Show simple item record

dc.contributor.authorSriram, Urshila
dc.date.accessioned2019-10-15T16:49:32Z
dc.date.issued2019-08-30
dc.identifier.otherSriram_cornellgrad_0058F_11635
dc.identifier.otherhttp://dissertations.umi.com/cornellgrad:11635
dc.identifier.otherbibid: 11050652
dc.identifier.urihttps://hdl.handle.net/1813/67668
dc.description.abstractRural populations, particularly women in rural areas, experience significant disparities in health outcomes relative to their urban counterparts. This is partly attributable to environmental conditions, including limited access to healthy foods and opportunities for physical activity. Although existing community-based programs have shown promise in changing women’s health behaviors, few programs have simultaneously targeted environmental factors or focused on rural populations. Civic engagement - collective actions designed to identify and address issues of public concern - is a potential strategy for improving rural environments and health outcomes; however, evaluation of these civic engagement approaches has been limited. The overall objectives of this dissertation were to evaluate the implementation and effectiveness of rural civic engagement and health behavior change strategies. These objectives were achieved through mixed-methods evaluation of two rural community-based programs: Healthy Eating and Activity in Rural Towns (HEART) Club and Strong Hearts, Healthy Communities (SHHC). To assess the feasibility and effectiveness of the HEART Club civic engagement curriculum, we conducted a pilot-study in three rural Northeastern U.S. towns. Participants reported increased awareness of community needs and assets, and successfully leveraged existing resources to improve local physical activity opportunities. To evaluate the implementation of SHHC intervention components, we conducted a mixed-methods process evaluation in rural Montana and central New York. Overall, the SHHC program was well-received by rural participants and intervention components were delivered with high fidelity. Recommendations for improvement including increasing class length, allocating more time for nutrition education, and creating more opportunities for group discussion. A mixed-methods evaluation was also used to assess the implementation and effectiveness of the HEART Club curriculum within the context of SHHC. Intervention sites reported good fidelity to the HEART Club curriculum; however, group progress towards project benchmarks was highly variable. Although some groups approached the HEART Club process with enthusiasm, many participants wished to prioritize personal behavior change over civic engagement activities. Taken together, these results highlight both the potential and challenges associated with rural civic engagement and health behavior change interventions. Findings from this research have informed modifications to the HEART Club and SHHC programs for future dissemination efforts in rural communities.
dc.language.isoen_US
dc.subjectPublic health
dc.subjectNutrition
dc.titleIMPLEMENTATION AND EVALUATION OF COMMUNITY-BASED STRATEGIES TO IMPROVE RURAL HEALTH: A MIXED-METHODS APPROACH
dc.typedissertation or thesis
dc.description.embargo2021-08-29
thesis.degree.disciplineNutrition
thesis.degree.grantorCornell University
thesis.degree.levelDoctor of Philosophy
thesis.degree.namePh.D., Nutrition
dc.contributor.chairSeguin, Rebecca
dc.contributor.committeeMemberSobal, Jeffery
dc.contributor.committeeMemberWells, Nancy M.
dc.contributor.committeeMemberLeonard, Lori
dcterms.licensehttps://hdl.handle.net/1813/59810
dc.identifier.doihttps://doi.org/10.7298/jnqx-at87


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record

Statistics