Appalachia Health Research

Appalachia Health Research

Frances Hardin-Fanning, PhD, RNUniversity of Kentucky College of Nursing

Breathitt County, Kentucky native Parents have owned small grocery store since

1965 Participated in Cooperative Extension activities Noted food accessibility problems as a child,

progression of food inaccessibility over years

Researcher Background

Improve frequency of lifestyle behaviors (nutrition and physical activity) associated with lower incidence of chronic disease

Study region: Appalachia

Goal

Model

THEORY of Planned Behavior

Nursing Clinics of North America (2008) Published review on the mechanisms by which a plant-based diet is associated with decreased risk of cardiovascular disease

Journal of Gerontological Nursing (2011)Published clinical recommendations for use of polyunsaturated fatty acids as immunomodulators in older adults Co-authors Terry Lennie, PhD, RN & Gilbert Boissonneault, PhD

Background Publications

Recruited volunteers from ten Appalachian churches

Cross-sectional study to analyze dietary habits and biomarkers of cardiovascular disease

Healthy volunteers

Fish consumption was associated with lower inflammation

Dissertation 2010-11

2011◦ To identify predisposing, reinforcing and enabling

factors associated with eating a plant-based diet in a rural Appalachian food desert with disproportionately high rates of cardiovascular disease

Funded by 2010 James S. Brown Graduate Student Award for Research in Appalachia University of Kentucky Department of Sociology

Studies

2011◦ Cost◦ Difficulty of preparation◦ Family attitudes toward food◦ Limited access to healthy foods◦ Difficulty changing personal habits◦ Limited knowledge of the health benefits of foods◦ Difficulty determining how to incorporate healthy foods

into meals

Results

2011◦ Cost◦ Difficulty of preparation◦ Family attitudes toward food◦ Limited access to healthy foods◦ Difficulty changing personal habits◦ Limited knowledge of the health benefits of foods◦ Difficulty determining how to incorporate healthy foods

into meals

Results

Grocery voucher study Grocery store surveillance

◦ 2013 American Public Health Association Public Health Nursing Junior Investigator Award

Feasibility pilot in Breathitt County ◦ USDA Cooperative Extension collaboration with UK College of

Agriculture Satellite Farmers Markets

◦ 2013 Southeastern Kentucky United Way Community Research Award

◦ 2014-15 William & Elizabeth Morgan Community Health Research Award

Studies 2012-13

2014-2015◦ Received NINR Mentored Patient-Oriented

Research Career Development Award to pilot intervention in six Central Appalachian counties

◦ REACH Project - Rural Eating and Cooking Healthy Adair Breathitt Casey Lawrence Morgan Wayne

Studies

Creative Agriculture Driving Excellent Transitions (CADET)◦ Collaboration with Kentucky Department of Juvenile

Justice

Indoor Policies of Outdoor Lightning (IPOOL) ◦ Appalachia ◦ Research Match

Public Health RN-BSN Experiential Learning

Additional Research

Health Resources Service Administration

◦ Medic Veterans to BSN Option

◦ 3 year funding to develop, implement and evaluate option for returning veterans to earn BSN degree

◦ Mentoring/development of DNP Project Director

◦ Gruggs, A. B. & Hardin-Fanning, F. (September 2015). Transitioning medics into the nursing profession. University of Pittsburgh School of Nursing Conference -- The Veteran’s Journey to Achieving Wellness: Successful Reintegration into Civilian Life

Additional Funding

Hardin-Fanning, F. & Wiggins, A. (February 2016). “Food Costs are Higher in Counties with Poor Health Rankings” 2016 Southern Nursing Research Society Conference Podium PresentationHardin-Fanning, F., Rayens, M. K. & Wiggins, A. (December 2015) Food cost disparities in low income communities. National Institutes of Health 8th Annual Conference on the Science of Dissemination and Implementation. Washington, DC Hardin-Fanning, F. & Rayens, M. K. Self-efficacy and subjective norms are associated with fruit and vegetable consumption in Appalachia. (October, 2015). Appalachian Translational Research Conference, Charleston, WVHardin-Fanning, F. & Witt, C. (October 27, 2015). Factors impacting the success of satellite farmers markets in rural Appalachia. Southern Ohio Medical Center Nursing Research Conference Brendamour, B., Wiggins, A., Rayens, M.K. & Hardin-Fanning, F. (April 2015). “Food accessibility trends and health in America’s counties” 2015 National Council on Undergraduate Research Conference

Data-based Presentations

Carney, A., Gokun, Y. & Hardin-Fanning, F. (February 2014) "Cost Difference of Foods Contributing to Cardiovascular Disease and Risk Reducing Foods" 2014 Southern Nursing Research Society Conference

Hardin-Fanning, F. & Gokun, Y. (February 2014) "Factors Associated with Grocery Voucher Redemption for Healthy Food " 2014 Southern Nursing Research Society Conference

Hardin-Fanning, F. & Gokun, Y. (November 2014) Income is not associated with healthy food purchasing via grocery voucher in a rural, impoverished county. Podium Presentation, American Public Health Association Annual Conference, New Orleans, LA

Data-based Presentations

Hardin-Fanning, F. (November 2013) Supplemental Nutrition Assistance Program Participation (SNAP) and food cost in rural Appalachia. Podium Presentation, American Public Health Association, Boston, MA

Hardin-Fanning, F. (May 2013) Food cost disparities in rural Appalachia. Poster Presentation, Appalachian Translational Research Network Conference, Columbus, OH

*Hardin-Fanning, F. (February 2013). “Overall Nutritional Quality Index and food cost in an Appalachian food desert.” Podium Presentation at the 27th Southern Nursing Research Society Conference, San Antonio, TX

Data-based Presentations

Hardin-Fanning, F. & Ricks, J. (2015- in press). Attitudes, social norms, and perceived behavioral control factors influencing participation in a cooking skills program in rural Central Appalachia. Global Health Promotion. xx

Hardin-Fanning, F. & Rayens, M. K. (2015) Food cost disparities in rural communities. Health Promotion & Practice, 16(3), 383-91.

Hardin-Fanning, F. & Gokun, Y. (2014) Gender and age are associated with healthy food purchases via grocery voucher redemption. Journal of Rural & Remote Health, 14(3), 2830.

Hardin-Fanning F. (2013) Adherence to a Mediterranean diet in a rural Appalachian food desert. Journal of Rural and Remote Health, 13(1), 2293

Data-based Publications

Hardin-Fanning, F. & Rayens, M. K. (2015 – in process). Planned behavior is associated with fruit and vegetable consumption in rural Appalachia. Journal of Rural Health

Hardin-Fanning, F., Adegboyega, A. O. & Rayens, M. K. (2015 – in review) Youth’s perceptions of a gardening activity at a juvenile justice center. Behavioral Science & the Law

Hardin-Fanning, F. & Wiggins, A. T. (2015 – in review). Food costs are higher in counties with poor health rankings. Journal of Cardiovascular Nursing

Publications in review/process

Undergraduate Interns/Students◦ Smoking Cessation Meaningful Use Mandates ◦ LGBT Access to Care ◦ Six student publications from undergraduate research class

Nursing Graduate Student *◦ Interventionist for NINR-funded study

Communications Graduate Student ◦ Health Coach Relationships with Participants in Cooking Classes

Health Behaviors Graduate Student (Medical School) *◦ Physical Activity Barriers Survey on Research Match

Undergraduate Lynn Garman Au Scholarship Student *◦ Community Service Project in Appalachia

Activities with Students

Improved diet in rural Appalachia Increased student engagement in community

projects and research Decreased barriers to healthy living Additional collaborations with community

partners Research funding benefits local citizens

Potential

Thank you