North Carolina Models and Innovations
These stories feature model programs and successful rural projects that can serve as a source of ideas. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.
Updated/reviewed February 2020
- Need: To reduce the risk of HIV/STDs among Latino men living in rural regions of the United States.
- Intervention: Soccer team leaders are elected and trained as lay health advisors to promote sexual health education among team members.
- Results: Program participants report an increase in HIV testing, an increase in condom use, and an increase in awareness of how to prevent the transmission of HIV.
Updated/reviewed November 2019
- Need: In rural eastern North Carolina, Lenoir County residents experience significantly higher rates of cardiovascular disease, stroke, and obesity rates compared to other parts of the state and nation.
- Intervention: A community-based research project was designed to develop and test better ways to tackle cardiovascular disease, from prevention to treatment.
- Results: The end goal includes the development of long-lasting strategies and approaches within the community to help decrease the risk and disparities in risk of cardiovascular disease.
Updated/reviewed January 2018
- 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
Updated/reviewed October 2020
- Need: To reduce prescription opioid misuse and overdoses in North Carolina.
- Intervention: The ICPTTP standardizes and streamlines chronic pain management in primary care clinics.
- Results: The ICPTTP reduced patients' average morphine equivalent daily dose, and 29% of patients successfully tapered off chronic opioid therapy.
Updated/reviewed October 2019
- Need: To decrease the number of children entering kindergarten with untreated tooth decay in the rural Appalachian counties of Rutherford, Polk, and McDowell in western North Carolina.
- Intervention: A program to give children a dental home that included screenings, targeted outreach, and restorative services.
- Results: An overall decrease within the service area of children entering kindergarten with sub-par oral health.
Updated/reviewed September 2019
- Need: There is a lack of dementia-specific support for rural caregivers.
- Intervention: Project C.A.R.E. was created to meet the needs of rural and underserved caregivers of those with Alzheimer's or other dementias across North Carolina.
- Results: Under Project C.A.R.E., rural families receive information and referrals as well as individualized care consultation from dementia-trained family consultants.
Updated/reviewed May 2019
- Need: Improvement in service quality and patient experience in primary care practices in North Carolina's Blue Ridge region and across the state.
- Intervention: A practicum for healthcare management students was developed to help rural practices achieve Patient Care Medical Home (PCMH) status, identify quality improvement needs, and develop strategies.
- Results: With the help of practicum students, rural primary practices have have tackled a number of important quality improvement projects, achieved PCMH status and Blue Quality Physician Program Recognition.
Other Project Examples
Updated/reviewed July 2020
- Need: People living in under-resourced rural communities in North Carolina have poorer health than those living in urban areas.
- Intervention: Funded by the Kate B. Reynolds Charitable Trust, Healthy Places NC is investing $100 million over 10 years in rural North Carolina counties to improve residents' health.
- Results: As of June 2020, the Trust has invested more than $68 million in 10 Healthy Places NC counties.
Updated/reviewed June 2020
- Need: Children and youth with special healthcare needs (CYSHCN) face many barriers to coordinated, comprehensive, and culturally competent healthcare.
- Intervention: The North Carolina Innovative Approaches (IA) initiative works with families of CYSHCN and other community leaders to make systems changes in the state's healthcare system.
- Results: In ten years, IA has impacted 22 counties and has had a positive impact on increasing family engagement and community capacity for systems changes.
Updated/reviewed March 2020
- Need: Compared to the average North Carolinian, residents age 40 to 64 in rural Granville County were dying from heart disease and diabetes at a younger age.
- Intervention: Granville Greenways was created to promote active lifestyles and more walkable communities.
- Results: As of December 2019, 12 miles of greenways now exist allowing for community members' hiking and biking.
Updated/reviewed December 2019
- Need: Provision of medical care access and follow-up for rural North Carolina HIV patients with mental health, substance abuse, and unstable housing/homelessness challenges.
- Intervention: Medical home staff model expanded to a care coordination program with a core Network Navigator and Continuum of Care Coordinator assisting with medical, behavioral health, and basic life needs.
- Results: To date, the program has advanced three aspects of medical home patient care for this target population: provided further understanding of the spectrum of homelessness, including "hidden" homelessness; implemented outreach with creation of new community partnerships and a community housing coalition; and integrated medical care and behavioral health care for HIV.
Added December 2019
- Need: To improve students' access to behavioral health services in rural North Carolina.
- Intervention: North Carolina Project ACTIVATE provides three tiers of behavioral health supports in the school setting.
- Results: The three pilot sites have created or revised 10 mental health policies, and 1,083 school-based and related workforce have received training in different topics and protocols.
Added December 2019
- Need: Suicide among veterans has been steadily increasing, and rural veterans have a 20% increased risk of death by suicide compared to urban veterans.
- Intervention: A program called Together With Veterans was formed to help rural communities address and prevent suicides among veterans. The initiative is veteran-led, collaborative, evidence-based, and community-centered.
- Results: The program is currently in 6 states and reaches over 1,500 veterans every quarter while nurturing connections between agencies and community members.
Updated/reviewed November 2019
- Need: Suicide rates among white males age 65 and older have been rising in North Carolina. Challenges include losing friends, illnesses, and the loss of independence – all of which can lead to isolation and depression.
- Intervention: The Chatham County Council on Aging of North Carolina started Geezers, Gulpers, and Gardeners (3G Group) to connect retired men in need of male friends and mutual support.
- Results: Men in similar stages of life and varying backgrounds are forming friendships, engaging in activities, and taking care of their mental health.
Updated/reviewed October 2019
- Need: Rural school children lack proper healthcare resources within the school setting.
- Intervention: Health-e-Schools provides health services to students via telehealth using video conferencing and special equipment.
- Results: Health-e-Schools increases access to primary healthcare, increases attendance in the classroom, and decreases the amount of time that parents or guardians must take off of work to bring their child to health-related appointments.
Updated/reviewed April 2019
- Need: An increased interest among young people to pursue a medical career in rural North Carolina
- Intervention: Two medical students started a program that gives high school seniors medical academic training, mentor relationships, and hands-on experience in rural North Carolina facilities.
- Results: Project PROMISE has graduated 26 high school students, 7 of whom are pursuing an undergraduate degree with an interest in studying medicine.
Updated/reviewed October 2018
- Need: To lessen the impact of chronic disease and associated complications in North Carolina.
- Intervention: Partners in Health and Wholeness, an initiative of the NC Council of Churches, is a faith-based program that integrates healthy living within congregations while offering financial support to launch or expand health initiatives.
- Results: Since its founding in 2009, over 500 churches have become a part of the PHW, many in rural areas, and over 375 mini-grants have been awarded to congregations.
Last Updated: 10/2/2020