Opportunities for promoting physical activity in rural communities by understanding the interests and values of community members

Purpose. Physical activity (PA) has well-established health benefits, but most Americans do not meet national guidelines. In southeastern Missouri, trails have been developed to increase rates of PA. Although this has had success, broad-scale interventions will be needed to improve rates further. In this study, we surveyed residents of southeastern Missouri to identify ways to improve rates of PA. Methods. We conducted a telephone survey in 2015 of adults (n=524) from eight rural Missouri towns that had walking trails, regarding their activities and interests. Findings. Forty percent of respondents reported both walking and meeting PA recommendations, 29% reported walking but not meeting PA recommendations, and the remainder did not walk or did not answer. Respondents who used the trails were significantly more likely to meet PA recommendations (odds ratio = 2.7; 95% confidence interval = 1.7, 4.5). Certain values and interests that may encourage PA or draw people to trails were common. Conclusions. The group that walked but did not meet PA recommendations would be the ideal group to target for intervention, which could focus on their reported values and interests (e.g., personal relationships, being outdoors). Use of walking trails was associated with meeting PA recommendations

In-Depth Interviews With State Public Health Practitioners On The United States National Physical Activity Plan

Abstract Background The United States National Physical Activity Plan (NPAP; 2010), the country’s first national plan for physical activity, provides strategies to increase population-level physical activity to complement the 2008 physical activity guidelines. This study examined state public health practitioner awareness, dissemination, use, challenges, and recommendations for the NPAP. Methods In 2011–2012, we interviewed 27 state practitioners from 25 states. Interviews were recorded and transcribed verbatim. Transcripts were coded using a standard protocol, verified and reconciled by an independent coder, and input into qualitative software to facilitate development of common themes. Results NPAP awareness was high among state practitioners; dissemination to local constituents varied. Development of state-level strategies and goals was the most frequently reported use of the NPAP. Some respondents noted the usefulness of the NPAP for coalitions and local practitioners. Challenges to the plan included implementation cost, complexity, and consistency with other policies. The most frequent recommendation made was to directly link examples of implementation activities to the plan. Conclusions These results provide early evidence of NPAP dissemination and use, along with challenges encountered and suggestions for future iterations. Public health is one of eight sectors in the NPAP. Further efforts are needed to understand uptake and use by other sectors, as well as to monitor long-term relevance, progress, and collaboration across sectors

Physical Activity-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002-2013

Citation: Meyer, M. R. U., Perry, C. K., Sumrall, J. C., Patterson, M. S., Walsh, S. M., Clendennen, S. C., . . . Valko, C. (2016). Physical Activity-Related Policy and Environmental Strategies to Prevent Obesity in Rural Communities: A Systematic Review of the Literature, 2002-2013. Preventing Chronic Disease, 13, 24. doi:10.5888/pcd13.150406Additional Authors: Valko, C.Introduction Health disparities exist between rural and urban residents; in particular, rural residents have higher rates of chronic diseases and obesity. Evidence supports the effectiveness of policy and environmental strategies to prevent obesity and promote health equity. In 2009, the Centers for Disease Control and Prevention recommended 24 policy and environmental strategies for use by local communities: the Common Community Measures for Obesity Prevention (COCOMO); 12 strategies focus on physical activity. This review was conducted to synthesize evidence on the implementation, relevance, and effectiveness of physical activity-related policy and environmental strategies for obesity prevention in rural communities. Methods A literature search was conducted in PubMed, PsycINFO, Web of Science, CINHAL, and PAIS databases for articles published from 2002 through May 2013 that reported findings from physical activity-related policy or environmental interventions conducted in the United States or Canada. Each article was extracted independently by 2 researchers. Results Of 2,002 articles, 30 articles representing 26 distinct studies met inclusion criteria. Schools were the most common setting (n = 18 studies). COCOMO strategies were applied in rural communities in 22 studies; the 2 most common COCOMO strategies were "enhance infrastructure supporting walking" (n = 11) and " increase opportunities for extracurricular physical activity" (n = 9). Most studies (n = 21) applied at least one of 8 non-COCOMO strategies; the most common was increasing physical activity opportunities at school outside of physical education (n = 8). Only 14 studies measured or reported physical activity outcomes (10 studies solely used self-report); 10 reported positive changes. Conclusion Seven of the 12 COCOMO physical activity-related strategies were successfully implemented in 2 or more studies, suggesting that these 7 strategies are relevant in rural communities and the other 5 might be less applicable in rural communities. Further research using robust study designs and measurement is needed to better ascertain implementation success and effectiveness of COCOMO and non-COCOMO strategies in rural communities

Support for physical activity policies and perceptions of work and neighborhood environments: variance by BMI and activity status at the county and individual levels

PURPOSE: To examine support for local policies encouraging physical activity and perceived neighborhood environment characteristics by physical activity and weight status of respondents across U.S. counties. DESIGN: We used a random-digit-dial, computer-assisted telephone interview (CATI) to conduct a cross-sectional telephone questionnaire in selected U.S. counties in 2011. SETTING: Counties with high prevalences of obesity and sedentary behavior (HH; n = 884) and counties with low prevalences of obesity and sedentary behavior (LL; n = 171) were selected nationally. SUBJECTS: Adult respondents from HH (n = 642) and LL (n = 566) counties. MEASURES: Questions were asked of respondents, pertaining to support for physical activity policies in various settings, neighborhood features, time spent in physical activity and sedentary behaviors, self-reported weight and height, and personal demographic information. ANALYSIS: Means and frequencies were calculated; bivariable and multivariable linear and logistic regression models, developed. Models were adjusted for individual characteristics and county HH/LL status. RESULTS: Respondents in LL counties perceived their neighborhood and work environments to be more supportive of healthy behaviors and were more supportive of local physical activity policies than respondents in HH counties (p \u3c .001 for all). Positive neighborhood environment perceptions were related to reduced body mass index, increased physical activity, and decreased sedentary behavior. CONCLUSION: Policy support and neighborhood environments are associated with behaviors. Results can inform targeting policy agendas to facilitate the improvement of environments (community, work, and school) to be more supportive of physical activity

Practitioner perspectives on building capacity for evidence-based public health in state health departments in the United States: A qualitative case study

BACKGROUND: Public health agencies are responsible for implementing effective, evidence-based public health programs and policies to reduce the burden of chronic diseases. Evidence-based public health can be facilitated by modifiable administrative evidence-based practices (A-EBPs) (e.g., workforce development, organizational climate), yet little is known about how practitioners view A-EBPs. Thus, the purpose of this qualitative study was to understand state health department practitioners\u27 perceptions about how A-EBPs are implemented and what facilitators and barriers exist to using A-EBPs. METHODS: Chronic disease prevention and health promotion program staff who were members of the National Association of Chronic Disease Directors were recruited to participate in telephone interviews using a snowball sampling technique. Interviews were transcribed verbatim, and transcripts were analyzed using a common codebook and the a priori method in NVivo. RESULTS: Twenty seven interviews were conducted with practitioners in four states (5-8 interviews per state). All practitioners felt that their work unit culture is positive and that leadership encouraged and expected staff to use evidence-based processes. Participants discussed the provision of trainings and technical assistance as key to workforce development and how leaders communicate their expectations. Access to evidence, partnerships, and funding restrictions were the most commonly discussed barriers to the use of A-EBPs and EBDM. CONCLUSIONS: Results of this study highlight practitioners\u27 perspectives on promoting evidence-based public health in their departments. Findings can inform the development and refinement of resources to improve A-EBP use and organizational and leadership capacity of state health departments

Perceptions of the Built Environment and Support for Policies That Promote Physical Activity

BACKGROUND: To assess how perceptions of the community built environment influence support for community policies that promote physical activity (PA). METHODS: A national cross-sectional survey assessed perceptions of the local built environment and support of community policies, including school and workplace policies, promoting PA. A random digit-dialed telephone survey was conducted in US counties selected on Behavioral Risk Factor Surveillance System data for high or low prevalence of obesity and inactivity. A total of 1208 subjects were interviewed, 642 from high-prevalence counties and 566 from low-prevalence counties. Analyses were stratified by county prevalence of obesity and inactivity (high or low). Linear models adjusted for covariates were constructed to assess the influence of built environment perceptions on policy support. RESULTS: Perception of more destinations near the residence was associated with increased support for community policies that promote PA, including tax increases in low-prevalence (obesity and inactivity) counties (P \u3c .01). Positive perception of the workplace environment was associated (P \u3c .001) with increased support for workplace policies among those in high-, but not low-, prevalence counties. CONCLUSIONS: Support for community policies promoting PA varies by perception of the built environment, which has implications for policy change

Obesity-related gene ADRB2, ADRB3 and GHRL polymorphisms and the response to a weight loss diet intervention in adult women

The individual response to diet may be influenced by gene polymorphisms. This study hypothesized that ADRB2 (Gln27Glu, rs1042714 and Arg16Gly, rs1042713), ADRB3 (Trp64Arg, rs4994) and GHRL (Leu72Met, rs696217) polymorphisms moderate weight loss. The study was a seven weeks dietary weight loss intervention with Brazilian adult obese women (n = 109). The body mass index (BMI) was calculated and polymorphisms in these genes were assessed by real-time PCR assays. Two-way repeated-measures ANOVA (2 x 2) were used to analyze the intervention effect between polymorphisms and BMI over the period and after stratification for age and socioeconomic status (SES). The weight loss intervention resulted in decreased BMI over the seven-week period (p < 0.001), for high and low SES (p < 0.05) and mainly for participants with 30-49 y. The intervention did not result in a statistically significant difference in weight loss between polymorphism carriers and non-carriers, and although, the ADRB2, ADRB3 and GHRL polymorphisms did not moderate weight loss, the Gln27Glu polymorphism carriers showed a lower BMI compared to non-carriers in the low SES (p = 0.018) and the 30-39 y (p = 0.036) groups, suggesting a role for this polymorphism related to BMI control