Adolescent obesity: Identifying readiness and opportunities for change in a rural community

Background: Overweight and obesity are known to have significant morbidity, mortality, and financial consequences. The impact on rural communities and among adolescents remains disproportionate and there is a significant need for understanding community readiness. The IOM's recent report urging integration of primary care and public health to link clinical and community resources may help. Methods: We used mixed-methods to identify and determine social readiness to change and available resources in a rural community with a high rate of overweight and obese adolescents (43.8%). We developed and fielded a local health center-based survey, conducted key-informant interviews, and held focus groups in the local high school. Results: The majority of farmers, teachers, students, physicians, and other community leaders and members interviewed expressed interest in promoting healthy eating and exercise. 50% of respondents believe that they or a member of their family needs to change eating habits, and 81% of respondents reported having tried changing eating habits. However, there is no forum to pursue these goals in a unified manner, and lack of financial resources has limited the school-based health programs and other community initiatives. Conclusions: New partnerships between community health leaders, public schools, and other stakeholders are important for educating and mobilizing community members to participate in programs such as community gardening, walks, and cooking classes. Rural communities should be able to rely on clinicians and community based organizations to help empower adolescents to take charge of their own health through student-driven activities such as school health fairs and intramural sports.