Iowa Models and Innovations

Helping Kids PROSPER
Updated/reviewed January 2023

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.

Parent Partners
Updated/reviewed March 2023

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.

LIFE - Living well through Intergenerational Fitness and Exercise
Updated/reviewed November 2022

Need: Older adults in rural Iowa have inadequate access to physical activity specialists and/or exercise facilities, which limits their ability to remain sufficiently active.
Intervention: Iowa State University implemented an intergenerational "exergaming" program to encourage fun and safe physical fitness among rural older adults.
Results: Pilot studies showed that older adults demonstrated increases in strength, flexibility, activity levels, and confidence in their ability to be physically active. Younger adults experienced reduced ageism and increased knowledge and expectations of aging.

Rural Restaurant Healthy Options Program
Updated/reviewed September 2022

Need: Obesity is a widespread epidemic in the United States, especially in rural areas. Due to small profit margins and fear of losing customers, small owner-operated rural restaurants hesitate to make health-conscious changes to their menus.
Intervention: The Healthy Options Program offered an economical and low-maintenance program for owner-operated restaurants in Iowa to increase awareness of already existing healthy menu options and substitutions.
Results: Restaurants received positive feedback and experienced no financial loss. Customers noticed and appreciated the healthy option reminders, and ordering behavior improved.

TelePrEP
Updated/reviewed January 2023

Need: To prevent new cases of HIV in rural Iowa.
Intervention: TelePrEP provides preventive care via telehealth and prescription delivery.
Results: Between February 2017 and August 2020, TelePrEP received 456 referrals, with 403 patients completing an initial visit.

SD eResidential Facilities Healthcare Services Access Project
Updated/reviewed August 2020

Need: To increase local health services to rural elderly populations in long-term care facilities located in four Midwest states near a tertiary care organization.
Intervention: A non-profit healthcare organization implemented telehealth services to provide acute care evaluations for long-term residents in their home facilities.
Results: The program increased local care as evidenced by improved year-over-year provider-determined available transfer data: 33%, 50%, 63% program years 1 through 3, respectively. From the success of the initial pilot implementation, the program has further matured into a long-term care offering that now reaches many other rural facilities located in 10 states across the nation.

The Rural Virtual Infusion Program
Updated/reviewed April 2020

Need: Allow rural cancer patients in a region inclusive of 26 counties in Iowa, Minnesota, and South Dakota to have access to tertiary-level chemotherapy regimens in rural infusion centers.
Intervention: With telehealth-based oversight from a tertiary care oncology team, 3 rural infusion teams were trained to coordinate cancer treatment plans and administer complex chemotherapy regimens.
Results: Almost 130 patients were transitioned to receive chemotherapy in a rural infusion center, translating to over 1,000 infusion visits and saving patients/families nearly 65,000 trip miles, 1,800 travel hours and $71,000.

Avera LIGHT
Updated/reviewed March 2021

Need: Assistance for urban and rural physicians — as well as other healthcare providers — who are experiencing burnout and other issues associated with well-being.
Intervention: As part of its provider well-being focus in its rural and urban facilities, Avera Health system has created a program which attends to physician wellness issues starting with recruitment with continued support through retirement.
Results: With increasing engagement due to word of mouth, the program creates a culture of wellness where stigma is decreased and providers are encouraged to be proactive in reaching out for assistance for issues related to their personal and professional well-being.

Sowing the Seeds of Hope
Updated/reviewed November 2020

Need: Agriculture workers and their families have high rates of psychological distress and suicide, but limited access to mental health services.
Intervention: The "Sowing the Seeds of Hope" (SSoH) program was created to provide affordable and culturally appropriate mental health services to individuals working in agriculture and their families in Iowa, Kansas, Minnesota, Nebraska, North Dakota, South Dakota and Wisconsin.
Results: The regional program ran from 1999-2014 and successfully established a variety of interventions to help individuals in rural communities access behavioral health services.

Trinity Pioneer ACO
Updated/reviewed December 2019

Need: Transitioning from fee-for-service models to valued-based payment models in rural Iowa.
Intervention: In 2011, the Trinity ACO was formed in rural Iowa after being selected by the Center for Medicare and Medicaid Innovation as 1 of the 32 planned Medicare Pioneer Accountable Care Organizations.
Results: Now part of the Next Generation ACO, Trinity continues to bring attention to rural-specific organizations using its focus on palliative medicine and effective strategies to distribute value-based services.

Evidence-Based Examples