Related Experiment Video

Updated: May 13, 2026

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide

Published on: January 15, 2017

Addressing rural health disparities through policy change in the stroke belt

Stephanie B Jilcott Pitts¹, Tosha W Smith, Linden Maya Thayer

¹Department of Public Health, East Carolina University, Greenville, North Carolina (Dr Jilcott Pitts); and Department of Nutrition, Gillings School of Global Public Health and UNC Center for Health Promotion and Disease Prevention (Mss Smith, Thayer, Drobka, and Miller and Dr Ammerman), and Department of Medicine, School of Medicine (Dr Keyserling), University of North Carolina at Chapel Hill.

Journal of Public Health Management and Practice : JPHMP

|March 1, 2013

Abstract

Context:

Obesity-prevention policies are needed, particularly in low-income rural areas of the southern United States, where obesity and chronic disease prevalence are high. In 2009, the Centers for Disease Control and Prevention issued the "Common Community Measures for Obesity Prevention" (COCOMO), a set of 24 recommended community-level obesity-prevention strategies.

Objective:

A variety of stakeholders in Lenoir County, North Carolina, were surveyed and interviewed, ranking the winnability, defined as feasibility and acceptability, of each of the 24 COCOMO-recommended strategies based on local culture, infrastructure, funding, and community support.

Design:

Mixed-methods.

Setting:

This study was part of the Heart Healthy Lenoir project, a community-based project to reduce cardiovascular disease risk and disparities in risk in Lenoir County, North Carolina.

Participants:

COCOMO assessments were conducted with 19 Community Advisory Council members and in-depth interviews were conducted with 11 community stakeholders. Heart Healthy Lenoir lifestyle intervention participants (n = 366) completed surveys wherein they ranked their support for 7 obesity-prevention strategies (based on the COCOMO strategies).

Main Outcome Measures:

Ranking of obesity-prevention strategies.

Results:

Policies to improve physical activity opportunities were deemed the most winnable, whereas policies that would limit advertisement of unhealthy food and beverages were deemed the least winnable. The most winnable food-related strategy was improving mechanisms to procure food from local farms. Stakeholders perceived the public as unfavorably disposed toward government mandates, taxes, and incentives. Among Heart Healthy Lenoir participants, males indicated lower levels of support for COCOMO-related strategies than females, and African Americans indicated higher levels of support than white participants.

Conclusion:

The formative work presented here provides insight into the winnability of proposed obesity-prevention policy change strategies in Lenoir County, North Carolina.

More Related Videos

Prehospital Thrombolysis: A Manual from Berlin

Prehospital Thrombolysis: A Manual from Berlin

Published on: November 26, 2013

Related Concept Videos

Atherosclerosis IV: Nursing Management

Atherosclerosis IV: Nursing Management

Nursing management for a patient with arteriosclerosis involves a comprehensive approach focusing on lifestyle modification, disease monitoring, education, and symptomatic care. Here is an overview of effective nursing strategies:Assessment and Monitoring: Initial and ongoing assessments are crucial. Nurses must document the patient's medical history, including any hypertension, diabetes, hyperlipidemia, and other cardiovascular diseases. Assessments also cover family history and lifestyle...

Regulation of Stroke Volume

Regulation of Stroke Volume

The regulation of stroke volume, which is the amount of blood the heart pumps out during each heartbeat, is critical for maintaining a healthy circulatory system. Stroke volume is influenced by three main factors: preload, contractility, and afterload.
Preload refers to the degree of stretch on the heart before it contracts. It's analogous to the stretching of a rubber band; the more it's stretched, the more forcefully it snaps back. This concept is encapsulated in the Frank-Starling law of the...

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...

Hemorrhagic Stroke l: Introduction

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...

Atherosclerosis III: Management

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...

Hemorrhagic Stroke ll: Pathophysiology

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...

Articles linked to this work by shared authors, journal, and citation graph.

Weight Loss Intervention Promoting an Adapted Mediterranean-Style Dietary Pattern: The DELISH Randomized Clinical Trial.

JAMA network open·2026

Exploring the Facilitators and Barriers to Physical Activity among Adults Experiencing Food Insecurity During the Healthy Food First Trial: A Qualitative Study.

Current developments in nutrition·2026

It would be really great if I had greater confidence and ability there: Understanding the primary care physician experience with nutrition in training, clinical practice, and interprofessional collaboration.

PloS one·2026

Skin carotenoid scores are a valid approximation of fruit and vegetable intake among adults with obesity.

Nutrition research (New York, N.Y.)·2026

Validation of a Brief and Very Brief Screener to Assess Overall Diet Quality in a Southeastern US Sample.

Journal of nutrition education and behavior·2026

Daily intake of a lycopene-rich juice is associated with reductions in inflammatory markers but not increases in skin carotenoids in a pilot study among participants with obesity.

BMC nutrition·2025

See all related articles