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Rural Health Information Hub

Rural Project Examples: Substance use and misuse

Promising Examples

Nurse Navigator and Recovery Specialist Outreach Program

funded by the Federal Office of Rural Health Policy

Updated/reviewed November 2022

  • Need: To properly address and treat patients who have concurrent substance use and chronic healthcare issues.
  • Intervention: A referral system utilizes community health workers (CHWs) in a drug and alcohol treatment setting. A registered nurse helps with providers' medication-assisted treatment programs.
  • Results: This program has reduced hospital emergency visits and hospital readmissions for patients since its inception.

Contingency Management Smoking Cessation in Appalachia

Updated/reviewed June 2022

  • Need: To reduce smoking rates of pregnant women and adolescents in Appalachian regions of eastern Kentucky and Ohio.
  • Intervention: A web-based smoking cessation program that offered monetary incentives to reducing smoking.
  • Results: Participants significantly reduced smoking rates or quit altogether.

Cross-Walk: Integrating Behavioral Health and Primary Care

funded by the Federal Office of Rural Health Policy

Updated/reviewed October 2021

  • Need: To address and treat substance use disorder (SUD) and depression in the Upper Great Lakes region.
  • Intervention: Cross-Walk, a program that integrates behavioral healthcare into primary care services, was developed in Michigan's Marquette County.
  • Results: The collaborative efforts strengthened care management services in local healthcare facilities as primary care patients were referred to a behavioral health specialist.

Other Project Examples

First Day Forward

funded by the Health Resources Services Administration

Added March 2024

  • Need: Enhanced support for people with substance use disorders leaving jail and reentering communities in rural northeastern Kentucky.
  • Intervention: A reentry program that uses peer support specialists to teach cognitive life skills, obtain essential identification documents, and help people create and follow personalized case plans before and after their release.
  • Results: More than 420 people have been served by First Day Forward, with recidivism rates significantly lower among people who successfully completed the program.

Moms Do Care EMPOWER (MDC-E)

Added February 2024

  • Need: To support pregnant or new parents in rural Massachusetts affected by substance use or on medication for opioid use.
  • Intervention: This program offers a medical and behavioral health home, providing trauma-informed support before, during, and after childbirth.
  • Results: Six months after enrollment, there was a 20% increase in the number of participants who felt socially connected and a 5% increase in abstinence from all substances.

Positively Living & Choice Health Network

Updated/reviewed February 2024

  • Need: To provide affirming, destigmatized healthcare and support to thousands of Tennesseans living with HIV/AIDS, mental illness, substance use disorder, and homelessness – and prevention services for individuals at risk of contracting HIV.
  • Intervention: Positively Living & Choice Health Network provides services including a medical clinic, pharmacy, therapy, case management, client services like housing aid and transportation, HIV prevention, and a harm reduction program.
  • Results: The program currently serves 5,000 individuals and families through its offices in Knoxville, Chattanooga, Memphis, and Cookeville and its mobile medical unit for rural communities in Cocke and Claiborne counties.

Recovery Kentucky

Updated/reviewed February 2024

  • Need: To provide housing and recovery services for rural Kentuckians dealing with substance use.
  • Intervention: Recovery Kentucky has 8 rural locations and provides apartments within a congregate living environment and an opportunity to begin recovery from substance use disorder in a structured, peer-led 12-step environment.
  • Results: The rural and urban centers serve up to 2,200 people annually. An independent university-led resident outcome evaluation showed significant improvements in clients' drug and alcohol use, housing and employment status, decrease in criminal justice improvement, and improved health and mental health.

Spit It Out-West Virginia

Updated/reviewed February 2024

  • 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.

Nicotine Use Prevention and Control (NUPAC) Program

Updated/reviewed January 2024

  • Need: To foster relationships with American Indian people in New Mexico to determine culturally appropriate practices in reducing nicotine addiction.
  • Intervention: NUPAC provides outreach, community programs, and cessation services.
  • Results: In fiscal year 2023, 1,333 QUIT NOW and DEJELO YA quit line enrollees stopped using tobacco.

The Possibility Shop

Updated/reviewed January 2024

  • Need: To connect vulnerable populations in Allegany County, Maryland, to health and human services and to items like hygiene products, food, and clothing.
  • Intervention: The Possibility Shop partners with health organizations, insurance navigators, food banks, and other agencies.
  • Results: In 2023, 8,684 service encounters occurred and 501 intakes to services were performed.