title: A Participatory Regional Partnership Approach to Promote Nutrition and Physical Activity Through Environmental and Policy Change in Rural Missouri.
abstract: BACKGROUND
  Rural residents are less likely than urban and suburban residents to meet recommendations for nutrition and physical activity. Interventions at the environmental and policy level create environments that support healthy eating and physical activity.
  
  
  OBJECTIVE
  Healthier Missouri Communities (Healthier MO) is a community-based research project conducted by the Prevention Research Center in St. Louis with community partners from 12 counties in rural southeast Missouri. We created a regional partnership to leverage resources and enhance environmental and policy interventions to improve nutrition and physical activity in rural southeast Missouri.
  
  
  METHODS
  Partners were engaged in a participatory action planning process that included prioritizing, implementing, and evaluating promising evidence-based interventions to promote nutrition and physical activity. Group interviews were conducted with Healthier MO community partners post intervention to evaluate resource sharing and sustainability efforts of the regional partnership.
  
  
  RESULTS
  Community partners identified the benefits and challenges of resource sharing within the regional partnership as well as the opportunities and threats to long-term partnership sustainability. The partners noted that the regional participatory process was difficult, but the benefits outweighed the challenges.
  
  
  CONCLUSIONS
  Regional rural partnerships may be an effective way to leverage relationships to increase the capacity of rural communities to implement environmental and policy interventions to promote nutrition and physical activity.
authors.affiliation: Prevention Research Center in St Louis, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Ave, St Louis, MO 63104. Email: barnidge@slu.edu.
authors.forename: Ellen K
authors.initials: EK
authors.lastname: Barnidge
authors.affiliation: Prevention Research Center in St Louis, Saint Louis University College for Public Health and Social Justice, St Louis, Missouri.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Baker
authors.affiliation: Prevention Research Center in St Louis, Saint Louis University College for Public Health and Social Justice, St Louis, Missouri.
authors.forename: Amy
authors.initials: A
authors.lastname: Estlund
authors.affiliation: Prevention Research Center in St Louis, Saint Louis University College for Public Health and Social Justice, St Louis, Missouri.
authors.forename: Freda
authors.initials: F
authors.lastname: Motton
authors.affiliation: Prevention Research Center in St Louis, Brown School, Washington University in St Louis, St. Louis, Missouri.
authors.forename: Pamela R
authors.initials: PR
authors.lastname: Hipp
authors.affiliation: Prevention Research Center in St Louis, Brown School, Washington University in St Louis, and Division of Public Health Sciences and Alvin J. Siteman Cancer Center, Washington University School of Medicine, Washington University in St. Louis, St. Louis, Missouri.
authors.forename: Ross C
authors.initials: RC
authors.lastname: Brownson
mesh_terms: D057191:Capacity Building; D002318:Cardiovascular Diseases / Q000517:prevention & control; D002908:Chronic Disease / Q000517:prevention & control; D055812:Community-Based Participatory Research / Q000379:methods*; D004059:Diffusion of Innovation; D004779:Environment Design; D058735:Environmental Policy; D019317:Evidence-Based Medicine / Q000193:education; D015444:Exercise; D006265:Health Care Coalitions; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007373:Interinstitutional Relations; D007407:Interviews as Topic; D008923:Missouri; D018673:Nutrition Policy; D009752:Nutritional Status; D017063:Outcome Assessment, Health Care; D010865:Pilot Projects; D015397:Program Evaluation; D015980:Public Health Practice; D012040:Regional Health Planning / Q000379:methods*; D012108:Research Personnel; D019035:Rural Health Services / Q000458:organization & administration*