Study overview

Many risk factors have been associated with children being overweight or obese, including rural residency.

Attributes of the rural environment make it difficult for children to access and consume healthy foods and drinks, walk or bike to destinations, and/or participate daily in physical activity and recreational sport programs.

Furthermore, features of elementary schools, particularly those in lower resourced rural school districts, are such that students often face long bus commutes, minimal/no provision of health and physical education by certified teachers, and few resources to support health and/or enrich the academic environment.

Rural community features pose unique challenges for residents and visitors that differ from those in metropolitan regions, specifically the availability of easily accessible and affordable healthy foods and beverages and physically active lifestyle supports.

Nevertheless, most recommended strategies to improve environmental contexts and address rural obesity disparities have been developed and tested in non-rural settings.


Our overarching goal

Prevent a rise in overweight and obesity prevalence in elementary school students
as they progress from Kindergarten through grade six.



Here's how we do it


growhkc multi-state partners

Our first aim is to understand the rural obesogenic environment. To do so Oregon State University (OSU) will partner with Extension Services in six Western States to engage rural people in community-based participatory research efforts to:



Assess features of rural communities that are viewed as obesity preventing/promoting, community resources and readiness to implement and support environmentally-based obesity prevention efforts


Create a database to aggregate the data from community assessments


Develop a new eXtension Community of Practice as a vehicle to help practitioners and the public learn from our research findings


Our second aim is to plan, implement, and evaluate a multi-level intervention targeting rural home, school, and community behavioral settings to promote healthful eating and increase physical activity, and thus improve body mass index among rural children aged 5-8 years old. Toward this end, we will develop and test the GROW-HKC obesity prevention program in rural communities from three counties in Oregon. Applying a “people and places” framework, our intervention will utilize evidence-based strategies to affect positive changes in person-level attributes and in family home, school, and community environments related to healthful eating and physical activity.


growhkc wordle


We have developed four objectives to meet our aims




Create a resident-informed profile of the rural community environment that documents attributes which support or hinder healthful eating and physical activity among youth and use the data from multiple profiles to inform the development of a grounded theoretical model of the rural obesogenic environment.


Create a new eXtension CoP to inform, educate, and support individuals, families, schools and communities in efforts related to obesity prevention in rural communities.


Evaluate the impact of a comprehensive multi-level intervention to promote healthy eating and increase physical activity on obesity (change in BMI) among rural kindergarten through 3rd grade children.


Evaluate the effects of the intervention on changes in home, school, and community food and physical activity environments.