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Kaczynski AT, Wende ME, Eichelberger CA, Hesam Shariati F. Disparities in Obesogenic Environments by Income, Race/Ethnicity, and Rurality Across All US Counties. Child Obes 2024. [PMID: 38959161 DOI: 10.1089/chi.2024.0217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Background: Research is needed to explore inequities in physical activity (PA) and access to healthy eating resources for children on a national scale. This study examined disparities in childhood obesogenic environments across all United States (US) counties by income and race/ethnicity and their interaction with county rurality. Methods: Data for four PA variables (exercise opportunities, school proximity, walkability, crime) and six nutrition variables (grocery stores, farmers markets, fast-food restaurants, full-service restaurants, convenience stores, and births at baby-friendly hospitals) were collected for all US counties (n = 3142) to comprise the Childhood Obesogenic Environment Index (COEI). Variables were ranked and allocated a percentile for each county, and a total obesogenic environment score was created by averaging variable percentiles. Analysis of variance was used to assess differences by tertiles of county-level median household income (low/intermediate/high) and percentage of non-Hispanic (NH) White residents (low/intermediate/high). Interaction tests were used to assess effect modification by rurality, and stratified results were presented for all significant interactions. Results: There were significant differences in COEI values according to tertiles of median household income (F = 260.9, p < 0.0001). Low-income counties (M = 54.3, SD = 8.3) had worse obesogenic environments than intermediate (M = 49.9, SD = 7.9) or high (M = 45.9, SD = 8.8) income counties. There was also a significant interaction between rurality and median household income (F = 13.9, p < 0.0001). Similarly, there were significant differences in COEI values according to tertiles of race/ethnicity (F = 34.5, p < 0.0001), with low percentage NH White counties (M = 51.8, SD = 9.8) having worse obesogenic environment scores than intermediate (M = 48.7, SD = 8.4) or high (M = 49.5, SD = 8.5) NH White counties. There was also a significant interaction between rurality and race/ethnicity (F = 13.9, p < 0.0001). Conclusion: Low-income counties and those with more racial/ethnic minority residents, especially in rural areas, had less supportive PA and healthy eating environments for youth. Targeted policy and environmental approaches that aimed to address concerns specific to underserved communities are needed.
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Affiliation(s)
- Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
- Prevention Research Center, University of South Carolina, Columbia, South Carolina, USA
| | - Marilyn E Wende
- Department of Health Education and Behavior, University of Florida, Gainesville, Florida, USA
| | - Caylin A Eichelberger
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
| | - Farnaz Hesam Shariati
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina, USA
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Zhang C, Su Q, Zhu Y. Urban park system on public health: underlying driving mechanism and planning thinking. Front Public Health 2023; 11:1193604. [PMID: 37377543 PMCID: PMC10292818 DOI: 10.3389/fpubh.2023.1193604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023] Open
Abstract
The driving mechanism and planning thinking of the impact of urban park system on public health the mission of urban geography, urban and rural planning or landscape architecture are to coordinate the relationship between people and places, people and nature. The municipal park system is an important part of the urban green space system. In order to effectively play the role of the urban park system in promoting the health of urban residents. This manuscript studies the coupling relationship between the "urban park system" and the "public health system" by building a coordination model, reveals the driving mechanism of the urban park system affecting the benign development of public health, and clarifies the positive driving effect of urban parks on public health. Finally, based on the analysis results, the manuscript considers the optimal development strategy of urban parks from the macro and micro levels to promote the sustainable development of urban public health.
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Affiliation(s)
- Cheng Zhang
- School of Geography and Tourism, Anhui Normal University, Wuhu, Anhui, China
- Center of Urban and Rural Habitat Sustainable and Ecological Environment Planning Engineering Technology Research, Wanjiang University of Technology, Ma’anshan, Anhui, China
| | - Qin Su
- School of Geography and Tourism, Anhui Normal University, Wuhu, Anhui, China
| | - Yanqun Zhu
- School of Geography and Tourism, Anhui Normal University, Wuhu, Anhui, China
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Brown NI, Stewart L, Rogers LQ, Anne Powell M, Hardy CM, Baskin ML, Oster RA, Pisu M, Demark-Wahnefried W, Pekmezi D. Assessing the built environment, programs, and policies that support physical activity opportunities in the rural Deep South. Prev Med Rep 2023; 33:102223. [PMID: 37223566 PMCID: PMC10201820 DOI: 10.1016/j.pmedr.2023.102223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/27/2023] [Accepted: 04/25/2023] [Indexed: 05/25/2023] Open
Abstract
Disparities in physical activity (PA) exist in rural regions and prior research suggests environmental features and community resources likely contribute. It is important to identify the opportunities and barriers that influence activity to appropriately inform PA interventions in such areas. Thus, we assessed the built environment, programs and policies related to PA opportunity in six rural Alabama counties that were purposively selected to inform a PA randomized controlled trial. Assessments were conducted August 2020-May 2021 using the Rural Active Living Assessment. Town characteristics and recreational amenities were captured using the Town Wide Assessment (TWA). PA programs and policies were examined with the Program and Policy Assessment. Walkability was evaluated using the Street Segment Assessment (SSA). Using the scoring system (0-100), the overall TWA score was 49.67 (range: 22-73), indicating few schools within walking distance (≤5 miles of the town's center) and town-wide amenities (e.g., trails, water/recreational activities) for PA. The Program and Policy Assessment showed a paucity of programming and guidelines to support activity (overall average score of 24.67, [range: 22-73]). Only one county had a policy requiring walkways/bikeways in new public infrastructure projects. During assessment of 96 street segments, few pedestrian-friendly safety features [sidewalks (32%), crosswalks (19%), crossing signals (2%), and public lighting (21%)] were observed. Limited opportunities for PA (parks and playgrounds) were identified. Barriers such as few policies and safety features (crossing signals, speed bumps) were indicated as factors that should be addressed when developing PA interventions and informing future policy efforts.
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Affiliation(s)
- Nashira I. Brown
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lauren Stewart
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Laura Q. Rogers
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mary Anne Powell
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Claudia M. Hardy
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Monica L. Baskin
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Robert A. Oster
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maria Pisu
- Department of Medicine, Heersink School of Medicine, University of Alabama at Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wendy Demark-Wahnefried
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Dori Pekmezi
- Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA
- O’Neal Comprehensive Cancer Center at the University of Alabama at Birmingham, Birmingham, AL, USA
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Norman-Burgdolf H, DeWitt E, Gillespie R, Cardarelli KM, Slone S, Gustafson A. Impact of community-driven interventions on dietary and physical activity outcomes among a cohort of adults in a rural Appalachian county in Eastern Kentucky, 2019-2022. Front Public Health 2023; 11:1142478. [PMID: 37124781 PMCID: PMC10140309 DOI: 10.3389/fpubh.2023.1142478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 03/22/2023] [Indexed: 05/02/2023] Open
Abstract
Several environmental level factors exacerbate poor health outcomes in rural populations in the United States, such as lack of access to healthy food and locations to be physically active, which support healthy choices at the individual level. Thus, utilizing innovative place-based approaches in rural locations is essential to improve health outcomes. Leveraging community assets, like Cooperative Extension, is a novel strategy for implementing community-driven interventions. This prospective cohort study (n = 152), recruited in 2019 and surveyed again in 2020 and 2021, examined individual level changes in diet and physical activity in one rural Appalachian county. During this time, multiple community-driven interventions were implemented alongside Cooperative Extension and several community partners. Across the three-year study, the cohort indicated increases in other vegetables and water and reductions in fruits and legumes. There were also reductions in less healthy items such as French fries and sugar-sweetened beverages. The cohort also reported being less likely to engage in physical activity. Our findings suggest that key community-driven programs may have indirect effects on dietary and physical activity choices over time. Outcomes from this study are relevant for public health practitioners and community organizations working within rural Appalachian communities to address health-related behaviors.
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Affiliation(s)
- Heather Norman-Burgdolf
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
- *Correspondence: Heather Norman-Burgdolf,
| | - Emily DeWitt
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
| | - Rachel Gillespie
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Kathryn M. Cardarelli
- Department of Health, Behavior & Society, College of Public Health, University of Kentucky, Lexington, KY, United States
| | - Stacey Slone
- Dr. Bing Zhang Department of Statistics, College of Arts & Sciences, University of Kentucky, Lexington, KY, United States
| | - Alison Gustafson
- Department of Dietetics and Human Nutrition, College of Agriculture, Food and Environment, University of Kentucky, Lexington, KY, United States
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Pickett AC, Bowie M, Berg A, Towne SD, Hollifield S, Smith ML. Rural-Urban Differences in Physical Activity Tracking and Engagement in a Web-Based Platform. Public Health Rep 2023; 138:76-84. [PMID: 35060782 PMCID: PMC9730176 DOI: 10.1177/00333549211065522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Despite the well-established health benefits of regular participation in physical activity, most adults do not meet recommended exercise guidelines. In rural communities, limited local resources and geographic dispersion make engaging in regular activity particularly difficult. Web-based solutions offer a potential solution for addressing physical activity disparities between rural and urban areas. METHODS This study examined the physical activity logs of users (n = 6695) of a web-based platform called Walk Georgia, comparing residents of metropolitan and nonmetropolitan areas. We tabulated descriptive statistics for variables of interest, cross-tabulated for metropolitan and nonmetropolitan groups. We then used independent-samples t tests to compare logged activity between metropolitan and nonmetropolitan residing user groups. RESULTS In the analysis of group type (n = 6654), users were more likely to enroll in the program as part of a group than as individuals (n = 4391; 65.9%), particularly for users in metropolitan areas (3558 of 5192; 68.5%). Although the groups shared certain activities, nonmetropolitan residents were more likely than metropolitan residents to engage in maintenance-based activities. Nonmetropolitan residents earned fewer program points for their activity than metropolitan users (P = .007), largely because of lower average exercise difficulty (P < .001). CONCLUSIONS The web-based platform was effective in helping individuals track physical activity. Despite engaging in similar amounts of physical activity by time, on average, users in nonmetropolitan areas engaged in less rigorous and more maintenance-based tasks than users in metropolitan areas. One strategy for increasing physical activity among rural populations may be to leverage social support provided by group enrollment in such programming.
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Affiliation(s)
- Andrew C. Pickett
- Division of Kinesiology & Sport Management, University of South Dakota, Vermillion, SD, USA
- School of Education Research Center, University of South Dakota, Vermillion, SD, USA
| | - Maria Bowie
- Office of the Associate Dean, Cooperative Extension Service, University of Georgia, Athens, GA, USA
- Department of Health Policy and Management, College of Public Health, University of Georgia, Athens, GA, USA
| | - Alison Berg
- Department of Nutritional Sciences, College of Family and Consumer Sciences, University of Georgia, Athens, GA, USA
| | - Samuel D. Towne
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, USA
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, USA
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
- Southwest Rural Health Research Center, Texas A&M University, College Station, TX, USA
- Center for Population Health and Aging, Texas A&M University, College Station, TX, USA
| | | | - Matthew Lee Smith
- Department of Environmental and Occupational Health, School of Public Health, Texas A&M University, College Station, TX, USA
- Center for Population Health and Aging, Texas A&M University, College Station, TX, USA
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Charron LM, Milstein C, Moyers SI, Abildso CG, Chriqui JF. Do State Comprehensive Planning Statutes Address Physical Activity?: Implications for Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12190. [PMID: 34831946 PMCID: PMC8617896 DOI: 10.3390/ijerph182212190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/15/2021] [Accepted: 11/17/2021] [Indexed: 12/30/2022]
Abstract
Less than one-quarter of U.S. adults meet physical activity (PA) recommendations, with rural residents less likely to be active than urban residents. The built environment has been identified as a potential facilitator of PA and local comprehensive plans are a foundational tool for guiding the development of the built environment. The purpose of this study was therefore to understand the current landscape of comprehensive planning state statutes related to PA and rural communities. We used primary legal research methods to identify, compile, and evaluate all 50 state comprehensive planning statutes for items related to PA and conditional mandates based on population size of local jurisdictions. The presence of population-conditional planning mandates and the inclusion of PA-related items was analyzed by state-level rurality using Fisher's exact tests. Our analyses demonstrated that (1) broader PA-related items were addressed in state statutes more often than more specific PA-related items; (2) when PA-related items were addressed, they were most likely to be mandated, subsumed elements; (3) several PA-related items were less likely to be addressed in the most rural states and/or conditionally mandated for jurisdictions meeting minimum population requirements; and (4) only two states addressed PA directly and explicitly in their comprehensive planning statutes.
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Affiliation(s)
- Lisa M. Charron
- Nelson Institute for Environmental Studies, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Chloe Milstein
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA; (C.M.); (J.F.C.)
| | - Samantha I. Moyers
- Department of Social and Behavioral Health Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA; (S.I.M.); (C.G.A.)
| | - Christiaan G. Abildso
- Department of Social and Behavioral Health Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA; (S.I.M.); (C.G.A.)
| | - Jamie F. Chriqui
- School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA; (C.M.); (J.F.C.)
- Institute for Health Research and Policy, University of Illinois at Chicago, Chicago, IL 60612, USA
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Abildso CG, Perry CK, Jacobs L, Umstattd Meyer MR, McClendon M, Edwards MB, Roemmich JN, Ramsey Z, Stout M. What Sets Physically Active Rural Communities Apart from Less Active Ones? A Comparative Case Study of Three US Counties. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10574. [PMID: 34682319 PMCID: PMC8535724 DOI: 10.3390/ijerph182010574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 10/05/2021] [Accepted: 10/06/2021] [Indexed: 11/16/2022]
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.
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Affiliation(s)
- Christiaan G. Abildso
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA;
| | - Cynthia K. Perry
- School of Nursing, Oregon Health & Science University, Portland, OR 97239, USA;
| | - Lauren Jacobs
- School of Kinesiology and Physical Education, College of Education and Human Development, University of Maine, Orono, ME 04469, USA;
| | - M. Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA; (M.R.U.M.); (M.M.)
| | - Megan McClendon
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 76798, USA; (M.R.U.M.); (M.M.)
| | - Michael B. Edwards
- Department of Parks, Recreation and Tourism Management, College of Natural Resources, North Carolina State University, Raleigh, NC 27695, USA;
| | - James N. Roemmich
- US Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND 58201, USA;
| | - Zachary Ramsey
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV 26506, USA;
| | - Margaret Stout
- Department of Public Administration, West Virginia University, Morgantown, WV 26506, USA;
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Trail Conditions and Community Use: Utilizing Geospatial Video to Guide the Adoption of a Spatial-Temporal Trail Audit Tool (STAT). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168741. [PMID: 34444490 PMCID: PMC8391724 DOI: 10.3390/ijerph18168741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/07/2021] [Accepted: 08/17/2021] [Indexed: 11/17/2022]
Abstract
Physical activity (PA), associated with all-cause mortality, morbidity, and healthcare costs, improves vitamin D absorption, immune response, and stress when completed outdoors. Rural communities, which experience PA inequities, rely on trails to meet PA guidelines. However, current trail audit methods could be more efficient and accurate, which geospatial video may support. Therefore, the study purpose was (1) to identify and adopt validated instruments for trail audit evaluations using geospatial video and a composite score and (2) to determine if geospatial video and a composite score motivate (influence the decision to use) specific trail selection among current trail users. Phase 1 used a mixed-method exploratory sequential core design using qualitative data, then quantitative data for the development of the Spatial-temporal Trail Audit Tool (STAT). Geospatial videos of two Northeast Ohio trails were collected using a bicycle-mounted spatial video camera and video analysis software. The creation of STAT was integrated from Neighborhood Environment Walkability Scale (NEWS), Walk Score, and Path Environment Audit Tool (PEAT) audit tools based on four constructs: trail accessibility, conditions, amenities, and safety. Scoring was determined by three independent reviewers. Phase 2 included a mixed-method convergent core design to test the applicability of STAT for trail participant motivation. STAT has 20 items in 4 content areas computing a composite score and was found to increase trail quality and motivation for use. STAT can evaluate trails for PA using geospatial video and a composite score which may spur PA through increased motivation to select and use trails.
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Kye SY, Cho H, Thao TTP, Oh JK, Lim MK. Associations of physical activity at work and household income with obesity: a cross-sectional study among rural adults in Korea. Epidemiol Health 2020; 43:e2021003. [PMID: 33445825 PMCID: PMC7973149 DOI: 10.4178/epih.e2021003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 12/25/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVES This study was performed to identify the effect of physical activity at work on obesity and to analyze the contribution of socioeconomic factors and health behaviors to this association, which has been relatively little studied. METHODS From the Korean National Cancer Center Community Cohort, a total of 5,587 adults (2,125 men; 3,462 women) aged more than 30 years living in rural areas were enrolled. Information on socio-demographic factors, health behaviors, and body mass index was gathered using face-to-face interviews and measurements of height and weight. RESULTS Inverse associations were identified between vigorous-intensity physical activity at work and obesity in both men and women, while no association was found between vigorous-intensity physical activity during leisure time and obesity. High household income was independently associated with a lower risk of obesity among those who had low levels of vigorous-intensity physical activity at work. Vigorous physical activity at work showed an inverse association with obesity in rural areas where heavy manual labor is common. CONCLUSIONS Our findings indicate the necessity to account for various types of physical activity to improve the assessment and prevention of obesity.
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Affiliation(s)
- Su Yeon Kye
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Heeyoun Cho
- Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Tran Thi Phuong Thao
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - Jin-Kyoung Oh
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
- Division of Cancer Prevention and Early Detection, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Min Kyung Lim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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Cadmus-Bertram LA, Gorzelitz JS, Dorn DC, Malecki KMC. Understanding the physical activity needs and interests of inactive and active rural women: a cross-sectional study of barriers, opportunities, and intervention preferences. J Behav Med 2020; 43:638-647. [PMID: 31197537 PMCID: PMC7891881 DOI: 10.1007/s10865-019-00070-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/06/2019] [Indexed: 01/16/2023]
Abstract
Despite the health benefits of physical activity, many women remain inactive and the needs of rural women are understudied. To understand access to physical activity barriers, opportunities, and intervention preferences in rural women and determine how these differ by self-reported activity level. A mailed questionnaire was distributed to 900 rural women and included measures of physical activity, health status, barriers, opportunities for exercise, and preferences for intervention type, components, and delivery. Questionnaires were completed by 507 women; 72.0% reported meeting the physical activity guideline. Inactive women reported greater barriers to activity (higher scores on 18 of 22 barriers; p < 0.05), less access to or usage of 8 of 9 places to exercise (p < 0.05), and less belief in the relevance of physical activity to personal health (p < 0.001). Both inactive and active women were most interested in programs that use walking, yoga, or strength training. Physical activity interventions for rural women need to address their specific needs, including barriers to physical activity and lower access to places in which to be physically active.
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Affiliation(s)
- Lisa A Cadmus-Bertram
- Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Drive, Madison, WI, 53706, USA.
| | - Jessica S Gorzelitz
- Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Drive, Madison, WI, 53706, USA
| | - Diana C Dorn
- Department of Kinesiology, University of Wisconsin-Madison, 2000 Observatory Drive, Madison, WI, 53706, USA
| | - Kristen M C Malecki
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, USA
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Gilbert AS, Duncan DD, Beck AM, Eyler AA, Brownson RC. A Qualitative Study Identifying Barriers and Facilitators of Physical Activity in Rural Communities. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2019; 2019:7298692. [PMID: 31341485 PMCID: PMC6612376 DOI: 10.1155/2019/7298692] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 05/19/2019] [Accepted: 06/03/2019] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Amanda S. Gilbert
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Dixie D. Duncan
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Alan M. Beck
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Amy A. Eyler
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
| | - Ross C. Brownson
- Prevention Research Center in St. Louis, Brown School at Washington University in St. Louis, St. Louis, MO, USA
- Department of Surgery (Division of Public Health Sciences) and Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA
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A multilevel approach for promoting physical activity in rural communities: a cluster randomized controlled trial. BMC Public Health 2019; 19:126. [PMID: 30700262 PMCID: PMC6354358 DOI: 10.1186/s12889-019-6443-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 01/14/2019] [Indexed: 11/10/2022] Open
Abstract
Background Physical 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/design Guided 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. Discussion This 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 registration Clinical Trials NCT03683173, September 25, 2018.
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