Rural Project Examples Addressing Chronic respiratory conditions

Project ENABLE (Educate, Nurture, Advise, Before Life Ends)

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 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 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.

Updated/reviewed December 2022

Need: To increase access to medical screening for miners in New Mexico.
Intervention: A mobile screening clinic with telemedicine capability screens miners for respiratory and other conditions.
Results: In a survey, 92% of miners reported their care as very good, while the other 8% reported it as good. The program has expanded to three other states.

Updated/reviewed June 2022

Need: Evidenced-based intervention to improve function and quality of life for patients with chronic obstructive pulmonary disease and other chronic lower respiratory conditions.
Intervention: Pulmonary rehabilitation program implementation in 1989.
Results: Compared to a national average of only about 3% of referred Medicare beneficiaries actually enrolling in pulmonary rehabilitation, 60% of the program's referred patients enroll. Averaging around 15 patients/year completing the program, a large combined cardiac and pulmonary rehabilitation maintenance population averages 8,000 visits/year.

Updated/reviewed December 2019

Need: Organized effort targeting COPD patients' medical needs in order to prevent hospital readmission in Zanesville, Ohio.
Intervention: Creation of an integrated system model using nurse navigators that incorporates evidence-based chronic disease care management approaches to COPD care.
Results: Improved readmission rates and overall improved acute and chronic care for the area's COPD patients.