Document Type


Publication Date


Date of Final Presentation


Committee Chair

Pamela Gehrke

Committee Member

Deena Rauch

Coordinator/ Chair of DNP Program

Pamela Gehrke

Abstract/ Executive Summary

Problem: Childhood obesity is more prevalent in rural areas, and these areas have fewer resources to address it. Geographic distance to available resources, health care provider shortages, parental obesity, and poverty contribute to higher prevalence of obesity in rural children compared to urban children.

Rationale: Obesity prevention and treatment often requires long-term healthy lifestyle behavior changes including nutrition counseling and physical activity (PA). It is likely an obese pre-adolescent will have obesity as an adult, and the likelihood increases if obesity continues into adolescence. Pre-adolescence provides a window of opportunity to influence healthier PA habits to prevent overweight (OW) and obesity, thus improving population health in this rural area. Rural faith-based organizations (FBOs) provide safe spaces for PA and access to groups experiencing health disparities. The Social Ecological Theory for Health Promotion frames a health promotion physical activity (HPPA) program for multi-level influence.

Interventions: This DNP project provided a HPPA program to middle school youth in a rural faith-based organization (FBO). Eight weekly sessions provided a variety of physical activities along with health promotion topics. Body mass index (BMI) and satisfaction with PA were assessed. Mean attendance was eight participants per session.

Results: Participant body mass index (BMI) showed very little change in the project timeframe, although two participants increased BMI from pre- to post-intervention resulting in changes in percentile rank from OW to obese and healthy weight to OW percentiles. Satisfaction with PA was relatively stable throughout the intervention with a slight decrease in negative feelings associated with PA over the course of the program. Participants identified peer support and encouragement as important in plans to maintain PA post-intervention.

Summary: The DNP project was consistent with available knowledge of obesity prevention and treatment. Following a “Prevention Plus” concept, the HPPA program in the rural FBO had little impact on BMI for the short time period of the intervention but provided insight into the usefulness of FBOs in delivery of HP topics for rural populations and those experiencing health disparities. Participants reported a decrease in negative feelings associated with PA possibly leading to increased satisfaction with PA. The FBO may be a vital resource to improve the health of parishioners through HP topics and activities, including those experiencing health disparities (DeHaven, Hunter, Wilder, Walton, & Berry, 2004).

Conclusion: In rural areas, FBOs are a vital resource to provide HP activities across all ages, sexes, races, ethnicities, education levels, and income levels, including those experiencing health disparities. Collaborative use agreements and public policy including FBOs for structured HP activities maximizes efficient use of community resources in rural areas to address childhood obesity.

Available for download on Wednesday, April 14, 2021