Rural Project Examples Addressing Social connectedness

SASH® (Support and Services at Home)

Updated/reviewed March 2024

Need: In Vermont, the growing population of older adults, coupled with a lack of a decentralized, home-based system of care management, poses significant challenges for those who want to remain living independently at home.
Intervention: SASH® (Support and Services at Home), based in affordable housing and their surrounding communities throughout the state, works with community partners to help older adults and people with disabilities receive the care they need so they can continue living safely at home.
Results: Compared to their non-SASH peers, SASH participants have been documented to have better health outcomes, including fewer falls, lower rates of hospitalizations, fewer emergency room visits, and lower Medicare and Medicaid expenditures.

Updated/reviewed December 2022

Need: To coordinate formal and informal community-based caregivers for optimal patient experience.
Intervention: The Maryland Faith Health Network unites places of worship and healthcare systems in Maryland. This program aims to decrease the amount of potentially avoidable hospitalizations, improve a patient's overall wellness, and cut down on the cost of medical services.
Results: This model is currently running in 3 hospitals that serve both rural and urban residents in central Maryland. So far, 1,300 congregants from 70 congregations representing Christian, Jewish, and Muslim faiths have enrolled in the Network.

Updated/reviewed April 2024

Need: To connect patients to resources in order to reduce use of emergency services, emergency department visits, and hospital readmissions.
Intervention: Patients receive support (by in-person visit, phone call, or telehealth visit) from a paramedic, community health nurse, peer recovery specialist, and pharmacist.
Results: Between July 2016 and March 2024, the program made 1,098 patient contacts and continued to see a reduction in emergency department and inpatient visits and costs.

Updated/reviewed January 2024

Need: To connect underserved and isolated older adults in rural Minnesota, Montana, North Dakota, and South Dakota to services and supports so they can age in place.
Intervention: The Rural Aging Action Network is a collaborative of organizations that offer different services like caregiver support, behavioral health, financial counseling, and assistance with chores and household maintenance.
Results: Since 2015, the collaborative has reached over 4,000 older adults and caregivers in over 100 rural communities.

Updated/reviewed January 2024

Need: To connect vulnerable populations in Allegany County, Maryland, to health and human services and to items like hygiene products, food, and clothing.
Intervention: The Possibility Shop partners with health organizations, insurance navigators, food banks, and other agencies.
Results: In 2023, 8,684 service encounters occurred and 501 intakes to services were performed.

Updated/reviewed November 2023

Need: Mental health assessment and referral to resources for men in rural Michigan who struggle with depression and suicidal thoughts.
Intervention: The Healthy Men Michigan campaign was a research study testing online screening for depression, including irritability and anger, and suicide risk in working-aged men. The Healthy Men Michigan campaign website also provided referrals to local and national resources specific to men's mental health and suicide prevention.
Results: More than 5,000 individuals completed anonymous online screenings and 550 men enrolled in the study. Healthy Men Michigan secured partnerships with over 225 individual and organizational partners, including healthcare facilities, small businesses, and recreational groups across the state. Together, their efforts have helped to promote screenings, reduce stigma, and encourage help-seeking behavior to prevent suicide.

Updated/reviewed September 2022

Need: Suicide rates among white males age 65 and older have been rising in North Carolina. Challenges include losing friends, illnesses, and the loss of independence – all of which can lead to isolation and depression.
Intervention: The Chatham County Council on Aging of North Carolina started Geezers, Gulpers, and Gardeners (3G Group) to connect retired men in need of male friends and mutual support.
Results: Men in similar stages of life and varying backgrounds are forming friendships, engaging in activities, and taking care of their mental health.