Abstract
Introduction Obesity disproportionately affects rural communities, and Appalachia has some of the highest obesity rates in the nation. Successful policy, systems, and environmental (PSE) interventions to reduce obesity must reflect the circumstances of the population. We used a health equity lens to identify barriers and facilitators for healthy food access in Martin County, Kentucky, to design interventions responsive to social, cultural, and historical contexts. Methods We conducted 5 focus groups in Martin County, Kentucky, in fall 2019 to obtain perspectives on the local food system and gauge acceptability of PSE interventions. We used grounded theory to identify perceived barriers and facilitators for healthy eating. Results Thirty-four adults (27 women; median age, 46 years) participated in 5 groups. One prominent theme was declining interest in farming; many participants believed this decline was generational. One participant noted, “Most of my adult male relatives worked in the coal mines, and they worked 6 days a week…. My grandpa had the garden, but then my dad’s generation is the one quit gardening.” Another shared, “You would probably have to have someone to teach [gardening].” Instead of enhancing farmers markets, participants suggested building community capacity for home gardens to increase vegetable consumption. Conclusion Our findings demonstrate the importance of obtaining community input on the development of PSE interventions to mitigate inequities in obesity. Although farmers market interventions were deemed not feasible, other solutions to enhance access to produce were identified. Developers of community-responsive PSE interventions to improve healthy eating in rural, food-insecure locations should consider using an equity-oriented prevention framework to ensure acceptable interventions.
Original language | English |
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Pages (from-to) | 1-10 |
Number of pages | 10 |
Journal | Preventing chronic disease |
Volume | 17 |
DOIs | |
State | Published - 2020 |
Bibliographical note
Funding Information:We gratefully acknowledge the contributions to this study by Dr Jennifer Hunter, Dr Alison Gustafson, University of Kentucky graduate student Caroline Blincoe, and the members of the Martin County High Obesity Project Coalition. We thank the University of Kentucky College of Public Health’s Office of Scientific Writ- ing for assistance in preparing this manuscript. This study was supported by cooperative agreement 1NU58DP0065690100 by the Centers for Disease Control and Prevention. No copyrighted tools or instruments were used in this research.
Funding Information:
We gratefully acknowledge the contributions to this study by Dr Jennifer Hunter, Dr Alison Gustafson, University of Kentucky graduate student Caroline Blincoe, and the members of the Martin County High Obesity Project Coalition. We thank the University of Kentucky College of Public Health?s Office of Scientific Writing for assistance in preparing this manuscript. This study was supported by cooperative agreement 1NU58DP0065690100 by the Centers for Disease Control and Prevention. No copyrighted tools or instruments were used in this research.
Publisher Copyright:
© 2020, Preventing Chronic Disease. All Rights Reserved.
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health