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Ashleigh J. Sowle, Sarah L. Francis, Jennifer A. Margrett, Mack C. Shelley and Warren D. Franke

Providing opportunities for rural-residing older adults (OA) to be physically active is important for their health and well-being. OA (65 years and older) now comprise 13.3% of the overall United States population ( Administration on Aging and the Department of Health and Human Services, 2012

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Verity Cleland, Marita Sodergren, Petr Otahal, Anna Timperio, Kylie Ball, David Crawford, Jo Salmon and Sarah A. McNaughton

This study aimed to determine whether associations between the perceived environment and physical activity are moderated by urban-rural status among midolder aged adults. Environmental (safety, aesthetics, physical activity environment) and physical activity (total, leisure, transport) data from 3,888 adults (55 to 65 years) from urban and rural areas of Victoria, Australia, were analyzed. Multinomial logistic regression examined interactions between urban-rural status and environments in associations with physical activity. Significant (P < .05) interactions were evident and indicated positive associations only among older rural adults for both safety and aesthetics with total and transport physical activity (e.g., rural adults reporting higher safety were 91% to 118% more likely to have higher activity than rural adults reporting low safety). In contrast, the physical activity environment was positively associated with leisure activity among only urban adults. Findings suggest that some tailoring of physical activity promotion strategies targeting the environment may be required for urban and rural midolder aged adults.

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Jolanthe L. de Koning, Afroditi Stathi and Kenneth R. Fox

The frequency of trips outdoors is a strong indicator of older adults’ physical activity levels. This qualitative study compared and contrasted determinants of trips outdoors between rural- (n = 13) and urban-living (n = 15) people aged 65 and older living in England. Interview transcripts were analyzed through directed and summative content analysis employing the Ecological Model framework. Some personal-level determinants (age-related barriers) and environment-level factors (car dependence, bus services) were shared across samples. The main differences were seen in how a community-based social network instigated trips outdoors for rural participants while family ties mostly led to trips outdoors for urban-living participants. Urban participants used and valued recreational facilities, but rural participants did not report them as important in determining trips outdoors. Strategies to improve public transport and minimize age-related barriers may translate from urban to rural contexts. However, social and/or physical environment interventions could be more effective if they were rural-grounded, not urban-translated.

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Danae Dinkel, Dipti Dev, Yage Guo, Emily Hulse, Zainab Rida, Ami Sedani and Brian Coyle

Delaney et al 16 suggested that additional provider characteristics, such as urban or rural location, are needed to determine appropriate recommendations for policy and practice to provide important contextual information for providers. Further, in Nebraska, a majority of FCCHs are in rural areas. This

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Jill R. Reed, Paul Estabrooks, Bunny Pozehl, Kate Heelan and Christopher Wichman

, and depression. 16 – 18 Because physical inactivity is a risk factor for multiple chronic diseases, it is important to address inactivity in all adults, particularly those living in rural areas. Rural communities have higher rates of preventable conditions and chronic diseases, such as obesity and

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Michelle C. Kegler, Iris Alcantara, Regine Haardörfer, Alexandra Gemma, Denise Ballard and Julie Gazmararian

Background:

Physical activity levels, including walking, are lower in the southern U.S., particularly in rural areas. This study investigated the concept of rural neighborhood walkability to aid in developing tools for assessing walkability and to identify intervention targets in rural communities.

Methods:

Semi-structured interviews were conducted with physically active adults (n = 29) in rural Georgia. Mean age of participants was 55.9 years; 66% were male, 76% were white, and 24% were African American. Participants drew maps of their neighborhoods and discussed the relevance of typical domains of walkability to their decisions to exercise. Comparative analyses were conducted to identify major themes.

Results:

The majority felt the concept of neighborhood was applicable and viewed their neighborhood as small geographically (less than 0.5 square miles). Sidewalks were not viewed as essential for neighborhood-based physical activity and typical destinations for walking were largely absent. Destinations within walking distance included neighbors’ homes and bodies of water. Views were mixed on whether shade, safety, dogs, and aesthetics affected decisions to exercise in their neighborhoods.

Conclusions:

Measures of neighborhood walkability in rural areas should acknowledge the small size of self-defined neighborhoods, that walking in rural areas is likely for leisure time exercise, and that some domains may not be relevant.

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Constantinos A. Loucaides

Background:

A number of studies indicate higher prevalence of overweight and obesity among rural school children. The purpose of this study was to examine the differences in personal, social, and environmental correlates of physical activity between school location (urban versus rural) and gender.

Methods:

Middle school children (N = 676) from different districts in Cyprus completed questionnaires assessing physical activity and potential correlates.

Results:

Children from rural schools reported higher friend support for physical activity and more ease of walk to a bus station from their home. Urban school children reported higher presence of sidewalks in their neighborhood. Boys reported more hours per day playing outside and higher enjoyment and friend support for physical activity than girls, whereas girls reported higher means in the variable ‘I see a lot of people walking or being physically active in my neighborhood’. Significant two-way interactions between gender and school location were noted with rural school girls having less favorable scores in a number of correlates of physical activity.

Conclusions:

More studies are needed to further understand the higher incidence of overweight and obesity observed among rural youth. Girls from rural areas may be targeted as a priority group for promoting physical activity.

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Margaret McGladrey, Angela Carman, Christy Nuetzman and Nicole Peritore

The impact on personal health of living in a rural county in the United States has received great attention of late. A person’s place of residence can mean less than optimal access to healthy foods and safe venues for physical activity. Combining lack of access to conditions that support health

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Sam Zizzi, Dave Goodrich, Ying Wu, Lindsey Parker, Sheila Rye, Vivek Pawar, Carol Mangone and Irene Tessaro

Although much has been learned about the global determinants of physical activity in adults, there has been a lack of specific focus on gender, age, and urban/rural differences. In this church-based community sample of Appalachian adults (N = 1,239), the primary correlates of physical activity included age, gender, obesity, and self-efficacy. Overall, 42% of all participants and 31% of adults age 65 years or older met recommended guidelines for physical activity, which suggests that most participants do not engage in adequate levels of physical activity. Of participants who met physical activity guidelines, the most common modes of moderate and vigorous activity were walking briskly or uphill, heavy housework or gardening, light strength training, and biking. These particular activities that focus on building self-efficacy might be viable targets for intervention among older adults in rural communities.

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Michael B. Edwards, Michael A. Kanters and Jason N. Bocarro

Background:

This study’s purpose was to assess the opportunities for North Carolina adolescents to be physically active in extracurricular middle school environments and to compare opportunities across community types.

Methods:

Data were analyzed based on the results of an electronic questionnaire distributed to a sample of 431 schools with a response rate of 75.4% (N = 325).

Results:

Nearly all schools offered interscholastic sports while fewer than half offered intramurals or noncompetitive activities to students. “Open gym” was offered at only 35% of schools, while 24% of schools offered extracurricular activities to students with disabilities. Overall, 43.4% of schools offered special transportation to students who participated in some extracurricular physical activities. Schools in rural areas generally offered fewer programs and had fewer supports than schools located in more urbanized areas. Over two-thirds of rural schools offered no extracurricular programs other than interscholastic sports.

Conclusions:

Schools can be important settings for physical activity. North Carolina’s middle schools and its rural schools in particular, are falling short in efforts to provide extracurricular physical activity programming recommended by researchers and policy groups.1−6 Lower accessibility to extracurricular physical activities may partially contribute to higher levels of physical inactivity found in the state.