Rural Project Examples Addressing Population health

keepin' it REAL Rural

Updated/reviewed April 2025

Need: A drug and alcohol prevention program for middle school students that is specific to rural culture.
Intervention: An adaptation of the evidence-based keepin' it REAL curriculum was customized for rural middle school students.
Results: Students showed a reduction in all substance use and less personal acceptability of substance use.

Updated/reviewed July 2024

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: StrongPeople™ 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.

Updated/reviewed September 2023

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.

Updated/reviewed January 2023

Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.

Updated/reviewed August 2020

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.

Updated/reviewed April 2025

Need: To increase access to medical screening for miners in New Mexico.
Intervention: A mobile screening clinic with telemedicine capability screens miners for respiratory and other conditions.
Results: In a survey, 92% of miners reported their care as very good, while the other 8% reported it as good. The program has expanded to three other states.

Updated/reviewed March 2025

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.

Updated/reviewed March 2025

Need: Due to West Virginia's high ranking for its use of smokeless tobacco, prevention and cessation education efforts were needed.
Intervention: Development and implementation of the Spit It Out-West Virginia program.
Results: Supported by a 2008-2010 grant allowing the program to be delivered to hundreds of people, 5 workplaces became tobacco free. The program continues to be delivered across the state and reaches hundreds with its face-to-face presentations and thousands with its specific media prevention and cessation messages.

Updated/reviewed November 2024

Need: To encourage farmers to make health and safety changes on their farms.
Intervention: Farm Dinner Theater is an event in which farmers and their families watch three 10-minute plays covering health and safety topics and then discuss solutions to the issues addressed in each.
Results: In a study, farmers who attended the plays were more likely to make changes and tell others what they learned, compared to farmers who received an educational packet with the same information.

Updated/reviewed October 2024

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 2024, over 196,801 rural residents were served. Preventive health strategies, screenings, educational services, and referrals are all offered at no charge to clients.