Rural Project Examples: Appalachia
Effective Examples
Kentucky Homeplace
Updated/reviewed October 2023
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.

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
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-Based Pulmonary Rehabilitation Program
Updated/reviewed February 2021
Updated/reviewed February 2021
- 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.
Community Health Worker-based Chronic Care Management Program
Added May 2020
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.

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 December 2022
Updated/reviewed December 2022
- 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
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
School-Based Drug Misuse Prevention Program
Updated/reviewed July 2023
Updated/reviewed July 2023
- Need: School-based drug misuse prevention program in Appalachian Ohio, a need triggered by a high school student's overdose death.
- Intervention: Implementation of the HOPE curriculum, an age-appropriate K through 12th grade drug abuse prevention program.
- Results: No further drug overdose deaths after curriculum initiated.

Updated/reviewed May 2023
- Need: To address the needs of pregnant women who are using substances and infants born into drug-positive families.
- Intervention: The Mothers and Infants Sober Together (MIST) program assisted mothers who used substances get treatment and provide a safe, drug-free home for themselves and their newborn.
- Results: MIST has helped mothers find treatment and education and has helped children grow up in safe and healthy homes.
For examples from other sources, see: