Skip to main content

Rural Project Examples: Appalachia

Effective Examples

funded by the Federal Office of Rural Health Policy Regional Oral Health Pathway
Updated/reviewed November 2020
  • 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 has increased oral health visits in the area and has provided residents with valuable information on oral health resources and services.
Kentucky Homeplace
Updated/reviewed June 2020
  • 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 address the lifestyle choices, inadequate health insurance, and environmental factors that are believed to contribute to these diseases.
  • Results: From July 2001 to June 2019, over 166,464 rural residents were served. Preventive health strategies, screenings, educational services, and referrals are all offered at no charge to clients.
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.
Community-Based Pulmonary Rehabilitation Program
Updated/reviewed January 2020
  • 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.
funded by the Health Resources Services Administration Appalachian Preceptorship Program
Updated/reviewed December 2019
  • Need: To prepare future physicians for practicing in rural southern Appalachia.
  • Intervention: The Appalachian Preceptorship Program offers medical students clinical preceptorships to give them experience practicing in rural, underserved communities of southern Appalachia.
  • Results: Students who participate in this preceptorship are more than 3 times as likely to practice medicine in a rural location.
funded by the Federal Office of Rural Health Policy Trinity Hospital Twin City's Fit for Life
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.
Project Lazarus
Updated/reviewed January 2018
  • 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

Promising Examples

funded by the Federal Office of Rural Health Policy Healthy Smiles: Early Childhood Dental Outreach
Updated/reviewed November 2020
  • Need: To decrease the number of children entering kindergarten with untreated tooth decay in the rural Appalachian counties of Rutherford, Polk, and McDowell in western North Carolina.
  • Intervention: A program to give children a dental home that included screenings, targeted outreach, and restorative services.
  • Results: An overall decrease within the service area of children entering kindergarten with sub-par oral health.
Successfully Training and Educating Pre-medical Students (STEPS)
Updated/reviewed November 2020
  • 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 exams for regional students applying to medical school.
  • Results: Approximately 70% of participants have been accepted into medical school. The program has been replicated among all of Kentucky's regional AHECs.
Closing Preventive Care Gaps in Underserved Areas
Updated/reviewed June 2020
  • Need: Address the need to increase cancer screening rates as well as other preventive care measures in Appalachian Kentucky, a region with high cancer incidence and mortality rates, and noted health disparities.
  • Intervention: Federally Qualified Health Centers (FQHCs) and an academic center partnered to adapt and implement an office-based intervention, building on existing primary care resources to decrease gaps in preventive care measures, including cancer screenings.
  • Results: After intervention implementation, White House Clinics saw a marked increase in various preventive care measures, including screenings for cancer, human immunodeficiency virus and hepatitis C.