Meeting the Needs of Public Health Preparedness of Rural Health Providers – A Spatial Analysis Approach

Meeting the emergency and response needs of rural communities presents a unique challenge for health providers practicing in these jurisdictions. The primary purpose of this study is to assess whether health providers' confidence and training needs of public health preparedness varied by various Medically Underserved Areas (MUA) designations of their practice in rural Texas. Four type of healthcare providers including physicians, nurses, physician assistants and veterinarians were recruited for this study (N=4,454). Data were collected through a mailed survey. In addition to statistical analysis, GIS mapping and spatial analysis was applied to analyze the data. Response rates averaged 31%. Respondents reported seeing patients with diverse cultural background, and they communicated in more than 16 different languages. Geocoding results identified the geographic areas in which various language-speaking providers are available in the event of emergency. Attribute and spatial queries revealed that, in full MUAs, the experience and confidence of healthcare providers in the diagnosis and treatment of public health emergency declines, while training needs are much higher than those in other MUA designations. The results provide lessons for realigning current preparedness efforts, including the improvement of training and confidence for health providers in rural jurisdictions; correction of inaccurate providers' contact information; and enhancement of moderately low response rates of health providers. These challenges could be overcome by tailoring training to specific rural community's needs, providing incentives and partnering with professional organizations to encourage health providers' participation. In addition, the study provides evidence for potential utility of applying spatial analysis in public health preparedness research and practice.