A Participatory Regional Partnership Approach to Promote Nutrition and Physical Activity Through Environmental and Policy Change in Rural Missouri

Abstract

BackgroundRural residents are less likely than urban and suburban residents to meet recommendations for nutrition and physical activity. Interventions at the environmental and policy level create environments that support healthy eating and physical activity.Community ContextHealthier Missouri Communities (Healthier MO) is a community-based research project conducted by the Prevention Research Center in St. Louis with community partners from 12 counties in rural southeast Missouri. We created a regional partnership to leverage resources and enhance environmental and policy interventions to improve nutrition and physical activity in rural southeast Missouri.MethodsPartners were engaged in a participatory action planning process that included prioritizing, implementing, and evaluating promising evidence-based interventions to promote nutrition and physical activity. Group interviews were conducted with Healthier MO community partners post intervention to evaluate resource sharing and sustainability efforts of the regional partnership.OutcomeCommunity partners identified the benefits and challenges of resource sharing within the regional partnership as well as the opportunities and threats to long-term partnership sustainability. The partners noted that the regional participatory process was difficult, but the benefits outweighed the challenges.InterpretationRegional rural partnerships may be an effective way to leverage relationships to increase the capacity of rural communities to implement environmental and policy interventions to promote nutrition and physical activity.

Physical Activity–Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002–2013

“…A search of literature published from June 2013 through October 2015 found 6 additional articles representing 5 interventions that implemented PA-related policy or environmental strategies in rural areas. Four studies focused on school or preschool children or facilities ( 62 – 66 ); one focused on both the community-at-large and schools ( 67 ); none were RCTs; PA levels increased in 3 studies. PA was measured by using pedometers ( 65 , 66 ), direct observation ( 63 ), or through a coalition member’s report ( 67 ).…”

“…13, “increase physical activity in PE” ( 64 – 66 ); 4 interventions used no. 14, “extracurricular physical activity” ( 62 , 64 – 67 ); one used no. 16, “improve access to outdoor recreation facilities” ( 67 ); and one used no.…”

Implementing and Evaluating Environmental and Policy Interventions for Promoting Physical Activity in Rural Schools

“…The work described in this manuscript was part of a broad based effort to disseminate evidence‐based environmental and policy interventions to promote healthy eating and physical activity in rural contexts . The first step of this overall initiative was to provide an evidence‐based public health training for community members and staff of community‐ and faith‐based organizations.…”

“…The first step of this overall initiative was to provide an evidence‐based public health training for community members and staff of community‐ and faith‐based organizations. The training provided participants with nutrition and physical activity terminology and a basic overview of evidence‐based public health . At the end of this training, participants identified and ranked priority areas associated with nutrition or physical activity for their communities.…”

“…Healthier Missouri Communities (Healthier MO) examined and addressed environmental and policy interventions to promote healthy eating and physical activity in rural contexts . This paper: (1) identifies the factors that facilitated or hindered the dissemination of school‐based environmental and policy interventions; and (2) reports on changes in student behavior before and after these changes.…”