Nutrition-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002–2013
Published Date:Apr 30 2015
Source:Prev Chronic Dis. 12.
Pubmed Central ID:PMC4416478
Funding:5-37850/PHS HHS/United States
5T32NR008856/NR/NINR NIH HHS/United States
P30 DK093002/DK/NIDDK NIH HHS/United States
T32NR007091/NR/NINR NIH HHS/United States
U48/DP000059/DP/NCCDPHP CDC HHS/United States
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.
The review was guided by a list of Centers for Disease Control and Prevention RecommendedCommunity 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.
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.
Findings from this literature review provide guidance on adapting and implementing policy and environmental strategies in rural communities.
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