Laurel HARVEST: Helping Appalachia Restore a Vibrant Food Environment for Self Sufficiency Together

• Published in: Journal of nutrition education and behavior Vol. 55; no. 7; p. 111
• Main Authors: Cardarelli, Kathryn, Barr, Makenzie, Mayfield, Christa, Swanson, Mark, Luecking, Courtney, Slone, Stacey, Mullins, Janet
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01-07-2023
• ISSN: 1499-4046; 1878-2620
• DOI: 10.1016/j.jneb.2023.05.235

Inequities in obesity and related chronic diseases between rural and urban communities have grown in recent years, as rural residents face numerous barriers to healthy eating. The goal of this project is to improve food security and nutritional health outcomes in a rural Kentucky community. Our team is employing a community-based participatory approach to identify and adapt evidence-based healthy eating interventions at multiple levels of the sociologic model.
Working in partnership with the Kentucky Cooperative Extension Services and its Extension Council, this project builds on our team's long relationship with residents living in Appalachian Kentucky to implement policy, systems and environmental (PSE) interventions in this rural and underserved population. Guided by a Community Advisory Board (CAB) of 16 community leaders from multiple sectors, multi-level interventions are being implemented in the study county- Laurel County, Kentucky. We are implementing alternative programming in a control county with similar sociodemographic characteristics. Interventions in Laurel County include evidence-based multigenerational cooking classes to enhance self-efficacy to prepare nutritious meals and structural interventions with the farmers market to enhance community access to fruits and vegetables. All interventions are tailored for the target population and guided by the CAB.
We are employing a mixed methods evaluation approach to measure short and intermediate term outcomes, including a longitudinal cohort study in both the intervention and control communities. Primary project outcomes include increased food security and increased fruit and vegetable consumption. Our process evaluation to document implementation employs the Reach, Effectivness, Adoption, Implementation, and Maintenance (RE-AIM) framework.
Evidence-based programs to promote healthy eating that can be successful in rural environments are needed, and some have suggested that the capacity to adapt or develop obesity prevention strategies for rural communities might be best informed by the communities themselves. This community-engaged project has the potential to advise feasible strategies to reduce the rural burden of food insecurity and poor nutritional outcomes, leading to greater self-sufficiency.
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This work is supported by the USDA National Institute of Food and Agriculture.