What Sets Physically Active Rural Communities Apart from Less Active Ones? A Comparative Case Study of Three US Counties.

Christiaan G Abildso,Megan Mcclendon,Zachary Ramsey,M Renée Umstattd Meyer,Lauren Jacobs,Margaret Stout,Cynthia K Perry,Michael B Edwards,James N Roemmich

doi:10.3390/ijerph182010574

Abstract

Background: Rural US communities experience health disparities, including a lower prevalence of physical activity (PA). However, “Positive Deviants”—rural communities with greater PA than their peers—exist. The purpose of this study was to identify the factors that help create physically active rural US communities. Methods: Stakeholder interviews, on-site intercept interviews, and in-person observations were used to form a comparative case study of two rural counties with high PA prevalence (HPAs) and one with low PA prevalence (LPA) from a southern US state, selected based on rurality and adult PA prevalence. Interview transcripts were inductively coded by three readers, resulting in a thematic structure that aligned with a Community Capital Framework, which was then used for deductive coding and analysis. Results: Fifteen stakeholder interviews, nine intercept interviews, and on-site observations were conducted. Human and Organizational Capital differed between the HPAs and LPA, manifesting as Social, Built, Financial, and Political Capital differences and a possible “spiraling-up” or cyclical effect through increasing PA and health (Human Capital), highlighting a potential causal model for future study. Conclusions: Multi-organizational PA coalitions may hold promise for rural PA by directly influencing Human and Organizational Capital in the short term and the other forms of capital in the long term.

Highlights

Physical activity (PA) is widely recognized as an important determinant of both physical and mental health [1] and a critical public health target [2]
Our analysis described what forms of capital were present or absent in each case so that the presence or absence could be compared between the high physical activity” (HPA) and low PA prevalence (LPA)
Differences in Cultural Capital were found between the HPAs and LPA regarding

Summary

Introduction

Physical activity (PA) is widely recognized as an important determinant of both physical and mental health [1] and a critical public health target [2]. Focusing on the influence that policy and built environment changes have on PA [4], the evidence displays a decidedly urban bias [5,6,7]. This bias in evidence-based community-level interventions that increase access. Rural US communities experience health disparities, including a lower prevalence of physical activity (PA). The purpose of this study was to identify the factors that help create physically active rural US communities. Human and Organizational Capital differed between the HPAs and LPA, manifesting as Social, Built, Financial, and Political Capital differences and a possible “spiraling-up” or cyclical effect through increasing PA and health

Objectives

Methods

Results

Discussion

Conclusion