*Article* **Perceptions of COVID-19 Mitigation Strategies between Rural and Non-Rural Adults in the US: How Public Health Nurses Can Fill the Gap**

**Alan M. Beck 1,\*, Amy J. Piontek 2, Eric M. Wiedenman 1,3 and Amanda Gilbert <sup>1</sup>**


**Abstract:** The purpose of this study was to capture the perceptions of COVID-19 mitigations' efficacy of rural and non-rural participants, using the health belief model (HBM), as well as to describe where public health nursing may be able to fill behavior gaps in rural communities. Rural and non-rural participants completed electronic surveys. Surveys collected demographic information and perceptions of various mitigation strategies' effectiveness. Rurality was significantly associated with perceptions of the effectiveness of public health mitigation strategies including wearing facemasks, limiting time indoors, avoiding gatherings, non-essential business closure, and staying home. Our findings suggest people in rural areas perceive mitigations to be effective. Other researchers have consistently shown rural residents are least likely to partake in the same mitigations. Rural public health nurses on the front line serve as the key to closing the aforementioned gap. Understanding where their community's perceptions lie is pivotal in creating educational programs to continue mitigation efforts as we embark on the second year of this pandemic.

**Keywords:** rural; COVID-19; public health nursing
