Rural Tribal Health – 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.

Effective Examples

Care for Our Elders/Wakanki Ewastepikte
Updated/reviewed June 2022

• Need: To provide Lakota elders with tools and opportunities for advance care planning.
• Intervention: An outreach program in South Dakota helps Lakota elders with advance care planning and wills by providing bilingual brochures and advance directive coaches.
• Results: Care for Our Elders saw an increase in the number of Lakota elders understanding the differences between a will and a living will and the need to have end-of-life discussions with family and healthcare providers.

Other Project Examples

Facing Diabetes: Quality Improvement in Rural South Dakota Project
Updated/reviewed May 2023

• Need: To help adults and children in rural South Dakota prevent or manage their diabetes.
• Intervention: The Facing Diabetes Project offered medical visits for adults and provided prevention and education sessions for the local 4th and 5th graders.
• Results: Many adults and children in the region felt better equipped to choose healthy foods, exercise regularly, and manage their stress: all factors that can help prevent diabetes or decrease its effects.

Portable Alternative Sanitation System (PASS)
Updated/reviewed December 2022

• Need: To bring low-cost water and sanitation improvements to homes in Alaska Native villages without access to piped water or sewer systems.
• Intervention: The Portable Alternative Sanitation System (PASS) treats hauled water, provides for handwashing with clean water, and disposes waste without traditional piping.
• Results: Residents in the pilot project reported that PASS was cleaner and healthier than the self-haul method.

Fostering Futures in Menominee Nation
Updated/reviewed August 2022

• Need: Since the late 1800's, trauma caused by historic events have greatly affected the way of life for Menominee Indians living on the Menominee Reservation. Economic, socioeconomic, behavioral health, and physical health issues have risen and are causing direct implications for Menominee youth.
• Intervention: Through Fostering Futures, clinic, school, and Head Start/Early Head Start staff are trained in administering trauma-informed care and building resilience among children.
• Results: Behavioral health visits at the Menominee Tribal Clinic have increased, school suspension rates have decreased, and graduation rates have improved from 60% to 94% since 2008.

Nictotine Use Prevention and Control (NUPAC) Program
Updated/reviewed October 2021

• Need: To foster relationships with indigenous people in New Mexico to determine culturally appropriate practices in reducing nicotine addiction.
• Intervention: NUPAC provides outreach, community programs, and cessation services.
• Results: In fiscal year 2020, 1,938 QUIT NOW and DEJELO YA quit line enrollees stopped using tobacco, and over 4,520 tobacco users made progress on their path to quitting.