Community gardens are increasing in popularity and are associated with extensive physical and mental health benefits, increased access to fresh produce, and increased social connections. However, evidence is primarily from research in urban and school settings, and little is known about the role of community gardens in rural settings as part of policy, systems, and environmental (PSE) changes to promote health. This study explores the implementation of community gardens as part of an obesity prevention project, titled Healthier Together (HT), in five rural Georgia counties with limited food access and high obesity prevalence (>40%) using a mixed-methods research design that included data from project records, a community survey, interviews, and focus groups with county coalition members. Nineteen community gardens were implemented across five counties, 89% distributed produce direct to consumers, and 50% were integrated into the food system. Few (8.3%) of the survey respondents (n = 265) identified gardens as a food source, but 21.9% reported using an HT garden in the past year. Themes emerging from interviews (n = 39) and five focus groups suggested community gardens were a catalyst for broader community health change by increasing awareness of the value and absence of healthy food and generating excitement for future PSE initiatives to more comprehensively address food and physical activity access. Practitioners should consider placement of rural community gardens to optimize access to and distribution of produce as well as communication and marketing strategies to increase engagement and leverage gardens as gateways for PSE approaches to improve rural health.
Keywords: appreciative inquiry; community coalitions; community gardens; environmental change; food access; policy; rural; systems.