Despite the recognition that environments play a role in shaping physical activity and healthy eating behaviors, relatively little research has focused on rural homes and neighborhoods as important settings for obesity prevention. This study, conducted through community-based participatory research, used a social ecological model to examine how home and neighborhood food and physical activity environments were associated with weight status among rural-dwelling adults. Data were from a cross-sectional survey of White and African American adults (n = 513) aged 40-70 years living in rural southwest Georgia. Data were analyzed using measured variable path analysis, a form of structural equation modeling. The results support a social ecological approach to obesity prevention. Physical activity had a direct effect on BMI; self-efficacy, family support for physical activity, and household inventory of physical activity equipment also had direct effects on physical activity. Neighborhood walkability had an indirect effect on physical activity through self-efficacy and family social support. Although neither fruit and vegetable intake nor fat intake had direct effects on BMI, self-efficacy and household food inventories had direct effects on dietary behavior. Perceived access to healthy foods in the neighborhood had an indirect effect on healthy eating and a direct effect on weight; neighborhood cohesion had an indirect effect on healthy eating through self-efficacy. Overall, individual factors and home environments tended to exhibit direct effects on behavior, and neighborhood variables more often exhibited an indirect effect.

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Background: The home and neighborhood environments may be important in obesity prevention by virtue of food availability, food preparation, cues and opportunities for physical activity, and family support. To date, little research has examined how home and neighborhood environments in rural communities may support or hinder healthy eating and physical activity. This paper reports characteristics of rural homes and neighborhoods related to physical activity environments, availability of healthy foods, and family support for physical activity and maintaining an ideal body weight.

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The influence of church environments on healthy eating and physical activity was explored through in-depth interviews with rural adults aged 50-70 (n = 60). Data were analyzed using a constant comparative approach, with an emphasis on noting similarities and differences between African American and predominantly white churches. Findings suggest that church-based nutrition and exercise programs were rare, and existing recreational facilities were geared toward younger members. The majority of church leaders did not talk about nutrition or physical activity, but social support from church friends for healthy eating and physical activity was fairly common. Despite barriers to establishing healthy environments in church settings, churches are rich in social support that could be tapped to promote healthy behavior.