Context: Decades of behavioral research suggest that awareness of health threats is a necessary precursor to engage in health promotion and disease prevention, findings that can be extended to the community level. Purpose: We sought to better understand local perspectives on the main health concerns of rural Appalachian communities in order to…

Surveys of 3,346 rural and small-town residents of Kentucky and 138 rural prenatal service providers found that neither males nor females were knowledgeable about the harmful effects of alcohol use during pregnancy, with males having significantly less knowledge. Service providers identified barriers to health promotion and prevention efforts and…

In the Kentucky Homeplace Project, specially trained paraprofessionals who live in medically underserved rural communities make home visits, facilitate access to health care, and provide case management and culturally appropriate prevention education for poor families. Strengths include local administration and staff and holistic and traditional…

Complex community health promotion programs are being held accountable for their effectiveness, but rural public health departments lack staff and expertise to carry out evaluations. In Kentucky, a university evaluation expert trains local public health staff in technical skills for program evaluation and provides ongoing mentoring and technical…