Purpose-Despite the well-established benefits of physical activity (PA), most Americans, especially those in rural, traditionally underserved areas, engage in considerably less PA than recommended. This study examines perceived barriers to and facilitators of PA and promising organized PA programs among rural Appalachians. Design-Eight focus groups and seven group key informant interviews were conducted.Setting-This study was conducted in eastern Kentucky, in Central Appalachia. Subjects-114 rural Appalachian residents (74% female, 91% White) participated.Measures-Open-ended, semi-structured, and structured questions regarding perceptions of, barriers to/facilitators of, and examples of successful/failed PA programs were asked.Analysis-Qualitative data analysis was conducted, including codebook development and steps taken to ensure rigor and transferability. Interrater reliability was over 94%.Results-In addition to barriers that are consistent with other populations, rural Appalachian residents indicated that travel time, family commitments, and inadequate community resources undermine PA. Suggested avenues to increase PA include partnership with churches and the U.S. Cooperative Extension Service; programs that include families, are well-advertised, focus on health rather than appearance; and, underlying all suggestions, culturally-relevant yet nonstereotyping activities. NIH Public Access Author ManuscriptAm J Health Promot. Author manuscript; available in PMC 2012 January 5. NIH-PA Author ManuscriptConclusions-When developing PA interventions in rural Appalachia, it is important to employ community-based participatory approaches that leverage unique assets of the population and show potential in overcoming challenges to PA. KeywordsPhysical activity; Appalachia; community-based research Indexing Key WordsManuscript format: research; Research purpose: descriptive; Study design: qualitative; Outcome measure: cognitive; Setting: local community; Health focus: fitness/physical activity; Strategy: education, skill building/behaviors change; Target population age: youth, adults, seniors; Target population characteristics: geographic location, underserved PurposeDespite the well-established benefits of physical activity (PA), most Americans, especially those in rural, traditionally underserved areas, engage in considerably less PA than recommended. In order to develop a community-based PA intervention, we conducted formative research with residents of rural Appalachian Kentucky to identify their perceptions of PA and to glean suggestions for programs to promote PA. Benefits and Rates of Physical ActivityOptimal physical activity is a key component of health and well-being and is associated with decreased risk of morbidity and mortality1 -3 and higher levels of perceived health.4 Higher levels of PA have been associated with lower rates of coronary heart disease, high blood pressure, stroke, type 2 diabetes, metabolic syndrome, colon and breast cancer, depression, and overall mortality.1Although the benefit...

Objectives This study examines cognitive outcomes for alcohol drinking status over time, across cognitive ability and age groups. Methods Data (1998-2005) from N=571 Seattle Longitudinal Study participants age 45+years (middle-aged: 45-64, young-old: 65-75, old-old: 75+) were analyzed to examine the alcohol drinking status effect (e.g. abstinent, moderate (≤7 drinks/week), at-risk (≥8 drinks/week)) on cognitive ability (e.g., Memory, Reasoning, Spatial, Verbal Number, Speed abilities). Results Findings indicated that alcohol drinking status was associated with change in verbal ability, spatial ability, and perceptual speed. Decline in verbal ability was seen among alcohol abstainers and moderate alcohol consumers, but at-risk drinkers displayed relative stability. At-risk old-old adults and middle-aged adults (regardless of drinking status), displayed relative stability in spatial ability. Decline in spatial ability was however present among young-old adults across drinking status, and among abstaining and moderate drinking old-old adults. At-risk drinkers showed the most positive spatial ability trajectory. A gender effect in perceptual speed was detected, with women who abstained from drinking displaying the most decline in perceptual speed compared with women that regularly consumed alcohol, and men displaying decline in perceptual speed across drinking status. Discussion In this study, consuming alcohol is indicative of cognitive stability. This conclusion should be considered cautiously, due to study bias created from survivor effects, analyzing two time points, health/medication change status, and overrepresentation of higher socioeconomic status and white populations in this study. Future research needs to design studies that can make concrete recommendations about the relationship between drinking status and cognition.

Objectives To identify perspectives on smoking cessation programs in Appalachian Kentucky, a region with particularly high smoking rates and poor health outcomes. Methods Insufficient existing research led us to conduct 12 focus groups (smokers and nonsmokers) and 23 key informant interviews. Results Several findings previously not described in this high-risk population include (1) transition from pro-tobacco culture toward advocacy for tobacco cessation approaches, (2) region-specific challenges to program access, and (3) strong and diverse social influences on cessation. Conclusions To capitalize on changes from resistance to support for smoking cessation, leaders should incorporate culturally appropriate programs and characteristics identified here.

Objectives The current study examines the prevalence of health risk behaviors and their cumulative effects on cardiovascular disease (CVD) among a sample of adults. Age cohort is also examined to determine the role of age in predicting CVD and risky health behaviors. Method Medical records of a sample of adults from the Seattle Longitudinal Study categorized into one of four age-group cohorts were examined. Data regarding participants’ health risk behaviors were examined individually and cumulatively for predicting later CVD diagnosis. Results The prevalence of CVD increases with age, obesity, and risky medical checkups. Female risky sleepers are more likely to receive a CVD diagnosis than men who report risky sleep patterns (p < .05). Discussion A high risk of CVD appears to exist for adults across the life span, and several risky health behaviors also seem to place individuals more at risk for being diagnosed with CVD.