What we leave behind: Factors influencing community institutionalization of public health projects

In 2003, a Prevention Research Center (PRC) at an academic health science center secured a three-year Health Services and Resources Administration grant to support the development of infrastructure to extend access to care into four rural communities.  This effort was in response to a regional assessment conducted in the east Central Texas region known as the Brazos Valley consisting of a small urban hub and six surrounding rural counties. Assessment findings highlighted the limited availability to services and barriers, (e.g. lack of public transportation) to accessing care in the centrally located hub.  The PRC worked with local communities willing to leverage local financial and in-kind resources to guide the establishment of health resource centers. Five centers were established, giving regional providers a facility to offer ancillary health and supportive services on an itinerant basis where these services previously did not exist. Designed by local stakeholders, each center was customized to address unique community needs within local context and evolve as community needs shift. Twelve years later, all five centers continue to exist as each community forged local and external partnerships for sustainability. Subsequently, the centers have become embedded in local government and health care organizations as evidenced in local policy and funding priorities.

This presentation will highlight factors associated with the sustainability of these five centers in diverse rural communities that are of particular importance are: 1.) broad community support; 2.) diverse funding streams; 3.) broad community stakeholders; 4.) leveraging of funding; 5.) longevity of each center.