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Rural Health Information Hub

Rural Project Examples: Substance use and misuse

Evidence-Based Examples

keepin' it REAL Rural
Updated/reviewed March 2022
  • 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.
Helping Kids PROSPER
Updated/reviewed June 2019
  • 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.
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.

Effective Examples

Parent Partners
Added March 2022
  • Need: To support parents whose children have been removed from the home so that the parents can make the changes needed for the children to return safely home.
  • Intervention: A statewide program in Iowa pairs these parents with mentors who have successfully navigated their own child welfare cases.
  • Results: Participants' children were more likely to return home than non-participants' children and participants were less likely to have another child removal within a year of the child coming home.
Franklin Cardiovascular Health Program (FCHP)
Updated/reviewed February 2022
  • 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.
Project Lazarus
Updated/reviewed November 2021
  • Need: To reduce overdose-related deaths among prescription opioid users in rural Wilkes County, North Carolina
  • Intervention: Education and tools are provided for prescribers, patients and community members to lessen drug supply and demand, and to reduce harm in prescription opioid use
  • Results: Opioid overdose death rates have decreased in Wilkes County
Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder
Updated/reviewed August 2020
  • Need: Increase access to medication-assisted treatment for opioid use disorder in rural Vermont.
  • Intervention: Statewide hub-and-spoke treatment access system.
  • Results: Increased treatment capacity and care coordination.
Midcoast Maine Prescription Opioid Reduction Program
Updated/reviewed May 2020
  • 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.
Strong African American Families-Teen Program
Updated/reviewed April 2019
  • 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.
funded by the Federal Office of Rural Health Policy Madison Outreach and Services through Telehealth (MOST) Network
Updated/reviewed December 2018
  • 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.