ArticlePloS one2025
A discrete choice experiment with health professions trainees to improve the urban-rural health care access disparity in Appalachia: Study protocol.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
2 citing papers in PubMed.
- Preferences of health professions learners: a scoping review of the use and role of DCEs in health professions education.Medical education online · 2026Article
- What factors influence health professions trainees' preferences for employment in rural Appalachia? a qualitative study to inform the design of a discrete choice experiment.Medical education online · 2026Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Globally, those who live in rural areas experience significant barriers to accessing health care due to a maldistribution of health care providers. Those who live in rural areas in the Appalachian region of the United States face one of the worst shortages of health care providers despite experiencing more complex health needs compared to Americans in more affluent, urban areas. Prior research has failed to identify effective solutions to narrow the provider maldistribution, despite it being a policy focus for decades. More work is needed to better understand the complex, multidimensional process in which health care providers select jobs and how job, community, and providers' intrapersonal characteristics influence job selection. This paper is a protocol for a study aimed at identifying effective policies and incentives to improve recruitment of healthcare providers for their first job in rural Appalachia. We will use rigorous, theoretically grounded discrete choice experiment methodology (DCE) to accomplish the study's objective. The main outcome will be the relative importance of alternative community and job characteristics for trainees' choices of jobs in rural Appalachia. secondary outcomes of interest will be trade-offs that these trainees make when selecting a job, described in the form of marginal rates of substitution (mRS). Participants include medical residents and fellows, PA students and NP students in their final year of training. The choice context will be the recruitment of these trainees for their first job. Data will be analyzed using mixed logit analysis. Results from this DCE will improve our understanding of the job selection process for health care providers. The identification and prioritization of predictors of trainees' rural job choices will allow for the development of policies and incentives that will enable policymakers and health care systems to recruit more providers to rural and underserved areas.
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Registered trials
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