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

• 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

• 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

• 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

• 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

• 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.

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.

Other Project Examples

Garrett County Regional Cancer Patient Navigator Program
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.