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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 2018
  • 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.

Promising Examples

funded by the Federal Office of Rural Health Policy 4P's Plus Pregnancy Support Project
Updated/reviewed December 2017
  • Need: Pregnancy support services for Native American women struggling with substance use.
  • Intervention: An integrated behavioral health network implemented in Lake County, California.
  • Results: Fewer Native American babies exposed to alcohol, tobacco, and other drugs.

Other Project Examples

Portable Alternative Sanitation System (PASS)
Updated/reviewed November 2018
  • Need: To bring a low-cost water and sanitation system to an Alaska Native village with no running water or sewer system.
  • Intervention: The Portable Alternative Sanitation System (PASS) collects and treats 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 September 2018
  • 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 85% since 2008.
funded by the Federal Office of Rural Health Policy Prince of Wales Health Network
Updated/reviewed July 2018
  • Need: To increase collaboration between healthcare facilities and other organizations on a rural Alaska island in order to provide better access to and quality of healthcare.
  • Intervention: A health network focused on collaboration in order to best meet healthcare needs of island residents.
  • Results: Increased collaboration and cooperation among healthcare facilities and other organizations, leading to enhanced healthcare services for island residents while eliminating unneeded duplication of services and filling in service gaps.
funded by the Federal Office of Rural Health Policy Facing Diabetes: Quality Improvement in Rural South Dakota Project
Updated/reviewed June 2018
  • Need: To help adults and children in rural South Dakota prevent or manage their diabetes.
  • Intervention: The Facing Diabetes Project offered group medical visits for adults and provides prevention and education sessions for the local 4th to 5th graders.
  • Results: Many adults and children in the region feel better equipped to choose healthy foods, exercise regularly, and manage their stress: all factors that can help prevent diabetes or decrease its effects.
Mobile Women's Health Unit
Updated/reviewed July 2017
  • Need: Because breast cancer is a leading cause of cancer death for American Indian and Alaska Native (AI/AN) women, access to screening mammograms for those women living in remote areas is needed.
  • Intervention: The Great Plains Area Indian Health Service Mobile Women's Health Unit provides mammograms to women on multiple reservations across four states.
  • Results: Approximately 1,000 women are screened annually for breast cancer by the mobile unit.
funded by the Federal Office of Rural Health Policy Reach Out Program
Updated/reviewed January 2017
  • Need: Diabetes is the most common health problem in the African American, Latino, and Native American populations of rural Lake County, California.
  • Intervention: A Promotores/Community Health Workers model is used to teach positive lifestyle habits to people of all ages in order to live healthier lives, specifically to manage or prevent Type 2 diabetes.
  • Results: Participants in the Reach Out Program have improved their habits relating to nutrition and physical activity, leading to healthier lives.
Teck John Baker Youth Leaders Program
Updated/reviewed October 2016
  • Need: The teen suicide rate in rural Northwest Arctic Borough, Alaska, was 7 times higher than the statewide teen suicide rate.
  • Intervention: The Teck John Baker Youth Leaders Program trains student leaders to effectively give support to struggling peers and appropriately deal with social issues.
  • Results: The number of teen suicides in the Northwest Arctic Borough decreased from 8 in 2008 to 5 in 2009 (when the program first began) and has successfully dropped and remained at zero every year since.

Last Updated: 11/15/2018