Rural Project Examples Addressing Populations - Rural Health Information Hub

Fit & Strong!®

Updated/reviewed November 2025

Need: Osteoarthritis is a chronic condition which often causes multiple related disabilities in older adults.
Intervention: An evidence-based curriculum incorporating physical activity, behavior change, and fall prevention geared to older adults with lower extremity osteoarthritis.
Results: Participants experienced less stiffness, improved joint pain, improved lower extremity strength and mobility, in addition to creating their own unique program for continued post-class use.

Updated/reviewed June 2025

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 May 2025

Need: To enhance palliative care access to rural patients with serious illness, such as advanced cancer, heart failure, and COPD, 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 or palliative care coach/navigator 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.

Updated/reviewed April 2025

Need: To reduce violence against pregnant women and women with infants in rural Missouri.
Intervention: A tool for existing home visiting programs, DOVE was a brochure-based and safety planning intervention for women experiencing interpersonal violence.
Results: Women receiving the DOVE intervention saw a larger average decrease in number of violent incidents than women in the control group.

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 April 2025

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.

Updated/reviewed March 2025

Need: Arkansas had high rates of low birthweight babies, and pregnant patients in rural areas had difficulty accessing specialty obstetric care.
Intervention: The University of Arkansas for Medical Sciences (UAMS) created the Institute for Digital Health & Innovation (IDHI) High-Risk Pregnancy Program to increase access to care for pregnant patients in an effort to improve outcomes for high-risk pregnancies.
Results: The program has increased access to care and improved neonatal outcomes for rural Arkansas individuals through a variety of programs and has been recognized by various organizations as a model program.

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 November 2025

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 2025

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.