Perspectives on health care choices: women users, service providers, and community leaders in Appalachia

TR Number



Journal Title

Journal ISSN

Volume Title


Virginia Tech


National health care reform proposals advocate Primary Health Care (PHC) and preventive medicine as an efficacious way to control health care costs in the United States. This study examined a community in rural, southwest Virginia and evaluated the potential for PHC success. The study used focus groups to determine how Women Users, as consumers of health care, view their health and health care problems and potential solutions. Views of Community Leaders and Service Providers, as controllers of services, were obtained using semi-structured interviews. The results were compared using the PRECEDE framework of predisposing, enabling, and reinforcing factors influencing health behavior.

This study was a component of a larger project - The Dickenson County Women's Health Project. The premise of that project was that women in Dickenson County would respond to a health education intervention program and the goal was to develop such a program. This study shows that Women Users fully comprehend the health behaviors and available services that would make themselves more healthy, but feel constrained by enabling and reinforcing factors that prevent healthy lifestyles. By contrast, Service Providers and Community Leaders focus on predisposing factors and remain convinced that women in Dickenson County need more education about healthy lifestyles and available health services. The study concludes that the women of Dickenson County are valuable resources for health program development. The success of PHC in Dickenson County is wholly dependent upon developing a mechanism whereby women are given a greater voice in program development and implementation.