Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples

Smith, Tina; Adimu, Tanisa Foxworth; Martínez, Amanda Phillips; Minyard, Karen

doi:10.1353/hpu.2016.0179

Cited by 24 publications

(39 citation statements)

References 9 publications

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“…Additional adaptations we propose to maximize reach include having initial face‐to‐face meetings between the NP/CHW team and program participants with the option for transitioning to future phone‐based meetings, having additional examples and explanations regarding strategies to lessen CVD risk in the COACH program guide, addressing geographic distance in rural communities, and having linguistically appropriate services available. These findings are consistent with a previous study that describes the following contextual factors that can affect the implementation of evidence‐based interventions in rural settings: logistical, environmental, and cultural obstacles such as geographic isolation, workforce availability, health literacy, population diversity, and rural cultural factors . Furthermore, in line with the existing COACH program, participants expressed a need for a rural COACH intervention to include social support/encouragement in addition to the specific health education components.…”

Section: Discussionsupporting

confidence: 89%

“…The literature underscores the need for making deliberate modifications to evidence‐based original models to enhance program fit to rural communities . Results from our study confirm this finding.…”

Section: Discussionsupporting

confidence: 80%

“…Called for in the Patient Protection and Affordable Care Act, the National Prevention Strategy recommends support for research to identify effective strategies to eliminate health disparities, a strategic focus on communities of greatest risk, and an increased capacity of the prevention workforce to address disparities . Furthermore, an examination on how federal grantees implement evidence‐based health practices in rural settings concluded that opportunities for building a more robust rural health evidence base include investments in rural‐specific research and theory building and translation of existing evidence using a rural lens . While results from this study provide descriptive narratives and generalizability to other rural communities is not ensured, the adaptation process undertaken in the context of the RE‐AIM framework, to maximize reach and efficacy for a COACH intervention implemented in a rural setting, can be generalized.…”

Section: Discussionmentioning

confidence: 98%

“…Evidence supports the need and desire of rural residents to reduce CVD risk in their communities, yet few interventions have been designed, or adapted, specifically for rural settings . Considering different structures and resources needed for implementation in rural areas, there exist opportunities to adapt efficacious urban health promotion interventions, based on generalizable behavior change theories, for rural populations . Potential program modifications include innovative program design strategies to develop prevention programs that build in adaptation to enhance program fit to a specific community while simultaneously maximizing fidelity of implementation and program effectiveness .…”

Section: Background/rationalementioning

confidence: 99%

“…Potential program modifications include innovative program design strategies to develop prevention programs that build in adaptation to enhance program fit to a specific community while simultaneously maximizing fidelity of implementation and program effectiveness . Data from 70 Federal Office of Rural Health Policy grantees found that programs may need to address the following barriers to implementation in rural settings: geographic isolation, literacy rates, persistent workforce shortages, population diversity, and poverty …”

Section: Background/rationalementioning

confidence: 99%

See 4 more Smart Citations

Adapting an Evidence‐based Cardiovascular Disease Risk Reduction Intervention to Rural Communities

Johansson

Schober²,

Tutsch

et al. 2018

The Journal of Rural Health

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Section: Discussionsupporting

confidence: 89%

Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 98%

Section: Background/rationalementioning

confidence: 99%

Section: Background/rationalementioning

confidence: 99%

See 3 more Smart Citations

Adapting an Evidence‐based Cardiovascular Disease Risk Reduction Intervention to Rural Communities

Johansson

Schober²,

Tutsch

et al. 2018

The Journal of Rural Health

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World Health Organization building blocks in rural community health services: An integrative review

Stockton

Fowler

Debono

et al. 2021

Health Science Reports

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Introduction Developing and adapting health service models to effectively meet the needs of rural and remote communities is an international priority given inequities in health outcomes compared with metropolitan counterparts. This integrative review aims to inform rural and remote health service delivery systems by drawing on the WHO Framework building blocks to identify lessons learned from the literature describing experiences of rural and remote community health service planning and implementation; and inform recommendations to strengthen often disadvantaged rural and remote health systems for policy makers, health service managers, and those implementing international healthcare initiatives within these contexts. Methods The integrative review examined the literature reporting rural and remote community health service delivery published from 2007 to 2017 (the decade following the release of the WHO Framework). Using an analytic frame, a structured template was developed to extract data and categorized against the WHO building blocks, followed by a synthesis of the key findings. Results This integrative review identified that WHO Framework building blocks such as “Service Delivery” and “Health Workforce” are commonly reflected in rural and remote community health service delivery literature in the decade since the Framework's release. However, others such as “Sustainable Funding and Social Protection” are less commonly reported in the literature despite these elements being identified by the WHO as being integral to successful, sustainable health service delivery systems. Conclusions We found that collaboration across the health system governance continuum from local to policy level is an essential enabler for rural and remote health service delivery. Community‐based participatory action research provides an opportunity to learn from one another, build capacity, optimize service model suitability, and promotes cultural safety by demonstrating respect and inclusivity in decision‐making. Policy makers and funders need to acknowledge the time and resources required to build trust and community coalitions to inform effective planning and implementation.

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Implementation studio: implementation support program to build the capacity of rural community health educators serving immigrant communities to implement evidence-based cancer prevention and control interventions

Ko,

Vu,

Bishop

et al. 2023

Cancer Causes Control

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Purpose Rural community-based organizations (CBOs) serving immigrant communities are critical settings for implementing evidence-based interventions (EBIs). The Implementation Studio is a training and consultation program focused on facilitating the selection, adaptation, and implementation of cancer prevention and control EBIs. This paper describes implementation and evaluation of the Implementation Studio on CBO’s capacity to implement EBIs and their clients’ knowledge of colorectal cancer (CRC) screening and intention to screen. Methods Thirteen community health educators (CHEs) from two CBOs participated in the Implementation Studio. Both CBOs selected CRC EBIs during the Studio. The evaluation included two steps. The first step assessed the CHEs’ capacity to select, adapt, and implement an EBI. The second step assessed the effect of the CHEs-delivered EBIs on clients’ knowledge of CRC and intention to screen (n = 44). Results All CHEs were Hispanic and women. Pre/post-evaluation of the Studio showed an increase on CHEs knowledge about EBIs (pre: 23% to post: 75%; p < 0.001). CHEs’ ability to select, adapt, and implement EBIs also increased, respectively: select EBI (pre: 21% to post: 92%; p < 0.001), adapt EBI (pre: 21% to post: 92%; p < 0.001), and implement EBI (pre: 29% to post: 75%; p = 0.003). Pre/post-evaluation of the CHE-delivered EBI showed an increase on CRC screening knowledge (p < 0.5) and intention to screen for CRC by their clients. Conclusion Implementation Studio can address unique needs of low resource rural CBOs. An implementation support program with training and consultation has potential to build the capacity of rural CBOs serving immigrant communities to implementation of cancer prevention and control EBIs. Clinical Trials Registration Number: NCT04208724 registered.

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Selecting, Adapting, and Implementing Evidence-based Interventions in Rural Settings: An Analysis of 70 Community Examples

Cited by 24 publications

References 9 publications

Adapting an Evidence‐based Cardiovascular Disease Risk Reduction Intervention to Rural Communities

Adapting an Evidence‐based Cardiovascular Disease Risk Reduction Intervention to Rural Communities

World Health Organization building blocks in rural community health services: An integrative review

Implementation studio: implementation support program to build the capacity of rural community health educators serving immigrant communities to implement evidence-based cancer prevention and control interventions

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