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Rural Health Information Hub

Rural Project Examples: Appalachia

Effective Examples

Updated/reviewed October 2024

  • 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 2024, over 196,801 rural residents were served. Preventive health strategies, screenings, educational services, and referrals are all offered at no charge to clients.

Updated/reviewed August 2024

  • Need: Improve healthcare access and decrease chronic disease disparities in rural Appalachia.
  • Intervention: A unique community health worker-based chronic care management program, created with philanthropy support.
  • Results: After a decade of use in attending to population health needs, health outcomes, healthcare costs, in 2024, the medical condition-agnostic model has a 4-year track record of financial sustainability with recent scaling to include 31 rural counties in a 3-state area of Appalachia and recent implementation in urban areas.

Updated/reviewed May 2024

  • 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.

Updated/reviewed February 2024

  • Need: Due to West Virginia's high ranking for its use of smokeless tobacco, prevention and cessation education efforts were needed.
  • Intervention: Development and implementation of the Spit It Out-West Virginia program.
  • Results: Supported by a 2008-2010 grant allowing the program to be delivered to hundreds of people, 5 workplaces became tobacco free. The program continues to be delivered across the state and reaches hundreds with its face-to-face presentations and thousands with its specific media prevention and cessation messages.

Updated/reviewed January 2024

  • 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.
funded by the Federal Office of Rural Health Policy

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

Updated/reviewed January 2024

  • 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 courses/exams for regional students applying to medical school.
  • Results: More than 70% of participants have been accepted into medical school. The program has been replicated among most of Kentucky's regional AHECs.

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.

Other Project Examples

funded by the Health Resources Services Administration

Added March 2024

  • Need: Enhanced support for people with substance use disorders leaving jail and reentering communities in rural northeastern Kentucky.
  • Intervention: A reentry program that uses peer support specialists to teach cognitive life skills, obtain essential identification documents, and help people create and follow personalized case plans before and after their release.
  • Results: More than 420 people have been served by First Day Forward, with recidivism rates significantly lower among people who successfully completed the program.

Updated/reviewed July 2023

  • Need: School-based drug misuse prevention program in Appalachian Ohio, a need triggered by a high school student's overdose death.
  • Intervention: Implementation of the HOPE curriculum, an age-appropriate K through 12th grade drug abuse prevention program.
  • Results: No further drug overdose deaths after curriculum initiated.