Community-Wide Efforts to Improve the Consumer Food Environment and Physical Activity Resources in Rural Kentucky.

Community interventions to improve access to food and physical activity resources can reduce obesity rates and improve obesity-related health outcomes. We describe a Kentucky community project that consisted of collaborating with grocery store managers to improve the consumer food environment and partnering with community members to improve walking trails, bicycle racks, and other physical activity resources. We surveyed 2 random samples of community residents in 6 participating rural counties, 741 in 2016 (year 1) and 1,807 in 2017 (year 2). Fruit and vegetable intake significantly increased from year 1 (mean servings fruits, 2.71; vegetables, 2.54) to year 2 (mean servings fruit, 2.94; vegetables, 2.72). Although moderate physical activity did not change from year 1 to year 2, concern among residents about places to be physically active improved (P = .04). Involving community members in promoting obesity prevention programs may improve dietary intake and alleviate community concern about physical activity.

A Community-Based Marketing Campaign at Farmers Markets to Encourage Fruit and Vegetable Purchases in Rural Counties With High Rates of Obesity, Kentucky, 2015-2016.

Availability of farmers markets may increase fruit and vegetable consumption among rural residents of the United States. We conducted a community-based marketing campaign, Plate it Up Kentucky Proud (PIUKP), in 6 rural communities over 2 years to determine the association between exposure to the campaign and fruit and vegetable purchases, adjusted for Supplemental Nutrition Assistance Program recipient status. Logistic regression was used to examine the odds of the PIUKP campaign influencing purchases. Awareness of the PIUKP marketing campaign was significantly associated with a willingness to prepare fruits and vegetables at home. Using marketing strategies at farmers markets may be an effective way to improve fruit and vegetable purchases in rural communities.

Effect of Peanut Butter Intake on Sleep Health in Firefighters: A Randomized Controlled Trial.

Sleep is often impaired in firefighters due to the psychologically and physiologically intense nature of their work and working shift schedules. Peanut butter is affordable and a substantial source of monounsaturated fatty acids, which may aid sleep health. Thus, this study sought to determine if a daily serving of peanut butter consumed before bedtime for seven weeks altered sleep quality and quantity among full-time firefighters. Forty firefighters (peanut butter group = 20; control group = 20) participated in this eight-week randomized controlled trial. All participants completed a subjective questionnaire on mood, focus, and alertness twice daily and wore an Actigraph wristwatch to measure sleep variables, including latency, efficiency, time in bed, time asleep, wake after sleep onset, number of awakenings, and time spent awake. After a baseline week, the peanut butter group consumed two tablespoons of peanut butter two hours prior to bedtime for seven weeks. Compared to the control group, the peanut butter group did not demonstrate significant changes (p > 0.05) in sleep measures or subjective feelings of mood, focus, or alertness after consuming peanut butter for seven weeks. Therefore, peanut butter as a source of peanuts did not alter sleep quality or quantity in this group of firefighters.

Extension as a Backbone Support Organization for Physical Activity Promotion: A Collective Impact Case Study From Rural Kentucky.

BACKGROUND: Rural counties in the United States face daunting structural issues that reduce their populations' physical activity levels, including geographic isolation as well as deficits in infrastructure, public transportation, health care providers, and funding. METHODS: Funding from the Centers for Disease Control and Prevention provided an opportunity to assess how Extension enhanced the collective impact of systems-level physical activity promotion programming through a multisectoral coalition in Clinton County, Kentucky. RESULTS: The Extension-led coalition accomplished the 6 essential functions of a backbone support organization by identifying obesity as a critical local issue (function 1: providing overall strategic direction), developing a multisectoral coalition (function 2: facilitating dialog between partners), compiling data on the county's physical activity infrastructure (function 3: managing data collection and analysis), creating communication channels (function 4: handling communication), organizing community awareness events (function 5: coordinating community outreach), and securing additional grants (function 6: mobilizing funding). The average rating of Extension's leadership across multiple dimensions by 3 coalition members in a postproject survey was "excellent" on a 5-point Likert scale. CONCLUSIONS: Extension is well positioned through their mission, broad community engagement, data collection, needs assessment, community and academic relationships, and embeddedness in local communities to serve as the backbone support organizations for rural physical activity promotion coalitions.

Examining Key Stakeholder and Community Residents' Understanding of Environmental Influences to Inform Place-Based Interventions to Reduce Obesity in Rural Communities, Kentucky 2015.

PURPOSE: Rural residents report high rates of obesity, physical inactivity, and poor eating habits. The objectives of this study were to (1) use the collective impact model to guide efforts to elicit community members' perceptions of county-specific factors influencing high obesity rates; (2) determine the association between utilization of food retail venues and concern about obesity and healthy eating; and (3) determine community members' utilization of physical activity infrastructure and concern about physical inactivity. METHODS: The study was conducted in 6 rural counties in Kentucky with adult obesity prevalence rates >40%. Community stakeholders met to assess counties' needs and assets in implementing interventions to reduce obesity in their communities. A random-digit dial survey (n = 756) also was conducted to examine awareness and availability of community resources for healthy eating and physical activity. FINDINGS: Stakeholders identified lack of access to fruits and vegetables and poor physical activity infrastructure as contributors to obesity. Reporting moderate and serious concern about obesity and healthy eating was associated with higher odds of shopping at a supercenter compared with those expressing little concern. Reported access to information about physical activity opportunities was associated with higher odds of reporting the availability of safe places for physical activity, sidewalks, and trails compared with those who reported that information was difficult to obtain. CONCLUSIONS: This study elicits community-identified barriers to healthy behaviors and provides foundational data to inform future place-based obesity reduction interventions.

A comprehensive evaluation of motion sensor step-counting error.

The purpose of this study was to conduct a comprehensive evaluation of the effect that walking speed, gender, leg length, motion sensor tilt angle, brand, and placement have on motion sensor step-counting error. Fifty-nine participants performed treadmill walking trials at 6 speeds while wearing 5 motion sensor brands placed on the anterior (Digiwalker, DW; Walk4Life, WFL; New Lifestyles, NL; Omron, OM), midaxillary (DW; WFL; NL; ActiGraph, AG), and posterior (DW, WFL, NL) aspects of the waistline. The anterior-placed NL and midaxillary-placed AG were the most accurate motion sensors. Motion sensor step-count error tended to decrease at faster walking speeds, with lesser tilt angles, and with an anterior waistline placement. Gender and leg length had no effect on motion sensor step-count error. We conclude that the NL and AG yielded the most accurate step counts at a range of walking speeds in individuals with different physical characteristics.