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Rural Project Examples: American Indians, Alaska Natives, and Native Hawaiians

Effective Examples

Care for Our Elders/Wakanki Ewastepikte
Updated/reviewed June 2019
  • Need: To provide Lakota elders with tools and opportunities for advance care planning.
  • Intervention: An outreach program in South Dakota helps Lakota elders with advance care planning and wills by providing bilingual brochures and advance directive coaches.
  • Results: Care for Our Elders saw an increase in the number of Lakota elders understanding the differences between a will and a living will and the need to have end-of-life discussions with family and healthcare providers.

Promising Examples

funded by the Federal Office of Rural Health Policy 4P's Plus Pregnancy Support Project
Updated/reviewed December 2017
  • Need: Pregnancy support services for Native American women struggling with substance use.
  • Intervention: An integrated behavioral health network implemented in Lake County, California.
  • Results: Fewer Native American babies exposed to alcohol, tobacco, and other drugs.

Other Project Examples

Portable Alternative Sanitation System (PASS)
Updated/reviewed November 2019
  • Need: To bring a low-cost water and sanitation system to an Alaska Native village with no running water or sewer system.
  • Intervention: The Portable Alternative Sanitation System (PASS) collects and treats water and disposes waste without traditional piping.
  • Results: Residents in the pilot project reported that PASS was cleaner and healthier than the self-haul method.
Tobacco Use Prevention and Control (TUPAC) Program
Added October 2019
  • Need: To reduce non-ceremonial use of tobacco among American Indians in New Mexico.
  • Intervention: TUPAC provides outreach, community programs, and cessation services.
  • Results: 139 people have received cessation services so far, and 7 rural communities received an award to work on cigarette/e-cigarette policy changes.
Frontier Area Rural Mental Health Camp and Mentorship Program (FARM CAMP)
Updated/reviewed August 2019
  • Need: To reduce the shortage of behavioral health professionals in rural Nebraska.
  • Intervention: A week-long camp teaches high school students in rural and tribal communities about different career options in behavioral health and provides mentorship after the camp ends.
  • Results: In 2019, 13 high school students participated in the camp, with six alumni returning. Eight students attended the camps in 2018, with four alumni returning. Many camp participants talk about their positive experiences with younger students.
Mobile Women's Health Unit
Updated/reviewed July 2019
  • Need: Because breast cancer is a leading cause of cancer death for American Indian and Alaska Native (AI/AN) women, access to screening mammograms for those women living in remote areas is needed.
  • Intervention: The Great Plains Area Indian Health Service Mobile Women's Health Unit provided mammograms to women on multiple reservations across four states.
  • Results: Approximately 1,000 women were screened annually for breast cancer by the mobile unit.
funded by the Federal Office of Rural Health Policy Facing Diabetes: Quality Improvement in Rural South Dakota Project
Updated/reviewed June 2019
  • Need: To help adults and children in rural South Dakota prevent or manage their diabetes.
  • Intervention: The Facing Diabetes Project offers medical visits for adults and provides prevention and education sessions for the local 4th and 5th graders.
  • Results: Many adults and children in the region feel better equipped to choose healthy foods, exercise regularly, and manage their stress: all factors that can help prevent diabetes or decrease its effects.
Seneca Strong's Certified Recovery Peer Advocates
Added June 2019
  • Need: Like many Native American populations, the Seneca Nation of Indians has experienced disproportionate rates of opioid, alcohol, and substance misuse.
  • Intervention: The Seneca Nation Government and Executives founded Seneca Strong, a cultural recovery peer advocate program, to try to reduce substance misuse across the Nation.
  • Results: Since the start of the program, 300 people have received help from recovery peer advocates. Seneca Strong has since extended to meet the needs of Allegany and Cattaraugus territories.
funded by the Federal Office of Rural Health Policy Delta Dental/Head Start Early Childhood Caries Prevention Project
Added May 2019
  • Need: To provide dental care to Head Start children on South Dakota reservations.
  • Intervention: The Early Childhood Caries (ECC) Prevention Project brings dental hygienists to tribal Head Start programs to provide dental care to children and oral health education to parents.
  • Results: In three years, 1,133 children and their parents completed an ECC visit. An additional 2,780 children received preventive care.
KÅ«lana Hawai'i Weight Management Program
Updated/reviewed May 2019
  • Need: To improve the health status and overall well-being of Native Hawaiians and other medically underserved populations in rural areas of Hawaii.
  • Intervention: A comprehensive weight management program is led by an integrated team of health professionals who work with participants on making sustainable, lifelong changes.
  • Results: Patients reported statistically significant reductions in weight, BMI, blood pressure, and chronic disease and pain, along with increased physical activity and health knowledge.