Date of Final Oral Examination (Defense)

5-2011

Type of Culminating Activity

Thesis

Degree Title

Master of Health Science, General Research

Department

Community and Environmental Health

Major Advisor

Theodore W. McDonald, Ph.D.

Abstract

Depression and other significant mental and behavioral health (MBH) problems have not been well documented in frontier areas of Idaho. It has been suggested that residents of frontier areas access their primary care provider (PCP) for most of their general health and MBH needs. To determine PCPs’ perceptions of MBH issues in frontier areas of Idaho, surveys were sent to all 252 PCPs with a registered practice location in one of Idaho’s 26 frontier counties. The survey asked questions regarding the PCPs’ practice history, the percentage of their patients who have an MBH problem and what those MBH problems are, how often they make referrals to MBH care professionals, and if there are barriers to obtaining care, how prepared they feel to identify and treat MBH problems, and whether further training in these areas would be beneficial. Seventy-four PCPs (of the 228 successful mailings) replied to the survey, yielding a response rate of 32.5%, which was proportional to the distribution of the true PCP population and represented all frontier Idaho. It was found that doctors (MDs and DOs) had their professional degree longer and had practiced in a frontier area of Idaho longer than midlevel providers (physician assistants and nurse practitioners). PCPs reported that about 30% percent of their patients may have a MBH problem. Mood disorders, anxiety, and substance abuse were the three most commonly reported MBH problems that PCPs encountered in their clinics. Finances and transportation (88.6% and 71.4%, respectively) were the most frequently reported barriers to obtaining professional MBH care. Finally, although all PCPs reported feeling prepared to identify and treat MBH problems, most reported that additional training in the identification and treatment of MBH problems would be beneficial.

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