Health Extension is a method of helping communities, and the primary care practices that serve them, to overcome barriers to transformation by sharing common resources including local expertise coupled with the technical resources of universities, health departments and social services agencies available during and after the transformation process. Health Extension has developed over the last five years and is built on the agricultural Cooperative Extension Service model which was successful in the transformation of rural America through the modernization of agriculture and the diffusion of innovation. Click on the video at right for a quick introduction to the development of health extension:


A growing number of institutions and agencies from around the country have sought information about health extension—how it operates, what are its primary care outcomes, and how it can be implemented in their home community or institution. Thus, the creation of a Health Extension Toolkit aimed at states, academic health centers, professional societies and Tribal Nations so they might adopt aspects of health extension’s transformational learning relevant to their own purpose and objectives. This Toolkit was put together from the experiences of 18 states– rural and urban, from all regions of the country– that are pioneering this new concept.

Click on any of the toolkit chapters below to get started:

What is the purpose of this toolkit? How do I navigate it? What is “health extension”? How can we begin implementing this innovative model in our state?

What is true community engagement? How does the concept of university “extension” relate to engagement? What is the role of different kinds of institutions in the community?

What are the components within health extension? What does a health extension agent do? What are the outcomes from implementing health extension?

How does health extension relate to primary care practices? How can health extension help small, independent practices in their path towards transformation into patient-centered medical homes?

What really makes us sick? How can addressing the so-called “social” determinants of health improve community health outcomes? What is the role of community health workers in improving population health?

How are movements created? What kind of financing exists for implementing health extension? How will we know we are being effective?

Find out more about the states participating in health extension around the country:

Lead States (funded through AHRQ IMPaCT grants)
Learning Community Participants

Montana Idaho Vermont New York Pennsylvania New Jersey Maryland West Virginia Kentucky North Carolina Arkansas Missouri Oklahoma Kansas Colorado New Mexico Oregon