Generating Rural Options for Weight Healthy Kids and Communities – Outcomes and Impacts


      A stakeholder-informed contextual model for rural obesity prevention emerged from community-engaged participatory research and resident-informed resource maps and readiness conversations collected using our HEAL MAPPS™ Toolkit. Rural communities (n=3) and elementary schools (n=3) were engaged in developing and implementing data-driven environmental (PSE) strategies to change the obesogenic context (GROW); comparison communities (n=3) and schools (n=3) received educational programming during the 3-year intervention study implemented in 3 geographically diverse Oregon counties.


      Mixed-method triangulation design was applied longitudinally at multiple levels to assess child-level and family-level intervention effects, and evaluate PSE changes in the school and community context. Environmental changes and intervention exposures in all participating communities were examined in relation to improved weight-healthy behaviors and obesity prevalence (BMI) among elementary school students.


      Obesity and physical activity (PA) were inversely associated among elementary students. Food insecure families were more likely to use school meal programs and less likely to provide out-of-school PA opportunities. Improved school and community capacity, resources, and readiness to address obesogenic factors emerged in all communities but more so in GROW intervention sites. Preliminary analyses of primary outcome data - students’ height-weight collected biannually over 3 years - indicate that in the GROW sites children’s weight health is improving. Increased population exposure options to multiple and various community and school PSE strategies that support children’s healthy eating and physical activity behavioral patterns and population weight-health improvements were positively related.

      Conclusions and Implications

      Rural context is inadequately resourced to easily support weight-healthy patterns for under-resourced families. Improving the encountered obesogenic context at multiple ecological levels is required to support children’s weight-healthy patterns over time and address rural obesity disparities.


      USDA Grant #2011-68001-30020

      Supplementary data