Implementation | Healthy Appalachia

Blueprint Implementation

The Southwest Virginia Health Authority and the Healthy Appalachia Institute were pleased to sponsor local projects addressing priorities outlined in the 2023-2024 Blueprint for Health Improvement and Health-Enabled Prosperity.

Blueprint for Health Improvement and Prosperity: SVHA Program Guidelines

Purpose

The Southwest Virginia Health Authority (SVHA), established by the Virginia General Assembly, drove health transformation for underserved Appalachian communities. Its mission was to elevate access, enhance health, address regional issues, advance technology, boost accountability, engage academia, strengthen the health workforce, and foster collaboration.

Foundation

In 2022, USDA’s REHC funding fueled the Virginia Consortium for Advancement of Health Care in Rural Appalachia. Led by SVHA and partners, this initiative targeted critical health barriers across Lenowisco, Cumberland Plateau, and Mount Rogers, implementing strategic actions from the 2023-2024 Blueprint for Health Improvement.

Core Priorities

Expand Health Access: Enabled remote monitoring for high-risk patients and telehealth in libraries, pharmacies, and senior centers.
Combat Substance Use: Integrated care for child abuse, primary and behavioral health, trauma therapy, and job training for recovery.
Promote Nutrition & Exercise: Supported nutrition education, diabetes prevention, and physical activity.

Download Guidelines

Project Evaluation Methods

Data Collection: The project evaluation process followed a sequential mixed methods research design over an eighteen-month period, from November 2024 to May 2026 and the end of the overall project. The sequential approach involved the collection of project-specific data on a quarterly basis, which consisted of four quarters for most projects and five for those requesting no-cost extensions through February 2026. Quantitative and qualitative data were collected using structured survey instruments, along with qualitative data from structured observations and unstructured interviews conducted by Dr. Driscoll during site visits with project personnel and their community partners. Both quantitative and qualitative data collected in previous quarters were analyzed to inform the manner and content of subsequent data collection.

Data Analysis: Four investigators independently analyzed the data collected from quarterly reports and site visits to assess adherence to the proposed processes and their outcomes. The team iteratively developed and refined consensus on emergent themes, or codes, related to the process and outcome data in three consecutive phases.

OPEN CODING: Assessed pre-established meaningful units associated with project activities related to a project goal, particularly proposed processes or their outcomes. This inductive phase allowed unanticipated experiences, particularly those related to problems encountered, changes made, and assistance received, to emerge from the data.
AXIAL CODING: Assessed pre-established or emergent open codes, including factors associated with actual adherence to proposed project processes, and the context and extent to which proposed project outcomes were achieved.
SELECTIVE CODING: Assessed and summarized key insights regarding overall project processes and achievement of outcomes, allowing for emergent conceptual relationships and broader themes.

Awarded Community Partners

Appalachian College of Pharmacy

Expanded a multi-organization virtual clinic collaboration anchored in Food City retail pharmacy locations and supported by regional clinical partners. Key collaborations included the Food City supermarket chain as host for project sites, Appalachian Family Clinic and other clinical providers to deliver primary and urgent medical services, and regional clinical providers to support online referrals and continuity of care. The project also sought to employ pharmacy students and pharmacists as an implementation workforce for patient education, diabetes enrollment, and service navigation to strengthen the clinical-community interface.

Mount Rogers Community Services

Advanced clinical and recovery-oriented partnerships to expand access to integrated behavioral health services and strengthen Peer Wellness Center capacity. Collaboration was to be reinforced across internal clinical teams and peer services staff to support caseload growth, appointment adherence, and continuity of care, including telehealth-enabled services where needed. MRCS also sought to expand community partnerships to support food access and recovery supports through donations and an established food distribution partner, while building a wider local ecosystem of collaboration to respond to increased community need.

Mountain Empire Community College

Built a regional Community Health Worker training and internship collaboration aligned with state certification requirements. This included establishing an advisory network inclusive of community health and workforce stakeholders, and strengthening collaboration with medical providers, including regional Federally Qualified Health Centers and supporting organizations through formal clinical rotation and employment opportunities. Students would have opportunities to engage with local medical partners and residents through community-outreach and needs assessment events to gain real-world knowledge of the root causes of community health.

Stone Mountain Health Services

Strengthened clinic-to-clinic collaboration across its service area through telehealth infrastructure that connected primary care sites to centralized behavioral health providers. The organization built coordinated workflows between local clinics, psychiatric mental health nurse practitioners, and counseling staff to increase access in a multi-county region. In addition, Stone Mountain developed a technology-enabled collaboration model to support same-day clinical access and expanded its partnership approach through a contracted remote patient monitoring (RPM) model for diabetes, linking patients, providers, and external monitoring support to build a foundation for longer-term chronic disease management.

Mountain Empire Older Citizens

Developed a telehealth-enabled collaboration model to extend nutrition counseling, preventive education, and behavioral health resources across congregate settings and home-delivered meal networks. MEOC’s partnerships would include technical and implementation support relationships that strengthened training, deployment, and operations of telehealth programming, as well as content-delivery collaborations with subject matter professionals to expand education on mental health, dementia, and healthy aging. MEOC also proposed to build relationships that elevated the project into broader telehealth learning networks through conference participation and field-wide knowledge sharing.

The University of Virginia College at Wise

Provided a school-based implementation partnership with LF Addington Middle School in Wise to implement the Eat Smart Play Strong curriculum, an evidence-based model for promoting both nutritional awareness and exercise in young people. The project involved engaging and coordinating the efforts of PE teachers and UVA Wise student research assistants around delivery of the curriculum and collection of structured evaluation data in accordance with the evidence-based model. One important evaluation criterion was that the practical collaboration model would integrate nutrition literacy into PE instruction, support rigorous data collection, and maintain high levels of physical activity in PE classes.