Community-Oriented Primary Care: Implementation of a National Rural Demonstration

G. Kukulka, J. B. Christianson, I. S. Moscovice, R. DeVries

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


A major objective of community-oriented primary care (COPC) is to focus the clinical practice on the health care problems of the community that the practice serves. The COPC process defines the community of interest, identifies and prioritizes community health problems, and implements and evaluates interventions. Under sponsorship from the W. K. Kellogg Foundation, the COPC National Rural Demonstration Program was established to explore the feasibility of implementing COPC in 13 rural practices. An evaluation of the program found that local communities played critical roles in defining and implementing COPC interventions. These interventions were most often focused on health promotion/illness prevention activities. At most sites, clinical practices were limited in their ability to incorporate COPC activities by staff and physician turnover and the extensive patient demands on the time of rural primary care physicians. While the COPC process proceeded at different rates across the sites, after 2 1/2 years of grant funding, most sites continued to devote the majority of their resources to designing and implementing interventions. Thus, it appears that coordination by dedicated nonphysician staff and more than 2 years of effort are required to implement COPC concepts in rural practices in underserved areas.

Original languageEnglish (US)
Pages (from-to)495-501
Number of pages7
JournalArchives of Family Medicine
Issue number6
StatePublished - Jun 1 1994
Externally publishedYes


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