A Civic Engagement Approach to Encourage Healthy Eating and Active Living in Rural Towns: The HEART Club Pilot Project.

PURPOSE

To assess the feasibility and effectiveness of a civic engagement curriculum (encouraging Healthy Eating and Activity in Rural Towns [HEART] Club) designed to engage rural residents in improving their local food or physical activity environment.

DESIGN

Pre-post surveys and focus groups.

SETTING

Three rural Northeastern towns in the United States.

PARTICIPANTS

Twenty-six rural residents (7-12 per town) recruited by local extension educators.

MEASURES

Online surveys were used to assess outcomes related to feasibility (satisfaction) and effectiveness (knowledge, awareness, motivation, self-efficacy, and group efficacy for community change). Feasibility was also assessed through attendance logs, benchmark achievement records, and post-implementation focus groups.

ANALYSIS

Participant characteristics and feasibility measures were summarized using descriptive statistics. Pre-post changes in effectiveness outcomes were assessed using Wilcoxon signed rank tests. Focus group data were thematically examined to identify barriers to and facilitators of HEART Club progress.

RESULTS

Meeting attendance and program satisfaction were high (88% and 91%). Participants reported improvements in awareness; however, no other significant changes were observed. All HEART Clubs accomplished 3 or more project benchmarks after 6 months of implementation. Despite competing priorities and limited finances, groups effectively leveraged existing resources to achieve their goals. Important facilitators of success included stakeholder support, effective leadership, and positive group dynamics.

CONCLUSION

These findings suggest that resident-driven initiatives that build upon local resources and establish feasible goals can successfully foster environmental change in rural communities.