CONTRASTING RURAL AND URBAN KANSAS CHRONIC DISEASE RISK REDUCTION PHYSICAL ACTIVITY AND NUTRITION GRANTEES

Abstract

A major public health objective is to reduce the risk of the population for chronic disease. To achieve this goal in the U.S., the Centers for Disease Control and Prevention provides funds to states to distribute to local communities. How states can assist local communities in their public health efforts is not well understood. Furthermore, the little evidence that does exist is based on research conducted largely in urban areas with higher-income populations (Barnidge, et al., 2013; Frost, Goins, Hooker, Bryant, Kruger, & Pluto, 2010). “One size fits all” technical assistance delivered by state health departments does not always fit the needs of every community due to contrasting population densities in the state. With health disparities between rural and urban populations on the rise, public health practitioners in rural areas face great challenges improving the health of residents (Singh & Siahpush, 2014). Thus, public health practitioners at the state and local level must adapt the evidence-base to fit the characteristics of rural areas. The Kansas Department of Health and Environment (KDHE) is a state level health agency serving the residents of Kansas. The mission of KDHE is to protect and improve the health of all Kansans and the environment in which they live (KDHE, 2014). Within KDHE is the Division of Public Health, which houses the Bureau of Health Promotion. This report covers projects and learning objectives conducted during a field experience for fulfillment of a Master in Public Health degree at Kansas State University. Research and projects were completed within the field experience timeframe and were conducted as part of the Physical Activity and Nutrition Program within the Bureau of Health Promotion. Detailed results from qualitative interviews held with Chronic Disease Risk Reduction (CDRR) physical activity and nutrition (PAN) grantees in Kansas counties were provided in this report. The primary aim of the project was to contrast the needs between rural and urban county health departments and to develop guidelines to improve state technical assistance efforts to CDRR grantees. Rural county barriers included lack of human capital and resources, lack of interest in physical activity and nutrition initiatives among local leaders, and lack of opportunities for training. Both urban and rural grantees expressed a strong need for better access to best practice examples for communities similar to theirs. Facilitators for rural grantees were partnerships with foundations or organizations, good trail systems, and a strong “sense of community.” Facilitators for urban grantees included the availability of resources and access to PAN-inducing environments. Qualitative interviews and feedback may fill an important role of altering and improving technical assistance efforts in states which have a wide array of population densities.