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Rural Schools and 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.

Evidence-Based Examples

Helping Kids PROSPER
Updated/reviewed January 2017
  • Need: An approach to support sustained, quality delivery of evidence-based programs for youth and families in rural communities.
  • Intervention: PROSPER, a program delivery system, guides communities in implementing evidence-based programs that build youth competencies, improve family functioning, and prevent risky behaviors, particularly substance use.
  • Results: Youth in PROSPER communities reported delayed initiation of a variety of substances, lower levels of other behavioral problems, and improvements in family functioning and other life skills.

Promising Examples

funded by the Federal Office of Rural Health Policy Noble County Outreach Project
Updated/reviewed October 2017
  • Need: To help enroll and retain children and their families in health insurance in Noble County, Indiana.
  • Intervention: A school-based health insurance outreach program focused on connecting children to health insurance.
  • Results: More than 600 individuals have enrolled in health insurance.
funded by the Federal Office of Rural Health Policy Healthy Early Learning Project (HELP)
Updated/reviewed May 2017
  • Need: An ongoing health need to alleviate early childhood obesity in the rural Kansas counties of Marshall and Nemaha.
  • Intervention: 5 distinct physical and nutritional programs were introduced to 9 preschool sites through the overarching Healthy Early Learning Project (HELP).
  • Results: HELP comprehensively increased children's physical activity and healthy food consumption and established a sustainable presence at each preschool site.
funded by the Federal Office of Rural Health Policy School-Based Health Center Dental Outreach
Updated/reviewed December 2016
  • Need: To improve the oral health status of children ages 3 to 13 living in underserved rural areas of Louisiana.
  • Intervention: Students enrolled in school-based health centers receive oral health assessments as part of their comprehensive physical exams.
  • Results: During the 2012-2015 grant period, SBHCs provided 2,136 fluoride varnishes and 2,273 caries risk assessments and identified 715 dental homes for children. In year one of the 2015-2018 grant, SBHCs provided 938 fluoride varnishes.
funded by the Federal Office of Rural Health Policy Coast to Cascade Coordinated Approach to Child Health (CATCH) Program
Updated/reviewed November 2016
  • Need: To build up physical activity and healthy eating practices in order to reduce childhood obesity in rural Oregon communities.
  • Intervention: A national program was applied on a local level to provide physical activity and nutrition education in a school setting.
  • Results: The physical activity rate surpassed the Department of Health and Human Services recommended rate by 5%, and schools started serving healthier options in their cafeterias.

Other Project Examples

Capitol Dental Care's Virtual Dental Homes
Added November 2017
  • Need: Dentists in Polk County, Oregon who accepted Oregon Health Plan were booked out for months, causing patients with dental needs to have to wait for an appointment or travel to an adjoining county for dental care.
  • Intervention: Capitol Dental Care began a Virtual Dental Home teledentistry model to bring preventive dental care to 3 elementary schools and several Head Start programs.
  • Results: Through this program, over 700 students have received dental care in their schools.
funded by the Federal Office of Rural Health Policy CATCH-UP (Coordinated Approach to Child Health in the Upper Peninsula)
Updated/reviewed November 2017
  • Need: To reduce childhood obesity and risk for chronic illness for youth aged 5-12 in the rural Western Upper Peninsula region of Michigan.
  • Intervention: Integrated the evidence-based CATCH program to increase physical activity and healthy eating habits in children.
  • Results: Created a healthy school environment in 12 districts promoting daily physical activity, good nutritional choices, and supportive communities for more than 3,000 children.
funded by the Federal Office of Rural Health Policy Healthy Families
Updated/reviewed November 2017
  • Need: High obesity rates among preschool children are a public health concern.
  • Intervention: The Healthy Families program was created to provide school-based obesity prevention and intervention in preschools throughout three Michigan counties.
  • Results: Healthy Families provided education on nutrition and physical fitness to hundreds of preschool children and their families, helping children maintain or improve their BMI and instill lifelong healthy habits.
Fostering Futures in Menominee Nation
Updated/reviewed September 2017
  • 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.
It's a Girl Thing: Making Proud Choices
Added September 2017
  • Need: Teen pregnancy and sexually transmitted diseases, including HIV, in young girls were concerns for members of Union Parish, Louisiana.
  • Intervention: Union General Hospital, a Critical Access Hospital, created the program It's a Girl Thing: Making Proud Choices to teach prevention, self-confidence, and personal responsibility to teen girls.
  • Results: Teen pregnancy rates in Union Parish have dropped by 18%, exceeding the program's initial goal of 5%. Graduation rates have also increased the longer girls remain in the program.
funded by the Federal Office of Rural Health Policy Santa Cruz County Adolescent Wellness Network
Updated/reviewed September 2017
  • Need: To integrate and enhance adolescent services in a rural Arizona county that borders Mexico.
  • Intervention: The Santa Cruz County Adolescent Wellness Network (AWN) was developed to maximize local assets to improve adolescent health and wellness in Santa Cruz County. Their efforts enhance health services in schools, develop youth leaders, and equip adolescent-serving organizations.
  • Results: Successfully improved adolescent wellness understanding and involvement, training a total of 783 participants in adolescent development topics. A school-linked healthcare system resulted in 217 referrals to primary care or behavioral health in 1 semester.
funded by the Health Resources Services Administration Health-e-Schools
Updated/reviewed August 2017
  • Need: Rural school children lack proper healthcare resources within the school setting.
  • Intervention: Health-e-Schools provides health services to students via teleconferencing 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.
funded by the Federal Office of Rural Health Policy Visiting School Nurse Program
Updated/reviewed August 2017
  • Need: Students in rural communities lacked access to healthcare services, resulting in poor school performance.
  • Intervention: The Visiting School Nurse program was created to improve access to health care for 6,000 students in Fulton County, Illinois.
  • Results: After the three years of the grant-funded program, the program continues to serve one school district and staff with a variety of health services and educational campaigns.
Club Scrub
Updated/reviewed July 2017
  • Need: Rural Wisconsin communities experience threatened healthcare infrastructure due to workforce shortages.
  • Intervention: The Rural Wisconsin Health Cooperative, in partnership with the Wisconsin Office of Rural Health, created a youth program to increase awareness of health-related professions known as Club Scrub.
  • Results: Middle-school students attend the program and gain a better understanding of career options in the healthcare industry.
Island Hospital’s Psychiatry & Behavioral Health Clinic
Updated/reviewed July 2017
  • Need: Anacortes of Washington State, has limited access to mental healthcare services. In addition, psychiatric or behavioral health services were sparse for students in the Anacortes School District.
  • Intervention: Island Hospital opened a Psychiatry & Behavioral Health Clinic that serves patients on their campus and at schools located in the Anacortes School District.
  • Results: Over 2,500 mental health and social work appointments have been facilitated at Anacortes's public schools. Thousands more appointments have been provided at the clinic to meet the mental health needs of the community.
funded by the Federal Office of Rural Health Policy Butte Child Evaluation Center
Updated/reviewed June 2017
  • Need: Before 2000, Butte and southwest Montana had around 1,300 cases of child abuse a year, with only a 20% conviction rate for perpetrators of sexual abuse.
  • Intervention: Multiple agencies in the community came together to address the issue of child abuse by forming the Butte Child Evaluation Center (CEC), a Children's Advocacy Center.
  • Results: During a 3-year grant cycle, over 200 interviews and exams were performed on victims of sexual abuse and the Butte CEC became the first program in Montana to be accredited by the National Children's Alliance.
funded by the Federal Office of Rural Health Policy Cold Water Safety in the Schools
Updated/reviewed June 2017
  • Need: Drowning was a leading cause of death for children in Alaska.
  • Intervention: Cold Water Safety and Survival for Educators workshops were developed in 1998, with help from a 4-year federal grant, to train educators to provide education and hands-on skills for school children and members of the public.
  • Results: The safety program was integrated into many Alaskan schools curriculum, helping to train hundreds of educators and thousands of Alaskan children on the importance of cold water safety.
South Dakota Harvest of the Month Program
Updated/reviewed June 2017
  • Need: To encourage children to make healthy eating choices through learning and tasting.
  • Intervention: Brief, fun, and informative presentations for children on over 42 different fruits and vegetables.
  • Results: Participants are exposed to new foods and show more interest in healthy eating.
The Walking Classroom
Updated/reviewed April 2017
  • Need: To help elementary and middle school children become more active and reduce their risk of obesity
  • Intervention: A classroom, afterschool, or summer program offered several times per week throughout the school year that gets students walking as a class for 20 minute lessons while listening to an educational podcast
  • Results: Children increase their activity level while learning academic content, building health literacy, and developing healthy lifestyle habits to prevent obesity
Together We Can Be Bully Free
Added April 2017
  • Need: Rural Union Parish, Louisiana experienced higher than average suicide rates among youth.
  • Intervention: Union General Hospital, a Critical Access Hospital, started a program to educate students 4th through 12th grade on the negative effects of bullying and how to model positive social behavior.
  • Results: The 1,500+ students trained have learned how to recognize, report, and react to bullying.
Hope Squad
Added March 2017
  • Need: To reduce youth suicide rates in Utah.
  • Intervention: Hope Squad is a statewide program that trains youth to look after their classmates and refer those with suicidal thoughts or other mental health concerns to adult advisors.
  • Results: Surveys indicate that Hope Squad members increase and retain their knowledge of suicide and increase help-seeking behaviors after completing training.
Schools as a Hub for Health
Added March 2017
  • Need: To improve health outcomes in rural Appalachian Ohio.
  • Intervention: Schools as a Hub for Health promotes holistic wellness for the whole community by creating or bringing in programs that support physical, mental, and social health.
  • Results: The project has gained administrator buy-in and was featured in a December 2016 County Health Rankings & Roadmaps webinar.
Hoonah Fun and Fit Partnership
Updated/reviewed February 2017
  • Need: Rural Alaskans are significantly more likely to be obese compared to the rest of the state.
  • Intervention: The rural community of Hoonah, AK, is creating more opportunities for participation in physical activities and community engagement through Hoonah Fun and Fit Partnership.
  • Results: Healthier school menus and various fitness options are being encouraged throughout the community. Community members have reported healthier lifestyles and higher levels of physical activity.
Munson Healthcare Charlevoix Hospital School Nurse Program
Added February 2017
  • Need: School nurses to assess and care for students in rural Michigan schools who have limited access to healthcare.
  • Intervention: Munson Healthcare Charlevoix, a CAH in Northern Michigan, created the School Nurse Program to provide medical care and education to students, school staff, and families.
  • Results: The School Nurse Program brings healthcare to over 3,400 students in 8 schools every year and chronic absenteeism in participating schools has dramatically decreased.
funded by the Federal Office of Rural Health Policy Nelson County School Nurse Program
Updated/reviewed February 2017
  • Need: Low rates of immunization and a lack of knowledge about physical health among school age children in the rural areas of Nelson County, Virginia.
  • Intervention: A School Nurse Program placed a registered nurse in each of the four county public schools to track and encourage immunization compliance, provide health education, and handle students' daily health issues.
  • Results: School-age children are having many of their minor health concerns addressed throughout the day by registered nurses at school. Compliance for childhood immunizations is now extremely high.
funded by the Federal Office of Rural Health Policy Chautauqua Opportunities, Inc.
Updated/reviewed January 2017
  • Need: To reduce obesity and diabetes in children and adults of rural southwest New York.
  • Intervention: Chautauqua Opportunities, Inc. Rural Outreach Program was developed to bring diabetes and obesity services to Chautauqua and Cattaraugus county residents.
  • Results: The program saw a 50% improvement rate in Type 1 and prediabetic participants and just over 50% for Type 2 diabetics.
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.
Northeast Iowa Food and Fitness Initiative
Added November 2015
  • Need: Close to 70% of adults and 37% of children ages 4 and under in Northeast Iowa are overweight or obese.
  • Intervention: In rural Iowa, efforts are being made to support and promote access to locally-grown, healthy foods and active lifestyles, particularly in children, through the Northeast Iowa Food & Fitness Initiative.
  • Results: Over $70,000 of food grown by local farmers was purchased by Northeast Iowa schools during the 2014-15 school year. The Central Community School K-6 overweight or obesity rate decreased from 38% in 2010-2011 to 30.6% in 2014-15.
funded by the Federal Office of Rural Health Policy On the Move: Unlawful Narcotics Investigations, Treatment & Education (Operation UNITE)
Added October 2015
  • Need: Illicit drug and alcohol use continued to increase in the Central Appalachian region of Kentucky where many schools had no type of prevention curriculum.
  • Intervention: Using engaging simulations and presentations, the program delivered substance abuse education to middle school and high school students.
  • Results: Post-test surveys showed that thousands of students were reached through the On the Move project and gained positive knowledge on the dangers of substance abuse.

Last Updated: 11/21/2017