National and Multi-State Rural Project Examples

Updated/reviewed March 2024

Need: A drug and alcohol prevention program for middle school students that is specific to rural culture.
Intervention: An adaptation of the evidence-based keepin' it REAL curriculum was customized for rural middle school students.
Results: Students showed a reduction in all substance use and less personal acceptability of substance use.

Updated/reviewed February 2024

Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural and underserved patients with hepatitis C, a chronic, complex condition that has high personal and public health costs when left untreated.
Intervention: Project leveraging an audiovisual platform to accomplish "moving knowledge, not patients" that used a "knowledge network learning loop" of disease-specific consultants and rural healthcare teams learning from each other and learning by providing direct patient care.
Results: In 18 months, the urban specialist appointment wait list decreased from 8 months to 2 weeks due to Hepatitis C patients receiving care from the project's participating primary care providers. Improved disease outcomes were demonstrated along with cost savings, including those associated with travel. The project model, now known as Project ECHO® – Extension for Community Healthcare Outcomes — has evolved into a telementoring model used world-wide.

Updated/reviewed February 2024

Need: To enhance palliative care access to rural patients with advanced cancer or heart failure and their family caregivers.
Intervention: Project ENABLE consists of: 1) an initial in-person palliative care consultation with a specialty-trained provider and 2) a semi-structured series of weekly, phone-delivered, nurse-led or palliative care coach/navigator sessions designed to help patients and their caregivers enhance their problem-solving, symptom management, and coping skills.
Results: Patients and caregivers report higher quality of life and lower rates of depression and (caregiver) burden.

Updated/reviewed September 2023

Need: To help people with chronic conditions learn how to manage their health.
Intervention: A small-group 6-week workshop for individuals with chronic conditions to learn skills and strategies to manage their health.
Results: Participants have better health and quality of life, including reduction in pain, fatigue, and depression.

Updated/reviewed July 2023

Need: Rural areas face challenges in access to mental health services, including shortages of mental health providers.
Intervention: This 8-hour course trains rural community members to recognize mental health and substance use issues and learn how to help someone who is developing a mental health concern or experiencing a mental health crisis.
Results: Numerous studies of this method have found that course participants are better able and more likely to help others regarding mental health issues.

Updated/reviewed July 2023

Need: Population-based rates of adult vaccinations and cancer screenings are low. Delivery rates are lower still in low-income and minority communities.
Intervention: SPARC was established to develop and test new community-wide strategies to increase the delivery of clinical preventive services.
Results: Across the United States in both rural and urban communities, SPARC programs, which broaden the delivery of potentially life-saving preventive services, have been successfully launched, improving residents' health.

Updated/reviewed July 2023

Need: Few older adults, particularly women and those in rural areas, participate in healthy living interventions.
Intervention: Health educators lead community-based healthy living classes, which include strength training, aerobic exercise, dietary skill building, and/or civic engagement, depending on the program.
Results: StrongPeople™ programs have been shown to improve weight, diet, physical activity, strength, cardiovascular health profile, physical function, pain, depression, and/or self-confidence in midlife and older adults.

Updated/reviewed August 2020

Need: Osteoarthritis is a chronic condition which often causes multiple related disabilities in older adults.
Intervention: An 8-week physical activity, behavior change, and falls prevention program geared to older adults with osteoarthritis.
Results: Participants gained confidence with increased exercise, lessened stiffness, improved joint pain and improved lower extremity strength and mobility.

Updated/reviewed March 2024

Need: To increase access to telemental health services for rural veterans, especially women, with a history of trauma.
Intervention: STAIR (Skills Training in Affective and Interpersonal Regulation) is a 10-week program designed to reduce PTSD and depression symptoms and increase emotional regulation and social functioning in clients.
Results: Therapists reported that clients attended more sessions when offered via teleconferencing, and clients reported satisfaction with the program.

Added October 2023

Need: To recruit and train medical students who are committed to choosing rural practice.
Intervention: An add-on curriculum that includes seminars, field trips, and clinical rotations in rural and underserved areas.
Results: 436 students have graduated from the RMED program between 1997 and 2023, with 65% of program graduates practicing in towns of less than 50,000 people.

Rural Project Examples: National and Multi-State