Study Overview

Many risk factors have been associated with children being overweight or obese, including rural residency. Attributes of the rural environment make it difficult for children to access and consume healthy foods and drinks, walk or bike to destinations, and/or participate daily in physical activity and recreational sport programs.

Furthermore, features of elementary schools, particularly those in lower resourced rural school districts, are such that students often face long bus commutes, minimal/no provision of health and physical education by certified teachers, and few resources to support health and/or enrich the academic environment.

Rural community features pose unique challenges for residents and visitors that differ from those in metropolitan regions, specifically the availability of easily accessible and affordable healthy foods and beverages and physically active lifestyle supports.

Nevertheless, most recommended strategies to improve environmental contexts and address rural obesity disparities have been developed and tested in non-rural settings.

Our overarching goal

Prevent a rise in overweight and obesity prevalence in elementary school students as they progress from Kindergarten through grade six.

Here's how we do it

Our first aim is to understand the rural obesogenic environment. To do so Oregon State University (OSU) partnered with Extension Services in six Western States to engage rural people in community-based participatory research efforts to:

• Assess features of rural communities that are viewed as obesity preventing/promoting, community resources and readiness to implement and support environmentally-based obesity prevention efforts
• Create a database to aggregate the data from community assessments
• Develop a new eXtension Community of Practice as a vehicle to help practitioners and the public learn from our research findings

Our second aim was to plan, implement, and evaluate a multi-level intervention targeting rural home, school, and community behavioral settings. This is to promote healthful eating and increase physical activity, and thus improve body mass index among rural children aged 5-8 years old.

Toward this end, we developed and tested the GROW-HKC obesity prevention program in rural communities from three counties in Oregon. Applying a “people and places” framework, our interventionutilized evidence-based strategies to affect positive changes in person-level attributes and in family home, school, and community environments related to healthful eating and physical activity.

We developed four objectives to meet our aims

1. Investigate: Create a resident-informed profile of the rural community environment that documents attributes which support or hinder healthful eating and physical activity among youth and use the data from multiple profiles to inform the development of a grounded theoretical model of the rural obesogenic environment.
2. Create: Create a new eXtension CoP to inform, educate, and support individuals, families, schools and communities in efforts related to obesity prevention in rural communities.
3. Monitor: Evaluate the impact of a comprehensive multi-level intervention to promote healthy eating and increase physical activity on obesity (change in BMI) among rural kindergarten through 3rd grade children.
4. Understand: Evaluate the effects of the intervention on changes in home, school, and community food and physical activity environments.

GROW Healthy Kids and Communities uses community engagement methods and tools to establish and contribute to a rural-specific, evidence-based research model for childhood obesity prevention. This was done with a participatory action research approach. The program uses innovative technologies, including community mapping and geographic information systems data. We explored the obesogenic context in rural landscapes and develop policy, systems, and environmental strategies that communities can use to help families cultivate and maintain weight healthy lifestyle patterns.

Research Domains: Family, School, and Community

GROW Healthy Kids & Communities supports families of rural places to survey and improve their family home nutrition and physical activity environments. GROW HKC supports Oregon rural families’ abilities to make healthy eating and physical activity behaviors at home easy and sustainable.

Families with children attending our partnered Oregon elementary schools in Bonanza, Chiloquin, Clatskanie, Estacada, Molalla, and Rainier were invited to join GROW Healthy Kids and Communities. Children in grades K-5/6 and their parents, guardians or caregivers participated in project programming to help families and children learn to eat, grow, and play healthfully.

GROW Healthy Kids & Communities supports families of rural places to survey and improve their family home nutrition and physical activity environments. GROW HKC supports Oregon rural families’ abilities to make healthy eating and physical activity behaviors at home easy and sustainable.

Family

Family Surveys

• Family Physical Activity Measurement. Families have an opportunity to measure their physical activity using accelerometers.
• Nutrition & Physical Activity Self Survey. Families complete self-reports that measure family home nutrition and physical activity supports and readiness for change.

Family Feedback

• Physical Activity Feedback. This report provides families with objective data that shows how active children are throughout the day.
• Self Assessment Feedback. These reports help families understand their family level behaviors and family-home characteristics, that relate to child-level health.

Family Benefits

• Healthy/Active Family Newsletters. A monthly newsletter directed toward supporting healthy home environmental and behavioral changes related to healthy eating, and physical activity.
• Family focus groups to inform policy and practice. Teach the researchers about what works in your family and what challenges you face and help support other rural families.

School

GROW Healthy Kids & Communities helped schools survey and improve school nutrition and physical activity environments. It supports evidence-based modifications to school environments and policies to promote and improve students’ healthy eating and physical activity behaviors at school.

School Surveys

• School Physical Activity & Nutrition Environment Tool (SPAN-ET): GROW surveyed school-level physical activity and nutrition environments.
• Height, weight, and physical activity collection: GROW helped enrolled schools measure the height, weight, and physical activity of students to understand change in health status over time.

School Feedback

• SPAN-ET Feedback: The SPAN-ET report suggests evidence-based improvement strategies and highlights positive actions resulting from environmentally-based treatments.
• Weight Status and Physical Activity Feedback: These reports show the results of school-level assessments and suggest evidence-based improvement sand communication strategies.

School Action

• GROW-HKC and wellness committee actions
• Farm to school partnerships
• Physical activity toolkits and trainings
• Securing school-centered grants to promote healthy school environments

Community

GROW Healthy Kids & Communities engaged with Oregon’s rural residents and stakeholders to learn about rural communities and to help select and implement evidence-based environmental strategies unique to Oregon’s rural areas that will benefit Oregon’s rural residents for years to come.

Community Surveys

• HEAL MAPPS™: HEAL MAPPS™ helps community stakeholders document people’s experience of place with respect to supports and barriers for regular healthy eating and physical activity.
• Community Food and Physical Activity Environment Survey: This tool assesses the actual (vs. perceived) rural community food & physical activity resources.

Community Feedback

• HEAL MAPPS™ Feedback: This report details the community supports and barriers to healthy eating and physical activity.
• Community Food and Physical Activity Environment Survey Feedback: This report analyzes all community food and physical activity resources

Community Action

• Building coalitions to work collaboratively on community-wide issues
• Securing local grants to improve healthy eating and physical activity opportunities in rural communities
• Working collaboratively to implement community-based change

Study Communities

GROW Healthy Kids and Communities' first aim was to understand the rural obesogenic environment. To do so we partnered with Extension Services in Colorado, Idaho, Nevada, New Mexico, and Washington to engage rural people in community-based participatory research efforts.

Our second aim was to plan, implement, and evaluate a multi-level intervention targeting rural home, school, and community behavioral settings to promote healthful eating and increase physical activity, and thus improve body mass index among rural children aged 5-8 years old. Toward this end, we developed and tested the GROW Healthy Kids and Communities' obesity prevention program in rural Oregon communities from Clackamas, Columbia, and Klamath County.

Project Outputs

Contact Campus Team

Hallie E. Ford Center for Healthy Children & Families
Oregon State University
2631 SW Campus Way, Rm. 345
Corvallis, Oregon 97331-8687
[map]

Telephone: 541-737-4542
Email: [email protected]

Project Team

The project team was assembled to reflect the breadth of scholarship and experience required of our comprehensive, integrated approach, with particular expertise in rural community-engaged research and Extension methods in the promotion of nutrition and physical activity behaviors, gardening and youth development among school-aged children.

We appreciate the support of our many contributors.

Principal Researchers

• Kathy Gunter: Campus, 2011-2016
• Deborah John: Campus, 2011-2016

Co-Investigators

• Lena Etuk: Campus, 2011-2014
• Perry Hystad: Campus, 2014-2016
• Gail Langellotto: Campus, 2011-2016
• Melinda Manore: Campus, 2011-2016

Project Coordinator

• Amanda Armington: Campus, 2013-2016
• Kristin Trost: Campus, 2011-2012

Research Assistants

• Sara Caldwell-Kan: Campus, 2014-2015
• Patty Case: Klamath County, 2011-2016
• Erin Devlin: Clackamas County, 2014-2016
• Leah Gramlow: Campus, 2015-2016
• Beret Halverson: Clackamas County, 2011-2016
• John Hicks: Campus, 2012-2016
• Brendan Klein: Campus, 2012-2014
• Allison O'Sullivan: Columbia County, 2012-2013
• Janet Rojina: Klamath County, 2014-2016
• Jenny Rudolph: Columbia County, 2011-2016
• Kelsey Sterrett: Clackamas County, 2012-2013
• Laurie Wayne: Klamath County, 2012-2014
• Tammy Winfield: Campus, 2014-2016

Graduate Students

• Patrick Abi Nader: Campus, 2013-2016
• Araya Assfaw: Campus, 2014-2015
• Alinna Ghavami: Campus, 2011-2013
• Evan Hilberg: Campus, 2013-2016
• Jenny Jackson: Campus, 2011-2016
• Erin Mitchell: Campus, 2011-2012

Undergraduate Research Awards Program (URAP) Apprentices

• Carolyn Booth: Campus-Mentor K. Gunter, 2014-2015
• Claire Chappuis: Campus-Mentor D. John, 2015
• Bridget Jamieson: Campus-Mentor D. John, 2014
• Deanna Kunkle: Campus-Mentor D. John, 2015
• Brooke Mischkot: Campus-Mentor D. John, 2016
• Ann Marie Richards: Campus-Mentor D. John, 2014
• Emily Van Meter: Campus-Mentor K. Gunter, 2014

Undergraduate Students

• Claire Chappuis: Campus, 2014-2016
• Bryan Crocker: Campus, 2013-2014
• Andrew Derringer: Campus, 2013-2014
• Kathleen Finneran: Campus, 2014-2015
• Regina Godoy: Campus, 2014
• Joshua Graves: Campus, 2011
• Mayra Juarez-Hernandez: Campus, 2014-2015
• Amanda Kidwell: Campus, 2013-2014
• Rose Locklear: Campus, 2013-2014
• Cheryl Truong: Campus, 2011
• Brittany Williams: Campus, 2014-2015

Interns & Mentees

• Mackenzie Bangs: Clackamas County, 2015
• Autumn Daley: Clackamas County, 2013
• Shellane Eckhart: Clackamas County, 2015
• Nova Elwood: Campus, 2014
• Clark Lawrence: Campus, 2012
• Danielle McNaughton: Campus, 2013
• Alena Merino: Columbia County, 2013
• Jules Montes: Columbia County, 2013
• Abbie Muniz: Campus, 2013
• Ricky Naverette: Campus, 2013-2014
• Amanda Rhodes: Campus, 2013
• Lisa Robinson: Campus, 2014
• Melissa Snider: Clackamas County, 2013
• Ted Vixay: Campus, 2015
• Hailey Warmbold: Clackamas County, 2013

Community Champions

• Christina Boothe: Columbia County, 2014-2015
• Nikki Elbert: Klamath County, 2014-2015
• Shilo Wittrock-Laccino: Clackamas County, 2014-2015

Special thanks to

Bob and Charlee Moore Trust on behalf of the Hallie E. Ford Center for Healthy Children & Families

Let's Move Molalla! GROW Healthy Kids and Communities works with communities, schools, and families throughout Oregon to create environments that make it easy for children to eat healthfully and be physically active. Molalla Grow Impact 2017