title: Adaptations to health care barriers as reported by rural and urban providers.
abstract: Barriers to ethical and effective health care in rural communities have been well-documented; however, less is known about strategies rural providers use to overcome such barriers. This study compared adaptations by rural and urban health care providers. Physical and behavioral health care providers were randomly selected from licensure lists for eight groups to complete a survey; 1,546 (52%) responded. Replies indicated that health care providers from small rural and rural communities were more likely to integrate community resources, individualize treatment recommendations, safeguard client confidentiality, seek out additional expertise, and adjust treatment styles than were providers from small urban and urban communities. Behavioral health care providers were more likely than physical health care providers to integrate community resources, individualize treatment recommendations, safeguard client confidentiality, and adjust their treatment styles; physical health care providers were more likely than behavioral health care providers to make attempts or have options to seek out additional expertise.
authors.affiliation: Joint PhD Program, Clinical-Community Psychology, University of Alaska, USA.
authors.forename: Cody L
authors.initials: CL
authors.lastname: Chipp
authors.forename: Mark E
authors.initials: ME
authors.lastname: Johnson
authors.forename: Christiane
authors.initials: C
authors.lastname: Brems
authors.forename: Teddy D
authors.initials: TD
authors.lastname: Warner
authors.forename: Laura Weiss
authors.initials: LW
authors.lastname: Roberts
mesh_terms: D003219:Confidentiality; D005260:Female; D006282:Health Personnel; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000458:organization & administration; D008875:Middle Aged; D010817:Physician-Patient Relations; D010818:Practice Patterns, Physicians' / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D011795:Surveys and Questionnaires; D019037:Urban Health Services / Q000458:organization & administration*