Empowering Youth Through Research: Adolescents’ Perceptions of Physical Activity Interventions in Appalachian Communities

Active participation in evaluation and research projects can empower youth and effect community change. Adolescents along with supervising teachers participating in after-school Health Sciences and Technology Academy clubs conducted research projects to increase physical activity in Appalachian communities. The sample involved 50 adolescents who participated across one of six focus groups. Two primary themes emerged from the focus groups, indicating the impact of the research experiences on students, teachers, and their communities. First, students reported increased public health and research competence as well as feelings of self-worth. Second, the participants reported developing a stronger sense of the barriers to and facilitators of physically active lifestyles relevant in their local communities. This research substantiates the “youth as asset” paradigm and suggests that involving adolescents in community health research benefits both them and their communities

Adolescents and Teachers as Partners in a School-Based Research Project to Increase Physical Activity Opportunities in a Rural Community

Schools are an important resource in combating the physical inactivity and obesity epidemics in rural economically depressed areas. Through a University-community partnership, teachers and adolescents in a rural West Virginia county with one of the highest obesity rates in the state developed a school-based research intervention to increase physical activity opportunities. The intervention included walking routes, educational sessions, and pedometers. A survey about barriers to physical activity revealed that “lack of willpower” was a barrier of concern among program participants (mostly school employees) and had a statistically significant (p = .0033) pre to post mean score decrease during the year two offering. Focus groups with the adolescent researchers revealed that pedometers may facilitate maintenance of physical activity and a broader community impact. Focus group dialogue combined with teacher-researcher perspectives suggested that the adolescents changed their weight control paradigm from “dieting” to include the critical role of energy expenditure. Approval to conduct this research was provided by the West Virginia University Institutional Review Board for the Protection of Human Subjects Protocols No. 16041 and 15632. A poster based on this paper was presented at the 135th Annual Meeting & Exposition of the American Public Health Association, Washington, DC, November, 2007. The authors are very appreciative of the HSTA students for their continued efforts in addressing important public health problems in their community. The project described was supported by funds from the Centers for Disease Control and Prevention (CDC) Grant Award No. H75CCH322130-02 through the West Virginia University Prevention Research Center and by Grant Number 2R25RR12329-04 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC, NCRR, or NIH

Developing a dissemination model to improve intervention reach among West Virginia youth smokers

The Not-On-Tobacco program is an evidence-based teen smoking cessation program adopted by the American Lung Association (ALA). Although widely disseminated nationally via ALA Master Trainers, in recent years, adoption and implementation of the N-O-T program in West Virginia has slowed. West Virginia, unfortunately, has one of the highest smoking rates in the US. Although it is a goal of public health science, dissemination of evidence-based interventions is woefully understudied. The present manuscript reviews a theoretical model of dissemination of the Not-On-Tobacco program in West Virginia. Based on social marketing, diffusion of innovations, and social cognitive theories, the nine-phase model incorporates elements of infrastructure development, accountability, training, delivery, incentives, and communication. The model components as well as preliminary lessons learned from initial implementation are discussed

Addressing Facilitators and Barriers Related to Early Childhood Obesity Prevention in Rural Appalachian Communities

Through a community-focused needs assessment conducted in rural Appalachia, we gauged perceptions of facilitators and barriers related to healthful eating and physical activity for young children and identified suggestions for improvement. Thirty-seven key informant interviews and three caregiver focus group sessions were coded and analyzed for key themes. Limited community resources emerged as a barrier to both healthful eating and physical activity. Suboptimal communication about existing opportunities was also identified. Community members reviewed the needs assessment data and implemented initiatives to address identified needs. The importance of Extension-facilitated needs assessments in rural settings to shape health initiatives to local contexts is highlighted

Opportunities for Impact: Health Promotion in Rural Early Care and Education Environments

Early care and education settings are essential partners in the battle against childhood obesity. We describe an Extension-facilitated early childhood obesity prevention intervention conducted in 25 rural early care and education settings. A total of 148 policy, systems, or environmental changes were achieved, reaching approximately 450 young children. Systems changes were the most prevalent outcome achieved. The experiences of Extension professionals in promoting policy, systems, and environmental changes are highlighted as are implications for other Extension systems and professionals promoting policy, systems, or environmental changes in early care and education settings

Early Childhood Obesity Prevention in Rural West Virginia Extension’s Role and Lessons Learned

The Cooperative Extension system is uniquely positioned to lead rural community efforts to prevent obesity in early childhood. This article explores best practices in promoting healthy weights among young children and shares examples and resources relevant to Extension programming. The West Virginia (WV) Healthy Children Project aims to improve community, home, and early care and education (ECE) environments by promoting healthy eating, physical activity, outdoor play, and reduced screen time. This project primarily focuses on interventions with ECE providers serving 2-5-year-old children in three rural counties. Comprehensive assessments informed the interventions and guided Community Advisory Committees. ECE providers were trained in “I Am Moving, I Am Learning” (IMIL) and “Nutrition and Physical Activity Self-Assessment for Child Care” (Go NAP SACC) best practices and were supported with technical assistance and classroom resources. Garden-based learning, natural playscapes, painted playgrounds, and farm-to-ECE further enhanced the environments and experiences. Community leaders were engaged in advisory committees, transformative projects, and local family-focused activities. The efficacy of these practices was tracked using quantitative and qualitative evaluation strategies conducted throughout the project, including observations, ripple effects mapping, and questionnaires. This article describes the overall project strategies and reveals the lessons learned and the challenges encountered

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

Citation: Meyer, M. R. U., Perry, C. K., Sumrall, J. C., Patterson, M. S., Walsh, S. M., Clendennen, S. C., . . . Valko, C. (2016). Physical Activity-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002-2013. Preventing Chronic Disease, 13, 24. doi:10.5888/pcd13.150406Additional Authors: Valko, C.Introduction Health disparities exist between rural and urban residents; in particular, rural residents have higher rates of chronic diseases and obesity. Evidence supports the effectiveness of policy and environmental strategies to prevent obesity and promote health equity. In 2009, the Centers for Disease Control and Prevention recommended 24 policy and environmental strategies for use by local communities: the Common Community Measures for Obesity Prevention (COCOMO); 12 strategies focus on physical activity. This review was conducted to synthesize evidence on the implementation, relevance, and effectiveness of physical activity-related policy and environmental strategies for obesity prevention in rural communities. Methods A literature search was conducted in PubMed, PsycINFO, Web of Science, CINHAL, and PAIS databases for articles published from 2002 through May 2013 that reported findings from physical activity-related policy or environmental interventions conducted in the United States or Canada. Each article was extracted independently by 2 researchers. Results Of 2,002 articles, 30 articles representing 26 distinct studies met inclusion criteria. Schools were the most common setting (n = 18 studies). COCOMO strategies were applied in rural communities in 22 studies; the 2 most common COCOMO strategies were "enhance infrastructure supporting walking" (n = 11) and " increase opportunities for extracurricular physical activity" (n = 9). Most studies (n = 21) applied at least one of 8 non-COCOMO strategies; the most common was increasing physical activity opportunities at school outside of physical education (n = 8). Only 14 studies measured or reported physical activity outcomes (10 studies solely used self-report); 10 reported positive changes. Conclusion Seven of the 12 COCOMO physical activity-related strategies were successfully implemented in 2 or more studies, suggesting that these 7 strategies are relevant in rural communities and the other 5 might be less applicable in rural communities. Further research using robust study designs and measurement is needed to better ascertain implementation success and effectiveness of COCOMO and non-COCOMO strategies in rural communities