Physical Activity In Rural Communities Research Articles

An exploratory study of mothers engaging in physical activity in rural communities

ABSTRACT Gender gaps in physical activity (PA) exist with women being less active than men. Multiple cultural and psychosocial factors influence women’s ability to successfully negotiate barriers to PA and other health promoting behaviors. The goal of this exploratory descriptive study was to better understand the daily experiences of mothers in making health promoting decisions for themselves and their families. Semi-structured interviews (N = 17) were conducted with rural dwelling mothers who were the primary caregivers of children in the home. Participants were asked to share their experiences with PA and other health behaviors, focusing on their motivators, barriers, and facilitators. Interviews were audio-recorded, transcribed verbatim, and analyzed using thematic content analysis. Emerging themes focused on 1) feeling internal and external pressures to prioritize family’s needs over one’s health, 2) family exerting both positive and negative influences on health choices, and 3) living in a rural community often resulting in a lack of opportunities to engage in physical activity and feelings of being isolated from social networks. To close the gender gap in PA, interventions should support mothers in navigating their multiple roles and competing demands while engaging in health promoting behaviors such as physical activity.

Potential unintended outcomes of policy and environmental strategies to increase physical activity in rural communities.

The authors report no conflict of interest.

Promoting Physical Activity in Rural Communities During COVID-19 with Exercise is Medicine® on Campus

Apply It! By reading this article, the health and fitness professional will: • Recognize the urgency for widespread promotion and implementation of physical activity during the COVID-19 pandemic • Learn how Exercise is Medicine On Campus (EIM-OC) can be used to promote physical activity in the surrounding communities, especially those in rural areas • Explore strategies for promoting, adapting, and facilitating physical activity during the pandemic and beyond • Consider collaborating with an EIM-OC program to improve community health

Association between Physical Activity in Rural Life and Sarcopenia in Community-Dwelling Middle-Aged and Older Japanese Adults: A Cross-Sectional Study.

Physical activity is crucial to prevent sarcopenia, but there is scant data on the link between sarcopenia and physical activity in rural communities. Therefore, this study investigated associations of farming activity and snow removal with sarcopenia in a middle-aged and older population in rural Japan. This cross-sectional study enrolled 3,056 residents aged ≥ 40 years (49.2% men; mean age, 64.2 years) in Yuzawa, Japan. Information on farming activity and snow removal were collected via questionnaire from May through November and from December through April, respectively. Sarcopenia was assessed by the SARC-F (strength, ambulation, rising from a chair, stair climbing, and history of falling) score. Associations of farming activity and snow removal with sarcopenia were assessed using multivariable logistic regression analysis with adjustment for potential confounders. Participants who engaged in farming activity, snow removal, and both accounted for 3.8%, 40.5%, and 29.4% of the total, respectively. In the multivariable logistic regression analysis, adjusted odds ratios [95% confidence intervals (CI)] of sarcopenia for farming activity and snow removal were 0.80 (0.63-1.03) and 0.68 (0.53-0.87), respectively. Compared with participants who did not engage in farming activity or snow removal, participants who engaged in both had a significantly lower adjusted odds ratio of sarcopenia [0.63 (95% CI 0.47-0.86)]. Participants who engaged in snow removal and those who engaged in both farming activity and snow removal showed inverse associations with sarcopenia. Our findings further support the importance of physical activity in preventing or mitigating sarcopenia in rural communities.

Multilevel correlates of domain-specific physical activity among rural adults – a cross-sectional study

BackgroundIncreasing physical activity (PA) in rural communities is a vital prevention tactic in multiple chronic diseases; however, little is known on the multilevel correlates of PA rural areas. A better understanding of domain-specific PA adds context for promoting PA in rural communities. The current study sought to determine factors associated with domain-specific and overall moderate-vigorous physical activity (MVPA) in rural communities.MethodsSurveys were conducted across 14 rural mid-Western communities, with the final analytical sample including 1241 adults (ages 19–96, M = 57.0 [SD = 16.7], 67.8% female, 83.8% white). Generalized linear models with negative binomial distributions examined the relation between demographics, trail use, and perceptions of the neighborhood environment, with domain-specific and overall MVPA, measured via the Global Physical Activity Questionnaire.ResultsRural residents reported an average of 617 total minutes of weekly MVPA (SD = 1141), with 58.5% meeting MVPA guidelines. Higher age, female gender, and higher educated individuals had lower levels of overall and occupational MVPA. Females, higher education, and perceived indoor recreational access were associated with lower levels of transportation-related MVPA, while trail use was associated with increased transportation MVPA. Higher age and female gender respondents had lower levels of recreational MVPA, while trail users and those who perceived favorable indoor recreational access had higher levels of recreational MVPA.ConclusionsPA primarily occurred in the occupational domain among this sample of rural mid-Western adults. Findings highlight the need for multilevel interventions to address PA across multiple domains in rural communities, especially among females and older adults.

Inequities in Physical Activity Environments and Leisure-Time Physical Activity in Rural Communities.

IntroductionDifferential access to environments supportive of physical activity (PA) may help explain racial and socioeconomic disparities in leisure-time physical activity (LTPA) in rural communities.MethodsWe used baseline data from a mailed survey (N = 728) conducted in 2019 as part of an evaluation of The Two Georgias Initiative to examine the relationships among LTPA, sociodemographic characteristics, and perceived access to supportive PA environments (eg, areas around the home/neighborhood, indoor and outdoor exercise areas, town center connectivity) in 3 rural Georgia counties.ResultsMore than half of respondents (53.5%) engaged in LTPA in the previous month. Perceptions of PA environments were generally neutral to somewhat negative. In multivariable models, overall PA environment was associated with LTPA (OR, 1.58; 95% CI, 1.06–2.35), as was annual household income >$50,000 relative to ≤$20,000 (OR, 2.72; 95% CI, 1.53–4.83) and race, with Black respondents less likely to engage in LTPA than White respondents (OR, 0.49; 95% CI, 0.29–0.85). Of the 5 PA environment domains examined, town center connectivity was significantly associated with LTPA (OR, 1.68, 95% CI, 1.20–2.36). Both the overall PA score (β = −0.014; 95% CI, −0.029 to −0.002) and town center connectivity (β = −0.020; 95% CI, −0.038 to −0.005) partially mediated associations between annual household income and LTPA. Areas supportive of PA around the home/neighborhood partially mediated the association by race (β = 0.016; 95% CI, 0.001–0.034).ConclusionFindings lend support for investing in town centers and racially diverse neighborhoods to increase walkability and PA infrastructure as potential strategies to reduce inequities in LTPA.

Objective Measures of Physical Activity in Rural Communities: Factors Associated With a Valid Wear and Lessons Learned.

Compared with urban/suburban counterparts, rural communities experience lower rates of physical activity (PA) and higher rates of chronic disease. Promoting PA is important for disease prevention but requires reliable and valid measurement of PA. However, little is known about effectively collecting objective PA data in rural communities. Using data from a cluster randomized trial (Heartland Moves), which aims to increase PA in rural Missouri, this study explored factors associated with successful objective PA data collection and presents lessons learned. Baseline survey and accelerometry data were collected through Heartland Moves (n = 368) from August 2019 to February 2021, in southeast Missouri. Chi-square and logistic regression analyses were used to explore factors (demographics, subjective PA, and SMS reminders) associated with valid wear of PA devices. Overall, 77% had valid wears. Participants who were not married (odds ratio [OR] 0.48, 95% confidence interval [CI], 0.30-0.79) and those living alone (OR 0.49, 95% CI, 0.30-0.81) were less likely to have valid wears. Participants who met PA guidelines (OR 1.69, 95% CI, 1.03-2.75) or received SMS reminders (OR 3.25; 95% CI, 1.97-5.38) were more likely to have valid wears. Results are supported by lessons learned, including importance of communication (SMS reminders), accessing hard-to-reach groups (living alone), and need to adapt during data collection.

Youth sport participation and physical activity in rural communities

BackgroundPhysical activity, a high-frequency health behavior, varies by where children live, learn, and play. Children accumulate physical activity in adult-led in-school and out-of-school settings. Youth sport is a potential setting for physical activity, but there are differences in youth sport participation based on age, sex, and socioeconomic status. There is a gap in understanding demographic influences on youth sport participation and how these factors interact to influence physical activity. This study examines influences of grade, sex, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity of children in rural communities.MethodsChildren (n = 418 3rd–6th graders) living in two rural communities completed the online Youth Activity Profile as part of Wellscapes, a type 3 hybrid implementation-effectiveness community randomized trial. Mixed models with community as a random effect examined main effects and interactions of grade, sex, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity.ResultsAbout 80% of children engaged in youth sport, and full-pay lunch students were almost four times more likely to have youth sport participation than students with free/reduced lunch (OR = 3.91, 95% CI = 1.95, 7.8). Females and 6th graders (p < 0.05) had lower physical activity than comparison groups. Males with higher family income had greater physical activity; females with higher family income had less physical activity. For 6th graders, high family income had less effect on physical activity than similar 3rd-5th graders (p < 0.01).ConclusionsWhile a fairly high percentage of children participate in youth sports, there are disparities in rural communities on youth sport participation and physical activity outcomes based on age, sex, and family income.

A Qualitative Study Identifying Barriers and Facilitators of Physical Activity in Rural Communities.

Background Physical activity (PA) rates are lower in rural populations, compared to urban and suburban counterparts. Since PA is shown to decrease the risk of cancers and chronic diseases, increasing PA in rural environments is an important disease-prevention strategy. However, in order to develop effective interventions for rural populations, more research is needed. The purpose of the study was to elicit rural residents' thoughts and perceptions related to PA and walking trail use. Methods Key informant interviews were conducted via telephone, with 62 adults, living in six rural communities in southeast Missouri, who identified as stakeholders, walking trail users, and nontrail users. Participants were recruited through word of mouth and snowball sampling. Interviews were digitally audio-recorded, transcribed, and qualitatively analyzed. Findings Analysis revealed variation within the rural population, with each town unique in what constituted barriers and facilitators to PA. Life priorities other than physical health were found to be important motivators to PA and also influenced how PA was obtained. Community size was found to impact community resources and infrastructure, although this was mitigated by poverty rates. Conclusion Rural communities are distinct from one another with different views and approaches to PA. Future interventions designed to increase PA should be mindful of differences at the individual and town levels and avoid a one-size-fits-all approach. Interventions would benefit from insight and support from community members and stakeholders, to facilitate a tailored approach to increase PA.

Assessment of Town and Park Characteristics Related to Physical Activity in the Lower Mississippi Delta.

IntroductionOur objective was to determine aspects of the built environment that may have contributed to the low levels of physical activity reported in both the gestational and postnatal periods by women participating in a diet and physical activity intervention in the rural Lower Mississippi Delta.MethodsThe built environments of 12 towns were measured by using the Rural Active Living Assessment tools and the Community Park Audit Tool. Correlations between town assessment scores and town size variables were computed by using Kendall τ coefficient. The street distance from a participant’s home address to the nearest park was computed by using network analysis in ArcGIS.ResultsRural Active Living Assessment scores were low with mean values between 0% (town policy) and 68% (parks and playgrounds) of the highest possible scores. The mean (standard deviation) number of parks per town was 2.6 (3.2), and 55% of the 31 parks were in the 2 largest towns. Most parks (87%) had a single amenity while 1 park had more than 4 amenities. Distance from a participant’s home to the nearest park ranged from less than 0.1 to 8.8 miles (mean [standard deviation], 1.2 [1.8]).ConclusionThese 12 Lower Mississippi Delta towns scored low on assessments of physical environment features and amenities, town characteristics, and programs and policies associated with physical activity in rural communities. To increase the physical activity levels of rural residents, it may be necessary to first improve the built environment in which they live.

A multilevel approach for promoting physical activity in rural communities: a cluster randomized controlled trial

BackgroundPhysical activity (PA) has demonstrated a decreased risk in various cancers and other chronic diseases; however, rural residents are less likely to attain recommended levels of PA compared to urban and suburban counterparts. Given rural residents make up 15% of the United States population, there is a need for novel approaches to increase PA among this population. The goal of the present study is to investigate the effectiveness of a multilevel intervention to increase PA rates among rural residents.Methods/designGuided by an ecological framework, a group-randomized design will be used to evaluate the effects of a three-level intervention for increasing PA among adult residents residing in 6 rural communities (n = 600) along with 6 control communities (n = 600). The intervention includes components at the individual (short message service [SMS] text messages), interpersonal (social support in walking groups), and community levels (events at existing trails). Innovative methods to encourage participation will be employed as well as a focus on life priorities (family, recreation, hobbies) other than health. Aim 1 includes a literature review and key informant interviews to determine the local contexts for intervention adaptation. Aim 2 will employ a set of interventions at the individual, interpersonal, and community-levels to evaluate their impact on moderate-to-vigorous PA as measured by self-reported (telephone survey) and objectively assessed (accelerometry) measures. These data are supplemented by location based on Global Positioning System and community audits, which provide information on recreational amenities, programs/policies, and street segments.DiscussionThis study is among the first of its kind to test a multilevel intervention in a rural setting, address life priorities that compliment health outcomes, and examine moderation between behavioral interventions and the natural environments where people are physically active. Our results will influence the field by enhancing the ability to scale-up innovative, PA interventions with the potential to reach high-risk, rural populations.Trial registrationClinical Trials NCT03683173, September 25, 2018.

Level of insufficient physical activity among adults in a rural area of South India: A population-based cross-sectional study

Introduction: Insufficient physical activity is the fourth leading cause of death globally. Increased physical activity improves the physical and psychological well-being and decreases the incidence of type 2 diabetes mellitus, cardiovascular diseases, stroke, and cancer. Methods: This is a cross-sectional study conducted among 267 adults from a rural area of Kancheepuram District in Tamil Nadu, South India. Cluster sampling method was used. Clusters were selected randomly. Within each clusters, the simple random sampling method was used to select the individual participants. Data were collected using the World Health Organization's standard Global Physical Activity Questionnaire. Results: Overall prevalence of insufficient physical activity among adults in a rural area of South India was 22.5% (17.88–27.85) (n = 60), and the prevalence of sufficient physical activity was 77.5 (72.2–82.08) (n = 207). Among overall physical activity, major contribution was from work (75%) followed by transport time activity (18%) and the least by leisure-time physical activity, which was only 7%. With increase in age, level of adequate physical activity was decreasing (adjusted odds ratio (0.95 [0.92–0.98], P Conclusion: In a rural area of South India, the physical activity was contributed majorly by work domain and least by other domains. Leisure-time physical activity in rural community was poor and to be encouraged in future by community interventions.

Opportunities for Promoting Physical Activity in Rural Communities by Understanding the Interests and Values of Community Members.

Purpose Physical activity (PA) has well-established health benefits, but most Americans do not meet national guidelines. In southeastern Missouri, trails have been developed to increase rates of PA. Although this has had success, broad-scale interventions will be needed to improve rates further. In this study, we surveyed residents of southeastern Missouri to identify ways to improve rates of PA. Methods We conducted a telephone survey in 2015 of adults (n = 524) from eight rural Missouri towns that had walking trails, regarding their activities and interests. Findings Forty percent of respondents reported both walking and meeting PA recommendations, 29% reported walking but not meeting PA recommendations, and the remainder did not walk or did not answer. Respondents who used the trails were significantly more likely to meet PA recommendations (odds ratio = 2.7; 95% confidence interval = 1.7, 4.5). Certain values and interests that may encourage PA or draw people to trails were common. Conclusions The group that walked but did not meet PA recommendations would be the ideal group to target for intervention, which could focus on their reported values and interests (e.g., personal relationships, being outdoors). Use of walking trails was associated with meeting PA recommendations.

Implementing Physical Activity Recommendations in a Tri-Ethnic Rural Community through a Community-University Partnership.

A tri-ethnic rural community with limited resources and a university Prevention Research Center (PRC) developed a partnership to promote evidence-based physical activity. The purpose of this study was to investigate how a community-university partnership can disseminate and implement ἀe Commu nity Guide's recommendations for increasing physical activity and create a model for other under-resourced communities experiencing high rates of chronic disease. Qualitative data collected through 47 semistructured interviews, meeting minutes, and local newspaper articles were coded for themes and analyzed for patterns across the data. Implementation resulted in the creation of new paths and trails, increased walkability throughout the community, local park enhancements, and a community-wide campaign. Lessons learned included the importance of community-defined goals and outcomes, leadership, volunteerism, mutually beneficial goals, synergy, and having nontraditional partners. This research provides a community-university partnership model for implementing evidence-based strategies to increase physical activity in rural communities.

Assessing the Environment for Support of Youth Physical Activity in Rural Communities

ObjectiveAssess environmental support of physical activity (PA) in rural areas and determine whether there is a correlation between the measured environment for PA and participant perceptions of the environment for PA. DesignThe PA environment was assessed using the Active Neighborhood Checklist (ANC) and the Physical Activity Resource Assessment (PARA). Youth behavior and perceptions related to PA and the local environment were assessed using 5 questions from previously validated tools. SettingFour rural low-income communities in South Dakota and Kansas. ParticipantsSixth- through eighth-grade youth. Variables MeasuredPhysical Activity Resource Assessment, ANC, behavior, and perception. AnalysisThe authors used ANOVA to determine whether there were differences in ANC, PARA, and Perception of the Environment scores among communities. Pearson correlations were used to assess associations between ANC and student perception of the environment and PARA and student perception of the environment. ResultsThere were no differences in total ANC or total PARA among communities. Perception was weakly correlated with total ANC (multivariate coefficient, 0.016; P = .026; n = 308) but not total PARA. Conclusions and ImplicationsPerception of PA in rural communities may not match objective measures. Future research should work toward refining and improving existing environmental audit tools and developing new, comprehensive, location-specific tools.

Assessing environmental support for better health: Active living opportunity audits in rural communities in the southern United States

ObjectiveLeisure-time physical activity in the United States is lower rural areas and the South and has been linked to socioeconomic and environmental aspects of where people live. The purpose of this study is to assess the built environment and policies for physical activity in rural communities. MethodsEight rural communities in Alabama and Mississippi were assessed in 2011 using the Rural Active Living Assessment (RALA) street segment (SSA), town-wide (TWA), and town program and policies (PPA) assessment tools. Community Health Advisors Trained as Research Partners (CHARPS) and local staff conducted the assessments. The TWA and PPA were scored by domain and total scores. Data were analyzed using descriptive and nonparametric statistics. Results117 segments were assessed in 22 towns in 8 counties. Built environmental barriers existed in all communities. Sidewalks were available in only 10–40% of the segments. TWA identified parks and playgrounds as the most available community feature. PPA scores indicated few policies for physical activity outside of school settings with mean scores higher in Mississippi compared to Alabama (61 vs. 49, respectively). ConclusionsMultiple components of rural communities can be successfully assessed by CHARPs using RALA tools, providing information about resources and barriers for physical activity.

Church leader’s perspectives on coalition development to improve nutrition and physical activity in rural communities (624.2)

Obesity disparities persist among rural areas and the South, which often have higher rates of obesity and comorbidities. Churches in rural areas generally provide support, stability, facilities and resources which makes them ideal for nutrition and physical activity interventions. Community‐engaged participatory research partnerships between academic researchers and church leaders may be beneficial for guiding interventions in rural, underserved communities using health ministries. The aim of this study is to determine church leader’s perspectives on the infrastructure of the Coalition for South Mississippi Church Health partnership and benefits and barriers of church involvement in community health. During a series of focus groups, African American and Caucasian church leaders of various denominations discussed health ministries, health disparities of the congregations and local communities, and collaboration of churches, academic researchers, and key stakeholders to address obesity and preventable chronic disease. Data was transcribed and organized using thematic content analysis. Observations collected from the focus groups shared reoccurring themes, including: integration of church spaces and resources, need of external resources from nutrition experts, partnership of churches with multiple denominations, and barriers to intervention. This study uniquely identified that church leaders recognize the need to collaborate with other churches, despite denominational differences, to address obesity and ‐related issues, which has great implications for nutrition and physical activity interventions in the rural South.

Association Between Physical Activity and Insomnia Symptoms in Rural Communities of Southeastern Missouri, Tennessee, and Arkansas

The purpose of this study is to examine whether physical activity is associated with less insomnia symptoms in the rural communities. This study used cross-sectional data collected from a 2005 telephone survey for evaluation of a community walking trails intervention to promote physical activity in rural communities including 6 communities in the Missouri Ozark region and 6 communities in Arkansas and Tennessee (n = 1,234). The exposure variable is self-reported regular current physical activity. The outcome includes symptoms of insomnia operationalized as having trouble falling asleep, staying asleep, and waking up too early nearly every day. Logistic regression was used to calculate prevalence odds ratios (PORs) and 95% confidence intervals (95% CI). The study sample includes mostly white (95%), married (62%), overweight/obese (61%) women with a high school degree and a mean age of 54. Fourteen percent of participants reported having insomnia symptoms. Self-report of currently being physically active regularly was associated with decreased odds of insomnia symptoms (adjusted POR: .37; 95% CI, 0.14-0.99) among participants with under or normal body weight, after controlling for age, gender, education level, marital status, and chronic diseases. There was also a negative linear correlation between the number of days and total minutes of vigorous physical activity and insomnia symptoms. In these rural communities, we observed a significant relationship between regular physical activity and decreased insomnia symptoms.

Adaptations to Achieve Physical Activity in Rural Communities

This multiple, descriptive, explanatory case study design described and explained the perceptions of rural women regarding rural built environments conducive to physical activity. Sources of data included women's focus groups, city council focus groups, city administrator and clerk interviews, women's verification individual interviews, individuals referred to the researcher as individuals with perceived power, and analysis of documents. The study involved two rural communities with populations of 1,000 or less, and data were collected between March 2006 and April 2007. Content analysis of each data source and a combined data source analysis for each community was completed using NVivo7. Rural women adapted to conditions of built environments, seasonal concerns, wild animals, traffic control issues, other people, and personal needs. Adaptation emerged as a central theme in the women's focus groups as a way rural women engaged in physical activity.

Promoting physical activity in rural communities: Walking trail access, use, and effects

Introduction: Environmental and policy approaches to promote physical activity, such as walking trail construction and promotion, are being widely recommended, yet sparse data exist on their effectiveness. In conjunction with ongoing community-intervention projects in Missouri, walking trails are being built, promoted, and evaluated. Objectives include determining: (1) patterns and correlates of walking, (2) the availability of places to walk and perform other forms of physical activity, (3) the extent of walking trail use and possible effects on rates of physical activity, and (4) attitudes toward the trails and their uses. Methods: In 12 rural counties in Missouri we used a cross-sectional telephone survey to ask a population-based sample of residents aged >18 years ( n = 1269) some standard and specially developed questions about walking behaviors, knowledge, and attitudes. Results: Only 19.5% of respondents were classified as regular walkers. About one third of respondents (36.5%) reported having access to walking trails in their area, and 50.3% reported having access to indoor facilities for exercise. Among persons with access to walking trails, 38.8% had used the trails. Groups who were more likely to have used the walking trails included women, persons with more education, those making $35,000 or more per year, and regular walkers. Among persons who had used the trails, 55.2% reported they had increased their amount of walking since they began using the trail. Women and persons with a high school education or less were more than twice as likely to have increased the amount of walking since they began using the walking trails. Conclusions: Walking trails may be beneficial in promoting physical activity among segments of the population at highest risk for inactivity, in particular women and persons in lower socioeconomic groups.