title: Acceptance of nurse practitioners and physician assistants in meeting the perceived needs of rural communities.
abstract: Nurse practitioners and physician assistants have provided a partial solution to the shortage of primary care services in medically underserved rural areas. This paper describes the results of a study exploring community acceptance of nurse practitioners and physician assistants in rural medically underserved areas. Community acceptance in the context of this study implies not only satisfaction with care received, but also willingness of the community to support NP/PA practice through its infrastructure and encourage members to initially seek and continue to receive care from an NP or PA. Five focus groups were conducted in each of five rural medically underserved communities. The two most pervasive findings were the lack of previous exposure to NPs and PAs and the general belief that NPs and PAs would be accepted in these communities if certain conditions could be met. The theme of conditional acceptance included both personal and system factors. Personal factors included friendliness, competence, willingness to enter into the life of the community, and the ability to keep information confidential. System factors considered critical for acceptance included service type, integration with the existing health care system, cost, geographic proximity, and availability. The results of this study offer insight into community attitudes and suggest marketing strategies for those who plan to introduce NP or PA services into rural communities.
authors.affiliation: Public Health, Mental Health, and Administrative Nursing, University of Illinois, Chicago College of Nursing, Peoria 61656-1649, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Baldwin
authors.forename: R J
authors.initials: RJ
authors.lastname: Sisk
authors.forename: P
authors.initials: P
authors.lastname: Watts
authors.forename: J
authors.initials: J
authors.lastname: McCubbin
authors.forename: B
authors.initials: B
authors.lastname: Brockschmidt
authors.forename: L N
authors.initials: LN
authors.lastname: Marion
mesh_terms: D017144:Focus Groups; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D006801:Humans; D007587:Job Description; D008507:Medically Underserved Area; D015146:Midwestern United States; D009722:Nurse Practitioners / Q000592:standards* / Q000600:supply & distribution; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010823:Physician Assistants / Q000592:standards* / Q000600:supply & distribution; D011320:Primary Health Care; D019035:Rural Health Services; D000078329:Workforce