Addressing the shortage of health care providers in rural areas, this study examined the relationship between selected sociodemographic and background factors of students to intentions to practice as physician assistants in rural underserved areas. Respondents in the study were 82 students in the University of Kentucky physician assistant program between 1986 and 1990. A 34-item test yielded background data and information on attitudes and values associated with potential practice in rural and Appalachian areas. Key variables were rural background and marital status. Major findings were: (1) 44% of students preferred a rural area or small town as a practice site (among those who were single, 40.35% preferred the more rural areas, compared to 62.5% of married students); (2) of those students from rural areas, 78.6% considered rural areas as ideal practice sites while only 10% of students from metropolitan cities agreed; (3) of the students from rural areas (under 2,500 in population), 92.9% were attracted to medically underserved areas; (4) by background category, 89.5% of students from small towns and rural areas versus 44.4% from urban areas had considered practice in Appalachian Kentucky. A strong positive relationship exists between rural background and intention to practice in a rural area. Therefore, attention to selection of students with rural background may improve health care manpower toward service in rural underserved areas. (KS)