• Larissa Calancie, Jennifer Leeman, Stephanie B Jilcott Pitts, KhanLaura KettelLKCenters for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity, Atlanta, Georgia., Sheila Fleischhacker, Kelly R Evenson, Michelle Schreiner, Carmen Byker, Clint Owens, Jared McGuirt, Ellen Barnidge, Wesley Dean, Donna Johnson, Jane Kolodinsky, Emily Piltch, Courtney Pinard, Emilee Quinn, Lauren Whetstone, and Alice Ammerman.
• Department of Nutrition, University of North Carolina, Chapel Hill, Gillings School of Global Public Health, CB No 7426, 1700 MLK/Airport Rd, Room 239, Chapel Hill, NC 27599-7426. Telephone: 315-350-1689. Email: lcalancie@unc.edu.
• Prev Chronic Dis. 2015 Apr 30; 12: E57.

IntroductionResidents 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.MethodsThe 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.ResultsOf 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.ConclusionsFindings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities.

25 keywords...

hide…