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Rural Project Examples: Service delivery models

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.
ANGELS: Antenatal & Neonatal Guidelines, Education and Learning System
Updated/reviewed August 2017
  • Need: Arkansas had high rates of low birthweight babies, and women in rural areas had difficulty accessing specialty obstetric care.
  • Intervention: The University of Arkansas for Medical Sciences created the ANGELS telemedicine program to increase access to care for pregnant rural women in an effort to improve outcomes for high-risk pregnancies.
  • Results: ANGELS has increased access to care and reduced infant mortality for rural Arkansas women through a variety of programs and has been recognized by various organizations as a model program.
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.
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

funded by the Federal Office of Rural Health Policy Perinatal Health Partners Southeast Georgia
Updated/reviewed March 2018
  • Need: In the 11 rural southeast Georgia counties, high-risk pregnant women potentially face adverse birth outcomes, including maternal or infant mortality, low birthweight, very low birthweight, or other medical or developmental problems.
  • Intervention: An in-home nursing case management program for high-risk pregnant women in order to maximize pregnancy outcomes for mothers and their newborns.
  • Results: Mothers carry their babies longer and the babies are larger when born, leading to improved health outcomes.
Wyoming Trauma Telehealth Treatment Clinic
Added January 2018
  • Need: To provide psychotherapy to survivors of domestic violence and sexual assault.
  • Intervention: University of Wyoming psychology doctoral students provide psychotherapy via videoconferencing to crisis center clients in two rural locations.
  • Results: Clients, student therapists, and crisis center staff were satisfied with the quality of services, and clients reported reduced symptoms of depression and PTSD.
funded by the Health Resources Services Administration New Mexico Mobile Screening Program for Miners
Updated/reviewed December 2017
  • 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 recent survey, 92% of miners reported their care as very good, while the other 8% reported it as good. Since 1989, the program has served 6,685 miners.
Patient Care Connect
Updated/reviewed December 2017
  • Need: Cancer patients living in the Deep South encounter multiple barriers in accessing regular cancer treatment.
  • Intervention: The University of Alabama at Birmingham Comprehensive Cancer Center developed a program that uses lay patient navigators to support and direct patients to appropriate resources to overcome barriers to accessing care.
  • Results: The program has become a model for improving cancer care quality, decreasing unnecessary utilization (ER visits and hospitalizations), removing barriers to care, and enhancing patient satisfaction.
funded by the Federal Office of Rural Health Policy Madison Outreach and Services through Telehealth (MOST) Network
Updated/reviewed November 2017
  • Need: More mental health and substance abuse prevention and treatment services in rural Texas.
  • Intervention: A network was formed to bring counseling services through telehealth systems and community health workers to Brazos Valley, Texas.
  • Results: The program improved health outcomes, increased general knowledge of the impact of substance abuse, and raised awareness of services among Hispanic residents.