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Baquero B, Novak N, Sewell DK, Kava CM, Daniel-Ulloa J, Pham H, Askleson N, Ashida S, Laroche H, Maldonado Gonzalez A, Bucklin R, Haines H, Parker EA. Effectiveness of implementing evidence-based approaches to promote physical activity in a Midwestern micropolitan area using a quasi-experimental hybrid type I study design. BMC Public Health 2024; 24:1082. [PMID: 38637782 PMCID: PMC11027347 DOI: 10.1186/s12889-024-18523-9] [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: 04/12/2023] [Accepted: 04/04/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Much evidence-based physical activity (PA) interventions have been tested and implemented in urban contexts. However, studies that adapt, implement, and evaluate the effectiveness of these interventions in micropolitan rural contexts are needed. The study aimed to evaluate the effectiveness of the Active Ottumwa intervention to promote PA in a micropolitan community. METHODS Between 2013 - 2019, we implemented Active Ottumwa in a micropolitan setting, and subsequently implemented and evaluated its effectiveness using a Hybrid Type I design. In this paper, we describe the intervention's effectiveness in promoting PA. We collected PA data over 24 months from a cohort of community residents using accelerometers and PA data from two cross-sectional community surveys administered in 2013 and 2018, using the Global Physical Activity Questionnaire. RESULTS From the cohort, we found significant change in PA over 24 months (P = 0.03) corresponding to a 45-min daily decrease in sedentary activity, a daily increase of 35-min in light PA and 9 min in moderate-to-vigorous PA. There was a statistically significant (P = 0.01) increasing trend at the population-level in the moderate-to-vigorous composition of 7 min between the two cross-sectional assessments (95% CI: 0.1%-1.34%). CONCLUSIONS The study demonstrates that the adapted evidence-based PA interventions in a micropolitan context is effective.
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Affiliation(s)
- Barbara Baquero
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA.
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA.
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA.
| | - Nicole Novak
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Daniel K Sewell
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Christine M Kava
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Health Systems and Population Health, University of Washington, School of Public Health, Seatle, WA, USA
| | - Hanh Pham
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Department of Biostatistics, University of Iowa College of Public Health, Iowa City, IA, USA
| | - Natoshia Askleson
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Sato Ashida
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Helena Laroche
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
- Center for Children's Healthy Lifestyles and Nutrition, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Adriana Maldonado Gonzalez
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Rebecca Bucklin
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Heidi Haines
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
| | - Edith A Parker
- Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City, IA, USA
- University of Iowa Prevention Research Center for Rural Health, Iowa City, IA, USA
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Daniel-Ulloa J, Reyes JA, Morales-Campos DY, Villareal E, López Cevallos DF, Hernandez H, Baquero B. Rural Latino Men’s Experiences and Attitudes Toward Health: A Pilot Photovoice Study. Am J Mens Health 2023. [PMCID: PMC9998422 DOI: 10.1177/15579883231158525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/11/2023] Open
Abstract
Much of the research regarding Latino men’s health tends to focus on specific health outcomes (e.g., HIV or diabetes). Few studies have examined how Latino men perceive factors that influence their health and/or health-related behaviors. This study explored rural Latino men’s experiences and attitudes toward health, using photovoice, in the context of a community-based participatory research partnership. We recruited nine Latino men living in a small town in Southeastern Iowa. Four to nine men attended four sessions and led a community forum. All the men were foreign-born, identified as Latino, aged between 34 and 67 years, and had lived in the United States for at least 7 years. Five themes were identified: (a) cultural conflict, (b) too much and discordant information, (c) lifestyles conflict, (d) sacrifice, and (e) family connectedness. An important implication of this study derives from familial and community connections and sacrifice. Feeling disconnected from family may impact physical and mental health and health-promoting behaviors. Future research should explore ways to inform community- and family-level interventions to connect rural Latino men more strongly to their family and local community and help them to take better control of their health.
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Affiliation(s)
- Jason Daniel-Ulloa
- College of Public Health, University of Iowa, Iowa City, IA, USA
- Department of Nursing and Health Studies, University of Washington, Bothell, Bothell, WA, USA
| | | | | | | | - Daniel F. López Cevallos
- School of Language, Culture, and Society, College of Liberal Arts, Oregon State University, Corvallis, OR, USA
- School of Public Health and Health Sciences, University of Massachusetts, Amherst, Amherst, MA, USA
| | | | - Barbara Baquero
- College of Public Health, University of Iowa, Iowa City, IA, USA
- School of Public Health, University of Washington, Seattle, WA, USA
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Afifi RA, Parker EA, Dino G, Hall DM, Ulin B. Reimagining Rural: Shifting Paradigms About Health and Well-Being in the Rural United States. Annu Rev Public Health 2022; 43:135-154. [PMID: 34910581 PMCID: PMC11295601 DOI: 10.1146/annurev-publhealth-052020-123413] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Rural health disparities have attracted increased national attention, compelling an expanded focus on rural health research. In this article, we deconstruct the definitions and narratives of "rural" communities and suggest that a paradigm shift is needed that centers the complexity and strength of rural places. We discuss the relevance of health equity frameworks, implementation science, and community-engaged approaches to promote rural well-being. Focusing on rural in its own right will lead to intervention innovations and reinvention with implications beyond rural areas. We conclude with suggestions for research and practice to inspire renewed interest in partnering with rural communities to promote health equity.
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Affiliation(s)
- R A Afifi
- Department of Community and Behavioral Health, and Prevention Research Center for Rural Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States; ,
| | - E A Parker
- Department of Community and Behavioral Health, and Prevention Research Center for Rural Health, College of Public Health, University of Iowa, Iowa City, Iowa, United States; ,
| | - G Dino
- Department of Social and Behavioral Sciences, and West Virginia Prevention Research Center, School of Public Health, West Virginia University, Morgantown, West Virginia, United States;
| | - D M Hall
- Office of the Associate Director for Policy and Strategy, Centers for Disease Control and Prevention, Atlanta, Georgia, United States;
| | - B Ulin
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, United States;
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Novak NL, Baquero B, Askelson NM, Diers L, Dunn B, Haines H, Afifi R, Parker EA. Health Equity in Midsize Rural Communities: Challenges and Opportunities in a Changing Rural America. Am J Public Health 2020; 110:1342-1343. [PMID: 32783728 DOI: 10.2105/ajph.2020.305824] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Nicole L Novak
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Barbara Baquero
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Natoshia M Askelson
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Lynelle Diers
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Brian Dunn
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Heidi Haines
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Rima Afifi
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
| | - Edith A Parker
- Nicole L. Novak, Natoshia M. Askelson, Heidi Haines, Rima Afifi, and Edith A. Parker are with the Department of Community and Behavioral Health, University of Iowa College of Public Health, Iowa City. Barbara Baquero is with the Department of Health Services, University of Washington School of Public Health, Seattle. Lynelle Diers is with the Wapello County Public Health Department, Ottumwa, IA. Brian Dunn is with Sieda Community Action, Ottumwa, IA
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Respondent-Driven Sampling to Recruit Latinos in a Midwest Micropolitan Area: Lessons Learned and Recommendations for Translational Work. J Clin Transl Sci 2019; 2:245-248. [PMID: 30713748 PMCID: PMC6349367 DOI: 10.1017/cts.2018.322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Introduction Latinos constitute a hard-to-reach minority population in Iowa. Methods We used respondent-driven sampling (RDS) to supplement random digit dialing (RDD) to recruit Latinos for a community physical activity intervention. Results RDS yielded a 59% increase in Latino participation in just two months, with few demographic differences between RDS and RDD groups. Conclusions RDS may increase recruitment of underrepresented populations and strengthen community engagement; however, it is not a quick fix for underperforming recruitment methods.
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