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Rural Health Information Hub

Models & Innovations Search Results for: social determinants of health

47 Models & Innovations webpages matched your search. Here are matches 11 - 20:

11. COPD Readmission Prevention Program
Reviewed: Dec 17, 2019

Genesis HealthCare System, Zanesville, Ohio, created a post-discharge care coordination program with impact not only on readmission rates, but access to acute and chronic care.

...social determinants of health, for example, the ability to purchase and correctly use medications. When...

12. Northern Light Health Accountable Care Organization
Reviewed: Apr 26, 2024

Cares for roughly 125,000 Maine residents, most of whom reside in rural areas. Focuses on patient-centered care to improve overall wellness and reduce healthcare costs.

...health workers also complete social determinants of health intervention for all patients who endorse social...

13. ROAMS (Rural OB Access & Maternal Service)
Added: Feb 21, 2024

ROAMS in northeastern New Mexico offers tele-OB, tele-MFM, home telehealth kits, lactation consultants, and community health workers.

...health workers to address social determinants of health like transportation or food insecurity. Results UCGH...

14. Prevention through Care Navigation Outreach Program
Reviewed: May 2, 2020

A program that uses community health workers to create a system of coordinated care in order to reduce the prevalence of diabetes and cardiovascular disease in rural Colorado.

...health. Accountable Health Communities (AHC) Health-Related Social Needs (HRSN) Tool : Social Determinants of Health...

15. NC-REACH: NC-Rurally Engaging and Assisting Clients who are HIV positive and Homeless
Reviewed: Nov 30, 2020

Medical home staff model expanded to provide care coordination for HIV patients with mental health, substance abuse, and unstable housing/homelessness challenges.

...health comorbidities. Other challenges associated with the social determinants of health, like housing stability issues...

16. Health Extension Regional Offices (HEROs)
Reviewed: Nov 1, 2021

The University of New Mexico Health Sciences Center created Health Extension Regional Offices (HEROs) whose agents link people in rural communities to local health and social services.

...Social Determinants of Health: Each HERO agent has convened stakeholders from different local community sectors...

17. Lakewood Engage Food Access Initiatives
Reviewed: Aug 25, 2023

Lakewood Engage is a collection of programs created to address food insecurity and nutrition in rural Minnesota by providing residents with fresh, locally-sourced fruits, vegetables, and meat, as well as shelf-stable goods.

...Health Systems Lakewood Engage 218.894.8215 aliciabauman@lakewoodhealthsystem.com Topics Elderly population Food security and nutrition Social determinants...

18. Kentucky Homeplace
Reviewed: Oct 5, 2023

A community health worker initiative to improve the health of rural Appalachian Kentucky residents who have deficits in health resources and health status, including high levels of cancer, heart disease, hypertension, asthma, and diabetes.

...health Assists communities and individuals to adopt healthy behaviors Trains CHWs to help find solutions that address social determinants...

19. HCC Network of Rural Missouri's Project Connect Event
Reviewed: Apr 19, 2023

To reach out to underserved adults living in rural West Central Missouri, Health Care Collaborative Network of Rural Missouri organizes Project Connect events, daylong resource fairs that offer free public health and human services.

...social determinants of health. Public Health Services Medical equipment such as wheelchairs and walkers are donated...

20. The Health-able Communities Program
Reviewed: Apr 28, 2021

Using Community Health Workers, an Idaho consortium leveraged grant-funding to bring health and wellness programs, disease screening, and health education to frontier residents.

...social determinants of health. Eleven CHWs performed disease screenings, provided general health and wellness education...