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

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

COMMUNITY CASE STUDY — Volume 12 — June 11, 2015

Ellen K. Barnidge, PhD, MPH; Elizabeth A. Baker, PHD, MPH; Amy Estlund, MPH; Freda Motton, MPH; Pamela R. Hipp, MPH; Ross C. Brownson, PhD

Suggested citation for this article: Barnidge EK, Baker EA, Estlund A, Motton F, Hipp PR, Brownson RC. A Participatory Regional Partnership Approach to Promote Nutrition and Physical Activity Through Environmental and Policy Change in Rural Missouri. Prev Chronic Dis 2015;12:140593. DOI: http://dx.doi.org/10.5888/pcd12.140593.

PEER REVIEWED

On this Page

• Abstract
• Background
• Community Context
• Methods
• Outcome
• Interpretation
• Acknowledgments
• Author Information
• References
• Table

Abstract

Background
Rural 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 Context
Healthier 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.

Methods
Partners 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.

Outcome
Community 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.

Interpretation
Regional 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.

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Background

Chronic diseases (eg, heart disease, cancer, stroke) account for most premature deaths (1). Although research demonstrates the association of risky behavior with chronic disease, particularly physical inactivity and poor nutrition, changing these behaviors is challenging, particularly in rural communities where residents are less likely to meet recommendations for these behavioral determinants (2–4).

Failure to meet the recommendations is due to factors across several ecological levels. At an individual level, rural residents have limited exposure to preventive health care messages (5). Rural residents also have limited access to environmental determinants of physical activity or healthy eating, such as safe, walkable communities, recreation facilities (including informal recreation areas such as hiking trails), parks, and healthful food outlets (5–7). Creating environmental supports and changing policy in rural communities is particularly challenging because rural communities have lower population density and, thus, fewer resources than their urban and suburban counterparts. Our case study describes how we created a regional partnership to leverage resources and enhance environmental and policy initiatives to improve nutrition and physical activity in rural Missouri.

Acknowledgments

We thank the community partners in Butler, Carter, Dunklin, Howell, Mississippi, Oregon, Pemiscot, Scott, Shannon, Reynolds, Ripley, and Wayne counties for their continued commitment to the health and well-being of their communities. We thank Sarah Denkler, our University of Missouri Extension partner, and Imogene Wiggs, our community–academic liaison until 2012, for their multiple contributions to the partnership. This article was supported by cooperative agreement no. U48/DP001903 from the Centers for Disease Control and Prevention, Prevention Research Centers Program. The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

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Author Information

Corresponding Author: Ellen K. Barnidge, PhD, MPH, Prevention Research Center in St Louis, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave, St Louis, MO 63104. Telephone: 314-977-3246. Email: barnidge@slu.edu.

Author Affiliations: Elizabeth A. Baker, Amy Estlund, Freda Motton, Prevention Research Center in St Louis, Saint Louis University College for Public Health and Social Justice, St Louis, Missouri; Pamela R. Hipp, Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St. Louis, Missouri; Ross C. Brownson, Prevention Research Center in St Louis, Brown School, Washington University in St Louis, and Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.

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