Bridging the gap: a review of the factors contributing to differences in vaccination coverage among rural and urban adults.

Abstract

<h4>Purpose</h4>To examine factors contributing to vaccination coverage differences between rural and urban adult populations; evaluate intervention studies aimed at increasing vaccine uptake among rural adult populations.<h4>Methods</h4>We reviewed literature published between January 2000 and April 2024. Findings are presented using the Capability, Opportunity, and Motivation Model for Behavior Change. Intervention studies were systematically evaluated using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.<h4>Findings</h4>Forty-five studies were included in the final analysis and summarized qualitatively within the following topic areas: 1) factors contributing to vaccination coverage differences between rural and urban adult populations and 2) effective strategies for increasing vaccine availability among rural adult populations. Of the six intervention studies identified, only three met the criteria for direct evidence (Level I or II, fair or good quality).<h4>Conclusions</h4>Vaccination coverage differences between rural and urban adults stem primarily from opportunity and motivation-related factors. Limited intervention studies have not effectively addressed the individual or systemic barriers to vaccination for rural populations.