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Rural Health Initiative

  • Need: Preventive and chronic medical condition care for farm families/agribusiness owners/employees with time and monetary constraints.
  • Intervention: Through a "Kitchen Wellness" program, a trained healthcare professional provides in-home or on-site complimentary preventive health screening, educational materials, and community referral information.
  • Results: Completion of hundreds of health screenings, tailored health education sessions along with referral information.


Rural Health Initiative logo Established in 2004, the Rural Health Initiative (RHI) is a nonprofit, community-supported program designed to help remove the barriers of understanding and managing health and healthcare for the agricultural community. Through its unique concept of "Kitchen Wellness", wellness services and health information are offered in rural homes or businesses.

Services are free for adults in the agriculture community, including crop and dairy farmers, other agribusinesses, as well as individuals and employees associated with agricultural enterprises, such as hoof trimmers. Kitchen Wellness also reaches the Amish community and Hispanic workers.

Assisting residents of Wisconsin's Shawano, Outagamie, and Waupaca counties, the program is delivered by trained Outreach Health Coordinators. These professionals come to homes or businesses and conduct complimentary on-site preventive health screenings. Key challenges this program addresses include:

Key challenges this program addresses include:

  • Culture of Farming
    Farmers are known to be selfless people, which often means their health comes second to the health of their animals. RHI is a trusted ear and resource for farmers.
  • Delivery Model
    Members of agriculture, primarily farmers, are accustomed to a delivery model that comes to the farm. However, society's current healthcare delivery model is opposite. This contributes to lower attendance rates within the healthcare system, usually only during emergencies. RHI's on-site outreach delivery model of helps connect farmers with basic health screening services.
  • High Deductibles
    Most farmers carry independent insurance, often with high(er) deductibles. RHI's complimentary services remove the barrier of cost.
  • Health Literacy
    Medical terminology can often be confusing to people. RHI's health coaching helps remove this barrier by explaining health information in simple and easy-to-understand terms.

RHI, a 501(c)3, is an effort supported by private and public agencies.

Services offered

  • Preventive Screenings:
    Blood pressure measurements, height/weight measurements to calculate body mass index (BMI). Glucose and cholesterol screening using minimal blood from a finger prick, allowing results in 10 minutes.
  • Health Coaching:
    Education geared to abnormal test results or any topic of interest; life-style optimization, including health goal-setting; prevention information, screening, and any desired health needs.
  • Referral information:
    Referrals to community agencies that might assist in reaching health goals, or for healthcare system information; in addition to counseling and networking services, financial planning, and agricultural assistance programs
  • Health Risk Assessments (HRA)
  • Personalized Follow-Up Packet:
    Based on test results and HRA results, a customized education packet is provided 2-3 weeks after personalized visit
RHI Table


For Shawano County, 2012:

  • 40% (about 325 farm families) used program services
  • 200 farm site visits
  • 400-500 health screenings
  • 97% physician follow-up when referral given
  • 58% visits detected an acute condition.

At 9 large dairies, 105 Hispanic workers received health screenings.

For Shawano, Outagamie, and Waupaca counties, 2016:

  • 100 new participants
  • 548 farm site visits
  • 339 health screenings are performed, 120 Spanish-speaking only
  • 274 individuals received health risk education and set goals; 326 received resources or referrals to live a healthier life
  • 52% of screenings detected an acute condition.

These screenings allowed farmers to seek treatment for conditions such as diabetes, heart disease, or depression.

To learn about how the Rural Health Initiative is impacting county farm families, see the Fall 2012 National Rural Health Association Rural Roads article Farm Calls (pages 6-7, 9).


Sustainability is a barrier for new and existing programs. The Rural Health Initiative is a nonprofit organization and must compete with many other nonprofits competing for funding.

RHI Community


The program originated in 2004 in Shawano County and in 2012, expanded to Outagamie and Waupaca counties. To read about RHI's expansion to other counties, refer to this ThedaCare article.

Program coordinators recommend finding a healthcare professional with a passion for agriculture and those working in/associated with agriculture. Additionally, individuals from communities served are seen as the local experts and often are more easily approached for healthcare solutions.

The program website contains an RHI News page, with webcasts, radio interviews, television appearances, annual reports, and press releases, as well as articles published about the initiative. The Resources page provides additional information on farm health, safety, and health insurance, among other topics.

RHI Worksite

Contact Information

Rhonda Strebel, Executive Director
Corporate Office (inside ThedaCare Physicians – Shawano)
Rural Health Initiative

Cultural competency
Farmers and farmworkers
Health screening
Hispanics and Latinos
Wellness, health promotion, and disease prevention

States served

Date added
November 25, 2014

Date updated or reviewed
December 13, 2017

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.