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Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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White Paper/Brief
This brief lists interventions to support state public health efforts to address rural disparities and racial discrimination. It emphasizes the importance of localized data on social determinants of health and improving systemic and structural underpinnings of racial disparities. Suggested interventions address data collection and workforce issues, including representativeness and paid family leave.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Toolkit
This blueprint presents recommendations for Illinois to reduce health disparities in rural areas. Recommendations include (1) investing in programs to recruit and retain rural health care workers; (2) improving rural data systems; (3) integrating health care and social services in rural areas; (4) increasing communication between rural health organizations and public health departments; and (5) creating a rural innovation center to coordinate data, policies, and strategies across state agencies.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Implementation Guide
This guidebook was designed to increase equity and access in COVID-19 testing and contact tracing in Virginia. The guidelines included a health equity framework, recommendations for working with communities, common barriers to COVID-19 testing faced by the most at-risk populations, and how to identify areas with unmet testing needs. Descriptions of how to determine appropriate interventions for testing, contact tracing, and building trusting community relationships are included.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Peer Review Study
This practice traces a 14-year partnership between health institutions and a rural Native Hawaiian community. The partnership began as a single study to study familial cardiomyopathy, then evolved towards a community-based project to improve overall health and wellbeing. As time went on, other institutions and community leaders became involved. The article focuses on the growth of institutional capacity and community service. Lessons learned can serve to engage communities in COVID-19 prevention and mitigation measures.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This article evaluates a partnership between the University of Maryland, Baltimore – an urban academic treatment center – and multiple rural behavioral health treatment centers to provide medication assisted treatment (MAT) to individuals with opioid use disorder via videoconference. Retention rates and toxicology results for patients who received MAT via videoconference were comparable to those receiving face-to-face treatment. It should be noted that data for this study were collected prior to the onset of the COVID-19 pandemic.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Peer Review Study
This article presents the results of a non-randomized controlled trial comparing in-person vs. telemedicine treatment for pregnant women with opioid use disorder in South Carolina. The authors found no statistically significant difference in treatment outcomes for women who received care in-person vs. via telemedicine, and no statistically significant difference in outcomes for the newborns of women in these respective groups. The authors were unable to assign trial participants to telemedicine vs. in-person care at random due to the inability of some rural patients to attend treatment in person. Also, the sample size was not sufficient to achieve ~80% power to detect a difference between the two groups. At the same time, the practice strategy is considered useful for helping to deliver telehealth treatment for vulnerable populations, including pregnant and newly parenting people with substance use disorder, and people living in rural communities.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Case Study
This article summarizes the lessons learned from implementing telehealth in rural environments over the past 3 years and how to expand these efforts in the context of COVID-19. The needs of elderly populations in rural environments are also addressed. It provides 5 strategies for implementing telehealth in this context: (1) Preparation and Training; 2) Standardize and Expedite Credentialing; (3) Technology; (4) Broadband; and (5) Feedback and Rapid Improvement.
Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Summary Report/Recommendations
This article compared community health workers (CHWs) in Indiana and Texas based on the results of two research studies in order to 1) investigate the unique role of CHWs and their Spanish-speaking counterparts, promotores de salud, in rural communities and 2) understand how their advocacy efforts represent a central form of caregiving. An analysis was done of how CHWs connect structurally vulnerable clients in rural areas to resources, health education, and health and social services. CHWs and promotores de salud have acted as first responders to the needs of marginalized rural populations, especially during the COVID-19 pandemic. In addition to health education and translation work, CHWs also play an important role in advocacy, bridging the gap between clients and community leaders. While informing clients of available resources, they empower the clients to advocate for their own needs in different settings. CHWs also have the ability to engage with stakeholders and policy makers in better addressing client needs.
Novel Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and are in the process of generating evidence of effectiveness or may not yet be tested.
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Peer Review Study
This article presents a model proposal for an interactive computer system using mobile phones and the internet for real-time collection and transmission of events related to COVID-19 that could aid the administration and presumptive management of COVID-19, especially in rural areas. This proposal shows that a sophisticated COVID-19 surveillance system can be built using mobile phones with the appropriate telecommunication technology partner.