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Rural Health Information Hub

Formerly the
Rural Assistance Center

Rural Project Examples: Substance abuse

Evidence-Based Examples

Helping Kids PROSPER
Updated/reviewed January 2017
  • Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
  • Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
  • Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.
Project ECHO® – Extension for Community Healthcare Outcomes
Updated/reviewed June 2015
  • Need: To increase the capacity for more effective treatment of chronic conditions in rural communities.
  • Intervention: Primary care providers and specialists work as a team to manage chronic conditions of rural patients and to increase the knowledge base through shared case studies.
  • Results: The treatment provided by rural providers has been evaluated to be as effective as treatment provided by specialists at the university medical center.

Effective Examples

Strong African American Families-Teen (SAAF-T)
Updated/reviewed April 2017
  • Need: There is a lack of interventions that addresses teenager behavioral problems, particularly for rural African American adolescents.
  • Intervention: Rural, locally trained leaders administered five 2-hour meetings for teenagers and their primary caregivers. Trainings focused on reducing risks that prevent positive development, specifically sexual risk-taking that can lead to HIV and other STIs.
  • Results: Teens reported reduced conduct problems, depressive symptoms, and substance abuse. Families were strengthened, and SAAF-T reduced unprotected intercourse and increased condom efficacy.
keepin’ it REAL Rural
Updated/reviewed March 2017
  • Need: A drug and alcohol prevention program for middle school kids that is specific to rural culture in Pennsylvania and Ohio.
  • Intervention: An adaptation of the evidence-based keepin' it REAL curriculum was customized for rural middle school students.
  • Results: Students showed a reduction in all substance use and less personal acceptability of substance use.
Midcoast Maine Prescription Opioid Reduction Program
Updated/reviewed March 2017
  • Need: Reduction in the number of emergency department dental patients abusing opioid prescriptions in rural southeastern Maine.
  • Intervention: Using a one-page opioid prescription guideline, opioid prescribing and emergency room visits for dental pain decreased.
  • Results: The rate of opioid prescription dropped nearly 20% after implementation, and in comparing the 12-month period before and after implementation, dental pain emergency department visits decreased from 26 to 21 per 1,000.
funded by the Federal Office of Rural Health Policy Madison Outreach and Services through Telehealth (MOST) Network
Updated/reviewed November 2016
  • Need: More mental health and substance abuse prevention and treatment services in rural Texas.
  • Intervention: A network was formed to bring counseling services through telehealth systems and community health workers to Brazos Valley, Texas.
  • Results: The program improved health outcomes, increased general knowledge of the impact of substance abuse, and raised awareness of services among Hispanic residents.
Project Lazarus
Added December 2015
  • 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
Franklin Cardiovascular Health Program (FCHP)
Added March 2015
  • Need: To develop sustainable, community-wide prevention methods for cardiovascular diseases in order to change behaviors and healthcare outcomes in rural Maine.
  • Intervention: Local community groups in Farmington, Maine, along with staff at the Franklin Memorial Hospital, studied mortality and hospitalization rates for 40 years in this rural, low-income area to seek intervention methods that could address cardiovascular diseases.
  • Results: A decline in cardiovascular-related mortality rates and improved prevention methods for hypertension, high cholesterol, and smoking.

Promising Examples

Communities that Care (CTC) Coalition
Updated/reviewed May 2017
  • Need: A way to address substance abuse among teenagers in Massachusetts's predominately rural areas of Franklin County and the North Quabbin Region.
  • Intervention: A community-based prevention initiative was formed to reduce youth violence, delinquency, and alcohol and tobacco use.
  • Results: CTC has seen significant reductions in substance abuse among local youth in the 30 rural towns they serve.
funded by the Federal Office of Rural Health Policy Healthy Outcomes Integration Team (HOIT)
Updated/reviewed November 2016
  • Need: To provide integrated treatment planning and coordinated healthcare services to rural residents.
  • Intervention: This program was designed to treat adults who have a serious mental health condition and those who have, or are at risk of developing, chronic health conditions.
  • Results: Thus far, 84 clients have received integrated health and mental health services.