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UKnowledge > College of Public Health > Journal of Appalachian Health > Vol. 7 (2025) > Iss. 4

 

Corresponding Author

Julie Plasencia; julieplasencia@uky.edu

Author Affiliations

  1. Alex Scott, MS, RDN, LD: Southeast Regional Director of Nutrition, Kentucky Cattlesmen’s Association (Lexington KY); E-mail: akscott96@gmail.com
  2. Melissa D. Olfert, DrPH, RDN: Professor, Davis College of Agriculture and Natural Resources, School of Agriculture and Food Systems, West Virginia University (Morgantown WV); ORCiD: https://orcid.org/0000- 0002-6686-3891
  3. Makenzie Barr-Porter, PhD, RDN, LD: Associate Professor, Department of Dietetics and Human Nutrition, University of Kentucky (Lexington KY); ORCiD: https://orcid.org/0000-0002-6332-215X
  4. Dawn Brewer, PhD, RD, LD: Associate Professor, Department of Dietetics and Human Nutrition, University of Kentucky; ORCiD: https://orcid.org/0000-0003-4219-0298
  5. Julie Plasencia, PhD, RDN, LD: Associate Professor, Department of Dietetics and Human Nutrition, University of Kentucky; E-mail: julieplasencia@uky.edu; ORCiD: https://orcid.org/0000- 0003-2143-3844

Author Area of Expertise

Alex Scott - Qualitative Research, Nutrition, Food Insecurity

Melissa D. Olfert - Qualitative Research, Nutrition, Food Insecurity, Chronic Disease Prevention, Appalachia

Makenzie Barr-Porter - Qualitative Research, Nutrition, Food Insecurity, Chronic Disease Prevention

Dawn Brewer - Qualitative Research, Nutrition, Food Insecurity, Community Engagement, Appalachia

Julie Plasencia - Qualitative Research, Nutrition, Food Insecurity, Cultural Food Practices, Chronic Disease Prevention

Abstract

Introduction: Community health workers (CHWs) are trusted professionals in communities because of the deep understanding and cultural insights learned from their lived experiences. In Appalachia, CHWs are embedded in the community, giving them a unique understanding of how social determinants, like food and nutrition security, impact health outcomes.

Purpose: This study aimed to examine the professional characteristics and knowledge of CHWs while identifying culturally sensitive practices around food insecurity.

Methods: This cross-sectional, mixed-methods study used an online survey and in-depth phone interviews with CHWs in the Appalachian Region to examine their professional characteristics and knowledge on food security in their community. Quantitative surveys included a Cultural Competence Assessment (CCA) with two subscales: Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behaviors (CCB). Surveys were analyzed descriptively to examine professional characteristics, while interviews underwent thematic analysis to identify community-based food and nutrition solutions.

Results: Fourteen CHWs completed the online survey, and over 75% reported being able to provide guidance to families on food assistance programs. Findings from in-depth interviews highlight the challenges that families face in accessing these programs, including generational differences that affect access to home-cooked v packaged foods, as well as access to entitlement programs due to non-custodial caretaker status.

Implications: The deep cultural competence among CHWs makes their partnerships a valuable community asset. Their unique position and knowledge of the community enable them to identify opportunities for community-based solutions to improve food and nutrition security in rural Appalachia.

DOI

https://doi.org/10.13023/jah.0704.05

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Additional Files
Appendix1.docx (16 kB)
Appendix 1

Recommended Citation

Scott A, Olfert MD, Barr-Porter M, Brewer D, Plasencia J. Leveraging community health worker’s deep community knowledge to address food and nutrition security in Appalachia. J Appalach Health 2025; 7(4):89-99. DOI: https://doi.org/10.13023/jah.0704.05

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