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Rural community systems: Youth physical activity promotion through community collaboration.

ABSTRACT: A common way to address rural population health issues is through community stakeholders working together. Youth physical activity (PA) happens in adult-led in-school and out-of-school group opportunities that vary across communities and generally occur in isolated settings. This study explores similarities and differences in rural community system structure and collaborative process variables that help to conceptualize the collaborative impact influencing population youth PA outcomes. Stakeholders (Community 1, n = 23; Community 2, n = 26) and youth (Community 1, n = 205; Community 2, n = 213) were recruited in 2018-2019 as part of Wellscapes, a hybrid implementation-effectiveness community randomized trial. A stakeholder survey (n = 49) measured community system structures and collaboration processes. Youth completed the Youth Activity Profile to measure PA levels. More Community 1 respondents than Community 2 resided within city limits (73.9% vs. 34.6%). Collective efficacy was significantly greater in Community 1 (M = 4.0, SD = 0.5) than in 2 (M = 3.2, SD = 0.4), p < 0.05. Perceptions of trust scored significantly greater in Community 1 (M = 4.1, SD = 0.3) than in 2 (M = 3.3, SD = 0.5), p < 0.05. Though both communities met rural definitions and had stakeholder investment, Community 1 had a greater proportion of PA-implementing stakeholders and more residing within city limits which may have influenced that community's higher scores in collective efficacy and trust. Community 2 had more stakeholders in administrator roles and yielded greater youth PA levels. Unique and common variables of rural communities should be considered in understanding system factors that impact youth PA.

SUBMITTER: Kellstedt DK

PROVIDER: S-EPMC8378795 | biostudies-literature |

REPOSITORIES: biostudies-literature

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A protocol for coordinating rural community stakeholders to implement whole-of-community youth physical activity surveillance through school systems.

Project description:Accurate and effective local data collection systems are needed to inform community change on youth health behaviors such as physical activity (PA). Systematic methods are particularly important for understanding PA behaviors that may be influenced by individual, interpersonal, organizational, and regional factors. The purpose of this study was to describe a protocol for coordinating community stakeholders to implement an online youth PA surveillance instrument. The research team collaborated with local health departments (LHDs) from two rural communities to coordinate schools in implementing school-wide youth PA surveillance. A data sharing agreement was established between all partners. School administrators and teachers attended in-person training sessions for an online PA survey and how to use the data. Following the training, students were provided individualized logins to complete the survey once a semester over a two-year academic period. Across both communities, 23 teachers and administrators attended the training sessions that were facilitated by the LHDs and research team. In Year 1 (Y1), a total of 465 3rd through 6th grade students were enrolled in the participating schools (community 1 = 227; community 2 = 238). Survey response rates ranged from 86.1% to 95.4% completion, depending on the community and semester. In Year 2 (Y2), a total of 501 3rd through 6th grade students were enrolled (community 1 = 260; community 2 = 241). Response rates ranged from 86.3% to 89.6% in the fall term. A protocol for coordinating LHD and community stakeholders was an effective strategy for implementing population-level youth PA surveillance with high levels of reach.

| S-EPMC8683876 | biostudies-literature

Cross-country collaboration for physical activity promotion: experiences from the European Union Physical Activity Focal Points Network.

Project description:BackgroundAn analysis of currently existing partnerships and cross-country collaboration for physical activity (PA) promotion is valuable for understanding how such partnerships operate, and how they impact national PA promotion efforts. This study aimed to outline the formation and development of the European Union's (EU) Physical Activity Focal Points Network, to evaluate its outputs and benefits and to describe its potential and challenges.MethodsA mixed methods approach were employed, including document analysis, semi-structured interviews with key officials and an online evaluation survey with the focal points.ResultsThe network was founded in 2014. Its main task is to coordinate the national collection of information for the EU's Health-Enhancing Physical Activity (HEPA) Monitoring Framework. Besides collecting data, focal points usually meet twice a year to share best practices and plan activities for the promotion of PA within the EU. The results of the evaluation survey show that participation in the network helped members specify goals for PA promotion, gain more knowledge regarding how to promote PA, identify more opportunities to promote PA in their country and to join a collaborative project with other countries.ConclusionsThe study shows that the EU Physical Activity Focal Points Network may serve as an example of successful cross-country collaboration in PA promotion. The network has been able to make a contribution to monitoring the implementation of the EU Council Recommendation on HEPA across sectors in particular and of PA promotion in the EU in general.

| S-EPMC9421415 | biostudies-literature

Youth sport participation and physical activity in rural communities.

Project description:BackgroundPhysical activity, a high-frequency health behavior, varies by where children live, learn, and play. Children accumulate physical activity in adult-led in-school and out-of-school settings. Youth sport is a potential setting for physical activity, but there are differences in youth sport participation based on age, sex, and socioeconomic status. There is a gap in understanding demographic influences on youth sport participation and how these factors interact to influence physical activity. This study examines influences of grade, sex, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity of children in rural communities.MethodsChildren (n = 418 3rd-6th graders) living in two rural communities completed the online Youth Activity Profile as part of Wellscapes, a type 3 hybrid implementation-effectiveness community randomized trial. Mixed models with community as a random effect examined main effects and interactions of grade, sex, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity.ResultsAbout 80% of children engaged in youth sport, and full-pay lunch students were almost four times more likely to have youth sport participation than students with free/reduced lunch (OR = 3.91, 95% CI = 1.95, 7.8). Females and 6th graders (p < 0.05) had lower physical activity than comparison groups. Males with higher family income had greater physical activity; females with higher family income had less physical activity. For 6th graders, high family income had less effect on physical activity than similar 3rd-5th graders (p < 0.01).ConclusionsWhile a fairly high percentage of children participate in youth sports, there are disparities in rural communities on youth sport participation and physical activity outcomes based on age, sex, and family income.

| S-EPMC8028731 | biostudies-literature

Physical activity promotion in rural health care settings: A rapid realist review.

Project description:Physical activity promotion in health care settings is poorly understood and has limited uptake among health care providers. The environmental and health care context of rural communities is unique from urban areas and may interact to influence intervention delivery and success. The aim of this rapid realist review was to synthesize knowledge related to the promotion of physical activity in rural health and social care settings. We searched Medline EBSCO, CINAHL, PsychINFO, and SPORTDiscus for relevant publications. We included qualitative or quantitative studies reporting on an intervention to promote physical activity in rural health (e.g., primary or community care) or social (e.g., elder support services) care settings. Studies without a rural focus or well-defined physical activity/exercise component were excluded. Populations of interest included adults and children in the general population or clinical sub-population. Intervention mechanisms from included studies were mapped to the Behaviour Change Wheel (capability, opportunity, motivation (COM-B)). Twenty studies were included in our review. Most interventions focused on older adults or people with chronic disease risk factors. The most successful intervention strategies leading to increased physical activity behaviour included wearable activity trackers, and check-ins or reminders from trusted sources. Interventions with mechanisms categorized as physical opportunity, automatic motivation, and psychological capability were more likely to be successful than other factors of the COM-B model. Successful intervention activities included a method for tracking progress, providing counselling, and follow-up reminders to prompt behaviour change. Cultivation of necessary community partnerships and adaptations for implementation of interventions in rural communities were not clearly described and may support successful outcomes in future studies.

| S-EPMC9307466 | biostudies-literature

Community Readiness for the Promotion of Physical Activity in Older Adults-A Cross-Sectional Comparison of Rural and Urban Communities.

Project description:Communities can play an important role in delivering public health programs to older adults, but they differ in the provision of local structures and resources. The community readiness (CR) approach applies a stage model of change to the community level and analyzes structures and the degree of willingness to take action on a health issue. This study compared the CR regarding the promotion of physical activity as part of healthy ageing for older adults among urban and rural communities in North-West Germany. A cross-sectional CR assessment with key respondents in 23 municipalities (11 urban and 12 rural communities) was conducted using a semi-structured interview. Interviews were scored across the five CR dimensions and global CR score was calculated (scores between 1 = no awareness and 9 = professionalization). Wilcoxon rank-sum test and hierarchical regression models were used to compare urban and rural communities. In total, 118 interviews were conducted (response rate 69.8%). On average, the communities showed moderate CR scores (4.9 ± 0.3; Range: 4.3-5.4; preplanning or preparation phase). The global CR score was slightly higher in rural than in urban communities (regression coefficient = 0.29, 95% confidence interval (CI): -0.02-0.59). The rural communities showed significantly higher CR scores in the 'Knowledge of efforts' dimension (0.70, 95% CI: 0.26-1.14) and in the 'Knowledge of the issue' (0.37, 95% CI: 0.04-0.70). Rural communities display a slightly higher CR level than urban communities. In the next step, targeted capacity building activities will be initiated among communities with low CR levels.

| S-EPMC5876998 | biostudies-literature

Promoting Physical Activity Through Youth Sports Programs: It's Social.

Project description:Youth sport is a key physical activity opportunity for children and adolescents. Several factors influence youth sport participation, including social factors, but this has not to date been clearly delineated. This study is a scoping review to survey the literature on the influence of family and peers on youth sports participation. The review identified 111 articles of which the majority were cross-sectional, included boys and girls, and were conducted primarily in the United States, Canada, Australia, and the United Kingdom. The articles were grouped into 8 research themes: (1) reasons for participation, (2) social norms, (3) achievement goal theory, 4) family structure, (5) sports participation by family members, (6) parental support and barriers, (7) value of friendship, and (8) influence of teammates. Friendships were key to both initiation and maintenance of participation, parents facilitated participation, and children with more active parents were more likely to participate in sport. Less is known on how family structure, sibling participation, extended family, and other theoretical frameworks may influence youth sport. The review suggests that social influences are important factors for ensuring participation, maximizing the quality of the experience, and capitalizing on the benefits of youth sport. Future research studies, programs, and policies promoting and developing evidence-based youth sporting experiences should consider social influences on youth sport participation.

| S-EPMC6933572 | biostudies-literature

Community Capacity Building for Physical Activity Promotion among Older Adults-A Literature Review.

Project description:Community-based interventions to promote physical activity (PA) among older adults are of high interest in health promotion since they promise to be effective strategies to reach this population group. Community capacity building, that is, the local promotion of knowledge, skills, commitment, structures, and leadership, is among the recommended core strategies. However, little guidance is provided on how to achieve a high degree of community capacity. This study aims to identify practical strategies to enhance community capacities for PA promotion among older adults (50 years or older) and to evaluate their success. A literature review was conducted using scientific databases (PsycInfo and Web of Sciences) and grey literature (national and international project databases), and 14 studies (16 articles) were identified. Five groups of capacity building strategies emerged from the literature: (1) building community coalitions and networks, (2) training of professionals, (3) training of laypersons, (4) strengthening competence and awareness in the target population, and (5) allocation of financial resources. All studies used more than one strategy. Coalition building and strengthening competence and awareness were most frequently used. Feasibility and acceptability of the capacity building strategies were demonstrated. However, intervention effects on PA behavior and other relevant outcomes were inconsistent. The one study that systematically compared different capacity building approaches did not find any evidence for beneficial effects of intensified capacity building. More rigorous research evaluating the efficacy of specific strategies to enhance community capacities for PA promotion is needed.

| S-EPMC5615595 | biostudies-literature

Co-producing an action-oriented framework for community-based Physical Activity Promotion in Germany.

Project description:German National Recommendations for Physical Activity (PA) and PA Promotion recommend community-based approaches to promote PA at the local level with a focus on health equity. In addition, the German Federal Prevention Act addresses health equity and strengthens setting-based health promotion in communities. However, the implementation of both in the local context remains a challenge. This article describes Phase 1 of the KOMBINE project that aims to co-produce an action-oriented framework for community-based PA promotion focusing on structural change and health equity. (i) In a series of workshops, key stakeholders and researchers discussed facilitators, barriers and needs of community-based PA promotion focusing on health equity. (ii) The research team used an inductive approach to cluster all findings and to identify key components and then (iii) compared the key components with updated literature. (iv) Key components were discussed and incorporated into a gradually co-produced framework by the participants. The first result of the co-production process was a catalog of nine key components regarding PA-related health promotion in German communities. The comparison of key components with scientific evidence showed a high overlap. Finally, a six-phase action-oriented framework including key components for community-based PA promotion was co-produced. The six-phase action-oriented framework integrates practice-based and scientific evidence on PA-related health promotion and health equity. It represents a shared vision for the implementation of National Recommendations for PA and PA Promotion in Germany. The extent to which structural changes and health equity can be achieved is currently being investigated in pilot-studies.

| S-EPMC8672938 | biostudies-literature

Association of the built environment with physical activity and adiposity in rural and urban youth.

Project description:ObjectiveTo determine if: (1) differences exist for body mass index (BMI) and moderate-to-vigorous physical activity (MVPA) between rural and urban youth, and (2) perceived and objective measures of environmental supports for physical activity differentially correlate with BMI and MVPA in middle school rural and urban youth.MethodCross-sectional analyses were performed in spring 2012 on data collected from December 2008 until May 2010 for 284 middle school youth from a rural county and an adjacent urbanized area. Multivariable linear models estimated associations between BMI/MVPA and perceived environmental barriers/supports for physical activity and objectively measured neighborhood spatial variables.ResultsMean MVPA was significantly lower for rural youth (15.9 min/day) compared to urban youth (19.2 min/day). No differences were observed between rural and urban youth for BMI or BMI percentile. Significant differences in both perceived and objective correlates for MVPA and BMI percentile were found in multivariable models between rural and urban youth.ConclusionDifferences observed for correlates of MVPA and BMI across the settings suggest that rurality should be considered when identifying targets for intervention to promote MVPA and prevent adiposity in youth.

| S-EPMC4761410 | biostudies-literature

Objectively Measured Sedentary Behavior, Physical Activity, and Cardiometabolic Risk in Hispanic Youth: Hispanic Community Health Study/Study of Latino Youth.

Project description:Context:Time spent in moderate-to-vigorous physical activity (MVPA), but not in sedentary behavior (SB), is related to cardiometabolic risk among non-Hispanic white youth. Objective:Examine associations of SB and MVPA with cardiometabolic risk factors among Hispanic/Latino youth. Design:Cross-sectional analysis. Setting:Four US communities. Participants:Hispanic/Latino youth (N = 1,426) ages 8 to 16 years. Measurements:Associations of MVPA and SB, measured using 7-day accelerometer data (independent variables), with markers of glucose and lipid metabolism, inflammation, and endothelial function (dependent variables), were assessed in multivariable linear regression models while adjusting for sociodemographic characteristics and accelerometer wear time. Additional models controlled for obesity measures. Results:SB comprised a mean (SD) of 75% (13%) of accelerometer wear time; mean (SD) time of MVPA was 35 min/d (22 min/d). Deleterious levels of high-density lipoprotein-cholesterol (HDL-C), triglycerides, insulin resistance, C-reactive protein, and plasminogen activator inhibitor-1 were associated with lower levels of MVPA and higher levels of SB (all P < 0.05). Associations of MVPA with log-transformed triglyceride concentrations (β per 15-min/d increment, -0.039; SE, 0.018; P = 0.037) and SB with HDL-C (β per 30-min/d increment, -0.63; SE, 0.26; P = 0.018), but not those with other markers, remained significant after adjusting for MVPA or SB and further adjustment for body mass index and waist circumference. Higher SB tertiles were associated with lower soluble receptor for advanced glycation end products in fully adjusted models (P for trend = 0.037). Conclusions:Physiological precursors of diabetes and cardiovascular disease were associated with MVPA and SB among US Hispanic/Latino youth, a group that bears a disproportionate burden of metabolic disorders.

| S-EPMC6126884 | biostudies-other

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