Implementing Healthcare Career Pathway Training Programs in Rural Settings: Responsive Approaches by Tribal HPOG 2.0 Grantees

Publication Date: February 5, 2020
Cover of "Implementing Healthcare Career Pathway Training Programs in Rural Settings: Responsive Approaches by Tribal HPOG 2.0 Grantees."

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  • Published: 2020


This practice brief is one in a series developed by the Tribal Health Profession Opportunity Grants (HPOG) 2.0 evaluation team. The briefs are used to disseminate findings from the evaluation of the Tribal HPOG 2.0 Program. The Tribal HPOG 2.0 Program supports demonstration projects that provide eligible individuals with the opportunity to obtain education and training for occupations in the healthcare field that pay well and are expected to either experience labor shortages or be in high demand.


The purpose of this brief is to: (1) examine the opportunities and challenges in implementing education and training programs in rural communities, and (2) describe how the Tribal HPOG 2.0 grantees have leveraged their communities’ strengths to maximize these opportunities and overcome challenges.

Key Findings and Highlights

Rural communities frequently leverage strengths and assets, such as cross-sector cooperation, social cohesion, and community resilience, to facilitate program development and implementation. These assets often result in the creation of partnerships that can be leveraged to address challenges and barriers to program implementation in rural areas, such as high levels of poverty, geographic isolation, and a need to travel long distances for services.

Most of the Tribal HPOG 2.0 grantees serve participants who live and work in rural areas. These grantees have leveraged their community assets to develop program strategies that address the unique challenges experienced in rural areas. Grantees have:

  • Leveraged partnerships to expand healthcare training opportunities for Tribal HPOG 2.0 participants, including partnerships with higher education institutions and adult education centers as well as the use of distance education.
  • Addressed geographic isolation and increased access to training and services by providing financial assistance (such as gas cards) to address transportation barriers, hosting training programs at locations convenient for participants, and conducting certification exams at training sites or by providing financial support to travel to test sites.
  • Established a variety of communication methods for case management, co-located program staff at partner sites, and identified HPOG liaisons at partner institutions to assist with recruitment.


The tribal evaluation team is conducting a comprehensive implementation and outcome evaluation grounded in culturally appropriate approaches. In developing this practice brief, the tribal evaluation team used qualitative data collected during annual site visits to each of the tribal grantees, including focus groups with program participants and interviews with program staff, local employers, program completers and non-completers, and other stakeholders. The tribal evaluation team also used program operations data collected through the HPOG Participant Accomplishment and Grantee Evaluation System (PAGES) and other program documentation.


Meit, M., Hafford, C., Fromknecht, C., Miesfeld, N., Tolbert, E., and Nadel, T. (2020). Implementing Healthcare Career Pathways Training Programs in Rural Settings: Responsive Approaches by Tribal HPOG 2.0 Grantees. OPRE Report # 2020-08, Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services.


American Indian/Alaska Native
Health Profession Opportunity Grants
Cankdeska Cikana Community College
Cook Inlet Tribal Council, Inc.
Great Plains Tribal Chairmen's Health Board
Turtle Mountain Community College
Ute Mountain Ute Tribe
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