristics intrinsic to the mentioned categories, rurality criteria are defined circumscribed to the context of the MMP and based on them an indication of rurality is elaborated that is presented in a synthesis map, which is compared with the IBGE classification. This comparison reveals discrepancies between one and another understanding of the rural and urban of that territory. The study shows that in this context of complexity of contemporary urbanization the separation of rural and urban territory has become diluted, dynamic and resilient and that the distinction between these territories requires the conjugation of several variables and parameters as elaborated, being insufficient the rural / urban delimitation practice. It is hoped that the results of this study can guide the formulation of public policies directed to rural and urban spaces providing more realistic dimensions of spaces categories of the MMP territory.

Many individuals, especially those in rural areas, experience barriers to accessing medical care. Some barriers are attitudinal and represent perceived quality of care, such as patient satisfaction; however, some rural residents report elevated patient satisfaction scores, regardless of limited access to these services. Identifying how perceived need for medical care is related to patient satisfaction has not been previously explored. Using an online survey to collect data from a national sample (n=535), the current study used the Patient Satisfaction Questionnaire-Short Form (PSQ-18) and a single-item measure of perceived need to examine the association between these two variables, and further, whether rural status, measured by a single-item measure, moderated this association. Results indicated a significant negative correlation between patient satisfaction and perceived need, r(423)=-.12, p=.012. Although the overall moderation model was significant, F(5, 388)=7.10, p<.001, perceived need was not significantly associated with patient satisfaction, b=-.14, p=.20, and rurality status did not significantly moderate the relationship, F(1, 388)=.44, p=.51, ��R2=0.01. However, the covariates of income, b=.11, p<.001, and sexual orientation, b=.23, p=.01, significantly predicted patient satisfaction. This study identified an association between patient satisfaction with perceived need for medical care that has not been previously explored, although this relationship was no longer significant in a larger model, indicating other important factors likely influence this relationship and contribute to the elevated satisfaction scores identified in some rural areas. The lack of moderation by rurality may be due to consistently high barriers to accessing care across all regions of the United States; while rural areas certainly experience unique barriers to care, the barriers present in urban environments may be significant enough that level of rurality in itself does not significantly affect the relationship between perceived need and patient satisfaction. Furthermore, this study highlights the importance of social determinants of health in patients’ perceptions of quality of care. Sexual orientation and income emerged as significant predictors of patient satisfaction, in that higher satisfaction was associated with those who identified as heterosexual and had higher income, consistent with previous literature. Further investigation is necessary to determine the reasons why these relationships exist; however, it is important to acknowledge that individuals with low-income and who identify as sexual minorities experience stigma and discrimination in healthcare settings. These negative experiences with healthcare likely influence perceptions and health disparities that exist within these individuals and may directly impact patient satisfaction levels, which may be influential to these findings.

Introduction: Federally qualified health centers (FQHCs) and health departments (HDs) are essential in providing contraceptive care and ensuring reproductive autonomy for adolescents. Through offering adolescent-specific services and by training providers in adolescent-specific care and patient-centered contraceptive counseling, clinics can ensure access to high quality contraceptive care for adolescents. Despite the significant decrease in adolescent pregnancy rates, rates remain high in the South and in rural counties, suggesting that clinics in these areas may not have the capacity to provide adolescent-specific services and patient-centered counseling. This study compares the capacity to provide adolescent-specific and patient-centered contraceptive services in rural and urban FQHCs and HDs in two southeastern states -- South Carolina (SC) and Alabama (AL). Methods: Data were collected from a statewide survey of FQHC and HD clinics in SC and AL in 2020. A total of 239 clinics were included (FQHC N=112 and HD N=127) and were identified as rural (N=101) or urban (N=138) using Rural-Urban Continuum Codes. Capacity to provide patient-centered adolescent care is defined as 1) a clinic offering adolescent-specific services; 2) providers at the clinic receiving training in patient-centered counseling; and 3) providers receiving training in adolescent-specific care. To measure capacity, these three survey items were dichotomized into Yes/No responses and then combined into a new variable to measure clinics who responded Yes to each survey item. The type of adolescent-specific services was also measured as being onsite, offsite, outreach, or none. Capacity to provide patient-centered adolescent care was compared across clinics located in rural and urban settings and by clinic type. Statistical differences were determined using the Chi-Square test of independence (α= 0.05). Results: Overall, 44.8% of participating clinics in SC and AL had the capacity to provide patient-centered adolescent contraceptive services. Approximately 51.8% of rural and 66.1% of urban HDs reported the capacity to provide adolescent-specific services. In contrast, 26.7% of rural and 35.4% of urban FQHCs reported the capacity to provide adolescent-specific services. Approximately 55.4% of rural and 71.4% of urban HDs provided any adolescent-specific services, but fewer rural HDs (30.2%) provided onsite services than urban HDs (59.3%) (p=0.003). Fewer than half of rural (42.2%) and urban (48.8%) FQHCs provided adolescent-specific services, with approximately 23.8% of rural and 27.9% of urban sites providing onsite services. Conclusions: The capacity of clinics in SC and AL to provide contraceptive counseling to adolescents, which is anchored in reproductive autonomy, is contingent upon the provision of adolescent-specific services and provider training. Most clinics, especially rural clinics, did not have the capacity to provide patient-centered contraceptive counseling to adolescents. This gap in services may contribute to the higher adolescent pregnancy rates in rural areas of SC and AL. Clinics in SC and AL, especially FQHCs, should develop policies that support adolescent-specific contraceptive services and provider training.

Indiana University-Purdue University Indianapolis (IUPUI) / According to the US government, nearly 1 in 5 Americans live in rural areas. In general, rural Americans have poor health outcomes, including higher rates of chronic disease, mental illness and certain types of substance use. A variety of different methods are used to assess rurality in health services research, making it challenging to precisely quantify the prevalence of mental illness and substance use in this population, as well as compare study conclusions. As policymakers become increasingly interested in addressing health disparities between urban and rural populations, it is important to assess and evaluate the different methods used to define rurality itself and determine how those methods affect estimates of depression and substance use, so that true disparities can be accurately captured and addressed. This dissertation will identify current definitions and methods used to measure rurality among published studies and then employ various identified methods to quantify the effect of measurement choice on prevalence of mental illness and substance use in rural populations. The dissertation will follow a three publishable paper model that will include a literature review and two empirical studies using secondary data as described below. For Paper 1, I identify peer-reviewed studies from HSR journals that use any method to measure rurality in their analysis. I analyze whether geographic units and methods used to classify rurality differ by focus area including costs, quality, and access to care. For paper 2, I quantify the impact of different measurements of rurality have on estimates for hospitalizations for depression and substance use. Using 5 different measurements of rurality, I calculate the levels of agreement as well as examine how characteristics of patients with depression or substance use disorder differ based on the definition of rurality used. In paper 3, I examine differences in the relationship between unmet mental health need and subsequent drug use in individuals with a history of depression. Using the National Survey on Drug Use and Health and a pooled crosssectional study design, I examine drug use by alcohol, marijuana, and prescription opioid use. Additionally, I compare self-medication and substance use in individuals by geographic location.

No description available.

Although every state in the United States is experiencing a shortage of special education teachers, projections indicate that rural communities are disproportionally impacted (Levin et al., 2015). Despite professional development being widely identified in the literature as a possible method for improving teacher quality and readiness in rural schools, and thereby preventing teacher attrition, few studies have empirically examined the relationship between special education professional development experiences and attrition in rural schools. This project will test the hypothesis that early-career professional development opportunities for rural special educators are related to job satisfaction and attrition. Data for this study came from the 2017-2018 National Teacher and Principal Survey (NTPS). Extraction of data from the NTPS data set isolated early career special education teachers working in rural communities. A latent class analysis (LCA) was used to identify a teacher typology concerning early career professional development, resulting in a two-class model, 'Greater Access to Professional Development' (Latent Class 1) and 'Less Access to Professional Development' (Latent Class 2). These two classes had similar access to a variety of professional development opportunities; however, those in the Greater Access to Professional Development class had greater access overall. Additional analyses examined whether LCA groups differed on measures of job satisfaction and attrition and found that teachers with greater access to professional development experiences report higher levels of job satisfaction than teachers with less access to professional development opportunities. Implications for these findings are described in detail. / Doctor of Philosophy / Every state in the United States is experiencing a shortage of special education teachers. Rural school districts are disproportionately impacted, meaning they are at greater risk for hiring underqualified special education teachers in an effort to address these shortages. Professional development is one way that school districts can improve teacher quality and readiness. This will help prevent turnover, because teachers will be better prepared to handle the challenges associated with their job. However, it is not clear which professional development opportunities are most impactful in terms of improving job satisfaction and preventing attrition. This project examined the relationship between professional development opportunities of special education teachers working in rural communities, job satisfaction, and attrition using data from a nationally representative data set. Results found that special education teachers fell into two groups, those with 'Greater Access to Professional Development' and those with 'Less Access to Professional Development.' These group had similar access to various professional development opportunities; however, those in the 'Greater Access to Professional Development' group had greater access to professional development overall, and especially on preparing students to take annual assessments and analyzing and interpreting student achievement data. Results also found that teachers in the 'Greater Access to Professional Development' group reported higher levels of job satisfaction. These findings suggest that certain professional development opportunities can result in greater job satisfaction amongst rural special education teachers.