A Qualitative Study Identifying Barriers and Facilitators of Physical Activity in Rural Communities

Abstract

Background. Physical activity (PA) rates are lower in rural populations, compared to urban and suburban counterparts. Since PA is shown to decrease the risk of cancers and chronic diseases, increasing PA in rural environments is an important disease-prevention strategy. However, in order to develop effective interventions for rural populations, more research is needed. The purpose of the study was to elicit rural residents’ thoughts and perceptions related to PA and walking trail use. Methods. Key informant interviews were conducted via telephone, with 62 adults, living in six rural communities in southeast Missouri, who identified as stakeholders, walking trail users, and nontrail users. Participants were recruited through word of mouth and snowball sampling. Interviews were digitally audio-recorded, transcribed, and qualitatively analyzed. Findings. Analysis revealed variation within the rural population, with each town unique in what constituted barriers and facilitators to PA. Life priorities other than physical health were found to be important motivators to PA and also influenced how PA was obtained. Community size was found to impact community resources and infrastructure, although this was mitigated by poverty rates. Conclusion. Rural communities are distinct from one another with different views and approaches to PA. Future interventions designed to increase PA should be mindful of differences at the individual and town levels and avoid a one-size-fits-all approach. Interventions would benefit from insight and support from community members and stakeholders, to facilitate a tailored approach to increase PA.

Understanding how to reach the hard to reach in cancer rehabilitation

“…[30,31] Barriers to exercise for general populations living in rural and remote communities include social isolation and cultural differences, lack of transportation, lack of access to physical activity programming, and cost of programming. [32][33][34] These barriers are consistent with the present study in that a lack of available exercise programming and a lack of cancer specific programming were reported. Social support and availability of physical activity related amenities (e.g., trails, gyms) have shown to facilitate exercise in general populations living in rural and remote communities.…”

“…Social support and availability of physical activity related amenities (e.g., trails, gyms) have shown to facilitate exercise in general populations living in rural and remote communities. [34] This study echoed the facilitator of social support, specifically participants' desire to exercise with other cancer survivors and highlighted the need for online/virtual exercise education to inform survivors living in rural and remote areas. The importance of accurate, in-depth information is known to be critical in facilitating behavioural change.…”

“…[26,27,35] However, it is also known that there is variability across rural populations in regard to barriers and facilitators to exercise based on community size, resources and infrastructure available, and poverty rates. 34 Therefore, community-specific factors must be taken into consideration when devising cancer specific exercise programs in different rural and remote communities. A one-size fits all intervention is unlikely to be effective across communities.…”

A Cross-Sectional Comparison of Physical Activity during COVID-19 in a Sample of Rural and Non-Rural Participants in the US

“…There is wide variation and overgeneralization in the myriad definitions of rural [ 36 ]. Prior work of Gilbert et al reported unique differences among rural communities in barriers to PA [ 37 ], indicating community size influenced available resources and infrastructure to support PA. Thus, differences in PA between urban and rural residents may have less to do with traditional definitions of rurality (i.e., population density, spatial location) and more with availability of community resources and the impact of social determinants of health, such as poverty.…”

Associations Between Rural or Urban Status, Health Outcomes and Behaviors, and COVID-19 Perceptions Among Meditation App Users: Longitudinal Survey Study

“…Regarding health behaviors such as physical activity, rural residents have consistently been less physically active compared to their urban counterparts, which has been attributed to increased barriers and limited physical activity resources in rural areas [6,18,26]. For example, an analysis of data from the Behavioral Risk Factor Surveillance System, conducted among 398,208 adults, demonstrated that residents of nonmetropolitan counties had a lower prevalence of meeting national physical activity guidelines compared to their metropolitan counterparts [18].…”