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Rural Project Examples: Cultural competency

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.
Hidalgo Medical Services – Family Support Program
Updated/reviewed June 2019
  • Need: To reduce health disparities in two rural/frontier counties in southwest New Mexico.
  • Intervention: Community health workers work with clients to help them better manage their health and promote awareness of healthy lifestyle options in the community.
  • Results: Better health outcomes for patients.
The Pacific Care Model: Charting the Course for Non-communicable Disease Prevention and Management
Updated/reviewed April 2018
  • Need: The U.S. Associated Pacific Islands (USAPI) needed an efficient, effective, integrated method to improve primary care services that addressed the increased rates of non-communicable disease (NCD), the regional-specific phrase designating chronic disease.
  • Intervention: Through specialized training, multidisciplinary teams from five of the region's health systems implemented the Chronic Care Model (CCM), an approach that targets healthcare system improvements, uses information technology, incorporates evidence-based disease management, and includes self-management support strengthened by community resources.
  • Results: Aimed at diabetes management, teams developed a regional, culturally-relevant Non-Communicable Disease Collaborative Initiative that addresses chronic disease management challenges and strengthens healthcare quality and outcomes.

Promising Examples

funded by the Federal Office of Rural Health Policy Bridges to Health
Updated/reviewed October 2019
  • Need: To reduce barriers to accessing healthcare for immigrant farmworkers in the rural areas of Vermont.
  • Intervention: Bridges to Health uses care coordination and health promoters to reduce barriers to accessing healthcare on an individual level. The program offers targeted technical assistance to address systemic barriers at health access points in areas with high numbers of immigrant farmworkers.
  • Results: Some barriers to accessing healthcare have been reduced or removed for immigrant farmworkers in certain counties.

Other Project Examples

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.
Pennsylvania Rural Health Farm Worker Protection Safety Program
Updated/reviewed April 2019
  • Need: Agricultural producers and Pennsylvania's diverse farmworker population needed guidance on complying with Environmental Protection Agency regulations on the safe use of pesticides used in agricultural production.
  • Intervention: An outreach education program providing compliance and technical assistance for growers was developed which included culturally appropriate training materials targeted to workers.
  • Results: Pesticide use training and other farm safety information is now readily available to Pennsylvania's farmers and farmworkers.
funded by the Federal Office of Rural Health Policy Northern Dental Access Center Medical-Legal Partnership
Updated/reviewed January 2019
  • Need: To help low-income patients in rural Minnesota overcome legal barriers to oral healthcare and self-sufficiency.
  • Intervention: The medical-legal partnership of Northern Dental Access Center and Legal Services of Northwest Minnesota provides free consultations and support services.
  • Results: The innovative and collaborative approach has been recognized regionally and nationally, and over 9,000 new patients have been screened for legal issues.
Hawai'i Island Family Medicine Residency
Updated/reviewed December 2018
  • Need: Hawaii is experiencing a huge shortage of family medicine physicians.
  • Intervention: The Hawai'i Island Family Medicine Residency (HIFMR) program uses an interprofessional team-based approach so residents learn how to care for many types of patients in different healthcare settings.
  • Results: In 2017, the first class of residents graduated from a fully accredited program as Board-certified Family Medicine physicians. There were over 1,000 applicants to the residency program, and the residency increased its complement from 4 to 6 residents per year.
Family Wellness Warriors Initiative
Added October 2018
  • Need: Decrease rates of domestic violence, child sexual abuse, and child neglect for Alaska Native people in remote villages.
  • Intervention: An evidence-based model inclusive of traditional culture trains local communities on methods of prevention and treatment for domestic and interpersonal violence.
  • Results: Self-sustaining local system with improved family and spiritual well-being and decreased healthcare access needs.
Fostering Futures in Menominee Nation
Updated/reviewed September 2018
  • Need: Since the late 1800's, trauma caused by historic events have greatly affected the way of life for Menominee Indians living on the Menominee Reservation. Economic, socioeconomic, behavioral health, and physical health issues have risen and are causing direct implications for Menominee youth.
  • Intervention: Through Fostering Futures, clinic, school, and Head Start/Early Head Start staff are trained in administering trauma-informed care and building resilience among children.
  • Results: Behavioral health visits at the Menominee Tribal Clinic have increased, school suspension rates have decreased, and graduation rates have improved from 60% to 85% since 2008.