Rural Project Examples: Cardiovascular disease
Evidence-Based Examples
Project ENABLE (Educate, Nurture, Advise, Before Life Ends)
Updated/reviewed December 2022
Updated/reviewed December 2022
- Need: To enhance palliative care access to rural patients with advanced cancer or heart failure and their family caregivers.
- Intervention: Project ENABLE consists of: 1) an initial in-person palliative care consultation with a specialty-trained provider and 2) a semi-structured series of weekly, phone-delivered, nurse-led coaching sessions designed to help patients and their caregivers enhance their problem-solving, symptom management, and coping skills.
- Results: Patients and caregivers report higher quality of life and lower rates of depression and (caregiver) burden.
StrongPeopleâ„¢ Program
Updated/reviewed July 2022
Updated/reviewed July 2022
- Need: Few older adults, particularly women and those in rural areas, participate in healthy living interventions.
- Intervention: Health educators lead community-based healthy living classes, which include strength training, aerobic exercise, dietary skill building, and/or civic engagement, depending on the program.
- Results: StrongPeopleâ„¢ programs have been shown to improve weight, diet, physical activity, strength, cardiovascular health profile, physical function, pain, depression, and/or self-confidence in midlife and older adults.
Chronic Disease Self-Management Program
Updated/reviewed December 2019
Updated/reviewed December 2019
- Need: To help people with chronic conditions learn how to manage their health.
- Intervention: A small-group 6-week workshop for individuals with chronic conditions to learn skills and strategies to manage their health.
- Results: Participants have better health and quality of life, including reduction in pain, fatigue, and depression.
Effective Examples
Franklin Cardiovascular Health Program (FCHP)
Updated/reviewed February 2023
Updated/reviewed February 2023
- Need: To develop sustainable, community-wide prevention methods for cardiovascular diseases in order to change behaviors and healthcare outcomes in rural Maine.
- Intervention: Local community groups and Franklin Memorial Hospital staff studied mortality and hospitalization rates for 40 years in this rural, low-income area of Farmington to seek intervention methods that could address cardiovascular diseases.
- Results: A decline in cardiovascular-related mortality rates and improved prevention methods for hypertension, high cholesterol, and smoking.
Montana "Team Up. Pressure Down." Blood Pressure Medication Adherence Project
Updated/reviewed November 2022
Updated/reviewed November 2022
- Need: To help rural Montana patients manage their blood pressure levels.
- Intervention: Pharmacists distributed "Team Up. Pressure Down." materials from the Million Hearts Initiative and provided consultations.
- Results: 89% of patients were able to adhere to their blood pressure medication, compared to 73% before the intervention.
Heart Healthy Lenoir
Updated/reviewed October 2022
Updated/reviewed October 2022
- Need: In rural eastern North Carolina, Lenoir County residents experience significantly higher rates of cardiovascular disease, stroke, and obesity rates compared to other parts of the state and nation.
- Intervention: A community-based research project was designed to develop and test better ways to tackle cardiovascular disease, from prevention to treatment.
- Results: The end goal includes the development of long-lasting strategies and approaches within the community to help decrease the risk and disparities in risk of cardiovascular disease.
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.
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 December 2019
- Need: A cost-effective approach to help rural patients with hypertension learn to manage their condition.
- Intervention: Community volunteers trained as health coaches provided an 8-session hypertension management training program to hypertension patients older than 60, with an optional supplemental 8 sessions focused on nutrition and physical activity.
- Results: Just 16 weeks after the program, participants had improved systolic blood pressure, weight, and fasting glucose, greater knowledge of hypertension, and improved self-reported behaviors.
Promising Examples

Updated/reviewed April 2021
- Need: Expand healthcare access for the more remote residents of 3 frontier counties in north central Idaho.
- Intervention: Consortium of healthcare providers and community agencies used a hybrid Community Health Worker model to augment traditional healthcare delivery services in order to offer a diverse set of healthcare offerings to frontier area residents.
- Results: Increased healthcare access, especially for cancer and chronic disease screening, along with providing education on a diverse array of health topics.
For examples from other sources, see: