title: Obstetric Provider Trainees in Georgia: Characteristics and Attitudes About Practice in Obstetric Provider Shortage Areas.
abstract: Objectives In Georgia, 52 % of the primary care service areas outside metropolitan Atlanta have a deficit of obstetric providers. This study was designed to identify factors associated with the likelihood of Georgia's obstetric trainees (obstetrics and gynecology (OB/GYN) residents and certified nurse midwifery (CNM) students) to practice in areas of Georgia that lack obstetric providers and services, i.e. rural Georgia. Methods Pilot-tested electronic and paper surveys were distributed to all of Georgia's OB/GYN residents (N = 95) and CNM students (N = 28). Mixed-methods survey questions assessed characteristics, attitudes, and incentives that might be associated with trainee desire to practice in areas of Georgia that lack obstetric providers and services. Surveys also gathered information about concerns that may prevent trainees from practicing in shortage areas. Univariate and bivariate analyses were performed, and qualitative themes were abstracted from open-ended questions. Results The survey response rate was 87.8 % (108/123). Overall, 24.4 % (19/78) of residents and 53.6 % (15/28) of CNM students expressed interest in practicing in rural Georgia, and both residents and CNM students were more likely to desire to practice in rural Georgia with the offer of any of six financial incentives (P < 0.001). Qualitative themes highlighted trainees' strong concerns about Georgia's political environment as it relates to reproductive healthcare. Conclusions Increasing state-level, rurally-focused financial incentive programs and emphasizing the role of CNMs may alleviate obstetric provider shortages in Georgia.
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA. Liz.smulian@gmail.com.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Smulian
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Leilah
authors.initials: L
authors.lastname: Zahedi
authors.affiliation: Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Hurvitz
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA.|Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Abigail
authors.initials: A
authors.lastname: Talbot
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA.|Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Audra
authors.initials: A
authors.lastname: Williams
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA.|Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Zoë
authors.initials: Z
authors.lastname: Julian
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA. Adrienne.d.zertuche@emory.edu.|Emory University School of Medicine, Atlanta, GA, USA. Adrienne.d.zertuche@emory.edu.|Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, USA. Adrienne.d.zertuche@emory.edu.
authors.forename: Adrienne D
authors.initials: AD
authors.lastname: Zertuche
authors.affiliation: Emory University Rollins School of Public Health, Atlanta, GA, USA.
authors.forename: Roger
authors.initials: R
authors.lastname: Rochat
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003156:Community Mental Health Services; D005260:Female; D005845:Georgia; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000458:organization & administration*; D006801:Humans; D008427:Maternal Health Services / Q000600:supply & distribution; D008507:Medically Underserved Area; D009774:Obstetrics / Q000193:education*; D011247:Pregnancy; D012424:Rural Population; D011795:Surveys and Questionnaires; D014146:Training Support; D016387:Women's Health; D000078329:Workforce
keywords: Access; Certified nurse midwives; OB/GYN residents; Obstetrics; Training programs