Digital textbooks are replacing print books in school districts across the United States due to their adaptability for students with special needs, enhanced student interest, and lower cost. This is also true in the rural state of West Virginia which lags the U.S. in broadband Internet saturation. Therefore, the purpose of this study was to identify the hidden works of teachers in West Virginia who are using digital content in areas of low broadband Internet saturation and examine how they are assisting students who do not have home Internet access. This concurrent mixed methods study purposely selected two school districts in West Virginia with low broadband Internet saturation that had adopted digital content. Teacher efficacy was used as the conceptual framework for this study. A survey was used to collect quantitative data and interviews for qualitative data. The Teachers' Sense of Efficacy Scale, developed by Tschannen-Moran and Hoy (2001), was used to analyze any relationship between teachers' sense of efficacy and their years of experience or number of hidden works using Pearson r. Additionally, quantitative data was examined to see if teachers' sense of efficacy and their years of experience can predict the number of their hidden works using multiple regression. Statistical analyses yielded little, if any, relationships among variables. Qualitative interviews generated a depth of data from the lived experiences of administrators and teachers. This study found that teachers were utilizing district and school policy to create access through after school programs and advisory class periods. The hidden works teachers found to be effective were printing assignments, fluid due dates, individual tutoring sessions, and flexibility in medium by tailoring their hidden works to meet the individual access needs of each student. The data provided guidelines for selecting hidden works; teachers should know their learners, school and community contexts. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]