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Kara C. Hamilton, Mark T. Richardson, Shanda McGraw, Teirdre Owens and John C. Higginbotham

whether PA and the related constructs can be improved in rural, underserved, low SES children following an educational video series intervention. Determining the effectiveness of a video series, intervention would be beneficial, as videos can be accessed through the web, and they can reach any number of

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Kara A. Strand, Sarah L. Francis, Jennifer A. Margrett, Warren D. Franke and Marc J. Peterson

Exergaming may be an effective strategy to increase physical activity participation among rural older adults. This pilot project examined the effects of a 24-wk exergaming and wellness program (8 wk onsite exergaming, 16-wk wellness newsletter intervention) on physical activity participation and subjective health in 46 rural older adults. Sociodemographic data and self-reported physical activity were analyzed using descriptive statistics and Cochran’s Q, respectively. Qualitative data were reviewed, categorized on the basis of theme, and tabulated for frequency. Increased physical activity and perceived health were the most reported perceived positive changes. Significant increases in physical activity participation were maintained among participants who were physically inactive at baseline. Best-liked features were physical activity and socialization. Findings suggest that this pilot exergaming and wellness program is effective in increasing physical activity in sedentary rural older adults, increasing socialization, and increasing subjective physical health among rural older adults.

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Nisha Botchwey, Myron F. Floyd, Keshia Pollack Porter, Carmen L. Cutter, Chad Spoon, Tom L. Schmid, Terry L. Conway, J. Aaron Hipp, Anna J. Kim, M. Renee Umstattd Meyer, Amanda L. Walker, Tina J. Kauh and Jim F. Sallis

understudied groups at higher risk of physical inactivity and obesity, including youth of minority ethnic and racial groups and all ethnic and racial groups living in rural areas. Third, the research agenda would focus on a limited number of topic areas that are promising but understudied, within categories

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Mark Swanson, Nancy E. Schoenberg, Heather Erwin and Rian E. Davis

Background:

Most children in the United States receive far less physical activity (PA) than is optimal. In rural, under resourced areas of Appalachian Kentucky, physical inactivity rates are significantly higher than national levels. We sought to understand children’s perceptions of PA, with the goal of developing culturally appropriate programming to increase PA.

Methods:

During 11 focus groups, we explored perspectives on PA among 63 Appalachian children, ages 8−17. Sessions were tape recorded, transcribed, content analyzed, and subjected to verification procedures.

Results:

Several perspectives on PA emerged among these rural Appalachian youth, including the clear distinction between PA (viewed as positive) and exercise (viewed as negative) and an emphasis on time and resource factors as barriers to adequate PA. Additional PA determinants expressed in the focus groups are similar to those of other populations. We include children’s recommendations for appealing PA programs.

Conclusions:

Appalachian and other rural residents contend with the loss of rural health advantages (due to declines in farming/other occupational and avocational transitions). At the same time, Appalachian residents have not benefitted from urban PA facilitators (sidewalks, recreational facilities, clubs and organized leisure activities). Addressing low PA levels requires extensive community input and creative programming.

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Yoshinori Fujiwara, Shoji Shinkai, Shuichiro Watanabe, Shu Kumagai, Takao Suzuki, Hiroshi Shibata, Tanji Hoshi and Toru Kita

This study investigated the effect of chronic medical conditions on changes in functional capacity in Japanese older adults. Participants comprised 1,518 people aged 65-84 living in an urban and a rural community. They were interviewed to determine the presence of chronic medical conditions and assessed for functional capacity using the Tokyo Metropolitan Institute of Gerontology (TMIG) Index of Competence. Follow-up occurred 4 years later. Statistical analysis revealed that self-reported medical conditions at baseline contributed to declines in the TMIG Index over the 4 years, even after participants’ age, sex, educational attainment, and baseline TMIG level were controlled for. In the urban area, chronic obstructive pulmonary disease, diabetes mellitus, and musculoskeletal disease significantly predicted decline in the index, whereas in the rural area, hypertension and diabetes mellitus were significant predictors. These results indicate the importance of controlling chronic medical conditions in order to prevent further declines in functional capacity in older adults.

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Jordana L. Maisel

Built environment features can have varying impacts on user behavior depending on the perceptions of the opportunities and obstacles that the environments create. This study systematically evaluated the relationship between neighborhood perceptions and the specific types of self-reported walking behavior for 121 older adults who resided in urban, suburban, or rural neighborhoods. Perceptions of street connectivity, crime and traffic safety, and overall satisfaction were associated with specific types of walking behaviors, and the strength of the relationships differed by neighborhood type. Sociodemographic variables such as age and sex were associated with certain types and amounts of older adults’ walking behaviors both across and within each neighborhood type. The results of this study support the importance of perceived street connectivity regardless of neighborhood type and perceived crime safety in rural neighborhoods to impact the walking behavior among older adults.

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Roy J. Shephard and Hughes Lavallée

The influence upon muscle strength of 1 h/day of required physical education was tested in 546 prepubescent children over a 5-year period. Experimental students began the program in Grade 1, with immediately preceding and succeeding classes serving as controls. Annual measurements showed a linear increase of limb circumferences with stature (H), but strength increased more rapidly than H2. Strength data showed gender effects (M > F) at all ages and environmental effects (rural > urban) in older children (10–12 years). Experimental students were stronger in 19 of 42 comparisons. Girths were greater in girls (7 of 18 comparisons) and in the rural environment (4 of 18 comparisons), but were unaffected by the experimental intervention. Bone diameters were greater in the boys (16 of 18 comparisons) and in the urban environment (2 of IS comparisons). Daily required physical education leads to small increases of isometric strength without significant increments of limb dimensions.

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Hyung Jin Kim and Chanam Lee

Background:

A public elementary school has traditionally functioned as an important center of a neighborhood, but this role has diminished with sprawling urban developments. Despite the large number of studies of children’s walking to/from school (WTS), the school’s location in relation to the larger neighborhood context has not been fully explored. This study is to examine the relationship between school’s spatial centrality and children’s WTS in urban, suburban and rural settings.

Methods:

this study used school travel tally (11,721 students), environment audit, GIS and census data from 71 elementary school/neighborhoods in Texas, and employed the closeness centrality index to estimate a school’s spatial centrality. Data were collected from 2009–2012.

Results:

After controlling for neighborhood characteristics, it was found that more centrally located schools are likely to have higher proportions of WTS in the neighborhoods. And, among urban, suburban and rural settings, urban schools were the most and rural schools were the least likely to be centrally-located in the neighborhoods.

Conclusions:

The findings offer implications on school and community planning policies that can help promote WTS. Spatial centrality measures can be effective tools to identify environmental factors in complex urban networks related to human behaviors and community-based activities.

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Chanam Lee, Hyung Jin Kim, Diane M. Dowdy, Deanna M. Hoelscher and Marcia G. Ory

Background:

Several environmental audit instruments have been developed for assessing streets, parks and trails, but none for schools. This paper introduces a school audit tool that includes 3 subcomponents: 1) street audit, 2) school site audit, and 3) map audit. It presents the conceptual basis and the development process of this instrument, and the methods and results of the reliability assessments.

Methods:

Reliability tests were conducted by 2 trained auditors on 12 study schools (high-low income and urban-suburban-rural settings). Kappa statistics (categorical, factual items) and ICC (Likert-scale, perceptual items) were used to assess a) interrater, b) test-retest, and c) peak vs. off-peak hour reliability tests.

Results:

For the interrater reliability test, the average Kappa was 0.839 and the ICC was 0.602. For the test-retest reliability, the average Kappa was 0.903 and the ICC was 0.774. The peak–off peak reliability was 0.801. Rural schools showed the most consistent results in the peak–off peak and test-retest assessments. For interrater tests, urban schools showed the highest ICC, and rural schools showed the highest Kappa.

Conclusions:

Most items achieved moderate to high levels of reliabilities in all study schools. With proper training, this audit can be used to assess school environments reliably for research, outreach, and policy-support purposes.

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Jill A. Nolan, Christa L. Lilly, Janie M. Leary, Wesley Meeteer, Hugh D. Campbell, Geri A. Dino and Leslie Cotrell

Background:

Parent support for child physical activity is a consistent predictor of increased childhood activity. Little is known about factors that prevent or facilitate support. The purpose of this research was to identify barriers to parent support for child physical activity in Appalachian parents.

Methods:

A cross-sectional study assessed parents whose children participated in Coronary Artery Risk Detection in Appalachian Communities (CARDIAC) screenings in a rural Appalachian state. Barriers to parental support for physical activity, demographics, geographic location, and parental support for activity were measured.

Results:

A total of 475 parents completed surveys. The majority were mothers (86.7%), parents of kindergarteners (49.5%), white (89.3%), and living in a nonrural area (70.5%). Community-level factors were most frequently cited as barriers, particularly those related to the built environment. Rural and low-income parents reported significantly higher barriers. Community, interpersonal, and intrapersonal barriers were negatively correlated with parent support for child physical activity. Parents of girls reported a higher percentage of barriers related to safety.

Conclusions:

Reported barriers in this sample differed from those reported elsewhere (Davison, 2009). Specific groups such as low-income and rural parents should be targeted in intervention efforts. Future research should explore gender differences in reported barriers to determine the influence of cultural stereotypes.