Physical Activity Barriers and Assets in Rural Appalachian Kentucky: A Mixed-Methods Study.

Natalie Jones,Kathryn M Cardarelli,Deirdre Dlugonski,Emily Dewitt,Joann Lianekhammy,Stacey Slone,Rachel Gillespie

doi:10.3390/ijerph18147646

Natalie Jones, Kathryn M Cardarelli + Show 5 more

Open Access

https://doi.org/10.3390/ijerph18147646

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Abstract

Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five focus groups with elected community leaders, community residents, members, and key stakeholders to assess perspectives on physical activity barriers and resources within the county. The cohort survey sample (N = 152) reported a median of 6 barriers (range 0–13) to participating in at least 30 min of physical activity daily. The qualitative analysis yielded three overarching themes related to physical activity participation: lack of motivation, physical environment, and cultural barriers. This mixed-methods study revealed the challenges and perceptions among rural residents across the socioecological model when assessing physical inactivity. Findings can be used to tailor future interventions focused on expanding social support, designing infrastructure, and creating policies that promote physical activity.

Highlights

Introduction published maps and institutional affilPresent guidelines recommend that adults in the United States (U.S.) engage in at least150 min of moderate-intensity or 75 min of vigorous-intensity physical activity a week [1].Currently, 32.3% of Kentucky adults report no physical activity beyond their regular job in the past 30 days [2]
The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and focus groups with elected community leaders, community residents, and key stakeholders to assess perspectives on physical activity barriers and resources within the county
We cannot rule out errors in measurement of self-reported physical activity, such as over reporting due to social desirability or recall bias. Such bias would indicate that we have overestimated levels of physical activity in this population. This mixed-methods study revealed factors that are associated with physical activity engagement in a rural Appalachian county across various levels of the socioecological model (SEM)

Summary

Introduction

Introduction published maps and institutional affilPresent guidelines recommend that adults in the United States (U.S.) engage in at least150 min of moderate-intensity or 75 min of vigorous-intensity physical activity a week [1].Currently, 32.3% of Kentucky adults report no physical activity beyond their regular job in the past 30 days [2]. While the benefits of physical activity are widely documented, most adults in rural areas report participating in less physical activity than recommended [3]. In the central Appalachia region of the U.S, physical inactivity is even higher, with 33.8% of the population reporting no physical activity [4]. Obesity is an increasing public health concern in the U.S, and an important contributing factor to chronic disease, with trends revealing a rise in both adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations [5], including those in rural communities [6]. The Appalachian region of the U.S experiences a high obesity prevalence accompanied by numerous chronic diseases, including higher rates of iations

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