Developing a policy research agenda for healthy food access in rural communities: A transdisciplinary concept mapping approach

Introduction: Rural communities have high rates of nutrition-related disease and obesity. Rural residents often face unique barriers to accessing healthy, affordable foods. Many food access studies focus on urban communities and measures have often not been validated in rural settings. Policy and environmental change approaches would benefit from additional research that examines rural contexts. In 2011, participants of the CDC-funded Nutrition and Obesity Policy Research and Evaluation Network Rural Food Access Working Group (RFAWG) formed to conduct collaborative transdisciplinary policy research to address these concerns. Methods: Using concept mapping methodology, RFAWG researchers collected data from approximately 200 rural food access experts throughout the United States. Participants identified issues perceived as important to the topic and then prioritized those ideas for research and policy development. A subset of participants sorted the ideas, and researchers used aggregate results to create concept maps. Results: Concept maps included five high-level domains (Food and Nutrition Assistance; Food Retail and Availability; Food Production; Consumer Knowledge, Attitudes and Behaviors; and Data and Policy) and 17 lower-level domains (e.g., Agricultural Pathways, Healthy Food in Institutions, Price and Financial Resources). Policy research priorities included: 1) Food and nutrition support adaptations; 2) Retail availability and shopping patterns; 3) Food production and distribution capacity; and 4) Economic development and viability and consumer purchasing power. Discussion: Lessons learned from this transdisciplinary approach can inform others interested in developing policy research agendas. The domains and priorities identified can inform future policy research and actions to address access to healthy foods in rural communities.