PRC partners with Ottumwa to improve rural health

By Cindy Hadish

Published on January 22, 2015

Changing physical activity habits on an individual level can be challenging enough, but the University of Iowa Prevention Research Center (PRC) seeks to go beyond the individual level by improving the health of an entire community.

Ottumwa was chosen by the center for a special community based research project focused on physical activity. The U.S. Centers for Disease Control and Prevention (CDC) notes that regular physical activity can help reduce the risk for chronic diseases such as diabetes, heart disease, and cancer. The research project will inform community innovations to enhance the health of Iowans and residents of rural towns elsewhere.

“We considered several communities,” says Edith Parker, principal investigator and director of the PRC, which is based in the UI College of Public Health and funded by the CDC. “We realized we wanted to go where there was a need but also strengths to build upon, and Ottumwa had both.”

With nearly 25,000 residents, Ottumwa, the county seat of Wapello County in southeastern Iowa, was selected because of its health needs, as well as “their willingness to work with us,” says Parker, who also heads the college’s Department of Community and Behavioral Health. A Community Advisory Board was established to collaborate on identifying concerns, developing a community survey, and partnering with the center on other initiatives.

Survey results

The survey, conducted in 2012-2013 by the research center with more than 1,000 Ottumwa residents, showed that 35.8 percent of respondents reported being obese, compared to 29 percent of Iowans in general. One-third (36 percent) of respondents said they participated in the CDC’s recommended amount of weekly physical activity, compared to 43.9 percent of Iowans. Respondents living at or under median income level were less likely to have met the physical activity guidelines (25 percent) compared with respondents living above (50 percent). Mental health also arose as an issue, which Parker notes is entwined with physical health.

Evidence-based physical activity interventions have been tested in inner-cities and suburban areas, but Parker points out similar efforts in rural communities have been scant.

“While we’re focusing on Ottumwa, we feel what we do can be disseminated and serve a larger regional focus,” she says.

Desiree Johnson, president and CEO of the United Way of Wapello County and a member of the Community Advisory Board, says she appreciates the center’s work.

“We are very honored to have the Prevention Research Center staff here,” she says, adding that the center has opened an office on Ottumwa’s Main Street, another sign of its commitment to the community.

Active Ottumwa

Johnson says the goal is to see Wapello County, currently in the lowest quartile of Iowa in measurements of health, move up to the next quartile in the next 15 years. To meet that goal and as part of the project’s next phase, called Active Ottumwa, residents will work toward becoming active for at least 150 minutes per week, she says.

Some of that activity will take place on the county’s extensive parks and trail system. The project does not provide funding for “bricks and mortar” infrastructure, but works to train lay leaders in evidence-based health practices, says Barbara Baquero, co-principal investigator and deputy director of the PRC.

“That’s the biggest thing we’re going to build,” explains Baquero, who directs the Active Ottumwa research project, “advocates for health in their own community.”

Baquero says at least 20 UI faculty, staff, and students have been involved in the project so far, with that number expected to grow.

“The community engagement approach is not new,” Baquero says. “But how we’re putting it together has never been done before.”

Some of the issues—limited access to healthy foods, mental health issues such as depression, drug abuse, and domestic violence—are due to the lack of services available and because of the ways people cope with stress, she says.

The project will work on preventing those problems for the long-term and will create evidence-based protocols that can be replicated in other Iowa communities, as well as the Midwest, Baquero says, “So this is not just a one-time thing.”

The study also will follow residents over time to assess the community-wide impact of the program.

“Our commitment to Ottumwa is long-term,” Parker says. “We want to establish a lasting relationship. That’s our promise.”