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.
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.
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.
Need: Reduction in the number of emergency department dental patients abusing opioid prescriptions in rural southeastern Maine.
Intervention: Using a one-page opioid prescription guideline, opioid prescribing and emergency room visits for dental pain decreased.
Results: The rate of opioid prescription dropped nearly 20% after implementation, and in comparing the 12-month period before and after implementation, dental pain emergency department visits decreased from 26 to 21 per 1,000.
Need: There is a lack of interventions that addresses teenager behavioral problems, particularly for rural African American adolescents.
Intervention: Rural, locally trained leaders administered five 2-hour meetings for teenagers and their primary caregivers. Trainings focused on reducing risks that prevent positive development, specifically sexual risk-taking that can lead to HIV and other STIs.
Results: Teens reported reduced conduct problems, depressive symptoms, and substance abuse. Families were strengthened, and SAAF-T reduced unprotected intercourse and increased condom efficacy.