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Stakeholder Perceptions of Obesity-Prevention Strategies: A Comparison of Geographically Diverse Rural Counties

West, Stephanie T. PhD; Weddell, Melissa S. PhD; Whetstone, Lauren M. PhD; Jilcott Pitts, Stephanie B. PhD

Journal of Public Health Management and Practice: November/December 2013 - Volume 19 - Issue 6 - p 511–520
doi: 10.1097/PHH.0b013e318289476c
Original Articles

Understanding barriers and facilitators to strategies directed at obesity-prevention policy change, particularly in rural, southern US counties where obesity is more prevalent, is important so that strategies deemed most winnable can be pursued. As such, community stakeholders and policy makers were interviewed using the Centers for Disease Control and Prevention's Common Community Measures for Obesity Prevention Assessment in 2 rural, geographically diverse regions of North Carolina. Stakeholder interviews revealed many similarities despite population differences and unique geographic challenges to each region. In both Western and Eastern North Carolina, strategies involving increasing opportunities for physical activity were deemed the most winnable, whereas strategies incentivizing businesses to locate in underserved areas and limiting advertisements of unhealthy food and beverages were deemed the least winnable. Differences among Western and Eastern North Carolina regions revolved around zoning, geographic constraints, and topographically influenced local food strategies. These findings add to the literature by systemically identifying similarities and differences among geographically diverse rural communities.

This article provides a comparison of stakeholder perceptions of obesity-prevention strategies in geographically diverse rural counties of North Carolina. The potential relevance of Common Community Measures for Obesity Prevention as a community engagement tool is also discussed.

Department of Health, Leisure, and Exercise Science, Appalachian State University, Boone, North Carolina (Drs West and Weddell); Public Health Institute and Network for a Healthy California, Sacramento, CA (Dr Whetstone); and Department of Public Health (Dr Jilcott Pitts), East Carolina University, Greenville, North Carolina.

Correspondence: Stephanie T. West, PhD, Department of Health, Leisure, and Exercise Science, Appalachian State University, PO Box 32071, Boone, NC 28608 (

This publication was supported by Communities Putting Prevention to Work (Grantee number 1U58DP003053-01), from the Centers for Disease Control and Prevention (CDC). The contents of this paper are solely the responsibility of the authors and do not necessarily represent the views of the CDC. Stephanie West and Melissa Weddell were external evaluators for the Appalachian District CPPW project. Lauren Whetstone and Stephanie Pitts were external evaluators for the Pitt County CPPW project.

The authors gratefully acknowledge community members/stakeholders for their willingness to participate in the research study.

The authors declare no conflicts of interest.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.