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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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Sirotiak Z, Brellenthin AG, Hariharan A, Welch AS, Meyer JD, Franke WD. Psychological correlates of physical activity among adults living in rural and urban settings. Front Psychol 2024; 15:1389078. [PMID: 38659683 PMCID: PMC11039787 DOI: 10.3389/fpsyg.2024.1389078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024] Open
Abstract
Middle-aged and older adults living in rural settings have been consistently less likely to report regular physical activity (PA) than those living in urban settings. While past literature has identified sociodemographic and environmental correlates of PA that may contribute to these differences, consideration of psychological correlates has been limited. A total of 95 rural and urban adults ≥50 years old provided self-reported sociodemographic information, PA level, and psychological correlates of PA including measures assessing motivation, self-efficacy, social support, and attitudes related to PA. The average participant age was 68.6 years, and most were female (62.1%) and married (70.5%). While PA level did not differ significantly between the rural and urban groups, different psychological correlates contributed significantly to separate rural and urban linear regression models considering PA status. Among rural adults, more positive attitudes toward PA, and greater PA self-efficacy and social support were associated with greater amounts of PA while for urban adults, no psychological correlates were significantly associated with PA. Psychosocial factors may be key considerations in developing more effective PA interventions in middle-aged and older adults living in rural areas.
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Affiliation(s)
- Zoe Sirotiak
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | | | - Arjun Hariharan
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Amy S. Welch
- Department of Health and Human Performance, Norwich University, Northfield, VT, United States
| | - Jacob D. Meyer
- Department of Kinesiology, Iowa State University, Ames, IA, United States
| | - Warren D. Franke
- Department of Kinesiology, Iowa State University, Ames, IA, United States
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Twardzik E, Falvey JR, Clarke PJ, Freedman VA, Schrack JA. Public transit stop density is associated with walking for exercise among a national sample of older adults. BMC Geriatr 2023; 23:596. [PMID: 37752411 PMCID: PMC10521449 DOI: 10.1186/s12877-023-04253-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 08/24/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Walking is the primary and preferred mode of exercise for older adults. Walking to and from public transit stops may support older adults in achieving exercise goals. This study examined whether density of neighborhood public transit stops was associated with walking for exercise among older adults. METHODS 2018 National Health and Aging Trends Study (NHATS) data were linked with the 2018 National Neighborhood Data Archive, which reported density of public transit stops (stops/mile2) within participants' neighborhood, defined using census tract boundaries. Walking for exercise in the last month was self-reported. The extent to which self-reported public transit use mediated the relationship between density of neighborhood public transit stops and walking for exercise was examined. Covariates included sociodemographic characteristics, economic status, disability status, and neighborhood attributes. National estimates were calculated using NHATS analytic survey weights. RESULTS Among 4,836 respondents with complete data, 39.7% lived in a census tract with at least one neighborhood public transit stop and 8.5% were public transit users. The odds of walking for exercise were 32% higher (OR = 1.32; 95% confidence interval: 1.08, 1.61) among respondents living in a neighborhood with > 10 transit stops per mile compared to living in a neighborhood without any public transit stops documented. Self-reported public transit use mediated 24% of the association between density of neighborhood public transit stops and walking for exercise. CONCLUSIONS Density of neighborhood public transit stops was associated with walking for exercise, with a substantial portion of the association mediated by self-reported public transit use. Increasing public transit stop availability within neighborhoods may contribute to active aging among older adults.
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Affiliation(s)
- Erica Twardzik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E Monument Street, Suite 2-700, Baltimore, MD, 21205, USA.
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA.
| | - Jason R Falvey
- Department of Physical Therapy and Rehabilitation Science, University of Maryland School of Medicine, Baltimore, MD, USA
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Philippa J Clarke
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Vicki A Freedman
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Jennifer A Schrack
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 2024 E Monument Street, Suite 2-700, Baltimore, MD, 21205, USA
- Center on Aging and Health, Johns Hopkins University, Baltimore, MD, USA
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Abildso CG, Dyer AM, Daily SM, Lilly C, Sarkees EA, Moyers SI, Bias TK. Factors Associated with Physical Activity Increases and Decreases Among a Sample of Appalachian Residents During the COVID-19 Pandemic: A Cross-Sectional Study. JOURNAL OF APPALACHIAN HEALTH 2023; 5:38-58. [PMID: 38023109 PMCID: PMC10629888 DOI: 10.13023/jah.0501.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
Introduction Physical activity (PA) can prevent and reduce the deleterious physical and mental health effects of COVID-19 and associated lockdowns. Research conducted early in the pandemic demonstrates that a greater proportion of adults in the U.S. have decreased than increased PA, and the effects vary by sociodemographic factors. Ongoing evidence is important to identify patterns in PA changes during the pandemic. Purpose This study aims to identify factors associated with increases and decreases in PA during the COVID-19 pandemic in a convenience sample of adults residing in Appalachia. Methods: Surveys were collected from a convenience sample of adults from eight counties in West Virginia from January to March 2021. Logistic regression analysis was used to identify sociodemographic, health, and rurality factors associated with (1) increased PA and (2) decreased PA during the pandemic, assessed retrospectively via self-report. Results Analysis of 1,401 survey responses revealed that better self-rated health, lower body mass index, and higher income and education were associated with a greater likelihood of more time spent doing PA during the pandemic ( p ≤ .05). Respondents with lower self-rated health, higher body mass index, lower income, and lower levels of education-plus females and those living in a more urban county-were more likely to spend less time doing PA during the pandemic ( p ≤ .05). Implications Analyses suggest that pre-pandemic disparities in PA by health, wealth, and education were exacerbated during the pandemic. These must be addressed before physical inactivity and ill health become endemic to the Appalachian Region.
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Affiliation(s)
| | | | - Shay M Daily
- West Virginia University Office of Health Affairs
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Maddock JE, Demment M, Graham M, Folta S, Strogatz D, Nelson M, Ha SY, Eldridge GD, Seguin-Fowler RA. Changes in physical activity outcomes in the Strong Hearts, Healthy Communities (SHHC-2.0) community-based randomized trial. Int J Behav Nutr Phys Act 2022; 19:159. [PMID: 36578002 PMCID: PMC9795747 DOI: 10.1186/s12966-022-01401-1] [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: 09/29/2022] [Accepted: 12/15/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Physical inactivity is a risk factor for numerous adverse health conditions and outcomes, including all-cause mortality. Aging rural women are at particular risk for physical inactivity based on environmental, sociocultural, and psychosocial factors. This study reports on changes in physical activity and associated factors from a multicomponent community-engaged intervention trial. METHODS Strong Hearts, Healthy Communities 2.0 (SHHC-2.0) was a 24-week cluster (community) randomized controlled trial building on the results from the previous trial of SHHC-1.0. Rural women (n = 182) aged 40 and over living in 11 rural communities in upstate New York were recruited. The intervention consisted of twice-weekly experiential classes focused on exercise, nutrition, and civic engagement. Physical activity outcomes included accelerometry and self-report as well as related psychosocial measures at midpoint (12 weeks) and post-intervention (24 weeks). Data were analyzed using multilevel linear regression models with the community as the random effect. RESULTS Compared to participants from the control communities, participants in the intervention communities showed a significant increase in objectively measured moderate to vigorous intensity physical activity: at 12 weeks (increase of 8.1 min per day, P < 0.001) and at 24 weeks (increase of 6.4 min per day; P = 0.011). Self-reported total MET minutes per week also increased: at 12 weeks (increase of 725.8, P = 0.003) and 24 weeks (increase of 955.9, P = 0.002). Several of the psychosocial variables also showed significant positive changes. CONCLUSIONS The SHHC-2.0 intervention successfully increased physical activity level and related outcome measures. Modifications made based upon in-depth process evaluation from SHHC-1.0 appear to have been effective in increasing physical activity in this at-risk population. TRIAL REGISTRATION Clinicaltrials.gov: NCT03059472. Registered 23 February 2017.
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Affiliation(s)
- Jay E. Maddock
- grid.264756.40000 0004 4687 2082School of Public Health, Texas A&M University, College Station, TX 77843 USA
| | - Margaret Demment
- grid.264756.40000 0004 4687 2082Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252 USA
| | - Meredith Graham
- grid.264756.40000 0004 4687 2082Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252 USA
| | - Sara Folta
- grid.429997.80000 0004 1936 7531Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02155 USA
| | - David Strogatz
- grid.427850.cBassett Healthcare Network, Cooperstown, NY 13326 USA
| | - Miriam Nelson
- grid.467528.a0000 0004 5905 7925Newman’s Own Foundation, Westport, CT 06880 USA
| | - Seong-Yeon Ha
- grid.264756.40000 0004 4687 2082Department of Statistics, Texas A&M University, College Station, TX 77843 USA
| | - Galen D. Eldridge
- grid.264756.40000 0004 4687 2082Texas A&M AgriLife Research and Extension Center, Dallas, TX 75252 USA
| | - Rebecca A. Seguin-Fowler
- Institute for Advancing Health Through Agriculture, Texas A&M AgriLife, College Station, TX 77843 USA
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Pelletier C, White N, Duchesne A, Sluggett L. Rural-urban differences in individual and environmental correlates of physical activity in Canadian Adults. Prev Med Rep 2022; 30:102061. [DOI: 10.1016/j.pmedr.2022.102061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 11/16/2022] [Accepted: 11/19/2022] [Indexed: 11/22/2022] Open
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Kegler MC, Gauthreaux N, Hermstad A, Arriola KJ, Mickens A, Ditzel K, Hernandez C, Haardörfer R. Inequities in Physical Activity Environments and Leisure-Time Physical Activity in Rural Communities. Prev Chronic Dis 2022; 19:E40. [PMID: 35797473 PMCID: PMC9336193 DOI: 10.5888/pcd19.210417] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Differential access to environments supportive of physical activity (PA) may help explain racial and socioeconomic disparities in leisure-time physical activity (LTPA) in rural communities. METHODS We 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. RESULTS More 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). CONCLUSION Findings 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.
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Affiliation(s)
- Michelle C. Kegler
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Nicole Gauthreaux
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - April Hermstad
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kimberly Jacob Arriola
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Kelley Ditzel
- Public Administration, Georgia College & State University, Milledgeville, Georgia
| | - Clarisa Hernandez
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Regine Haardörfer
- Department of Behavioral, Social and Health Education Sciences, Emory Prevention Research Center, Rollins School of Public Health, Emory University, Atlanta, Georgia
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