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
Presentation
Hardin-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, WV
Hardin-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