Perceptions of Important Retention and Recruitment Factors by Therapists in Northwestern Ontario

Recruitment and retention of health professionals in rural and remote communities are well-known challenges. Although the literature states that lifestyle factors and being from a rural background influence recruitment and retention, much of the research is dated and of limited relevance to rehabilitation professionals. This study reports on a survey of physical therapists (PTs) and occupational therapists (OTs) in northwestern Ontario. Seventy-four percent of the OTs and PTs from this geographically isolated region of Canada responded to a mail survey examining factors that influenced their job recruitment and retention decisions. Availability of leisure and recreation activities, proximity of family of origin, need for OTs and PTs and influence of spouse or partner frequently contributed to recruitment decisions and were also important in retention decisions. Although professional autonomy was an important source of job satisfaction for the respondents, almost one-third reported a feeling of professional isolation. Professional development initiatives appeared to influence job satisfaction but were unlikely to influence working life decisions. The findings suggest that recruitment and retention strategies should be multifaceted to reflect the complexity of therapists' decision-making.     

Recruitment and Retention of Home Support Workers in Rural Communities

This qualitative study examined recruitment and retention of home support workers (HSWs) providing home support in rural communities. Thirty-two participants were recruited across four island-based communities located in British Columbia, Canada. Thematic analysis of interview data revealed several key themes: (a) how the rural context shapes HSWs’ employment decisions and opportunities; (b) why people become (and stay) HSWs in rural communities; and (c) how rurality influences the nature and scope of HSWs’ work. These findings suggest that health human resource policies and programs aimed at HSW recruitment and retention should be tailored to characteristics, strengths, and challenges of rural communities.     

The Rural Hospital as a Provider of Health Promotion Programs

Although patient education has always been recognized as an essential function of a hospital, it was not until the health concerns of the nation focused on prevention that hospitals began to develop activities aimed at primarily healthy individuals. Hospital health promotion evolved from patient education about specific diseases to programs focused on modifying of lifestyle practices to prevent future debilitating conditions. Studies conducted in the early 1980s show hospital-based health promotion programs increasing in number and including such target populations as senior citizens, children, business people, and hospital employees. However, the extent of involvement of the rural hospital in offering health promotion programs has not been clearly established. The current study was conducted to determine the status of health promotion programs in rural North Carolina hospitals. Elements considered were types of programs, target audiences, methods of financing, staff use, and availability of specialized facilities for health promotion programs. The results indicate rural hospitals do offer health promotion programs, but their primary focus is on hospital employees. Most programs are offered at low or no cost, making those offered for the community readily accessible. If input from the community is used and programming is aimed at specific health needs of rural populations, the rural hospital could make a significant contribution to an overall primary prevention strategy, lowering community health care costs.     

Availability of Child Care in Rural Communities: Implications for Workforce Recruitment and Retention

The objective of this study was to identify differences in child care availability by rural–urban location for all counties in Wisconsin, and describe implications for recruitment and retention of health care workforce. We used data on licensed child care slots for young children (age <5), socio-demographic characteristics, women’s and men’s labor force participation, and household structure for all counties in Wisconsin in 2013 (n = 72). Data came from KIDS COUNT, County Health Rankings, and the American Community Survey. We used t tests to analyze bivariate differences in child care availability and community characteristics by metropolitan, micropolitan, and non-core rural location. We then used ordinary least squares regression to analyze the relationship between geographic location and child care slots, adjusting for labor force participation and household structure. Rural counties had significantly fewer licensed child care slots per child than metropolitan and micropolitan counties. These counties also had, on average, higher rates of poverty and higher unemployment than micropolitan and metropolitan counties. The association between geographic location and child care availability remained, even after adjusting for household structure and labor force participation. The number of hours men worked and the percentage of men not working were both negatively associated with available child care slots, whereas there was not a significant relationship between women’s labor force participation and child care availability. Rural areas face health care workforce shortages. Recruitment strategies to overcome shortages must move beyond individual-level incentives to focus on community context and family support, including availability of child care in rural counties.     

Rural Health Research: Demographic, Educational and Economic Factors Related to Recruitment and Retention of Physicians in Rural Pennsylvania

While prior studies have identified a number of factors individually related to physician practice in rural areas, little information is available regarding the relative importance of these factors or their relationship to rural retention. Extensive data previously collected from the Jefferson Longitudinal Study were analyzed for 1972 to 1991 graduates of Jefferson Medical College practicing in Pennsylvania in 1996, as were recent self-reported perceptions of Jefferson Medical College graduates in rural practice. Rural background was overwhelmingly the most important independent predictor of rural practice, and freshman plans to enter family practice was the only other independent predictor. No other variable, including curriculum or debt, added significantly to the likelihood of rural practice. None of these variables, however, including rural background, was predictive of retention, which appeared to be more related to practice issues such as income and workload. These results suggest that increasing the number of physicians who grew up in rural areas is not only the most effective way to increase the number of rural physicians, but any policy that does not include this may be unsuccessful.     

Psychosocial Problems in Primary Care: Patient and Provider Perceptions

Primary care physicians and clinics have become the frontline of health care for most Americans—they are the first point of contact and the source of both treatment and referrals. Psychosocial problems, such as difficulty with finances, family, housing, and work, are associated with a high demand for medical care in primary care practice, yet little is known about the prevalence of psychosocial problems in primary care settings. The purpose of this study is to assess the type and level of psychosocial problems in primary care patients by examining patient and provider perceptions at the Veterans Affairs Greater Los Angeles Healthcare System (VAGLAHS). A purposive sample of 684 veterans and a convenience sample of 59 providers anonymously completed the Social Needs Checklist. Patients reported an average of five psychosocial problems, with finances, personal stress, transportation, employment, and legal issues being the most prevalent. Thirty-two percent of patients indicated a desire to see a social worker. Provider and patient differences were compared. Provider estimates of patients' problems were consistently lower than patient estimates in all psychosocial problem areas except need for nursing home placement and problem drinking or drug use. Implications for social work in primary care are discussed.     

Recruitment and Retention of Schools Participating in School Health Research

The quality of school health research projects can be enhanced by directing attention to recruitment and retention of schools. Successful recruitment plans go beyond research considerations to address political, economic, educational, and organizational needs of the school setting. Based on recent research, a taxonomy of decision-making procedures characteristic of school districts is presented. The taxonomy provides a framework for designing effective recruitment and retention strategies.     

Rural Health Research Community Perceptions of the Effects of Rural Hospital Closure on Access to Care

The purpose of this case study was to ascertain the perceptions of health professionals who were located in six rural communities where hospital closure occurred, regarding the impact of closure on community residents. These health professionals were asked to respond to questions about effects of hospital closures on the availability of medical services such as emergency care, physician services, hospital services and nursing home care. To control for trends in medical services utilization that were unrelated to hospital closure, the study design included comparison areas where similar hospitals remained open. A standardized questionnaire was administered to three health professionals in each of the areas that experienced a hospital closure and also in the matched comparison areas. Interviews of the health professionals in closure areas provide evidence suggestive of some perceived negative effects of hospital closure on these communities. These negative effects include difficulty recruiting and retaining physicians, concern of residents about the loss of their local emergency room, and increased travel times to receive hospital services. The perceived effects of closure appeared to be mediated by the distance required for travel to the nearest hospital. Respondents perceived increased travel times to most significantly affect vulnerable populations, such as the elderly, the disabled and the economically disadvantaged. Respondents in the majority of comparison areas also reported access barriers for vulnerable populations. These barriers primarily center on problems of obtaining transportation and enduring the rigors of travel. Improvements in the availability of transportation to medical care may offer some stabilization to communities where hospitals closed; however, it also is the case that transportation improvements are needed to increase access to care in rural communities where hospitals remained open.     

Recruitment and Retention of Latino Immigrant Families in Prevention Research

The development and testing of culturally competent interventions relies on the recruitment and retention of ethnic minority populations. Minority immigrants are a population of keen interest given their widespread growth, needs, and contributions to communities in which they settle, and particularly recent immigrants from Mexico and Central and South American countries. However, recruitment and retention strategies for entirely immigrant samples are rarely discussed in the literature. The current article describes lessons learned from two family-focused longitudinal prevention research studies of Latino immigrants in Oregon—the Adolescent Latino Acculturation Study (ALAS) and the Latino Youth and Family Empowerment Project-II (LYFE-II). Social, legal, economic, and political contexts are considered that shape Latino immigrants’ experiences in their home countries as well as in the United States. The implications of these contexts for effective recruitment and retention strategies are discussed.     

无偿献血者队伍建设与招募保留探讨

无偿献血者五支队伍建设与招募保留是无偿献血事业可持续发展的根本。结合工作实践,介绍了固定献血者队伍、应急献血者队伍、稀有血型献血者队伍、成分献血者队伍以及志愿者服务队伍的建立与招募保留的做法。     

Latino Immigrant Service Provision in Tennessee and Georgia: Provider Perceptions

Journal of Immigrant and Minority Health - Latinos and Latino immigrants are increasingly settling in new immigrant destinations, such as Tennessee and Georgia, that have historically lacked...     

Recruitment and Retention of Physicians for Primary Care Research

The primary objective of this report is to examine factors associated with recruitment of physicians in community-based primary care research. Reported results are based on an observational study of physician recruitment efforts undertaken in a randomized controlled trial designed to improve primary care physicians' cancer screening and counseling activities. The Partners for Prevention project was a state-wide randomized controlled trial of primary care physicians selected from the state of Colorado. Two-hundred and ten eligible internal medicine and family medicine practices in both rural and urban community settings of the state of Colorado were selected into this study and a sentinel physician was chosen to represent each practice. Only 6% (13/210) of recruited practices initially declined to participate in the study, but the total refusal rate had reached 30% (59/210) by the time the intervention was implemented five months later. Study participants (n = 136) were younger (mean age 45.7 vs. 50.0, p = 0.008) and more often located in a rural area (46% vs. 31%, p = 0.04) than decliners (n = 59), but there was no association with gender of the physician (87% for females vs. 95% for males, p = 0.13). Participants were more often family practice physicians by training rather than internists (75% vs. 56%, p = 0.008), whereas there was no difference in participation rates by practice type (solo versus group, 60% vs. 64%, p = 0.52). Differences in demographic, geographic, and training characteristics between trial participants and decliners suggest the potential for better targeting of recruitment efforts. Viable strategies for recruiting community-based primary care practices to research studies are proposed.     

医院执行力存在的问题及提升对策研究

执行力是社会各界了解医院、衡量医院工作质量和服务水平高低的“传感器”。因此,在医疗卫生改革不断深入,医疗市场竞争日益激烈的今天,着力加强医院执行力建设,提升医院整体执行能力,无疑是强化管理、创优服务、提升形象、推进发展的一项重要课题。本文就医院提升执行力的必要性、目前存在的问题和解决的对策展开研究。     

Waiting Room Education in a Community Health System: Provider Perceptions and Suggestions

The increasing burden of chronic diseases in the United States presents a major challenge to the nation’s primary care systems, so improving the efficacy and efficiency of patient education is an important goal. Understanding the current perspectives, practices, and needs of primary care providers should guide innovation towards this end. As a part of the authors’ ongoing quality improvement work, a short internet survey was an effective method of enhancing this understanding in one health care system. With a response rate of 24.6 %, the survey revealed that primary care waiting rooms in the health system studied are not conceived of or used by providers as spaces to engage patients in health education. To change this, providers suggested using both printed and technological methods for delivering health information, primarily related to medications, diabetes, and healthy lifestyle practices. Common barriers to improvement cited by providers included diverse language and literacy backgrounds in the patient population, as well as difficulty sustaining change due to infrastructural and administrative barriers. These results suggest steps for development, implementation, and investigation of new educational interventions for patients in the local primary care context.