Cancer Prevention and Treatment in Rural Areas – Models and Innovations
These stories feature model programs and successful rural projects that can serve as a source of ideas and provide lessons others have learned. Some of the projects or programs may no longer be active. Read about the criteria and evidence-base for programs included.
Evidence-Based Examples
Project ENABLE (Educate, Nurture, Advise, Before Life Ends)
Updated/reviewed December 2022
Updated/reviewed December 2022
- Need: To enhance palliative care access to rural patients with advanced cancer or heart failure and their family caregivers.
- Intervention: Project ENABLE consists of: 1) an initial in-person palliative care consultation with a specialty-trained provider and 2) a semi-structured series of weekly, phone-delivered, nurse-led coaching sessions designed to help patients and their caregivers enhance their problem-solving, symptom management, and coping skills.
- Results: Patients and caregivers report higher quality of life and lower rates of depression and (caregiver) burden.
Sickness Prevention Achieved through Regional Collaboration (SPARC, Inc.®)
Updated/reviewed July 2022
Updated/reviewed July 2022
- Need: Population-based rates of adult vaccinations and cancer screenings are low. Delivery rates are lower still in low-income and minority communities.
- Intervention: SPARC was established to develop and test new community-wide strategies to increase the delivery of clinical preventive services.
- Results: Across the United States in both rural and urban communities, SPARC programs, which broaden the delivery of potentially life-saving preventive services, have been successfully launched, improving residents' health.
Chronic Disease Self-Management Program
Updated/reviewed December 2019
Updated/reviewed December 2019
- Need: To help people with chronic conditions learn how to manage their health.
- Intervention: A small-group 6-week workshop for individuals with chronic conditions to learn skills and strategies to manage their health.
- Results: Participants have better health and quality of life, including reduction in pain, fatigue, and depression.
Effective Examples
Salud es Vida Cervical Cancer Education
Updated/reviewed January 2023
Updated/reviewed January 2023
- Need: Hispanic women have the highest incidence rates of cervical cancer among any ethnicity in the United States.
- Intervention: The development of a lay health worker (promotora) curriculum that provided information on cervical cancer, HPV, and the HPV vaccine to Hispanic farmworker women living in rural southern Georgia and South Carolina.
- Results: Significant increases in post-test scores relating to cervical cancer knowledge and increases in positive self-efficacy among promotoras.
Promising Examples
Texas C-STEP Project: Cancer Screening, Training, Education and Prevention Program
Updated/reviewed March 2021
Updated/reviewed March 2021
- Need: Improve screening rates for rural uninsured/underinsured patients in counties surrounding Bryan-College Station, Texas.
- Intervention: An academic center's nursing and family medicine training programs partnered with its public health program to obtain state grant funds for execution of a coordinated cancer prevention and detection program.
- Results: In 5 years of colorectal screening efforts, 18 cases of colorectal cancer were diagnosed in addition to detection of precancerous lesions in 25% of nearly 2000 screening colonoscopies. In 3 years of women's health screening, 18 cases of breast cancer and 141 precancerous cervical lesions were also detected. Due to the initial success of the project, the program continues.

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.
Other Project Examples

Updated/reviewed March 2020
- Need: Comprehensive cancer services for residents of an 8-county, 3-state area in Appalachia.
- Intervention: Using a Cancer Patient Navigation Tool Kit, a Maryland acute care facility led a multidisciplinary collaboration that provided the area's patients with expanded cancer treatment services.
- Results: In addition to several new cancer-related programs, expanded services are now available for cancer patients, families, and cancer survivors.
Last Updated: 1/6/2023