Nutrition-related policy and environmental strategies to prevent obesity in rural communities: A systematic review of the literature, 2002-2013

Authors

Larissa Calancie, The University of North Carolina at Chapel Hill
Jennifer Leeman, The University of North Carolina at Chapel Hill
Stephanie B. Jilcott Pitts, East Carolina University
Laura Kettel Khan, National Center for Chronic Disease Prevention and Health Promotion
Sheila Fleischhacker, National Institutes of Health (NIH)
R. Evenson Kelly, The University of North Carolina at Chapel Hill
Michelle Schreiner, The University of North Carolina at Chapel Hill
Carmen Byker, Montana State University - Billings
Clint Owens, The University of North Carolina at Chapel Hill
Jared McGuirt, The University of North Carolina at Chapel Hill
Ellen Barnidge, St. Louis University
Wesley Dean, United States Department of Agriculture
Donna Johnson, University of Washington, Seattle
Jane Kolodinsky, University of Vermont
Emily Piltch, Tufts University
Courtney Pinard, University of Nebraska–Lincoln
Emilee Quinn, University of Washington, Seattle
Lauren Whetstone, East Carolina University
Alice Ammerman, The University of North Carolina at Chapel Hill

Document Type

Article

Publication Date

4-1-2015

Abstract

Introduction Residents 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. Methods The 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. Results Of 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. Conclusions Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities.

Recommended Citation

Calancie L, Leeman J, Jilcott Pitts SB, Khan LK, Fleischhacker S, Evenson KR, Schreiner M, Byker C, Owens C, McGuirt J, Barnidge E. Nutrition-related policy and environmental strategies to prevent obesity in rural communities: a systematic review of the literature, 2002–2013.

DOI

10.5888/pcd12.140540