Extension as a Backbone Support Organization for Physical Activity Promotion: A Collective Impact Case Study From Rural Kentucky

Background: Rural counties in the United States face daunting structural issues that reduce their populations' physical activity levels, including geographic isolation as well as deficits in infrastructure, public transportation, health care providers, and funding.

Methods: Funding from the Centers for Disease Control and Prevention provided an opportunity to assess how Extension enhanced the collective impact of systems-level physical activity promotion programming through a multisectoral coalition in Clinton County, Kentucky.

Results: The Extension-led coalition accomplished the 6 essential functions of a backbone support organization by identifying obesity as a critical local issue (function 1: providing overall strategic direction), developing a multisectoral coalition (function 2: facilitating dialog between partners), compiling data on the county's physical activity infrastructure (function 3: managing data collection and analysis), creating communication channels (function 4: handling communication), organizing community awareness events (function 5: coordinating community outreach), and securing additional grants (function 6: mobilizing funding). The average rating of Extension's leadership across multiple dimensions by 3 coalition members in a postproject survey was "excellent" on a 5-point Likert scale.

Conclusions: Extension is well positioned through their mission, broad community engagement, data collection, needs assessment, community and academic relationships, and embeddedness in local communities to serve as the backbone support organizations for rural physical activity promotion coalitions.