Rural Project Examples: Appalachia
Effective Examples
Kentucky Homeplace
Updated/reviewed September 2022
Updated/reviewed September 2022
- 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 2022, over 182,783 rural residents were served. Preventive health strategies, screenings, educational services, and referrals are all offered at no charge to clients.

Updated/reviewed August 2022
- 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.

Updated/reviewed November 2022
- 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.
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.

Updated/reviewed January 2021
- Need: Healthcare access in Central Appalachia for the medically underserved challenged by social and economic determinants of health, including transportation barriers, food insecurity, poverty, and lack of health insurance.
- Intervention: Three mobile clinics and 2 stationary clinics provide free health care for people in 16 counties in Virginia, Kentucky, and Tennessee.
- Results: By leveraging technology and meeting patients where they are, Health Wagon provided comprehensive healthcare services — including specialty care — to 5,500 patients during 16,000 visit encounters in 2020.
For examples from other sources, see: