Year of Publication


Degree Name

Master of Science in Nutrition and Food Systems (MSNFS)

Document Type

Master's Thesis


Agriculture, Food and Environment


Dietetics and Human Nutrition

First Advisor

Dr. Julie Plasencia


Residents of the Appalachian region of Kentucky are disproportionately affected by poor social determinants of health that contribute to the persistence of food insecurity and diet related diseases in this region. Poverty levels persist in rural areas of the Appalachian region while they improve throughout the rest of the United States. As this further perpetuates food insecurity in rural Appalachia, it is critical to identify culturally sensitive solutions to food insecurity. Utilizing Community Health Workers (CHWs), lay members of the community who have deep understanding of the communities they live in and serve, may be the answer to this problem. The purpose of this mixed-methods study is to describe the knowledge and cultural expertise of CHWs in rural Appalachia to better understand factors influencing food insecurity. Specifically, we aimed to identify successful, sustainable services as well as gaps in services that address food insecurity and diet quality where CHWs are uniquely poised to intervene. Characteristics, skills, and knowledge of CHWs related to nutrition needs were assessed through interviews, questionnaires, and a cultural competence assessment. This study demonstrated the importance of obtaining knowledge from CHWs in rural communities of Appalachia to address problems related to food security. As well as providing recommendations for future programs, grants, and policies focusing on reducing food insecurity in rural Appalachian communities. Implications for future research include training of CHWs on existing food assistance programs and integration of CHWs into medical teams.

Digital Object Identifier (DOI)