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Understanding and Addressing Barriers to Implementation of Environmental and Policy Interventions to Support Physical Activity and Healthy Eating in Rural Communities

Authors

  • Ellen K. Barnidge PhD, MPH,

    1.  Prevention Research Center in St. Louis, School of Public Health, Saint Louis University, St. Louis, Missouri
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  • Catherine Radvanyi MPH,

    1.  Prevention Research Center in St. Louis, School of Public Health, Saint Louis University, St. Louis, Missouri
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  • Kathleen Duggan MPH, MS, RD,

    1.  Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri
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  • Freda Motton MPH,

    1.  Prevention Research Center in St. Louis, School of Public Health, Saint Louis University, St. Louis, Missouri
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  • Imogene Wiggs MBA,

    1.  Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri
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  • Elizabeth A. Baker PhD, MPH,

    1.  Prevention Research Center in St. Louis, School of Public Health, Saint Louis University, St. Louis, Missouri
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  • Ross C. Brownson PhD

    1.  Prevention Research Center in St. Louis, Brown School, Washington University in St. Louis, St. Louis, Missouri
    2.  Division of Public Health Sciences, Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, Missouri
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  • Funding: This research was supported by Cooperative Agreement Number U48/DP001903 from the Centers for Disease Control and Prevention, Prevention Research Centers Program.

  • For further information, contact: Ellen Barnidge, PhD, MPH, Prevention Research Center, School of Public Health, Saint Louis University, 3545 Lafayette Ave., St. Louis, MO 63104; e-mail: barnidge@slu.edu.

Abstract

Purpose: Rural residents are at greater risk of obesity than urban and suburban residents. Failure to meet physical activity and healthy eating recommendations play a role. Emerging evidence shows the effectiveness of environmental and policy interventions to promote physical activity and healthy eating. Yet most of the evidence comes from urban and suburban communities. The objectives of this study were to (1) identify types of environmental and policy interventions being implemented in rural communities to promote physical activity or healthy eating, (2) identify barriers to the implementation of environmental or policy interventions, and (3) identify strategies rural communities have employed to overcome these barriers.

Methods: Key informant interviews with public health professionals working in rural areas in the United States were conducted in 2010. A purposive sample included 15 practitioners engaged in planning, implementing, or evaluating environmental or policy interventions to promote physical activity or healthy eating.

Findings: Our findings reveal that barriers in rural communities include cultural differences, population size, limited human capital, and difficulty demonstrating the connection between social and economic policy and health outcomes. Key informants identified a number of strategies to overcome these barriers such as developing broad-based partnerships and building on the existing infrastructure.

Conclusion: Recent evidence suggests that environmental and policy interventions have potential to promote physical activity and healthy eating at the population level. To realize positive outcomes, it is important to provide opportunities to implement these types of interventions and document their effectiveness in rural communities.

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