Evaluating Individual-Level Programs
Interventions focused on individual behavioral change may provide education, training, and services to
individuals. Examples of rural obesity interventions that have been evaluated to assess individual
behavioral change are provided.
County Coalition for Health and Wellness
Summary: Eight Coalition and Activate programs used community coalitions to create healthier
environments, disseminate health promotion programs, and improve access to healthcare. The evaluation assessed
program reach and effectiveness in achieving knowledge and behavior change among participants in the initiative.
Evaluation goal: Assess program reach and effectiveness in achieving knowledge and behavior
change among program participants
Target population: Participants are primarily underserved and uninsured Martinsville-Henry
Evaluation methods: Key informant interviews and pre- and post-test surveys to measure
knowledge and behavior change among participants; analysis of changes in access to healthcare services by
examining enrollment and referral trends over time
Evaluation findings: The evaluation identified individual-level health benefits
Source: Transformation of a Rural
Community for Active Living
Smith, M.L., Bazzarre, T.L., Frisco, J., et al.
Family & Community Health, 34(2), 163-72
Program: The Treatment of Obesity in Underserved Rural Settings, Randomized trial, north-central
Summary: Between 2003 and 2007, a trial was conducted to demonstrate the effectiveness of
extended care programs that include face-to-face or telephone follow-up sessions to help participants maintain
weight loss in rural communities. Participants completed an initial lifestyle program focused on weight-loss,
and then were randomized to participate in an extended care component (telephone or face-to-face counseling) or
an education control group. Participants completed a six-month and 18-month assessment.
Evaluation goal: Assess effectiveness of extended-care programs designed to improve
maintenance of lost weight
Target population: 234 obese women, ages 50-75 years, from medically underserved rural
areas in north-central Florida
Evaluation methods: Participants were stratified by county and Body Mass Index (BMI) and
randomly assigned to participate in telephone or face-to-face counseling or an education control group;
weight loss was measured at the initial phase (0 to 6 months) and the extended care phase (6 to 18 months)
Evaluation findings: Extended care delivered either by telephone or in face-to-face
sessions improved maintenance of lost weight one year after randomization compared with education alone
Programs for Weight Management in Rural Communities: The Treatment of
Obesity in Underserved Rural Settings (TOURS) Randomized Trial
Perri, M.G., Limacher, M.C., Durning, P.E., et al.
Archives of Internal Medicine, 168(21), 2347-54