The research upon which this report is based was undertaken by the University of Iowa's Public Policy Center and was made possible by a grant from the Northwest Area Foundation. This project is the first of four yearly projects to be carried out at the Center in conjunction with the Northwest Area Foundation grant. The research projects have two objectives: first, to research public policy options for addressing the needs of the Midwest region which is undergoing major economic and social change; and second, to establish mechanisms for much more effective interaction between university researchers and the consumers of their research.

In the first year, the issue of declining access to health care in rural America was addressed. Together with an advisory committee from the state of Iowa's Office of Rural Health, university researchers examined how health services can best be provided in rural areas experiencing significant demographic and economic transition. This report is one of two reports produced as part of this project. It presents a methodology for prioritizing technical assistance to rural communities and health care providers. The other report addresses whether changes to hospital licensure regulations would help alleviate the loss of access to health care that would take place if traditional rural hospitals were to close. Building on these reports, a roundtable discussion on issues affecting access to health care in rural areas was held in the fall of 1990, featuring policy makers, health care providers, and academic researchers. The roundtable discussion was conducted to further promote understanding of rural health planning issues through dialogue between researchers and those charged with making public policy. This discussion was videotaped, and the tape is available for distribution.

The methodology for prioritizing technical assistance to rural health care providers developed in this research project has been adopted by the Office of Rural Health within the Iowa Department of Public Health. It is the result of a process whereby university researchers' work was guided by the insights of advisory committee members. The committee members, in turn, found that the work of the researchers expanded their knowledge of rural health care problems and prospects.

Research of this interactive nature is a key feature of the Public Policy Center. The Center is a reflection of the University of Iowa's commitment to applied research that seeks to address pressing questions facing a changing society. The Center's projects generally involve close interaction between decision makers and resource people in both the public and private sectors.

The project was carried out by an interdisciplinary research team led by Assistant Professor Douglas S. Wakefield of the University of Iowa's Graduate Program in Hospital and Health Administration. The research team also included Associate Professor James e. Rohrer of the Graduate Program in Hospital and Health Administration; Professor David J. Forkenbrock, Director of the Public Policy Center, Associate Professor Robert L. Ludke, Acting Director of the Center for Health Services Research; and Norman S. J. Foster, a Research Associate at the Public Policy Center. They were assisted by Kathleen A. Lucas and Cathy L. Young, Research Associates at the Public Policy Center.

36 pp., 1 figure, ibicomb binding