Knowledge, Attitudes, and Needs: Assessing the COVID-19 Impact in Rural America.

Objective: There is a lack of information concerning the impact of COVID-19 on rural populations. This report shares key results from a cross-sectional survey of South Dakota residents' perceptions on the impact and knowledge of COVID-19 during the early phases of the pandemic.

Methods: From March 24 to April 14, 2020, South Dakota residents (n = 4,761) reported on their psychological symptoms, pandemic-related stressful experiences, top concerns regarding the pandemic, attitudes towards COVID-19, and social distancing behaviors, and where residents were getting COVID information and who they trust to provide accurate information.

Results: Most participants were engaging in at least some social distancing and indicated at least moderate concern about COVID-19. Across age groups, getting sick from the coronavirus was the most frequently endorsed concern. Younger adults endorsed concerns about not being able to work, whereas older adults endorsed concerns about accessing medical care. The majority of the sample reported anxiety, worry, and sleep problems; about half the sample reported depressed mood, anhedonia, and appetite problems. Results highlight the importance of engaging public health experts and physicians in COVID-19 health messaging campaigns.

Conclusions: These data provide insight into the specific challenges experienced by adults and youth in a rural state during the early phase of the pandemic. Public Health professionals and medical doctors are in a unique position to guide targeted interventions and health messaging.