Identify Evidence-Based and Promising Program Models

When developing a rural community health program, it is important to review the evidence base related to the program topic. There is a spectrum of evidence that may support a program — from scientific literature in journals and public health surveillance data (objective) to qualitative data, word of mouth, and personal experience (subjective). Community health programs may be evidence-based, effective, promising, or emerging:

Evidence-based programs – Published in systematic reviews, syntheses, or meta-analyses whose authors have conducted a structured review of published high-quality, peer-reviewed studies and evaluation reports. Evidence-based strategies produce significant, positive health or behavioral outcomes and/or intermediate policy, environmental, or economic impacts.
Effective programs – Published in high-quality, peer-reviewed studies and have produced significant positive health or behavioral outcomes, and policy, environment, or economic impacts.
Promising programs – Based on exploratory evaluations that show potentially meaningful health or behavioral outcomes, and policy, environment, or economic impacts. They have strong qualitative or quantitative data supporting positive outcomes but are not yet generalizable to public health outcomes.
Emerging programs – Based on guidelines, protocols, or standards that may be in the process of being evaluated by researchers to measure their positive impact on public health. Emerging practices are new, and there is not enough information to determine effectiveness. Several guides contain information about evidence-based and promising programs that may be appropriate for rural communities. These guides, and their strengths and limitations, are discussed next.

It is important to note that not all evidence-based practices have been tailored to rural implementation settings. Rural program planners may need to consider adapting programs to rural contexts and community member priorities. The following section discusses Considerations When Adapting a Program.

Examples of Databases that Review the Evidence

The Community Guide
Practice Type: Evidence-based
Developed by the Community Preventive Services Task Force, through the Centers for Disease Control and Prevention (CDC). This group researches community, population, and health care system programs and policies to address a variety of public health and health promotion topics and evaluates the best models. It uses systematic reviews to answer questions about:

Which program and policy interventions have been proven effective?
Are there effective interventions that are right for my community?
What might effective interventions cost; what is the likely return on investment?

Strengths:

Rigorous standards of evidence are applied

Limitations:

Few effective interventions are highlighted (many have insufficient evidence)
Interventions designated as Recommended or Likely Effective may be cost-prohibitive to implement

Healthy People 2030 Evidence-Based Resource Database
Practice Type: Evidence-based, Effective
A searchable database of research on evidence-based programs and effective practices.

Strengths:

Wide range of topics relating to Healthy People 2030 goals
Resources given a rating for strength of evidence

Limitations:

Reliance on published literature may leave out newer programs with less rigorous evaluations

What Works for Health
Practice Type: Evidence-based, Effective, Promising, Emerging
A database of policies and programs that can improve health on a range of topics, including health behaviors, clinical care, social and economic factors, and physical environment. It reviews and summarizes findings from numerous sources. It also notes who the decision-maker would be for each.

Strengths:

Provides information on evidence of effectiveness, population reach, effect on health disparities, implementation, and other key information for each included policy and program

Limitations:

Addresses the effectiveness of policies and programs on health factors, not on the program’s effect on health

Compendium of Evidence-Based Interventions and Best Practices for HIV Prevention
Practice Type: Evidence-based
The National Center for HIV, STD, and TB Prevention, Division of HIV/AIDS Prevention at CDC developed this Compendium to organize science-based interventions that prevent HIV transmission. The Compendium is regularly updated as new evidence-based interventions and best practices are identified. Focuses specifically on interventions related to risk reduction, medication adherence, and HIV care.

Strengths:

Well-organized to clearly explain the population of interest, intervention effects, and the evidence base for the intervention
Provides information on considerations for others implementing the intervention
Some include contact information to access intervention packets for resources from the intervention

Limitations:

Not necessarily tailored to rural communities

Additional Resources

There are also many state agencies, federal agencies, and foundations that have compiled lists of successful, evidence-based models for programs on a variety of issues. These resources can help rural communities identify a model that works for their health program. For a list of additional resources, see Other Collections of Program Examples in the Rural Health Models & Innovations section.

Evidence-Based Practice
Website
Offers evidence-based resources on child well-being to address the needs of children and encourage healthy development.
Organization(s): Annie E. Casey Foundation

Evidence-Based Practices, Programs, and Resources
Website
An annotated list of evidence-based federal programs, practices, and resources to help improve health and prevent disease.
Organization(s): National Institutes of Health, Office of Disease Prevention

Rural Primary Care, Research, Education, and Practice (PREP): Resource Library
Website
Provides an annotated list of resources on community engagement and research in rural health and primary care with a focus on evidence-based practices in the preparation, recruitment, and retention of rural primary care practitioners.
Organization(s): WWAMI Rural Health Research Center