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Rural Project Examples: Health conditions

Evidence-Based Examples

Telepsychology-Service Delivery for Depressed Elderly Veterans
Updated/reviewed December 2017
  • Need: To provide evidence-based psychotherapy for depression in elderly veterans who are unable to seek mental health treatment due to distance or stigma.
  • Intervention: Telepsychology-Service Delivery for Depressed Elderly Veterans compared providing behavioral activation therapy via home-based telehealth and the same treatment delivered in a traditional office-based format.
  • Results: A 2015 study and two 2016 studies show that providing treatment via home-based telehealth to elderly veterans in South Carolina resulted in the same improved health outcomes, quality of life, satisfaction with care, and cost of healthcare compared to those receiving face-to-face treatment.
Chronic Disease Self-Management Program
Updated/reviewed October 2017
  • 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.
Fit & Strong!
Updated/reviewed August 2017
  • Need: Osteoarthritis is a chronic condition which often causes multiple related disabilities in older adults.
  • Intervention: An 8-week physical activity, behavior change, and falls prevention program geared to older adults with osteoarthritis.
  • Results: Participants gained confidence with increased exercise, lessened stiffness, improved joint pain and improved lower extremity strength and mobility.
Women to Women Online Support Network
Updated/reviewed August 2017
  • Need: Women living in rural areas with chronic illness often face little social support, leading to increased rates of depression and stress
  • Intervention: Women to Women offered rural women with chronic conditions social support networks via telecommunication
  • Results: WTW intervention participants experienced positive increases in self-esteem, social support, and empowerment over the control group
Project ECHO® – Extension for Community Healthcare Outcomes
Updated/reviewed July 2017
  • Need: To increase the capacity for more effective treatment of chronic, complex conditions in rural and underserved communities.
  • Intervention: Through a specially-designed project, remote primary care providers work with academic specialists as a team to manage chronic conditions of rural patients, expanding remote providers’ knowledge base through shared case studies.
  • Results: Patient management and care provided by rural providers through ongoing education and mentoring from Project ECHO® has proved as effective as treatment provided by specialists at a university medical center.
Sickness Prevention Achieved through Regional Collaboration (SPARC, Inc.®)
Updated/reviewed July 2017
  • Need: Population-based rates of adult vaccinations and cancer screenings are low, with fewer than 40% of older adults up to date with routinely recommended prevention services. Delivery rates are lower still in low-income and minority communities.
  • Intervention: SPARC was established to develop and test new community-wide strategies to increase the delivery of clinical preventive services.
  • Results: Across the United States in both rural and urban communities, SPARC programs, which broaden the delivery of potentially life-saving preventive services, have been successfully launched, improving residents' health.
Project ENABLE (Educate, Nurture, Advise Before Life Ends)
Added May 2017
  • Need: To enhance palliative care access to rural patients with advanced cancer 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 lower rates of depression and burden along with higher quality of life.

Effective Examples

Franklin Cardiovascular Health Program (FCHP)
Updated/reviewed March 2018
  • 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.
Salud es Vida Cervical Cancer Education
Updated/reviewed January 2018
  • Need: Hispanic women have the highest incidence rates of cervical cancer among any ethnicity in the United States.
  • Intervention: The development of a lay health worker (promotora) curriculum that provides information on cervical cancer, HPV, and the HPV vaccine to Hispanic farmworker women living in rural southern Georgia and South Carolina.
  • Results: Significant increases in post-test scores relating to cervical cancer knowledge and increases in positive self-efficacy among promotoras.
Updated/reviewed December 2017
  • Need: To reduce the risk of HIV/STDs among Latino men living in rural regions of the United States.
  • Intervention: Soccer team leaders are elected and trained as lay health advisors to promote sexual health education among team members.
  • Results: Program participants report an increase in HIV testing, an increase in condom use, and an increase in awareness of how to prevent the transmission of HIV.