Addressing Access Barriers in Rural America: A Mixed-Methods Study of Wisconsin's Family Resource Centers.

purposeFamily Resource Centers (FRCs) are place-based programs with great potential to address rural access barriers and improve health outcomes, yet empirical evidence on these programs is lacking. Using multiple data sources from a longitudinal investigation in Wisconsin, this mixed-methods study analyzed whether and how FRCs address rural access barriers.

methodsA convergent parallel mixed-methods design was used to gather, analyze, and interpret quantitative and qualitative data. Data from the Child Opportunity Index were used to compare opportunities in rural and nonrural areas statewide and among 646 rural and nonrural families who received support from one of 18 FRCs. Qualitative data gathered from interviews with nine FRC participants and 11 FRC staff were synthesized to describe rural access barriers and facilitators. To compare the types of support received by rural and nonrural families, baseline survey data collected from 646 FRC participants were analyzed using chi-square tests. To test whether FRC participation increased referral connections, follow-up survey data collected from 319 FRC recipients and a matched sample of 458 adults were analyzed via logistic regression.

findingsDisparities between rural and nonrural ZIP codes were evident statewide and in FRC catchment areas. Qualitative analyses identified rural resource gaps, transportation barriers, and FRC facilitators of family engagement. Baseline survey responses indicated that rural families were more likely to receive resource referrals; nonrural families were more likely to participate in parenting programming and parent-child activities. Longitudinal analyses linked FRC participation to higher rates of resource connections.

conclusionsFRCs address social determinants that disproportionately affect rural communities. Implications for public health intervention and policy are discussed.