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Rural Health Information Hub

Rural Project Examples: Appalachia

Effective Examples

Community-Based Pulmonary Rehabilitation Program

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.

Kentucky Homeplace

Updated/reviewed October 2023

  • Need: Rural Appalachian Kentucky residents have deficits in health resources and health status, including high levels of cancer, heart disease, hypertension, asthma, and diabetes.
  • Intervention: Kentucky Homeplace was created as a community health worker initiative to provide health coaching, increased access to health screenings, and other services.
  • Results: From July 2001 to June 2023, over 189,338 rural residents were served. Preventive health strategies, screenings, educational services, and referrals are all offered at no charge to clients.

Regional Oral Health Pathway

funded by the Federal Office of Rural Health Policy

Updated/reviewed August 2023

  • Need: To address the oral health needs of low-income uninsured and underinsured residents in rural Appalachia.
  • Intervention: An oral health education program was implemented in Appalachian Maryland, Pennsylvania, and West Virginia.
  • Results: This program increased oral health visits in the area and provided residents with valuable information on oral health resources and services.

Project Lazarus

Updated/reviewed November 2021

  • 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

Community Health Worker-based Chronic Care Management Program

Added May 2020

  • Need: Improve healthcare access and decrease chronic disease disparities in rural Appalachia.
  • Intervention: A community health worker-based Chronic Care Management program demonstrated such a level of success in a single West Virginia county that it was further scaled for implementation in a multi-center, 3-state area of Appalachia.
  • Results: When analysis of the disseminated program's results also demonstrated improved health outcomes and decreased healthcare costs, sustainability became possible due to innovative financial reimbursement models.

Trinity Hospital Twin City's Fit for Life

funded by the Federal Office of Rural Health Policy

Updated/reviewed November 2018

  • Need: To reduce obesity among adults in rural east central Ohio.
  • Intervention: Fit for Life Replication Project for Expansion was developed to make it possible to lose weight through practicing healthier lifestyle behaviors.
  • Results: Out of the 443 adults who have completed the program, 81% experienced weight loss, a tangible result of the program's overarching goal to enhance levels of health and fitness.

Promising Examples

Successfully Training and Educating Pre-medical Students (STEPS)

Updated/reviewed January 2024

  • Need: To increase the number of primary care providers in northeast Kentucky.
  • Intervention: STEPS provides support such as physician shadowing, mock interviews, and MCAT practice courses/exams for regional students applying to medical school.
  • Results: More than 70% of participants have been accepted into medical school. The program has been replicated among most of Kentucky's regional AHECs.

Contingency Management Smoking Cessation in Appalachia

Updated/reviewed June 2022

  • Need: To reduce smoking rates of pregnant women and adolescents in Appalachian regions of eastern Kentucky and Ohio.
  • Intervention: A web-based smoking cessation program that offered monetary incentives to reducing smoking.
  • Results: Participants significantly reduced smoking rates or quit altogether.

Other Project Examples

First Day Forward

funded by the Health Resources Services Administration

Added March 2024

  • Need: Enhanced support for people with substance use disorders leaving jail and reentering communities in rural northeastern Kentucky.
  • Intervention: A reentry program that uses peer support specialists to teach cognitive life skills, obtain essential identification documents, and help people create and follow personalized case plans before and after their release.
  • Results: More than 420 people have been served by First Day Forward, with recidivism rates significantly lower among people who successfully completed the program.

Spit It Out-West Virginia

Updated/reviewed February 2024

  • 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.