As obesity rates continue to climb in the United States, with over 40% of the adult population and 19.3% of children and adolescents now classified as obese, addressing this public health crisis remains a primary objective for practitioners in Kentucky. The Central Appalachian region displays an even greater proportion of obese adults, 35%, compared to other regions across the US. Research has shown that inactivity and low physical activity levels contribute to higher rates of obesity and the development of obesity-related chronic health conditions. However, the Appalachian region displays a 28% rate of physical inactivity among residents of the region in which no weekly physical activity is reported. Individuals residing in this region face several challenges to engaging in healthy lifestyle behaviors related to physical activity including high rates of disability, persistent poverty, and geographic isolation. This is true for Martin County, Kentucky, the setting for this work and current focus of the Centers for Disease Control High Obesity Program (CDC HOP) project. This project aims to address these health disparities by creating sustainable environmental and system changes to support healthier lifestyle behaviors such as healthier eating habits and regular physical activity. 

The Cooperative Extension Service (CES) is uniquely suited to implement policy, systems, and environmental (PSE) efforts for behavior change in these areas, as CES is a well-known and trusted organization with offices in every county in the U.S. The local CES office in Martin County has been an instrumental partner for carrying out the HOP team initiatives. Further, within the CES system, agents for Family and Consumer Sciences (FCS), SNAP-Education, 4-H, and Agriculture collaborate to deliver community-based programming supporting various facets of health. Collaboration between the CES agents, community partners, and the UK HOP team has been a crucial yet successful multidisciplinary approach to implementing appropriate community-based interventions that pose to elicit the greatest impact. 

The Martin County Health Coalition and other community partners have identified youth as a primary audience for engagement in health-promoting activities. In 2020, the Martin County CES was without an FCS agent, however, the 4-H agent who oversees youth engagement activities, agreed to collaborate with the HOP team to support project efforts in the meantime. In an effort to encourage physical activity among youth and families in Martin County, the 4-H agent and SNAP-Education assistant organized a one mile “Turkey Trot” event in partnership with the local school district. Over a three-day period, local families were encouraged to utilize the Inez Walking Trail to complete a one-mile trip, collecting clues along the way, and report to the CES office after completion to receive a prize bag for participation. This event was open to the community at large to encourage positive physical activity participation. 

In November 2020, 85 youth and 45 adults participated in the one mile “Turkey Trot” walk along the Inez Walking Trail. All participants received a prize bag including health coalition items (face mask, hand sanitizer, tote bag) and educational materials supporting healthy eating (Plate It Up Kentucky Proud recipes) and active living (FitBlue app instructions). The positive response from the community not only benefits participants, but also provides evidence of the success of organized events in encouraging physical activity when incorporating a family element into the event or programming. 

Event participants were receptive to this program, offering encouraging support for future PSE changes as part of the HOP project. Offering programs and providing organized opportunities for physical activity provides families time to participate when it is most suitable to their schedule, providing insight for future initiatives. The Martin County Tourism and Recreation Board is receptive to installing a Story Walk along the Inez Walking Trail and another walking trail located in the community. The goal is for this environmental enhancement is to support continued use and expanding use of the walking trails for families, encouraging physical activity, and supporting early literacy among young children. The Martin County CES, Tourism and Recreation Board, and the Martin County Public Library have expressed support for sustained success of these efforts, providing opportunities for collaboration among these community organizations. Through continued family-friendly programs, these partnerships will be vital to supporting obesity prevention efforts within the community at large.