Grant Number:	5R01CA211323-05 Interpret this number
Primary Investigator:	Brownson, Ross
Organization:	Washington University
Project Title:	Multilevel Approaches for Promoting Physical Activity in Rural Communities
Fiscal Year:	2021

PROJECT SUMMARY BACKGROUND: There are notable disparities in rates of physical activity in rural communities, with rural residents at higher risk than urban/suburban residents for cancer and other chronic diseases. Given that rural residents make up 15% of the US population, there is an imperative to develop and implement interventions to promote physical activity. Changing the built environment (e.g., building walking trails) is likely a necessary but not sufficient approach for increasing rates of physical activity—that is, communication/promotional efforts are also needed. GOAL AND AIMS: This project’s primary goal is to identify novel approaches for increasing the rate of physical activity in rural communities. To accomplish this goal, Aim 1 will inform intervention development based on the existing science and engagement with local residents and leaders. Aim 2 will test the independent and moderating (interactive) effects of a multilevel intervention and the community environment on physical activity. DESIGN AND METHODS: Guided by an ecological framework, a group-randomized design will be used to evaluate the effects of a three-level intervention for increasing physical activity among adults residing in 6 rural communities (along with 6 control communities). The intervention includes components at the individual (short message service [SMS] text messages), interpersonal (social support in walking groups), and community levels (events at existing trails). The project will be conducted in close collaboration with local partners. Innovative methods to encourage participation (e.g., use of “citizen scientists”) will be employed as well as a focus on life priorities (e.g., family, recreation, hobbies) other than health. Activities for Aim 1 include updating a “review of reviews” and conducting key informant interviews to determine the local contexts for intervention adaptations. To accomplish Aim 2, a set of interventions will be refined and implemented to include individual, interpersonal, and community-level approaches; evaluate the effects of intervention activities with objective (7- day accelerometry to assess minutes of moderate-to-vigorous physical activity) and self-report (telephone survey) methods. These data are supplemented by location based on Global Positioning System (GPS) and community audits that provide information on recreational amenities, programs/policies, and street segments. Study findings will be disseminated using traditional (publications, presentations) and less-traditional dissemination methods (social media, issue briefs). INNOVATIONS AND IMPACT: This project is innovative because it: 1) is among the first of its kind in rural settings to test a multilevel intervention, 2) addresses life priorities that complement health outcomes, and 3) examines moderation between behavioral interventions and the natural environments where people are physically active. Our results will impact the field by enhancing the ability to scale-up innovative, physical activity interventions with the potential to reach high-risk, rural populations.




Examining the Associations of and Interactions Between Intrapersonal and Perceived Environmental Factors With Objectively Assessed Physical Activity Among Rural Midwestern Adults, USA.
Authors: Serrano N. , Beck A. , Salvo D. , Eyler A. , Reis R. , Steensma J.T. , Gilbert A. , Brownson R.C. .
Source: American journal of health promotion : AJHP, 2023 May; 37(4), p. 511-515.
EPub date: 2022-10-21.
PMID: 36268648
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Multilevel correlates of domain-specific physical activity among rural adults - a cross-sectional study.
Authors: Beck A.M. , Serrano N.H. , Toler A. , Brownson R.C. .
Source: BMC public health, 2022-11-23; 22(1), p. 2150.
EPub date: 2022-11-23.
PMID: 36419021
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Mapping the Lay of the Land: Using Interactive Network Analytic Tools for Collaboration in Rural Cancer Prevention and Control.
Authors: Carothers B.J. , Allen P. , Walsh-Bailey C. , Duncan D. , Pacheco R.V. , White K.R. , Jeckstadt D. , Tsai E. , Brownson R.C. .
Source: Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2022-06-01; 31(6), p. 1159-1167.
PMID: 35443033
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Objective Measures of Physical Activity in Rural Communities: Factors Associated With a Valid Wear and Lessons Learned.
Authors: Gilbert A. , Beck A. , Serrano N. , Brownson R.C. .
Source: Journal of physical activity & health, 2022-04-01; 19(4), p. 267-274.
EPub date: 2022-03-10.
PMID: 35272263
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Perceptions of COVID-19 Mitigation Strategies between Rural and Non-Rural Adults in the US: How Public Health Nurses Can Fill the Gap.
Authors: Beck A.M. , Piontek A.J. , Wiedenman E.M. , Gilbert A. .
Source: Nursing reports (Pavia, Italy), 2022-03-02; 12(1), p. 188-197.
EPub date: 2022-03-02.
PMID: 35324565
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A Cross-Sectional Comparison of Physical Activity during COVID-19 in a Sample of Rural and Non-Rural Participants in the US.
Authors: Beck A.M. , Gilbert A.S. , Duncan D.D. , Wiedenman E.M. .
Source: International journal of environmental research and public health, 2021-05-08; 18(9), .
EPub date: 2021-05-08.
PMID: 34066791
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A multilevel approach for promoting physical activity in rural communities: a cluster randomized controlled trial.
Authors: Beck A.M. , Eyler A.A. , Aaron Hipp J. , King A.C. , Tabak R.G. , Yan Y. , Reis R.S. , Duncan D.D. , Gilbert A.S. , Serrano N.H. , et al. .
Source: BMC public health, 2019-01-30; 19(1), p. 126.
EPub date: 2019-01-30.
PMID: 30700262
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Opportunities for Promoting Physical Activity in Rural Communities by Understanding the Interests and Values of Community Members.
Authors: Park T. , Eyler A.A. , Tabak R.G. , Valko C. , Brownson R.C. .
Source: Journal of environmental and public health, 2017; 2017, p. 8608432.
EPub date: 2017-08-08.
PMID: 28932248
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