title: Gaps in the primary care of rural and underserved populations: the impact of nurse practitioners in four Mississippi Delta states.
abstract: OBJECTIVE
  The shortage and distribution of primary care providers (PCPs) has left a gap in the health care of society, particularly those residents within the Lower Mississippi River Delta region, where pockets of rural and underserved populations reside. Described in this study are the workforce distribution, characteristics, and likelihood of advanced practice nurses (APNs) to practice in these communities.
  
  
  METHODS
  Surveys were completed by 479 APNs in Arkansas, Louisiana, Mississippi, and Tennessee. Other sources included census data and the designation of Health Professional Shortage Areas as specified by Health Resources and Services Administration.
  
  
  CONCLUSIONS
  Fifty-one percent of respondents indicated they practice in primary care; 24% practice in a designated Health Professional Shortage Areas; and 54% practice in a rural area. Family nurse practitioners (FNPs), in particular, were more likely to practice in rural and shortage areas.
  
  
  CONCLUSIONS
  More APNs, especially nurse practitioners (NPs), are needed to address the PCP shortage. But more than just increased numbers of NPs is the need for redistribution of these providers. Efforts to expand the scope of practice and limit regulatory restrictions will enable NPs to practice more autonomously, which in turn will provide opportunities for better access and improved healthcare outcomes, especially in rural and underserved regions. Educational programs must include competencies and skill sets focused on meeting the needs of these populations.
authors.affiliation: University of AR, Fayetteville, Arkansas.
authors.forename: Ellen
authors.initials: E
authors.lastname: Odell
authors.forename: Tom
authors.initials: T
authors.lastname: Kippenbrock
authors.forename: William
authors.initials: W
authors.lastname: Buron
authors.forename: Marie-Rachelle
authors.initials: MR
authors.lastname: Narcisse
mesh_terms: D000328:Adult; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009722:Nurse Practitioners / Q000600:supply & distribution*; D011320:Primary Health Care / Q000458:organization & administration*; D019035:Rural Health Services / Q000458:organization & administration*; D015144:Southeastern United States
keywords: Nurse practitioners; primary care; rural; underserved