African American Perceptions of Service Provided by Supplemental Nutrition Assistance Program-Education: A Qualitative Exploration.

OBJECTIVE: To assess African Americans' satisfaction with Supplemental Nutrition Assistance Program-Education (SNAP-Ed) in Louisiana. METHODS: African American facilitators conducted 5 focus group discussions with 25 African American SNAP-Ed participants according to issues identified by African American SNAP-Ed implementers in Louisiana. Focus group discussion transcripts were coded independently using inductive and in vivo coding by 2 members of the research team. RESULTS: Participants viewed lessons as race-neutral and thought they should include more information about African American history and culture. Participants also noted a lack of engagement with the African American community and stressed the need for the program to employ African American staff. However, participants thought the information was important for African Americans in the context of medical issues faced by their community. CONCLUSIONS AND IMPLICATIONS: Findings indicate that SNAP-Ed in Louisiana be modified to address African American food history and culture, additional African American staff and better engagement with the African American community.

Empty Houses, Loose Dogs, and Engaged Citizens: Lessons Learned From Community Participatory Data Collection in Rural Areas.

Rural surveys tend to oversample easy to reach populations, which can misrepresent community health needs. To achieve baseline data reflective of the communities served by the high obesity program (HOP), an innovative evaluation plan was created to prioritize equity and reflect the whole community. Principles of Community-Based Participatory Research (CBPR) were used to guide instrument development, research protocols, and data collection. A random sample of addresses created with United States Postal Service records provided a representative list of addresses in three HOP counties in Louisiana. Local data collectors were recruited to go door to door at the selected addresses to collect in-person surveys (N = 682; response rate of 84%). Over a quarter of participants reported using the charitable food system and walking for transportation at least weekly. Collecting door to door data in rural communities presents unique challenges, including abandoned properties, inaccurate address records, loose dogs, and at times, racial tensions and houses far removed from public roads. Lessons learned include the importance of local knowledge, adapting protocols to fit local conditions, and community awareness of the survey. Health practitioners need confidence when they are making data-based decisions about interventions, and one way to provide this confidence is to collect data from a true cross-section of the community. With a plan and in partnership with community members, a probability sample is feasible to collect in rural communities.

Opportunities and Challenges Addressing Access to Healthy Food in Five Rural Louisiana Food Stores.

The prevalence of high obesity in rural communities may result from low access to healthy foods. To improve the local food environment, a multicomponent environmental food store intervention was implemented in 3 Louisiana parishes where obesity prevalence was greater than 40%. The intervention consisted of healthy-food demonstrations, in-store marketing, and encouraging store owners to stock healthy items. We documented aspects of the rural food store climate, such as store size and the store owner's willingness to stock healthy items, that affect improving access to healthy food. We found that although the intervention was not effective in shifting purchasing or dietary habits of customers, positive changes in some food store environments did occur. To maximize the effect that rural food store interventions can have on reducing obesity, it is essential to understand aspects of the rural food store climate.