The Oregon Rural Practice-based Research Network (ORPRN) at Oregon Health & Science University is dedicated to improving healthcare, impacting health policy, and disseminating health education in Oregon and beyond through three distinct programs: Research, Health Policy, and Education. Each program plays a crucial role addressing challenges to providing appropriate care for chronic health conditions. Using a diabetes care case study, ORPRN demonstrates how chronic diseases can be addressed through different programs with varying priorities and goals, all united by the aim to improve health outcomes. The Health Impact Pyramid will serve as a framework to illustrate this work at different levels.

The ORPRN Research Program (RP) partnered with the American Diabetes Association (ADA) to integrate diabetes research into Practice-based Research Networks (PBRNs). The collaboration aimed to enhance the role of Community Health Workers (CHWs) in primary care settings starting in Oregon’s rural Columbia Gorge communities. This aligns with the public health pyramid's focus on long-lasting protective interventions and changing context to make healthy choices easier.

The Health Policy Program works on the Diabetes Prevention Program (DPP), providing essential support to healthcare providers, including clarifying billing processes for DPP services and identifying new provider types to increase enrollment. These efforts correspond to the pyramid's emphasis on clinical interventions and addressing social determinants of health.

The Education program houses HEAL-OR, a five-year initiative, with key activities that include establishing a rural advisory panel, utilizing the Project ECHO® learning model to enhance access to and quality of diabetes care, collaborating with Coordinated Care Organizations, and developing a best-practice toolkit to support healthcare providers in delivering effective diabetes care. The Diabetes Care for Whole-Person Health ECHO program is currently in it’s fifth cohort, having drawn 136 participants over the past four cohorts to learn about topics from destigmatizing diabetes to addressing cost barriers. This program reflects the pyramid's tiers of counseling and education, as well as community-wide interventions.

ORPRN is working to improve care for diabetes in Oregon and offers examples for organizations to address chronic diseases through different levels and types of programming.