Rural Project Examples Addressing Behavioral health

keepin' it REAL Rural

Updated/reviewed April 2025

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 July 2024

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 February 2024

Need: Increase medical management knowledge for New Mexico primary care providers in order to provide care for the thousands of rural 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 January 2023

Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.

Updated/reviewed April 2025

Need: To support parents whose children have been removed from the home so that the parents can make the changes needed for the children to return safely home.
Intervention: A statewide program in Iowa pairs these parents with mentors who have successfully navigated their own child welfare cases.
Results: Participants' children were more likely to return home than non-participants' children, and participants were less likely to have another child removal within a year of the child coming home.

Updated/reviewed April 2025

Need: To provide psychotherapy to survivors of domestic violence and sexual assault.
Intervention: University of Wyoming psychology doctoral students provide psychotherapy via videoconferencing to crisis center clients in two rural locations.
Results: Clients, student therapists, and crisis center staff were satisfied with the quality of services, and clients reported reduced symptoms of depression and PTSD.

Updated/reviewed March 2025

Need: To develop sustainable, community-wide prevention methods for cardiovascular diseases in order to change behaviors and healthcare outcomes in rural Maine.
Intervention: Local community groups and Franklin Memorial Hospital staff studied mortality and hospitalization rates for 40 years in this rural, low-income area of Farmington to seek intervention methods that could address cardiovascular diseases.
Results: A decline in cardiovascular-related mortality rates and improved prevention methods for hypertension, high cholesterol, and smoking.

Updated/reviewed March 2025

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 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 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.