Food insecurity in rural settings is complex and not fully understood, especially from the perspective of low-income and Black residents. The goal of this study was to use qualitative methods to better understand experiences with food access and perceptions of the food environment among low-income, predominately Black rural Louisiana residents in the United States. Data were collected from focus group discussions (FGD) and focus group intake forms. Study participants were all rural residents eligible to receive at least one nutrition assistance program. FGD questions focused on perceptions of the food environment, with an emphasis on food access. Participants (n = 44) were predominately Black and female. Over half (n = 25) reported running out of food before the end of the month. Major themes included: store choice, outshopping, methods of acquiring foods other than the grocery store, and food insecurity. Concerns around price, quality, and transportation emerged as factors negatively impacting food security. Understanding residents’ perceptions and experiences is necessary to inform contextually appropriate and feasible policy and practice interventions that address the physical environment and social conditions that shape the broader physical food environment in order to achieve equitable food access and food security.

What is already known about this topic? Policy, systems, and environmental (PSE) change strategies combined with education are known to support healthy behavior change and obesity prevention in a community-based setting. What is added by this report? We share the process through which coalitions in rural Louisiana implemented PSE change. What are the implications for public health practice? By understanding the process, potential barriers, and time needed to establish and create fully operational community coalitions, communities can implement strategies to improve community engagement and entities funding PSE work can set better grantee expectations, ultimately leading to more sustainable obesity prevention interventions.

The role of educational attainment in explaining breastfeeding differences between conservative Protestants and other groups suggests that educational interventions may be beneficial within this population.

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Perceptions, knowledge, and attitudes of Cooperative Extension Service (CES) Family and Consumer Science (FCS) agents related to the planning and implementation of community-based multi-level ecological obesity prevention strategies were identified through qualitative, exploratory research. Focus group discussions (FGD) were conducted in the five regions of the Louisiana State University CES (LSU AgCenter). Participants included CES FCS Extension agents (n = 35; 97% of agents). Participants were female and responsible for conducting programming in parishes (counties). Thematic analysis of data found principal factors that influenced FCS Extension agents’ perceived ability to plan and implement community-based multi-level obesity prevention approaches to include knowledge of the socio-ecological model, beliefs about roles of CES, funding, human resources, community connectedness, community buy-in, guidance, and internal support. Assessing what FCS agents perceived as barriers and facilitators to implementing community-based obesity prevention approaches provided valuable direction to the state FCS office. Understanding gaps in knowledge, professional development needs, and existing strengths will help make the transition to community-based obesity prevention initiatives more effective. These findings may be beneficial to other CES and public health agencies implementing multi-level, community-based obesity prevention programs in partnership with community coalitions.