The intervention was effective in changing home environments and reducing energy intake.

A dults generally gain weight as they age, with recent estimates approaching 1 pound per year.1-5 Modest weight gains of 10 to 15 pounds are associated with increased risk of several chronic diseases, including diabetes and coronary heart disease. 3,6 Greater increases are associated with colon and several other cancers in both genders, and with endometrial and postmenopausal breast cancer in women. 7 AbstractBackground: Ecological models of healthy eating and physical activity emphasize the influence of behavioral settings such as homes and worksites in shaping behavior.Research on home environments suggests that both social and physical aspects of the home may impact physical activity and healthy eating.

Rural residents, particularly those in the South, are less physically active than their urban counterparts and often live in areas with limited walkability (e.g., no sidewalks) and minimal access to recreational facilities. The purpose of this study was to gain an understanding of what makes certain rural residents physically active despite their environment. Qualitative interviews (N = 29) were conducted with physically active adults who live in rural areas (e.g., outside of town) in southwest Georgia. Participants were 65.5% male and 24.1% African American, with a mean age of 55.9 years. Results suggest that physically active adults in rural areas are motivated by their health and perceive their local surroundings as a resource for physical activity. Understanding how these physically active adults take advantage of their living situations to be physically active has the potential to inform interventions that encourage physical activity in this high-risk population.

BackgroundDemocratic deliberation (DD), a strategy to foster co-learning among researchers and communities, could be applied to gain informed public input on health policies relating to genomic translation.PurposeWe evaluated the quality of DD for gaining informed community perspectives regarding targeting communities of African Ancestry (AAn) for Hereditary Breast and Ovarian Cancer (HBOC) screening in Georgia.MethodsWe audiotaped a 2.5 day conference conducted via zoom in March 2021 to examine indicators of deliberation quality based on three principles: (1) inclusivity (diverse viewpoints based on participants' demographics, cancer history, and civic engagement), (2) consideration of factual information (balanced and unbiased expert testimonies, participant perceived helpfulness), and (3) deliberation (speaking opportunities, adoption of a societal perspective on the issue, reasoned justification of ideas, and participant satisfaction).ResultsWe recruited 24 participants who reflected the diversity of views and life experiences of citizens of AAn living in Georgia. The expert testimony development process we undertook for creating balanced factual information was endorsed by experts' feedback. Deliberation process evaluation showed that while participation varied (average number of statements = 24, range: 3–62), all participants contributed. Participants were able to apply expert information and take a societal perspective to deliberate on the pros and cons of targeting individuals of AAn for HBOC screening in Georgia.ConclusionsThe rigorous process of public engagement using deliberative democracy approach can successfully engage a citizenry with diverse and well-informed views, do so in a relatively short time frame and yield perspectives based on high quality discussion.

Background-Ecological models of healthy eating and physical activity emphasize the influence of behavioral settings such as homes and worksites in shaping behavior. Research on home environments suggests that both social and physical aspects of the home may impact physical activity and healthy eating. Objective-Using a community-based participatory research (CBPR) approach, the Emory Prevention Research Center (EPRC), Cancer Coalition of South Georgia, and the EPRC's Community Advisory Board (CAB) designed and tested a coach-based intervention to make the home environment more supportive of healthy eating and physical activity for rural adults. Methods-The 6-week intervention consisted of a tailored home environment profile, goalsetting, and behavioral contracting delivered through two home visits and two telephone calls. The study used a quasi-experimental design with data collected via telephone interviews at baseline, 2 and 4 months post-baseline. Ninety households (n = 90) completed all three telephone interviews. Results-Multilevel models indicated that intervention households reported significant improvements in household food inventories, purchasing of fruit and vegetables, healthier meal preparation, meals with the TV off, and family support for healthy eating, relative to comparison households. Intervention households also reported increased exercise equipment and family support for physical activity relative to comparison households. Percent of fat intake decreased significantly, but no changes were observed for fruit and vegetable intake, physical activity, or weight among intervention relative to comparison households, although trends were generally in a positive direction. Conclusion-Coaching combined with a focus on the home environment may be a promising strategy for weight gain prevention in adults.

Few studies have identified barriers to creating a home environment more supportive of healthy eating. We examined barriers faced by participants in a randomized controlled trial and an adaptation study of the Healthy Homes/Healthy Families intervention, which uses health coaches to support low-income families in creating healthier home food environments. Coaches maintained logs of participant interactions as part of a process evaluation. We thematically analyzed logs from interactions with participants, mostly lower-income African American women (n = 114), to identify barriers for each of 8 healthy actions that serve as core elements of the intervention. Difficulty of changing current habits was a barrier for 5 of the healthy actions. No time/ convenience and limited family support each influenced 2 of the healthy actions, with interpersonal barriers also stemming from social situations and visitors, including grandchildren. Cost and economic challenges were barriers for 3 of the actions. Hunger, cravings, and limited access to resources (eg, transportation, fresh fruits and vegetables) were each noted as barriers for 1 healthy action. Overall, these findings provide insight for how to better support families who are trying to improve their home food environments and highlight the need for multilevel interventions.