Rural Health Care Services Outreach Grant Program - The Wayne-Pike-Hawley Health Initiative uses two evidence-based programs from Lifestyle Medicine and the American Heart Association, both focusing on the reduction of heart disease through a primary care and community engagement approach. Given the degree of disease burden, morbidity, and mortality, there is an urgent need to redirect our focus toward prevention and treatment through simple and cost-effective lifestyle strategies. Evidence pathways to health equity feature two broad themes that will be emphasized throughout the project. The first, capacity-building partnerships, is a form of community activism that can ameliorate social determinants of poverty, food deserts, and community safety over time through tenacious intersectoral partnerships, including representatives from vulnerable groups. The second theme engages health care providers to broaden health care impact by building health outside the clinical setting by focusing on lifestyle risk factors with their patients individually. The target population includes low-income individuals, primarily from two rural Northeastern Pennsylvania counties: Wayne and Pike. Both of these counties meet the HRSA geographic requirements for a rural service area. The most common underlying causes of death for both counties include acute myocardial infarction, atherosclerotic heart disease, congestive heart failure, and stroke. Neither clinical nor environmental changes alone are sufficient to address a problem of this magnitude. We propose a framework that integrates clinical and community systems to prevent and manage heart disease. Heart disease will be the special track of focus. Lifestyle Medicine will be the evidence-based model enhanced by the evidence-based programs and educational materials offered through the American Heart Association. The project goals and objectives are to expand service offerings, particularly those focused on heart health treatment and prevention at The Wright Center for Community Health’s Hawley Practice site and through the rural care outreach consortium, including the Human Service Agencies of Wayne and Pike Counties, The Wayne Pike Workforce Alliance, and the American Heart Association who is a key consortium participant. In an integrated system, the activated and empowered patient and family connect to community resources that support ongoing change. We qualify for all three of the funding preferences. The Wright Center for Community Health has the capacity and experience to form consortiums and serve the rural underserved populations, as evidenced by the successful implementation and administration of three HRSA Rural Community Opioid Response Program funding opportunities. The expected outcomes of the proposed project include the reduction of heart disease realized through community collaboration and improvements in the HRSA Uniform Data Set measures related to heart health and sustainable project funding supported by savings or revenue generated through population health value-based payment mechanisms.
