The Centers for Disease Control and Prevention (CDC) selected the University of Kentucky (UK) as one of 15 land grant universities funded to collaborate with the Cooperative Extension Service (CES) to increase access to healthier foods and safe and accessible places for physical activity. The funding is part of a High Obesity Program (HOP) cooperative agreement which will run through 2023.  

Martin County, a rural community situated on the West Virginia border in Appalachia, was chosen for this project due to its adult obesity rate of 40.2%, well above the state adult obesity prevalence of 34.3%. The county is representative of a geographically isolated and impoverished area in Eastern Kentucky, with a median household income less than $30,000 and nearly 36% of the community living in poverty.

Over the next several years, multiple community-based interventions targeting the food environment and community connectivity will be implemented. The CES at UK is working directly with agents at the Martin County Extension Office to emphasize policy, systems, and environmental (PSE) changes to promote healthy eating and active living. A community coalition, comprised of local officials, business owners, residents, farmers, regional representatives, and other community stakeholders, will guide the project in order to make sustainable and effective changes. 

For year 1, efforts have focused specifically on:

• PSE changes in churches through the Faithful Families curriculum
  This curriculum is designed to draw connections between the faith and overall health. The program is co-facilitated by the Martin County Family and Consumer Sciences (FCS) agent and a trained lay leader, an identified representative of the congregation, to aid in drawing these connections. Two churches were identified as partners for year 1, and both are currently walking through the 9-week curriculum, with favorable feedback thus far. The goal of the program is to implement one PSE change in each congregation at the end of the 9 weeks. There will also be opportunities to partner with other churches in the community in the subsequent years of the project.
• Increased purchase of fruits and vegetables through Power of Produce (POP) Club
  POP Club is an initiative developed by the national Farmer’s Market Coalition. This incentive program aims to teach youth about fruits and vegetables and their local food systems. It gives youth the purchasing power to support local farmers while also empowering them to make healthy choices. Four farmers expressed interest in participating and will provide produce for the three POP Club opportunities taking place at the farmers’ market later this summer.

Other efforts are currently underway and include collaboration with local grocery stores and food pantries to provide increased geographic and financial access to healthier foods, and partnerships with local and regional planners to enhance community design, connecting safe and accessible places for physical activities, with an emphasis on walking. These efforts will be the focus of year two of the project.

Long-term outcomes for this work aim to reduce obesity prevalence and decrease the risk of chronic disease in this rural community.