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Project TESAL was a three-year project with two weeks of professional development each summer, two days each semester, and classroom observations/support each year. Our vision leveraged design-based learning in resource-poor rural Appalachia as a context for teaching and learning that integrates mathematics and science content with building and testing of designs. We analyzed survey, content test, interview, and classroom observation data from 25 participating teachers and 22 comparison teachers. Participants increased confidence to teach engineering design, use technology with students, and knowledge of STEM careers more than teachers from similar schools. Participants valued active learning, collaborating with peers and experts around teaching, focusing on content across subjects and student learning, and the sustained nature of support and feedback.