title: Association Between Rural Background and Physical Therapist Practice Location
Creators: name: Parker, Caitlin
Publisher: name: University of Nevada, Las Vegas
Year: 2023

description: Purpose/Hypothesis To examine the association between physical therapists’ rural background and their decision to practice in a rural setting. We hypothesized that years of rural upbringing and size of hometown would be related to rural practice. Number of Subjects 257 physical therapists who graduated from one of two physical therapy programs in the Western United States between 2000 and 2020. Materials and Methods A survey was emailed to 19 physical therapy schools consisting of questions regarding participants’ background, demographics, and job history. We collected total number of years of practice and total years of rural practice. Length of practice varied, so we calculated a rural practice proportion (RPP) for each subject and used Pearson correlation to determine the association between years of rural upbringing and the RPP. To examine the association between size of hometown and practice in any rural setting, a Spearman correlation was conducted. Additionally, multivariate logistic regression was used to explore potential effects of several factors on the likelihood of rural practice. iv Results Alumni from two physical therapy programs housed at two institutions, the University of Nevada, Las Vegas (UNLV) (199) and the University of Colorado, Boulder (49) submitted 257 surveys. There were weak positive correlations between years of rural upbringing and RPP (r = .374, n = 152, p< .001) and between size of hometown and size of current practice location (r= .332, N = 225, 0 <0.001). A weak positive correlation existed between size of hometown and practice in any rural setting (r = .154, N = 234, p = .018), with smaller hometown correlating with rural practice. In our unadjusted models, several factors including completion of a rural clinical experience, partner’s rurality, and being from smaller towns were found to affect the likelihood of practicing in a rural setting (p < .05). However, in an adjusted model, only partners’ rurality was found to significantly increase the likelihood of practicing in a rural setting (p = .012). Conclusions Among survey respondents, those with more years of rural upbringing were more likely to have practiced in rural settings. Physical therapists from smaller sized hometowns showed increased odds of having worked in rural settings compared to those from urban areas. Lastly, physical therapists with partners from rural areas were more likely to have worked in rural areas versus those with partners from urban areas. Clinical Relevance Additional research is warranted to understand the intrinsic and extrinsic factors that increase the likelihood of physical therapists practicing in rural settings. Academic physical therapy programs v can consider recruiting students from rural areas and providing opportunities for rural clinical experiences since these appear to be related to rural practice. Programs are encouraged to partner with rural communities and clinical partners to enhance their understanding of the unique health care needs of these communities that are amenable to physical therapy intervention. Academic physical therapy programs, state boards of physical therapy, and the American Physical Therapy Association (APTA) should collaborate to create new and leverage existing databases to describe physical therapist practice patterns across the professional career cycle.