Nearly 70% of adults and 30% of children/adolescents living in North Carolina (NC) are overweight or obese. Structural inequalities across our state have led to limited access to healthy foods and opportunities for physical activity, particularly within rural communities. Families living in rural areas with low income and from historically marginalized backgrounds are less likely to exercise and eat the recommended servings of fruits and vegetables (FV). These neighborhood disparities have negative health impacts, including increased risk for obesity, type 2 diabetes, heart disease, and stroke. While obesity is a multifaceted problem, lack of access to healthy foods and safe places to be active are significant driving factors. Our project focuses on families living in rural communities and aims to: (1) increase access to healthy foods through produce prescription and FV voucher programs, (2) increase the number of places to be active through quick-builds, pop-ups, and shared use, (3) spread and scale family healthy weight programs, and (4) strengthen obesity prevention standards in early care and education settings across 10 counties with high obesity rates. NC State Extension will implement these activities through an approach grounded in health equity and the social-ecological model, partnering closely with local partners, county-level Extension staff, and key state-level partners. Implementation across these four strategy areas will provide opportunities to strengthen existing, evidence-based policy, systems, and environmental (PSE) strategies for preventing obesity and provide training and resources to support Extension’s role in community engagement and capacity-building within these counties.
