To identify health issues in two rural counties, a needs assessment was developed by health officials and researchers. Focus groups (n = 32) and interviews (n = 8) were conducted among community leaders and a modified BRFFS survey was completed by 399 community members. Results indicated the health of the participants was influenced by: 1) rural Appalachian culture, 2) geography and access to health care, and 3) lack of access/knowledge about preventive health behaviors. These issues likely contributed to 30% obesity prevalence among the sample, which was prioritized as the main health issue for both counties
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