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Paul S, Haynes E, Rush K, Hiwi BT, Jakobi J, Robbins F. Hunting can increase physical activity of Indigenous peoples in Canada: pixem re yecwme'nstut. Appl Physiol Nutr Metab 2024; 49:818-823. [PMID: 38382052 DOI: 10.1139/apnm-2023-0095] [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: 02/23/2024]
Abstract
This study examined whether Indigenous peoples could achieve the Canadian Physical Activity Guidelines (CPAG) for adults while engaging in the cultural practice of hunting. It was hypothesized that Indigenous hunters would achieve or surpass the physical activity (PA) thresholds set forth by the CPAG on days spent hunting. Step count and heart rate were recorded from six male participants during mule deer hunts and days spent on-reserve. Step count was not statistically different between days spent hunting (28 803 ± 10 657 steps) and on-reserve (15 086 ± 7536 steps) (p = 0.10). Time spent in light (257 ± 45 min; p = 0.04), moderate (118 ± 71 min; p = 0.03), and vigorous (45 ± 42 min; p = 0.04) activities while hunting was greater than on-reserve (light, 180 ± 86; moderate, 71 ± 73; vigorous, 7 ± 10 min). The duration of moderate-to-vigorous PA (119 ± 95 min) for an average day hunting nearly meets the weekly CPAG recommendation of 150 min per week and is 1.8× greater than on-reserve (67 ± 80 min). Data suggest that hunting is probably a viable mode of PA for Indigenous adults to achieve health benefits. A strength of this study is the 10 h of daily recording which includes vehicular transportation to remote hunting areas. The duration of very light/sedentary PA did not differ between hunting (233 ± 211 min) and on-reserve (327 ± 164 min; p = 0.10), and highlights the importance of modernized vehicles in traditional Indigenous activities. A larger sample size would facilitate greater exploration of transportation, as well as success of the hunt on PA. These data suggest that health researchers and clinicians should consider traditional activities such as hunting as a means for Indigenous adults to increase participation in sufficiently vigorous PA to incur health benefits.
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Affiliation(s)
- Sidney Paul
- Esk'etemc First Nation, Alkali Lake, BC, Canada
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Elijah Haynes
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Kathy Rush
- School of Nursing, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Braden Te Hiwi
- Indigenous Studies, Faculty of Arts, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Jennifer Jakobi
- School of Health and Exercise Sciences, Faculty of Health and Social Development, The University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Fred Robbins
- Esk'etemc Indian Band, Secwépemc First Nation, Alkali Lake, BC, Canada
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Müller C, Paulsen L, Bucksch J, Wallmann-Sperlich B. Built and natural environment correlates of physical activity of adults living in rural areas: a systematic review. Int J Behav Nutr Phys Act 2024; 21:52. [PMID: 38702772 PMCID: PMC11067138 DOI: 10.1186/s12966-024-01598-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Accepted: 04/17/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND According to social-ecological models, the built and natural environment has the potential to facilitate or hinder physical activity (PA). While this potential is well researched in urban areas, a current systematic review of how the built and natural environment is related to PA in rural areas is lacking. METHODS We searched five databases and included studies for adults (18-65 years) living in rural areas. We included quantitative studies investigating the association between any self-reported or objectively measured characteristic of the built or natural environment and any type of self-reported or objectively measured PA, and qualitative studies that reported on features of the built or natural environment perceived as barriers to or facilitators of PA by the participants. Screening for eligibility and quality assessment (using the Standard Quality Assessment Criteria for Evaluating Primary Research Papers from a Variety of Fields) were done in duplicate. We used a narrative approach to synthesize the results. RESULTS Of 2432 non-duplicate records, 51 quantitative and 19 qualitative studies were included. Convincing positive relationships were found between the availability and accessibility of places for exercise and recreation and leisure-time PA as well as between the overall environment and leisure-time PA. Possible positive associations were found between the overall environment and total and transport-related PA, between greenness/natural environment and total PA, between cycling infrastructure and aesthetics and MVPA, and between pedestrian infrastructure and total walking. A possible negative relationship was found between safety and security and total walking. Qualitative studies complemented several environmental facilitators (facilities for exercise and recreation, sidewalks or streets with low traffic, attractive natural environment) and barriers (lack of facilities and destinations, lack of sidewalks, speeding traffic and high traffic volumes, lack of street lighting). CONCLUSIONS Research investigating the relationship between the built and natural environment and PA behaviors of adults living in rural areas is still limited and there is a need for more high-quality and longitudinal studies. However, our most positive findings indicate that investing in places for exercise and recreation, a safe infrastructure for active transport, and nature-based activities are possible strategies that should be considered to address low levels of PA in rural adults. TRIAL REGISTRATION PROSPERO: CRD42021283508.
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Affiliation(s)
- Christina Müller
- Institute of Sport Science, University of Würzburg, Judenbühlweg 11, 97082, Würzburg, Germany.
| | - Lisa Paulsen
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
| | - Jens Bucksch
- Department of Prevention and Health Promotion, Heidelberg University of Education, Keplerstraße 87, 69120, Heidelberg, Germany
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Wende ME, Umstattd Meyer MR, Perry C, Prochnow T, Hamilton CNB, Abildso CG, Porter KMP. Implementation characteristics that may promote sustainability of a rural physical activity initiative: examination of Play Streets through the lens of community implementers. Implement Sci Commun 2024; 5:48. [PMID: 38698464 PMCID: PMC11064337 DOI: 10.1186/s43058-024-00571-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 03/14/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Play Streets, which are community-based environmental initiatives where public spaces/streets are temporarily closed to create safe, low-cost physical activity opportunities, have demonstrated feasibility and physical activity benefit in rural US areas. Yet, information is needed to identify implementation characteristics that may promote sustainability. This study examined rural Play Streets implementation characteristics that could impact sustainability from local partners' perspectives. METHODS Sixteen Play Streets implementation team members in rural Maryland, North Carolina, Oklahoma, and Texas, USA, participated in interviews. Semi-structured in-person individual and group interviews were conducted in the fall of 2018 (after Play Streets implementation in 2017 and 2018), recorded, and transcribed verbatim. Transcripts were analyzed using iterative, content analyses. Coding frameworks were based on the Public Health Program Capacity for Sustainability Framework, and emergent themes were also identified. RESULTS Interviewees' perceived characteristics for facilitating Play Streets implementation aligned with the Public Health Program Capacity for Sustainability Framework: funding stability, political support, partnerships, organizational capacity, program adaption, and communication. Interviewees also noted the importance of cultural alignment/support and the reciprocal impact of community connectedness/engagement. CONCLUSIONS Future research should examine the reciprocal role of public health impacts, as both outcomes and factors which may influence sustainability.
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Affiliation(s)
- Marilyn E Wende
- Department of Health Education and Behavior, College of Health and Human Performance, University of Florida, Gainesville, USA.
| | - M Renée Umstattd Meyer
- Department of Public Health, Robbins College of Health and Human Sciences, Baylor University, Waco, USA.
| | - Cynthia Perry
- School of Nursing, Oregon Health & Science University, Portland, USA
| | - Tyler Prochnow
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, USA
| | | | - Christiaan G Abildso
- Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, USA
| | - Keshia M Pollack Porter
- Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
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Robinson SA, Bamonti P, Richardson CR, Kadri R, Moy ML. Rural disparities impact response to a web-based physical activity self-management intervention in COPD: A secondary analysis. J Rural Health 2024; 40:140-150. [PMID: 37166231 DOI: 10.1111/jrh.12765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/04/2023] [Accepted: 04/16/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE This secondary exploratory analysis examined rural-urban differences in response to a web-based physical activity self-management intervention for chronic obstructive pulmonary disease (COPD). METHODS Participants with COPD (N = 239 US Veterans) were randomized to either a multicomponent web-based intervention (goal setting, iterative feedback of daily step counts, motivational and educational information, and an online community forum) or waitlist-control for 4 months with a 12-month follow-up. General linear modeling estimated the impact of rural/urban status (using Rural-Urban Commuting Area [RUCA] codes) on (1) 4- and 12-month daily step-count change compared to waitlist-control, and (2) intervention engagement (weekly logons and participant feedback). FINDINGS Rural (n = 108) and urban (n = 131) participants' mean age was 66.7±8.8 years. Rural/urban status significantly moderated 4-month change in daily step counts between randomization groups (p = 0.041). Specifically, among urban participants, intervention participants improved by 1500 daily steps more than waitlist-control participants (p = 0.001). There was no difference among rural participants. In the intervention group, rural participants engaged less with the step-count graphs on the website than urban participants at 4 months (p = 0.019); this difference dissipated at 12 months. More frequent logons were associated with greater change in daily step counts (p = 0.004); this association was not moderated by rural/urban status. CONCLUSIONS The web-based intervention was effective for urban, but not rural, participants at 4 months. Rural participants were also less engaged at 4 months, which may explain differences in effectiveness. Technology-based interventions can help address urban-rural disparities in patients with COPD, but may also contribute to them unless resources are available to support engagement with the technology.
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Affiliation(s)
- Stephanie A Robinson
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Massachusetts
- The Pulmonary Center, Boston University School of Medicine, Boston, Massachusetts
| | - Patricia Bamonti
- Department of Research & Development, VA Boston Healthcare System, Boston, Massachusetts
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Caroline R Richardson
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Reema Kadri
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, Michigan
| | - Marilyn L Moy
- Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, Boston, Massachusetts
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
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Gallagher J, Bayman EO, Cadmus-Bertram LA, Jenkins NDM, Pearlman A, Whitaker KM, Carr LJ. Physical Activity Among Rural Men: Barriers and Preferences. Prev Chronic Dis 2023; 20:E88. [PMID: 37797290 PMCID: PMC10557978 DOI: 10.5888/pcd20.230046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
INTRODUCTION Physical activity positively affects health. Although 94% of Americans know the health benefits of regular physical activity, more than 75% do not achieve recommended levels. The objective of our study was to identify and define the key components of a physical activity intervention tailored to rural American men. METHODS We recruited rural men (N = 447) via Amazon's Mechanical Turk online platform to complete a needs assessment survey focused on their interest in a physical activity intervention, preferred intervention features, and potential intervention objectives. Data were summarized by using descriptive statistics. A cumulative logistic regression model examined associations between the men's perceived importance of physical activity to health and their interest in a physical activity intervention. RESULTS Almost all participants (97.7%) rated physical activity as "at least somewhat important" to their health, and 83.9% indicated they would be "at least somewhat interested" in participating in a physical activity intervention. On a scale of 1 (not at all a barrier) to 5 (very much a barrier), motivation (mean 3.4; 95% CI, 3.3-3.5), cold weather (mean, 3.4; 95% CI, 3.3-3.5), and tiredness (mean, 3.3; 95% CI, 3.2-3.4) were rated the biggest barriers to physical activity. Becoming fitter (54.1%) was the top reason for joining a physical activity program. Preferred delivery channels for receiving an intervention were mobile application (ranked from 1 being the most preferred and 9 being the least preferred: mean, 2.8; 95% CI, 2.70-3.09) and e-mail (mean, 4.2; 95% CI, 3.92-4.36). Rural men preferred interventions that taught them how to exercise and that could be done from home. CONCLUSION Our findings suggest US men in rural areas are receptive to physical activity programs. A systematic approach and a clear model of development are needed to tailor future physical activity interventions to the special needs of rural men.
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Affiliation(s)
- Jacob Gallagher
- Department of Health and Human Physiology, University of Iowa, Iowa City
- 225 S Grand Ave, Iowa City, IA 52242
| | - Emine O Bayman
- Departments of Biostatistics and Anesthesia, University of Iowa, Iowa City
| | | | | | | | - Kara M Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City
- Department of Epidemiology, University of Iowa, Iowa City
| | - Lucas J Carr
- Department of Health and Human Physiology, University of Iowa, Iowa City
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Baxter SLK, Corbie G, Griffin SF. Contextualizing physical activity in rural adults: Do relationships between income inequality, neighborhood environments, and physical activity exist? Health Serv Res 2023; 58 Suppl 2:238-247. [PMID: 37208903 PMCID: PMC10339177 DOI: 10.1111/1475-6773.14183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/21/2023] Open
Abstract
OBJECTIVE To examine if income inequality, social cohesion, and neighborhood walkability are associated with physical activity among rural adults. DATA SOURCE Cross-sectional data came from a telephone survey (August 2020-March 2021) that examined food access, physical activity, and neighborhood environments across rural counties in a southeastern state. STUDY DESIGN Multinomial logistic regression models assessed the likelihood of being active versus inactive and insufficiently active versus inactive in this rural population. Coefficients are presented as relative risk ratios (RRRs). Statistical significance was determined using 95% confidence intervals (CIs). All analyses were performed in STATA 16.1. DATA COLLECTION/EXTRACTION METHODS Trained university students administered the survey. Students verbally obtained consent, read survey items, and recorded responses into Qualtrics software. Upon survey completion, respondents were mailed a $10 incentive card and printed informed consent form. Eligible participants were ≥18 years old and current residents of included counties. PRINCIPAL FINDINGS Respondents in neighborhoods with relatively high social cohesion versus low social cohesion were more likely to be active than inactive (RRR = 2.50, 95% CI: 1.27-4.90, p < 0.01), after accounting for all other variables in the model. Income inequality and neighborhood walkability were not associated with different levels of physical activity in the rural sample. CONCLUSIONS Study findings contribute to limited knowledge on the relationship between neighborhood environmental contexts and physical activity among rural populations. The health effects of neighborhood social cohesion warrant more attention in health equity research and consideration when developing multilevel interventions to improve the health of rural populations.
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Affiliation(s)
| | - Giselle Corbie
- Center for Health Equity Research, School of MedicineUniversity of North Carolina at Chapel HillChapel HillNorth CarolinaUSA
| | - Sarah F. Griffin
- Public Health SciencesClemson UniversityClemsonSouth CarolinaUSA
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Kokenge MC, Ruppar TM, Buchholz S. Physical Activity Interventions Among American Indian and Alaska Native Persons: A Systematic Review. Am J Health Promot 2022; 36:1350-1370. [PMID: 35499982 DOI: 10.1177/08901171221097687] [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: 02/01/2023]
Abstract
OBJECTIVE The purpose of this review was to identify and describe physical activity (PA) interventions that have been implemented with American Indian and Alaska Natives (AIANs) in the U.S. and Canada since 2006. DATA SOURCE Searches were conducted in 8 databases plus grey literature sources. STUDY INCLUSION AND EXCLUSION CRITERIA Eligible studies: (a) described an intervention designed to increase PA; (b) targeted AIANs residing in the U.S. or Canada, or if a multiethnic population, contained an AIAN subanalysis; (c) were published in 2006 or later; and (d) reported a PA outcome. DATA EXTRACTION Two reviewers independently extracted data, with conflicts resolved through discussion. DATA SYNTHESIS Data were synthesized by participant characteristics, intervention strategies, PA outcomes, and impact. RESULTS We identified 25 eligible studies, most targeting children and youth. Intergenerational, environmental policy, cultural adaptation, and curriculum-based approaches were used. Twenty studies used self-reported PA measures. 80% of studies used an element of cultural adaptation, mostly considering cultural needs in design, not program or outcome evaluation. Sedentary behavior and leisure-time PA were rarely assessed. Significant changes in PA outcomes were achieved post-intervention in 13 studies (52%). CONCLUSION Future interventions should target AIAN adults to evaluate sedentary behavior and leisure-time PA. Interventions should incorporate psychometrically tested objective measures and prioritize the Native perspective from intervention design through project evaluation.
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Affiliation(s)
- Molly C Kokenge
- College of Nursing, 2461Rush University, Chicago, IL, USA
- Orvis School of Nursing, 6851University of Nevada, Reno, Reno, NV, USA
| | - Todd M Ruppar
- College of Nursing, 2461Rush University, Chicago, IL, USA
| | - Susan Buchholz
- College of Nursing, 3078Michigan State University, East Lansing, MI, USA
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Physical activity promotion in rural health care settings: A rapid realist review. Prev Med Rep 2022; 29:101905. [PMID: 35879935 PMCID: PMC9307466 DOI: 10.1016/j.pmedr.2022.101905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/17/2022] [Accepted: 07/06/2022] [Indexed: 11/22/2022] Open
Abstract
Rural communities have a unique health care and physical activity context. We conducted a rapid realist review in partnership with knowledge users. Check-ins from health care providers may lead to intervention success and are valued by participants. A method for tracking progress is an important component of interventions delivered in rural health care settings.
Physical activity promotion in health care settings is poorly understood and has limited uptake among health care providers. The environmental and health care context of rural communities is unique from urban areas and may interact to influence intervention delivery and success. The aim of this rapid realist review was to synthesize knowledge related to the promotion of physical activity in rural health and social care settings. We searched Medline EBSCO, CINAHL, PsychINFO, and SPORTDiscus for relevant publications. We included qualitative or quantitative studies reporting on an intervention to promote physical activity in rural health (e.g., primary or community care) or social (e.g., elder support services) care settings. Studies without a rural focus or well-defined physical activity/exercise component were excluded. Populations of interest included adults and children in the general population or clinical sub-population. Intervention mechanisms from included studies were mapped to the Behaviour Change Wheel (capability, opportunity, motivation (COM-B)). Twenty studies were included in our review. Most interventions focused on older adults or people with chronic disease risk factors. The most successful intervention strategies leading to increased physical activity behaviour included wearable activity trackers, and check-ins or reminders from trusted sources. Interventions with mechanisms categorized as physical opportunity, automatic motivation, and psychological capability were more likely to be successful than other factors of the COM-B model. Successful intervention activities included a method for tracking progress, providing counselling, and follow-up reminders to prompt behaviour change. Cultivation of necessary community partnerships and adaptations for implementation of interventions in rural communities were not clearly described and may support successful outcomes in future studies.
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Bennion N, Redelfs AH, Spruance L, Benally S, Sloan-Aagard C. Driving Distance and Food Accessibility: A Geospatial Analysis of the Food Environment in the Navajo Nation and Border Towns. Front Nutr 2022; 9:904119. [PMID: 35873433 PMCID: PMC9301304 DOI: 10.3389/fnut.2022.904119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
The Navajo Nation, an area home to approximately 173,000 people in the southwest United States, experiences the highest rates of food insecurity in the United States and is classified as a food desert. The present study assessed the accessibility to food outlets (grocery stores, convenience stores, and restaurants) as measured by driving time on the Navajo Nation and in selected surrounding border towns. Food outlets located in neighboring border towns were examined using network analysis tools in ArcGIS Pro to calculate driving distance and examine the potential impact of driving time within the Navajo Nation on accessibility to nutritious foods. There were 14 grocery stores, 21 convenience stores, and 65 restaurants identified in the Navajo Nation using Mergent Intellect, a proprietary database, as compared to border towns which had a total of 542 grocery stores, 762 convenience stores, and 3,329 restaurants equaling a ratio of about 50:1 (grocery, 39:1; convenience, 36:1; restaurants, 51:1) when comparing food outlets nearby versus on the Navajo Nation. This ecological study presents a visual representation of driving time and food accessibility, revealing geographic areas within the Navajo Nation where access to border town food stores is sparse, and food insecurity may be elevated.
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Kotani K. Exercise Promotion in Rural Areas. Indian J Endocrinol Metab 2022; 26:391. [PMID: 36185962 PMCID: PMC9519827 DOI: 10.4103/ijem.ijem_175_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 05/29/2022] [Indexed: 11/04/2022] Open
Affiliation(s)
- Kazuhiko Kotani
- Division of Community and Family Medicine, Jichi Medical University, Tochigi, Japan
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Wilkinson A, Higgs C, Stokes T, Dummer J, Hale L. How to Best Develop and Deliver Generic Long-Term Condition Rehabilitation Programmes in Rural Settings: An Integrative Review. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:904007. [PMID: 36188934 PMCID: PMC9397970 DOI: 10.3389/fresc.2022.904007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022]
Abstract
People living rurally frequently experience health disparities especially if living with a long-term condition (LTC) or multi-morbidity. Self-management support is a key component of LTC management and commonly included in rehabilitation programmes to enhance ability to self-manage health and encourage physical activity. Such programmes are however often condition focussed and despite evidence for their effectiveness, are not always feasible to deliver in rural settings. Generic programmes are arguably more optimal in the rural context and delivery can be face to face or remotely (via telehealth). The aim of this explorative integrative review was to collate and present international evidence for development, delivery, integration, and support of community-based, generic LTC group rehabilitation programmes delivered rurally in person, or remotely using telehealth. Electronic databases were systematically searched using MeSH terms and keywords. For inclusion, articles were screened for relevance to the aim, and practical information pertaining to the aim were extracted, charted, and organized deductively into themes of Development, Delivery, Integration, and Support. Within each theme, data were synthesized inductively into categories (Theory, Context, Interpersonal aspects, and Technology and Programme aspects). Fifty-five studies were included. Five studies contributed information about community based programmes delivered via the internet. Development was the only theme populated by information from all categories. The theme of Support was only populated with information from one category. Our review has drawn together a large body of diverse work. It has focused on finding practical information pertaining to the best ways to develop, deliver, integrate, and support a community-based generic rehabilitation programme for people living with long-term health conditions, delivered rurally and/or potentially via the internet. Practical suggestions were thematically organized into categories of theory, context, interpersonal aspects, and technology and programme aspects. While the findings of this review might appear simple and self-evident, they are perhaps difficult to enact in practice.
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Affiliation(s)
- Amanda Wilkinson
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Chris Higgs
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Tim Stokes
- Department of General Practice and Rural Health, University of Otago, Dunedin, New Zealand
| | - Jack Dummer
- Department of Medicine, University of Otago, Dunedin, New Zealand
| | - Leigh Hale
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
- *Correspondence: Leigh Hale
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Wray P, Ward CK, Nelson C, Sulzer SH, Dakin CJ, Thompson BJ, Vierimaa M, Das Gupta D, Bolton DAE. Pickleball for Inactive Mid-Life and Older Adults in Rural Utah: A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8374. [PMID: 34444124 PMCID: PMC8391496 DOI: 10.3390/ijerph18168374] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 11/17/2022]
Abstract
Many diseases, disabilities, and mental health conditions associated with aging can be delayed or prevented through regular exercise. Several barriers to exercise, many of which are exacerbated in rural communities, prevent mid-life and older adults from accessing its benefits. However, recently, a racquet sport named pickleball has become popular among older adults, and it appears to overcome some of these barriers. We conducted a feasibility study to evaluate the impact of a six-week pickleball intervention on measures of muscle function, cognitive function, perceived pain, and cardio-metabolic risk, as well as several psychosocial factors contributing to adherence in sedentary rural participants. Participants improved their vertical jump, cognitive performance, and reported a decrease in self-reported pain, suggesting improved physical and cognitive health across the sample. Participants also reported high levels of satisfaction and demonstrated good adherence over the duration of the study. Perhaps of greatest value was the overwhelmingly positive response from participants to the intervention and follow-up interviews reporting a desire to continue pickleball play beyond the study period. Overall, pickleball appears to be a promising intervention to, (1) elicit functional- and cognitive-related improvements, and (2) motivate mid-life and older adults to adhere to exercise sufficiently long to benefit their health.
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Affiliation(s)
- Paige Wray
- Department of Home and Community, Utah State University Extension, Monticello, San Juan County, UT 84535, USA;
| | - Callahan K. Ward
- Department of Home and Community, Utah State University Extension, Panguitch, Garfield County, UT 84759, USA;
| | - Cindy Nelson
- Department of Home and Community, Utah State University Extension, Beaver, Beaver County, UT 84713, USA;
| | - Sandra H. Sulzer
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.H.S.); (C.J.D.); (B.J.T.); (D.D.G.)
| | - Christopher J. Dakin
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.H.S.); (C.J.D.); (B.J.T.); (D.D.G.)
| | - Brennan J. Thompson
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.H.S.); (C.J.D.); (B.J.T.); (D.D.G.)
| | - Matthew Vierimaa
- School of Kinesiology, Acadia University, Wolfville, NS B4P 2R6, Canada;
| | - Debasree Das Gupta
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.H.S.); (C.J.D.); (B.J.T.); (D.D.G.)
| | - David A. E. Bolton
- Department of Kinesiology and Health Science, Utah State University, Logan, UT 84322, USA; (S.H.S.); (C.J.D.); (B.J.T.); (D.D.G.)
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