Rural Project Examples Addressing Trauma-informed care

One Health Recovery Doulas

Updated/reviewed November 2024

Need: To support pregnant and parenting women with a history of substance use, mental health, or co-occurring disorders in rural areas of Montana.
Intervention: One Health, a consortium of Federally Qualified Health Centers (FQHCs), developed a team of "recovery doulas" – individuals who are dual-certified as doulas and peer-support specialists. The One Health recovery doula program offers group and individual services to women and their partners from pregnancy through the first years of parenthood.
Results: A team of nine recovery doulas (or doulas-in-training) employed by One Health offer services in 13 rural Montana counties. Recovery doulas have provided essential support to women with substance use disorder, survivors of sexual abuse, unhoused individuals, and individuals facing other complex challenges.

Updated/reviewed August 2024

Need: Before 2000, Butte and southwest Montana saw around 1,300 cases of child abuse a year, with only a 20% conviction rate for perpetrators of sexual abuse.
Intervention: Multiple agencies in the community came together to address the issue of child abuse by forming the Butte Child Evaluation Center (CEC), a Children's Advocacy Center.
Results: During a 3-year grant cycle, over 200 interviews and exams were performed on victims of sexual abuse and the Butte CEC became the first program in Montana to be accredited by the National Children's Alliance.

Updated/reviewed June 2024

Need: Clinicians in rural and underserved areas are often unprepared to provide comprehensive medical-forensic examinations for patients who present for care following a sexual assault.
Intervention: The MDPH TeleSANE Center uses secure telehealth software to connect sexual assault nurse examiners to clinicians and patients in hospitals across Massachusetts — including four in rural counties — offering expert clinical guidance and support before, during, and after examinations.
Results: Clinicians report that the service gives them increased confidence throughout the examination process. To date, the MDPH TeleSANE Center has assisted in the care of over 960 patients.

Added February 2024

Need: To support pregnant or new parents in rural Massachusetts affected by substance use or on medication for opioid use.
Intervention: This program offers a medical and behavioral health home, providing trauma-informed support before, during, and after childbirth.
Results: Six months after enrollment, there was a 20% increase in the number of participants who felt socially connected and a 5% increase in abstinence from all substances.

Updated/reviewed December 2023

Need: Agencies in Schoharie County, New York were seeing a widespread trend of Adverse Childhood Experiences (ACEs) in the children and families they served.
Intervention: The Schoharie ACEs Team was formed as a way to educate rural communities about ACEs, the associated brain science, and ways to build resiliency.
Results: The ACEs Team has put on 5 half-day educational conferences, 2 virtual conferences, and 10 trainings for various groups across the region. The team has also trained 3 school districts on trauma-informed care and provided resources for families exposed to trauma.

Updated/reviewed September 2023

Need: Improved health outcomes for Monadnock Region, a rural area of New Hampshire.
Intervention: A wide-scale effort across multiple sectors is aiming to improve health outcomes throughout the region.
Results: Community health trends have been tracked over time, and progress on goals such as increasing the number of residents with healthcare coverage, opportunities for physical activity, access to healthy foods, and smoking cessation has been made.

Added February 2023

Need: Black women living with HIV in rural southeastern Louisiana face challenges in accessing care and other needed resources, often while dealing with other life stressors such as poverty, physical and mental health comorbidities, and a history of trauma.
Intervention: Implementing three evidence-informed interventions simultaneously ensures success in linking, treating, and retaining Black women in HIV care to improve health outcomes.
Results: As of February 2023, Stepping Stones has recruited 38 participants.

Updated/reviewed August 2022

Need: Since the late 1800s, trauma caused by historic events have greatly affected the way of life for Menominee Indians living on the Menominee Reservation. Economic, socioeconomic, behavioral health, and physical health issues have risen and are causing direct implications for Menominee youth.
Intervention: Through Fostering Futures, clinic, school, and Head Start/Early Head Start staff are trained in administering trauma-informed care and building resilience among children.
Results: Behavioral health visits at the Menominee Tribal Clinic have increased, school suspension rates have decreased, and graduation rates have improved from 60% to 94% since 2008.

Updated/reviewed June 2022

Need: Improved behavioral health care offerings for a community after losing 5 senior-aged men to suicide.
Intervention: A Critical Access Hospital in Yoakum, Texas, created a community-based program focusing on inpatient and outpatient behavioral health care for area residents age 50 and older.
Results: A financially-sustainable behavioral health care delivery model demonstrating positive impacts on physical health conditions, healthcare service utilization, and high patient satisfaction rates.

Updated/reviewed November 2020

Need: Decrease rates of domestic violence, child sexual abuse, and child neglect for Alaska Native people in remote villages.
Intervention: An evidence-based model inclusive of traditional culture trains local communities on methods of prevention and treatment for domestic and interpersonal violence.
Results: Self-sustaining local system with improved family and spiritual well-being and decreased healthcare access needs.