Understanding and Addressing Barriers to Implementation of Environmental and Policy Interventions to Support Physical Activity and Healthy Eating in Rural Communities

Abstract

PURPOSE Rural residents are at greater risk of obesity than urban and suburban residents. Failure to meet physical activity and healthy eating recommendations play a role. Emerging evidence shows the effectiveness of environmental and policy interventions to promote physical activity and healthy eating. Yet most of the evidence comes from urban and suburban communities. The objectives of this study were to 1) identify types of environmental and policy interventions being implemented in rural communities to promote physical activity or healthy eating, 2) identify barriers to the implementation of environmental or policy interventions, and 3) identify strategies rural communities have employed to overcome these barriers. METHODS Key informant interviews with public health professionals working in rural areas in the United States were conducted in 2010. A purposive sample included 15 practitioners engaged in planning, implementing, or evaluating environmental or policy interventions to promote physical activity or healthy eating. FINDINGS Our findings reveal that barriers in rural communities include cultural differences, population size, limited human capital, and difficulty demonstrating the connection between social and economic policy and health outcomes. Key informants identified a number of strategies to overcome these barriers such as developing broad-based partnerships and building on the existing infrastructure. CONCLUSON Recent evidence suggests that environmental and policy interventions have potential to promote physical activity and healthy eating at the population level. To realize positive outcomes, it is important to provide opportunities to implement these types of interventions and document their effectiveness in rural communities.

Park Access among School-Age Youth in the United States

“…26,27 Additionally, in areas where there are no parks and where schools are farther from homes, places such as green or open spaces could be used for physical activities where youth can engage in structured or free play. 28 For those in urban areas with access to parks, using available park programming, amenities, and safety improvements could increase the use of parks for physical activity. 4 In conclusion, this study found that more than half of U.S. school-age youth live in a block group within half a mile of a park.…”

Built Environments and Active Living in Rural and Remote Areas: a Review of the Literature

“…Others have identified a lack of adequate staff and expertise in the built environment or in other wellness areas [93]. Additionally, the built environment is often seen as an amenity rather than a necessity by rural community members [93].…”

“…Additionally, the built environment is often seen as an amenity rather than a necessity by rural community members [93]. Therefore, strong public participation and buy-in, collaboration, and input are needed from community members and leaders, partners, and stakeholders [93][94][95], including mayors, town planners, public works departments, recreation department staff, school officials, church leaders, business owners, health care and public health professionals, architects, parents, senior citizens, and youth.…”

Rural Active Living: A Call to Action

“…Lack of programmatic activities and social connections appear to be important correlates, but these are potentially the most resistant to intervention in rural settings. 93,94 In the most recent rural-specific review examining the relationship between the social and physical environments and PA in adults, Frost and colleagues 2 found that aesthetics and civilities, perceived safety (from crime or traffic), and the presence of parks, trails, and recreation facilities were most consistently associated with PA in rural adults. The associations between sidewalks or traffic density and PA, which are consistently associated with PA in urban adults, were not consistently associated with PA in rural adults.…”