Rural Project Examples: Appalachia
Updated/reviewed September 2022
Need: Rural Appalachian Kentucky residents have deficits in health resources and health status, including high levels of cancer, heart disease, hypertension, asthma, and diabetes.
Intervention: Kentucky Homeplace was created as a community health worker initiative to provide health coaching, increased access to health screenings, and other services.
Results: From July 2001 to June 2022, over 182,783 rural residents were served. Preventive health strategies, screenings, educational services, and referrals are all offered at no charge to clients.
Regional Oral Health Pathway
Updated/reviewed August 2022
Need: To address the oral health needs of low-income uninsured and underinsured residents in rural Appalachia.
Intervention: An oral health education program was implemented in Appalachian Maryland, Pennsylvania, and West Virginia.
Results: This program increased oral health visits in the area and provided residents with valuable information on oral health resources and services.
Updated/reviewed November 2021
Need: To reduce overdose-related deaths among prescription opioid users in rural Wilkes County, North Carolina
Intervention: Education and tools are provided for prescribers, patients and community members to lessen drug supply and demand, and to reduce harm in prescription opioid use
Results: Opioid overdose death rates have decreased in Wilkes County
Community-Based Pulmonary Rehabilitation Program
Updated/reviewed February 2021
Need: More evidenced-based chronic lower respiratory disease management options for rural Appalachia patients, where lung disease rates are among the highest in the country.
Intervention: Implementation of outpatient pulmonary rehabilitation programs in 2 Federally Qualified Health Centers and a Critical Access Hospital in West Virginia.
Results: Improved health outcomes for patients with chronic lower respiratory disease, including those with chronic obstructive pulmonary disease.
Community Health Worker-based Chronic Care Management Program
Added May 2020
Need: Improve healthcare access and decrease chronic disease disparities in rural Appalachia.
Intervention: A community health worker-based Chronic Care Management program demonstrated such a level of success in a single West Virginia county that it was further scaled for implementation in a multi-center, 3-state area of Appalachia.
Results: When analysis of the disseminated program's results also demonstrated improved health outcomes and decreased healthcare costs, sustainability became possible due to innovative financial reimbursement models.
Appalachian Preceptorship Program
Updated/reviewed December 2019
Need: To prepare future physicians for practicing in rural southern Appalachia.
Intervention: The Appalachian Preceptorship Program offers medical students clinical preceptorships to give them experience practicing in rural, underserved communities of southern Appalachia.
Results: Students who participate in this preceptorship are more than 3 times as likely to practice medicine in a rural location.
Trinity Hospital Twin City's Fit for Life
Updated/reviewed November 2018
Need: To reduce obesity among adults in rural east central Ohio.
Intervention: Fit for Life Replication Project for Expansion was developed to make it possible to lose weight through practicing healthier lifestyle behaviors.
Results: Out of the 443 adults who have completed the program, 81% experienced weight loss, a tangible result of the program's overarching goal to enhance levels of health and fitness. Promising Examples
Healthy Smiles: Early Childhood Dental Outreach
Updated/reviewed November 2022
Need: To decrease the number of children entering kindergarten with untreated tooth decay in the rural Appalachian counties of Rutherford, Polk, and McDowell in western North Carolina.
Intervention: A program to give children a dental home that included screenings, targeted outreach, and restorative services.
Results: An overall decrease within the service area of children entering kindergarten with sub-par oral health.
Contingency Management Smoking Cessation in Appalachia
Updated/reviewed June 2022
Need: To reduce smoking rates of pregnant women and adolescents in Appalachian regions of eastern Kentucky and Ohio.
Intervention: A web-based smoking cessation program that offered monetary incentives to reducing smoking.
Results: Participants significantly reduced smoking rates or quit altogether.
Successfully Training and Educating Pre-medical Students (STEPS)
Updated/reviewed November 2021
Need: To increase the number of primary care providers in northeast Kentucky.
Intervention: STEPS provides support such as physician shadowing, mock interviews, and MCAT practice exams for regional students applying to medical school.
Results: 88% of participants have been accepted into medical school. The program has been replicated among most of Kentucky's regional AHECs.
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