National health service corps (NHSC) and area health education centers (AHEC): Recruiting and retaining primary care providers in underserved communities

Introduction: Federal and state governments have traditionally sought to improve access to healthcare in rural communities by investing resources into the recruitment of primary care providers often in the form of loan repayment programs. The National Health Service Corps (NHSC) provided funding to 36 State Primary Care Offices to conduct a two-year program called Retention and Evaluation Activities (REA. The primary goal is to examine retention of NHSC health care providers in underserved communities. Objective: The REA program in Texas utilized the Area Health Education Centers AHEC) system to provide personalized support to NHSC Loan Repayors, Scholars and technical support to NHSC clinical sites that fosters the retention of health providers. Supporting health care providers and students who are training for careers in primary care, behavioral health and dental care will help reduce health professional shortages in rural communities improving access to healthcare. Methodology: NHSC Loan Repayors and their clinical sites completed evaluations that measured 1) clinician work experience at their NHSC obligation site 2) strength of community integration and 3) clinician intent to remain at their obligation site after their service completion. Results: Preliminary results show a gap between being prepared to work in communities and being prepared to living in the communities that they serve. Approximately 66% of respondents felt very well prepared to work in the community compared to 45% who felt very well prepared to live in the community. Conclusion: Although retention of NHSC Loan Repayors in underserved Texas communities remains relatively high, improving community integration and helping clinical sites incorporate effective retention strategies may lead to even higher retention rates. Using collaborative partnerships to support practice entry and professional development of healthcare providers particularly those serving in underserved communities, can help improve provider retention. Implications for Public Health: Rural and medically underserved areas continue to face challenges in recruiting and retaining health professionals. Area Health Educations Centers can help like providers to the communities that they serve improving community integration and provider satisfaction that will utimately foster help improve retention.