Health coaching studies with well-specified methodologies and more rigorous designs are needed to strengthen findings; however, this behavioral change intervention suggests promise.

This operational definition and the proposed empirical measures of each attribute can be used to validate the presence of health coaching, develop theory-based applications, and consistently test the effectiveness of interventions using this concept.

Effective nursing interventions to promote physical activity should address barriers and motivating factors in all three categories of determinants for maximum efficacy. Additional research that clearly defines and consistently applies the terms "rural" and "physical activity" is needed to strengthen knowledge in this area.

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