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Rural Health Information Hub
Rural Health Information Hub

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

Updated/reviewed January 2023

  • 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

Updated/reviewed August 2024

  • 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

Updated/reviewed August 2024

  • Need: To provide mental health services to rural Kansas students and their families.
  • Intervention: The Schools That Care project provides mental health treatment and case management as well as community education events.
  • Results: From 2018 to 2021, 3,456 individuals participated in health education and counseling activities offered to the public, and 964 individuals and 303 families received direct services through the Family Advocate.
funded by the Federal Office of Rural Health Policy

Updated/reviewed July 2020

  • Need: To improve the oral health status of children ages 3 to 17 living in rural areas of Louisiana.
  • Intervention: School-based nurse practitioners perform oral health assessments, apply fluoride varnishes when indicated, and make dental referrals, with completion rates of the latter tracked by dental case managers.
  • Results: Significant numbers of school children are receiving oral health examinations, fluoride varnish applications, and receiving care coordination to improve numbers of completed dental appointments.

Other Project Examples

Updated/reviewed May 2025

  • Need: To improve students' access to behavioral health services in rural North Carolina.
  • Intervention: North Carolina Project ACTIVATE provides three tiers of behavioral health supports in the school setting.
  • Results: The six pilot sites (Cohorts 1 and 2) have created or revised 91 mental health policies, and 48,531 school-based and related employees have received training in different topics and protocols.
funded by the Federal Office of Rural Health Policy

Updated/reviewed April 2025

  • 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 about 79% of Alaskan school curriculum and schools in other states, helping to train hundreds of educators and thousands of children on the importance of cold water safety.

Updated/reviewed April 2025

  • Need: To reduce teen dating violence in middle schools, high schools, and youth organizations by promoting healthy relationship behaviors and fostering a culture of respect among adolescents.
  • Intervention: Jana's Campaign offers prevention programs, including curricular and co-curricular activities, to highlight the 'red flags' and underlying causes of unhealthy dating relationships.
  • Results: Since 2013, 677 middle and high schools and more than 102,350 students in Kansas, Nebraska, Colorado, Missouri, Oklahoma, Texas, Oregon, Montana, and Washington State have benefited from these programs.
funded by the Federal Office of Rural Health Policy

Updated/reviewed August 2024

  • Need: Before 2000, Butte and southwest Montana saw 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.

Added July 2024

  • Need: To increase access to preventive dental care among children living in rural Arizona.
  • Intervention: A nonprofit organization formed to offer free, school-based preventive dental services to children in two rural Arizona counties.
  • Results: Throughout the 2023-24 school year, Tooth B.U.D.D.S. provided preventive services to 1,710 students in rural Graham and Greenlee Counties. Program staff use a telehealth platform to connect children to local dentists for follow-up care.

Updated/reviewed June 2024

  • Need: To reduce youth suicide rates.
  • Intervention: First begun in Utah, Hope Squad is a nationwide program that trains youth to look after their classmates and refer those with suicidal thoughts or other mental health concerns to adult advisors.
  • Results: Studies suggest that Hope Squad schools' students with suicidal thoughts are more likely than non-Hope Squad schools' students to solicit help. In addition, stigma surrounding mental illness is decreasing.
Last Reviewed: 4/22/2025