Working With Rural Producers to Expand EBT in Farmers' Markets: A Case Study in Hardeman County, Tennessee.

Rural residents tend to eat less fruits and vegetables, placing them at higher risk of chronic diseases compared with urban residents. Farmers' markets can provide increased access to fresh produce for rural communities. Encouraging markets to accept Supplemental Nutrition Assistance Program (SNAP) benefits through Electronic Benefit Transfer (EBT) can expand access to healthy foods to low-income residents. Rural markets are less likely to accept SNAP compared with urban markets. Rural producers have identified lack of knowledge and limited support about the application process as barriers for accepting SNAP. This case study details how our Extension program helped a rural producer through the SNAP application process. We started with a workshop to inform rural producers about the benefits of accepting SNAP. After the workshop, we provided hands-on support and assistance to help one producer navigate the EBT application process as well as how to implement and advertise SNAP at the market. Implications for practitioners about tips to help producers overcome challenges and barriers for EBT acceptance are discussed.

A Community Profile of Walking and Cycling for Exercise or Transportation in a Rural County in the Southeastern United States.

People living in rural areas of the United States, especially in the southern region, are much less likely to walk or cycle for leisure time or transportation. The purpose of this study is to provide a more detailed community-level estimate of walking and cycling behaviors and attitudes among adults living in a rural county (Hardeman County, TN) participating in a High Obesity Program (HOP) from the Centers for Disease Control and Prevention. Telephone interviews and online surveys regarding walking and cycling behaviors, attitudes, and perceptions of the built environment were completed by 634 adults. Questions originated from the 2002 National Survey of Bicyclist and Pedestrian Attitudes and Behavior. Respondents were classified as walkers, cyclists, or both. Chi-square and logistic regression were used for data analysis. Of adults in this county, 67.2% were walkers and 16.2% cyclists. Both forms of active living tended to decrease with age, especially after 50 years. Walking was associated with younger ages, 2-person households, positive perceived health, and a feeling that walking was good for them. Cycling was only associated with age. Most people felt that their communities were safe places to walk or bike. Walking was most often done on roads or road shoulder. Social support and intrinsic motivators may also play a role in walking and bicycling in rural areas. Interventions that promote walking and cycling in rural areas should provide a means for social support, creating activity-friendly routes perceived to be safe, and enhanced destinations for places to be physically active.

Community Coalitions for Change and the Policy, Systems, and Environment Model: A Community-Based Participatory Approach to Addressing Obesity in Rural Tennessee.

Four rural counties in Tennessee adopted the policy, systems, and environment (PSE) approach to address the obesity epidemic in their communities. The community-based participatory initiative, Community Coalitions for Change (C3), was embraced by 67,400 community members and 67 organizations. During year 1, coalition members discussed a need to return to long-held traditions of collective community engagement and action to address rural obesity rates. In response, C3 established 25 community gardens and supported 10 existing gardens, resulting in 8,300 community members who received garden produce. Sites began with an average number of 11 physical activity resources, which increased by year 3 to an average of 13 resources as a result of C3 activities. Overall, 61% (248 of 405) of survey respondents participating in direct education programs reported being more physically active as a result of participating in the programs, 59% (117 of 199) reported eating more fruit, and 66% (131 of 199) reported eating more vegetables. Implications for public health include timing and aligning obesity prevention activities with ongoing initiatives that are working toward similar goals.

Cooperative Extension professionals' knowledge and attitudes toward the opioid epidemic: Implications for capacity development and outreach.

Introduction: Worsening of the opioid epidemic amplifies calls for involvement of the nationwide Cooperative Extension System (Extension) in addressing this crisis. Understanding knowledge and attitudes among Extension professionals who directly interact with communities is critical given identified needs for increased capacity and substantial federal investments supporting Extension's opioid response. This study explored opioid knowledge and attitudes among Extension professionals in one state to identify attitudes and perceptions that may influence community-level efforts. Methods: An online survey including 25 Likert scale questions about attitudes and beliefs related to substance use was administered to Extension professionals. Questions were categorized into five concept areas: treatment and community support, legal and punitive approaches, substance use as an illness, external causes of substance use, and personal causes of substance use. Descriptive statistics and response frequencies for all variables were calculated. One-way ANOVAs were used to calculate geographic differences between the state's three Extension regions. Results: Survey responses (n = 236) indicated respondents recognized the complexity of the opioid crisis and had favorable attitudes toward treatment and community support approaches. Support for legal and punitive approaches was mixed, as were attitudes toward external and personal causes of substance use. Most indicated needing better resources and more knowledge to engage in work locally. Conclusion: Increased capacity is needed in Extension to adequately support families and communities dealing with substance use disorder. Findings suggest areas of focus and provide insight for others seeking to develop capacity in opioid response by engaging Extension professionals or other community outreach workers in substance use prevention efforts.

Validation of a Collaboration Readiness Assessment Tool for Use by Supplemental Nutrition Assistance Program-Education (SNAP-Ed) Agencies and Partners.

OBJECTIVE: To evaluate content and face validity of a collaboration readiness assessment tool developed to facilitate collaborative efforts to implement policy, systems, and environment changes in Supplemental Nutrition Assistance Program-Education (SNAP-Ed). METHODS: Evaluation of the validity of the tool involved 2 steps. Step 1 was conducted with 4 subject matter experts to evaluate content validity. Step 2 used an iterative cognitive testing process with 4 rounds and 16 SNAP-Ed staff and community partners to evaluate face validity. RESULTS: Subject matter experts found that survey items appropriately matched the content area indicated and adequately covered collective efficacy, change efficacy, and readiness. Cognitive testing with SNAP-Ed staff and partners informed modifications and resulted in adequate face validity. CONCLUSIONS AND IMPLICATIONS: The ability to measure collaboration readiness will allow agencies and community partners that implement SNAP-Ed to target areas that facilitate collaboration efforts needed for policy, systems, and environment change and collective efficacy. Further cognitive testing of the tool with other populations is needed to ensure its applicability and usefulness. Evaluation of the reliability of the tool with a broad range of SNAP-Ed programs and community agencies is also recommended.

A family process model of marital hostility, parental depressive affect, and early adolescent problem behavior: the roles of triangulation and parental warmth.

This study examined a family process model of early adolescent problem behavior in a community sample of 416 two-parent families. With family systems theory, a model was developed that suggests (a) marital hostility and parental depressive affect are conjoint familial stressors for youths, (b) youth triangulation mediates the association between marital hostility and adolescent problems, and (c) parental warmth buffers the negative effects of parental depressive affect and youth triangulation. With structural equation modeling, youth-perceived triangulation mediated the association between marital hostility and adolescent internalizing problems. Marital hostility was associated with externalizing problems. Mothers' depressive affect was associated with internalizing problems, and fathers' depressive affect was associated with internalizing and externalizing problems. Parental warmth was not a significant moderator.

Adolescents' cognitive and emotional responses to marital hostility.

Early adolescents' (11-14 years) responses to marital hostility were examined in a sample of 416 families. The cognitive-contextual perspective and emotional security hypothesis guided the study and 9 adolescent responses were identified. Prospective associations were examined in several structural equation models that included adolescent problems as outcomes. Self-blame and perceived threat uniquely mediated the association between Year 1 marital hostility and Year 3 adolescent externalizing problems (p<.05). Self-blame, lower constructive representations, internalization of feelings, avoidance, and emotional dysregulation uniquely mediated the association between Year 1 marital hostility and Year 3 internalizing problems. Specific cognitive and emotionally based responses are important to understanding how martial hostility affects youth and need to be considered within an integrated model.