A participatory regional partnership approach to promote nutrition and physical activity through environmental and policy change in rural Missouri

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

Food Insecurity and Suicidal Behaviors Among Us High School Students*

BACKGROUND: Food insecurity (FI) rates in the United States are particularly high among households with children. This research set aims to analyze if high school students experiencing FI had higher risk for mental health and suicidal behaviors. METHODS: Using combined data from 11 states that conducted the 2017 Youth Risk Behavior Survey, a total of 26,962 and24,051 high school students were used to estimate race/ethnicity and sex-stratified prevalence ratios (PRs) from Poissonregression models. A single-question was used to measure the exposure of FI and outcomes of mental health and suicidalbehaviors. RESULTS: Overall, 10.8% of students reported FI. Students experiencing FI had increased risk for all mental health and suicide behavior outcomes, regardless of their race/ethnicity or sex. PRs ranged from 1.9 (95% confidence interval [CI]:1.8, 2.0) to 3.1 (CI:2.7, 3.6). Among males, PRs for the association between FI and all outcomes were highest among non-Hispanic black students(PRs ranged from 2.4 [CI: 1.7, 3.2] to 5.5 [CI: 2.3, 13.3]). Among females, PRs were highest among non-Hispanic white students(PRs ranged from 1.9 [CI:1.7, 2.1] to 3.6 [CI:2.9, 4.5]). CONCLUSIONS:FI is consistently associated with mental health and suicidal behaviors among different subgroups of students

Advancing system and policy changes for social and racial justice: comparing a Rural and Urban Community-Based Participatory Research Partnership in the U.S.

Abstract Background The paper examines the role of community-based participatory research (CBPR) within the context of social justice literature and practice. Methods Two CBPR case studies addressing health inequities related to Type 2 Diabetes and Cardiovascular disease were selected from a national cross-site study assessing effective academic-community research partnerships. One CBPR partnership works with African Americans in rural Pemiscot County, Missouri and the other CBPR partnership works with African American and Latinos in urban South Bronx, New York City. Data collection included semi-structured key informant interviews and focus groups. Analysis focused on partnerships’ context/history and their use of multiple justice-oriented strategies to achieve systemic and policy changes in order to address social determinants of health in their communities. Results Community context and history shaped each partnership’s strategies to address social determinants. Four social justice approaches (identity/recognition, procedural, distributive, and structural justice) used by both partnerships were identified. These social justice approaches were employed to address underlying causes of inequitable distribution of resources and power structures, while remaining within a scientific research framework. Conclusion CBPR can bridge the role of science with civic engagement and political participation, empowering community members to become political agents who integrate evidence into their social justice organizing strategies.http://deepblue.lib.umich.edu/bitstream/2027.42/136166/1/12939_2016_Article_509.pd

Nutrition-related policy and environmental strategies to prevent obesity in rural communities: A systematic review of the literature, 2002-2013

Introduction Residents of rural communities in the United States are at higher risk for obesity than their urban and suburban counterparts. Policy and environmental-change strategies supporting healthier dietary intake can prevent obesity and promote health equity. Evidence in support of these strategies is based largely on urban and suburban studies; little is known about use of these strategies in rural communities. The purpose of this review was to synthesize available evidence on the adaptation, implementation, and effectiveness of policy and environmental obesity-prevention strategies in rural settings. Methods The review was guided by a list of Centers for Disease Control and Prevention Recommended Community Strategies and Measurements to Prevent Obesity in the United States, commonly known as the COCOMO strategies. We searched PubMed, Cumulative Index of Nursing and Allied Health Literature, Public Affairs Information Service, and Cochrane databases for articles published from 2002 through 2013 that reported findings from research on nutrition-related policy and environmental strategies in rural communities in the United States and Canada. Two researchers independently abstracted data from each article, and resolved discrepancies by consensus. Results Of the 663 articles retrieved, 33 met inclusion criteria. The interventions most commonly focused on increasing access to more nutritious foods and beverages or decreasing access to less nutritious options. Rural adaptations included accommodating distance to food sources, tailoring to local food cultures, and building community partnerships. Conclusions Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities

The Garden of Eden: Acknowledging the Impact of Race and Class in Efforts to Decrease Obesity Rates

Geographic assessments indicate that the selection of produce in local supermarkets varies by both area-level income and racial composition. These differences make it particularly difficult for low-income African American families to make healthy dietary choices. The Garden of Eden produce market was created to improve access to high-quality, affordable produce for these communities. The Garden of Eden is housed in a church in an economically depressed African American community in St Louis, Mo, that has less access to fresh produce than surrounding communities. All staff are from the community and are paid a living wage. The market is run with an eye toward sustainability, with partners from academia, a local faith-based community organization, businesses, and community members collaborating to make all program decisions

Work–Family Conflict, Depression, and Burnout Among Jail Correctional Officers: A 1-Year Prospective Study

Background: Correctional officers (COs) experience elevated rates of mental and physical ill-health as compared with other general industry and public safety occupations. The purpose of this study was to investigate demographic, mental health, job tenure, and work–family characteristics and their prospective association to burnout within and between jail officers during one year of new employment. Methods: In 2016, newly hired jail officers (N = 144) completed self-reported surveys across four time points in a one-year prospective study at a Midwestern United States urban jail. Linear mixed-effects and growth modeling examined how work–family conflict (W-FC) and depressive symptoms relate to perceptions of burnout over time. Results: Jail officer burnout increased and was related to rises in W-FC and depression symptoms. Within-person variance for W-FC (Bpooled = .52, p < .001) and depression symptoms (Bpooled = .06, p < .01) were significant predictors of burnout. Less time on the job remained a significant predictor of burnout across all analyses (Bpooled = .03, p < .001). Conclusions: Results from this study indicate that burnout increased during the first year of new employment; and increased W-FC, higher depression, and brief tenure were associated with burnout among jail COs. Future study of correctional workplace health is needed to identify tailored, multilevel interventions that address burnout and W-FC prevention and early intervention among COs