Fidelity in Action
Rural Health Transformation Funding Is Coming — But Implementation Is the Real Work
It has been fascinating to watch where the federal government is investing in healthcare right now, particularly through the Rural Health Transformation Program (RHTP). These investments are significant, and they signal a growing recognition that rural and frontier communities need new strategies to improve outcomes in chronic disease, behavioral health, and access to care.
For those of us who have spent decades working in rural systems, this moment feels both exciting and familiar.
When I was at Washington State University and now through the work we do at the Institute for Individual and Organizational Change (IFIOC), much of our focus has been on a simple question: how do you actually implement evidence-based practices in rural communities in a way that works in the real world?
Because implementation—not the intervention itself—is almost always the barrier.
Reading through the goals of the RHTP, one thing becomes immediately clear: many of the outcomes being targeted rely heavily on human behavior change. Chronic disease management, behavioral health engagement, substance use treatment retention, and prevention all depend on how effectively providers can engage people in conversations about their health.
This is exactly where Motivational Interviewing (MI) becomes relevant.
Motivational Interviewing is one of the most extensively researched approaches for helping people make health-related behavior changes. When it is practiced well, it improves patient engagement, treatment adherence, and follow-through across a wide range of health conditions.
Yet there is an interesting paradox.
MI is widely known across healthcare and behavioral health. Because of that familiarity, many organizations assume they are already using it effectively. Research consistently shows that this is rarely the case. Without structured coaching and feedback, most professionals struggle to implement MI with the level of fidelity required to produce the outcomes seen in research.
In other words, the challenge is not access to the idea of Motivational Interviewing.
The challenge is implementing it well.
As organizations begin planning how to use RHTP resources, the conversation will inevitably shift from “what intervention should we use?” to a much more difficult question:
How do we implement it across a workforce in a way that actually improves outcomes?
That is where the real work begins.
–Casey Jackson, Founder & CEO
Want to learn more about the Rural Health Transformation Program? Click here to learn more.
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