Bridging the gap in population health for rural and Aboriginal communities: a needs assessment of public health training for rural primary care physicians.
BACKGROUND
The literature identifies significant inequalities in the health status of rural and Aboriginal populations, compared with the general population. Providing rural primary care physicians with public health skills could help address this issue since the patterns of mortality and morbidity suggest that prevention and health promotion play an important role. However, we were unable to identify any community needs assessment for such professionals with dual skills that had been performed in Canada.


METHODS
We conducted key informant interviews and focus groups in 3 rural and Aboriginal communities in British Columbia (chosen through purposive sampling). We analyzed transcripts following standard qualitative iterative methodologies to extract themes and for discussing content.


RESULTS
There was broad support for a program to train primary care physicians in public health. The characteristics identified as necessary in such a physician included a long-term commitment to the community with partnership building, advocacy, communication and cultural sensitivity skills. The communities we studied identified some priority challenges, most notably that the current remuneration structure does not support physicians engaging in public health or research.


CONCLUSIONS
There is great potential and support for the training of rural primary care practitioners in public health to improve population health and engage communities in this process.
Buxton
Jane A
JA
The Department of Health Care and Epidemiology, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Ouellette
Veronic
V
Brazier
Alison
A
Whiteside
Carl
C
Mathias
Rick
R
Dawar
Meena
M
Mulkins
Andrea
A
D001955:British Columbia; D002983:Clinical Competence; D003142:Communication; D003154:Community Medicine; D003159:Community-Institutional Relations; D003466:Cultural Characteristics; D017144:Focus Groups; D006801:Humans; D007198:Indians, North American; D007407:Interviews as Topic; D010821:Physicians, Family / Q000191:economics / Q000193:education*; D044382:Population Groups; D011634:Public Health / Q000193:education*; D019035:Rural Health Services; D012494:Sampling Studies