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DURHAM, NC - A joint project of Duke University Medical Center and East Carolina University to boost the number of primary care givers in 31 counties in Eastern North Carolina has received $1.3 million in support.

The grant from the Robert Wood Johnson Foundation, announced this week with additional funds from The Duke Endowment and the NC Area Health Education Center program, will allow the universities to launch the "distance learning" program to train health care providers in rural counties to become nurse practitioners, physician assistants and certified nurse midwives. The Robert Wood Johnson grant was part of a nationwide competition called "Partnerships for Training."

Students admitted to the program will earn degrees from the universities without leaving their communities through computer-based curricula and small group classes held at nearby community colleges and other sites. Local hospitals, clinics and doctors will provide clinical training for the students.

The part-time program was developed over the past two years as a model program for increasing the number of mid-level practitioners in communities with shortages of primary care professionals. The mid-level practitioners see and direct care of their patients, including prescribing medications, working in partnership with doctors who share responsibility for patient care.

"This is a terrific partnership between Duke and ECU, other universities and community colleges, the AHEC system, community hospitals and the three state professional associations, as well as other community partners," said Mary Champagne, dean of the Duke School of Nursing and primary investigator for the project. "We've worked together to develop a curriculum that will allow rural residents a chance to earn advanced degrees without having to leave their jobs, families and communities."

Forty-six students will enter the program this spring, with 30 studying to become family nurse practitioners, 10 to become physician assistants and six to become nurse midwives. So far, more than 250 prospective students have requested applications, Champagne said. A second wave of students will enter the program in spring 2000.

Students are expected to need three years to complete their degrees. Much of the course work will be completed via the Internet, with students using interactive programs, viewing high-resolution images and audio to review case studies and classes. The program is expected to become a model for mid-level practitioner training across the country, officials said.

The program was developed under a Robert Wood Johnson Foundation grant by Duke and ECU in partnership with the Eastern Area Health Education Center (AHEC); Southern Regional AHEC; Southeastern Regional Medical Center in Lumberton; Sampson Regional Medical Center in Clinton; Martin General Hospital in Williamston; Carteret General Hospital in Morehead City; UNC-Pembroke; Fayetteville State University; the state's Office of Rural Health and Resource Development; NC AHEC Program; NC Academy of Physician Assistants; NC Nurses Association; NC Association of Certified Nurse Midwives; and the NC Medical Society Foundation.

The counties targeted by the model program include Moore, Harnett, Richmond, Scotland, Hoke, Robeson, Bladen, Sampson, Cumberland, Hertford, Gates, Bertie, Martin, Chowan, Perquimans, Pasquotank, Camden, Currituck, Dare, Tyrell, Hyde, Washington, Beaufort, Greene, Craven, Pamlico, Wayne, Lenoir, Jones, Onslow and Carteret.

The Robert Wood Johnson Foundation, based in Princeton, NJ, is the nation's largest philanthropy devoted exclusively to health and health care. It became a national institution in 1972 with receipt of a bequest from the industrialist whose name it bears, and since then has made more than $2 billion in grants. The foundation focuses on three goals: to assure that all Americans have access to basic health care at reasonable cost; to improve the way services are provided to people with chronic health conditions; and to reduce the harm caused by tobacco and substance abuse.