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While many CVI programs have been piloted and evaluated in urban geographies, a subset of CVIs operate in more rural settings. This study focuses on the unique challenges and opportunities of implementing, operating and expanding a CVI program in a three county rural (population density of less than 500 people per square mile) region of Southern New Jersey. The study uses data collected from CVI staff and related grantee staff to understand how the program operates in a rural context, and highlights specific considerations for CVI programs in rural communities. Coordinating services across the three counties - Cumberland, Salem, and Gloucester underscores the immense logistical planning and knowledge of local communities within counties (as well as tensions between community members and political players) needed. In particular, budgets and vehicles for transportation for participants - to and from medical appointments, community events, and programming is essential. Opportunities include forging partnerships within and between counties, and pooling resources to share programming space and funding. Of particular note is the need for funders and government entities to be flexible in their understanding of what constitutes “rural” - and how population size is not always an accurate indicator of need as small communities often experience acute and repeated violence.