{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:53:59Z","timestamp":1767707639528,"version":"3.48.0"},"reference-count":29,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Chronic Disease Prevention & Health Promotion Division, Hawai\u2018i State Department of Health"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>People living in rural communities are typically underserved by public transportation services and face challenges in accessing healthcare, jobs, stores, and other destinations. Understanding the lived experiences of people who use public transportation in rural communities can help to inform a more equitable transportation system. This qualitative study gathered the perspectives of community health center employees about the public bus system for Hawai\u2018i Island, a rural county in the United States. Using a community-engaged research approach, the evaluation team interviewed 10 employees through either in-person small group interviews or online individual interviews between April and July 2023. Transcripts were coded and analyzed using a thematic analysis approach. While all study participants were selected for their interest in commuting to work by bus, most believed the bus was not a reliable or convenient option. Participants shared their experiences about not being able to rely on the bus schedule, feeling unsafe while walking to bus stops or waiting for the bus, and other barriers to using the bus system. Participants also shared their insights about how a reliable bus system would benefit community health center patients who needed transportation to more than just their medical appointments, but also to places like pharmacies, laboratory services, and grocery stores. These findings can be used to initiate discussions around the ways that community health centers can further address transportation as a social determinant of health and inform transportation providers about how to best plan and invest in transportation infrastructure and services to meet the needs of rural populations.<\/jats:p>","DOI":"10.3390\/ijerph23010078","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:49:46Z","timestamp":1767707386000},"page":"78","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perspectives of Community Health Center Employees on Public Bus Transportation in Rural Hawai\u2018i County"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2979-820X","authenticated-orcid":false,"given":"L. Brooke","family":"Keliikoa","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, University of Hawai\u2018i at M\u0101noa, 1960 East-West Road, Biomed D210, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Hartz","sequence":"additional","affiliation":[{"name":"Hawai\u2018i Island Community Health Center, 75-5751 Kuakini Highway, Kailua-Kona, HI 96740, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ansley","family":"Pontalti","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Hawai\u2018i at M\u0101noa, 1960 East-West Road, Biomed D210, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ke\u2019\u014dp\u016blaulani","family":"Reelitz","sequence":"additional","affiliation":[{"name":"Papa Ola Lokahi, 677 Ala Moana Blvd, Suite 720, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heidi","family":"Hansen Smith","sequence":"additional","affiliation":[{"name":"Chronic Disease Prevention & Health Promotion Division, Hawai\u2018i State Department of Health, 1250 Punchbowl Street, Room 422, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiana","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Oahu Metropolitan Planning Organization, 707 Richards Street, Suite 200, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0145-732X","authenticated-orcid":false,"given":"Lance K.","family":"Ching","sequence":"additional","affiliation":[{"name":"Chronic Disease Prevention & Health Promotion Division, Hawai\u2018i State Department of Health, 1250 Punchbowl Street, Room 422, Honolulu, HI 96813, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0960-1147","authenticated-orcid":false,"given":"Meghan D.","family":"McGurk","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, University of Hawai\u2018i at M\u0101noa, 1960 East-West Road, Biomed D210, Honolulu, HI 96822, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1593","DOI":"10.1093\/jnci\/djac134","article-title":"Addressing Transportation Insecurity Among Patients with Cancer","volume":"114","author":"Graboyes","year":"2022","journal-title":"J. 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