The use of evidence-based interventions (EBIs), programs and practices that have demonstrated effectiveness at improving outcomes, is often preferred, or even required, by funders of health programs and others. Many interventions are developed and studied in more resourced, populated urban settings. It is often assumed that EBIs developed in urban areas can be adapted for other settings. Demographic, cultural, and other differences between urban and rural populations may pose challenges to implementation in rural, often under-resourced settings. This project will investigate the benefits of piloting and researching interventions in rural areas to build the rural evidence base as a step in addressing health disparities and improving health conditions in rural communities. By informing policies to fund/support rural-based pilot programs, findings could help maximize resource efficiency and justify greater allocations by developing a strong evidence base for rural-specific programming.

This project will employ a mixed-methods approach to leverage innovative sources of data and information. First, researchers will conduct a brief literature review to summarize the research around piloting programs and demonstrations in rural settings. Second, researchers will review a variety of evidence-based and best practices repositories (e.g., Rural Health Information Hub's Rural Health Models and Innovations and Evidence-Based Toolkits for Rural Community Health) to identify programs implemented in rural communities and, where known, those which originated in rural communities. In addition to repositories, researchers will crowdsource examples of effective rural programs and interventions. Researchers will extract relevant findings for each program and summarize them accordingly. Lastly, researchers will conduct semi-structured interviews with key informants identified through the repository search and crowdsourcing efforts. Interviews will advance understanding regarding which practices and interventions were piloted in rural areas, why they were piloted in rural areas, and what the benefits were of piloting in rural areas.