Rural Project Examples Addressing Culture and cultural competency

Care for Our Elders/Wakanki Ewastepikte
Updated/reviewed June 2022

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 April 2022

Need: To reduce health disparities in two rural/frontier counties in southwest New Mexico.
Intervention: Community health workers worked 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 March 2021

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.

Hawai'i Island Family Medicine Residency
Updated/reviewed December 2022

Need: Hawai'i 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: Since 2017, HIFMR has graduated a class of 3 to 6 Board-certified family medicine physicians annually. Most graduates have remained in the state to practice medicine; those who have left have entered fellowship programs and plan to return to Hawai'i Island to practice.

Pride in Idaho Care Neighborhoods
Added December 2022

Need: Patients who identify as LGBTQ+ in rural settings may face barriers to receiving appropriate care, including a knowledge gap among healthcare providers regarding HIV prevention, hormone replacement therapy, and other types of care.
Intervention: A partnership between a Critical Access Hospital, statewide residency program, nonprofit organization and other regional entities provides training, virtual consultations, and resources to rural providers across Idaho.
Results: Physicians experienced in gender-affirming care have performed virtual consultations for rural physicians and patients around the state, and the number of local providers trained in PrEP management has doubled.

Fostering Futures in Menominee Nation
Updated/reviewed August 2022

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 94% since 2008.

Seneca Strong's Certified Addiction Recovery Coaches
Updated/reviewed July 2022

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, with the goal of reducing substance misuse across the Nation.
Results: Seneca Strong has since grown in personnel and capacity to meet the needs of the Allegany and Cattaraugus territories of the Seneca Nation.

Tea Time with Teens
Updated/reviewed November 2021

Need: To lower teen pregnancy rates in Marlboro County, South Carolina, and develop teen leaders.
Intervention: Tea Time with Teens brings together community leaders, mothers, and daughters to build life skills and make healthy decisions.
Results: Since 2009, the program has been educating teens on making healthy choices and adults on having meaningful conversations with teens.

La Red Health Center
Updated/reviewed December 2020

Need: Meeting the health care needs of the uninsured and underinsured population of Sussex County, Delaware.
Intervention: La Red Health Center was created to offer culturally competent primary and preventative care to children and adults, regardless of ability to pay.
Results: La Red Health Center (LRHC) serves thousands of residents at four clinical sites, a school-based wellness center and through a collaborative effort with a local senior center.

Family Wellness Warriors Initiative
Updated/reviewed November 2020

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.

Rural Project Examples: Culture and cultural competency