Identify Evidence-Based and Promising Program Models

When developing a rural community health program, it is important to review the evidence base related to the program topic. There is a spectrum of evidence that may support a program — from scientific literature in journals and public health surveillance data (objective) to qualitative data, word of mouth, and personal experience (subjective). Community health programs may be evidence-based, effective, promising, or emerging:

Evidence-based programs – Published in systematic reviews, syntheses, or meta-analyses whose authors have conducted a structured review of published high-quality, peer-reviewed studies and evaluation reports. Evidence-based strategies produce significant, positive health or behavioral outcomes and/or intermediate policy, environmental, or economic impacts.
Effective programs – Published in high-quality, peer-reviewed studies and have produced significant positive health or behavioral outcomes, and policy, environment, or economic impacts.
Promising programs – Based on exploratory evaluations that show potentially meaningful health or behavioral outcomes, and policy, environment, or economic impacts. They have strong qualitative or quantitative data supporting positive outcomes but are not yet generalizable to public health outcomes.
Emerging programs – Based on guidelines, protocols, or standards that may be in the process of being evaluated by researchers to measure their positive impact on public health. Emerging practices are new, and there is not enough information to determine effectiveness. Several guides contain information about evidence-based and promising programs that may be appropriate for rural communities. These guides, and their strengths and limitations, are discussed next.

It is important to note that not all evidence-based practices have been tailored to rural implementation settings. Rural program planners may need to consider adapting programs to rural contexts and community member priorities.

Examples of Databases that Review the Evidence

The Community Guide
Practice Type: Evidence-based
Developed by the Community Preventive Services Task Force, through the Centers for Disease Control and Prevention (CDC). This group researches programs and policies to address a variety of public health and health promotion topics and evaluates the best models. It uses systematic reviews to answer questions about:

Which program and policy interventions have been proven effective?
Are there effective interventions that are right for my community?
What might effective interventions cost; what is the likely return on investment?

Strengths:

Rigorous standards of evidence are applied

Limitations:

Few effective interventions are highlighted (many have insufficient evidence)
Interventions designated as Recommended or Likely Effective may be cost-prohibitive to implement

Healthy People 2030 Evidence-Based Resource Database
Practice Type: Evidence-based, Effective
A searchable database of research on evidence-based programs and effective practices.

Strengths:

Wide range of topics relating to Healthy People 2030 goals
Resources given a rating for strength of evidence

Limitations:

Reliance on published literature may leave out newer programs with less rigorous evaluations

Additional Resources

Many state agencies, federal agencies, and foundations have compiled lists of successful, evidence-based models for programs on a variety of issues. These resources can help rural communities identify a model that works for their health program. For a list of additional resources, see Other Collections of Program Examples in the Rural Health Models & Innovations section.

Resources to Learn More

Evidence-Based Practices, Programs, and Resources
Website
An annotated list of evidence-based federal programs, practices, and resources to help improve health and prevent disease.
Organization(s): National Institutes of Health, Office of Disease Prevention