Regrounding Our Response Appalachia (RORA) is adapted from the Maryland Department of Health’s Regrounding Our Response program, developed in 2020 in partnership with the University of Maryland in response to the growing overdose crisis. The original program was created to help communities develop a common language and shared understanding around substance use, overdose, and prevention.

West Virginia University’s Institute for Community and Rural Health adapted the curriculum for rural communities, and Hope in Action further expanded and branded it as RORA, centering Appalachian identity, culture, and regional collaboration.  

RORA is rooted in understanding the underlying drivers of substance use, including trauma, adverse experiences, and social determinants of health. The curriculum draws on well-established behavioral and public health frameworks—such as trauma-informed approaches and stages of change—to reduce stigma, strengthen collaboration, and support more effective, coordinated responses to overdose and substance use.

Hope in Action now leads RORA’s infrastructure and training across the Appalachian region, growing cross-state partnerships, including with the University of Pittsburgh. A multidisciplinary team of curriculum developers, advisors, and outreach educators ensures the program stays grounded in evidence, lived experience, and the needs of Appalachian communities.