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  1. Due to long-standing barriers to healthcare access in rural areas, telehealth has been promoted as an effective means of delivering healthcare services. However, there is a general absence of quantitative data showing how geographic residence and race affect telehealth adoption. This study examines variations in telehealth adoption based on race and geographic residence in Southern Illinois using a mail survey. It finds that residents of urban Carbondale, compared to those in rural Cairo, have better access to broadband and are more likely to use telehealth. Respondents significantly differ from each other based on their geographic location of residence and race when it came to using telehealth to save money on travel and to save money on childcare. A significant barrier to telehealth adoption identified across all groups is privacy protection concern. The findings highlight the crucial role of broadband infrastructure in healthcare access and the need for trust in telehealth systems to ensure data privacy. 
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    Free, publicly-accessible full text available June 1, 2025
  2. Ramsey, Doug (Ed.)
    This study delves into the adoption and challenges of telehealth services in rural settings, examining racial and locational influences on usage. Employing qualitative methods, it draws on 30 detailed interviews with both healthcare providers and patients in two racially diverse, economically disadvantaged towns in Southern Illinois from fall 2021 to spring 2023. Our findings indicate that insufficient internet access and lack of necessary devices are significant factors in the reluctance of rural residents to embrace telehealth services. Additionally, this study reveals a major barrier: a deep-seated mistrust in the telehealth infrastructure's ability to safeguard private medical information. Notably, our results show that Black participants have heightened concerns regarding the health care industry's capacity to maintain the confidentiality of their medical data. 
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    Free, publicly-accessible full text available May 13, 2025
  3. The past decade has seen a rise in the availability of modern information and communication technologies (ICTs) for developing smart societies and communities. However, the smart divide, characterized by inequalities in ICT infrastructures, software access, and individual capabilities, remains a significant barrier for rural communities. Limited empirical studies exist that explore what and how ICT infrastructures can be developed to bridge the smart divide. The paper aimed to address rural broadband access in the context of infrastructural dimensions of smart divide (i.e., smart infrastructural divide) in the United States, focusing on the wireless network infrastructure’s role in narrowing the gap. It examined the broadband specifications needed for smart applications like smart education and telehealth, emphasizing the importance of wireless network capabilities. While fixed broadband offers higher speeds, wireless networks can support many smart applications with decent flexibility and ease of access. To further understand the implications of wireless broadband to rural communities, we conducted a case study in Carbondale and Cairo, two rural towns in Southern Illinois, using on-site user-inspired speed testing. An Android application was developed to measure download/upload speeds and Reference Signal Received Power (RSRP) for broadband quality. Results suggest both Carbondale and Cairo experienced below-average speeds with high variability among census blocks, which highlights the need for improved wireless network infrastructure. The paper culminated in the technological and policy recommendations to narrow down the smart infrastructural divide. 
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    Free, publicly-accessible full text available November 1, 2024