What sets physically active rural places apart from less active ones? A comparative case study of three US counties.

Authors: ABILDSO, CHRISTIAAN - West Virginia University; PERRY, CYNTHIA - Oregon Health & Science University; JACOBS, LAUREN - University Of Maine; UMSTATTD MEYER, M - Baylor University; MCCLENDON, MEGAN - Baylor University; EDWARDS, MICHAEL - North Carolina State University; Roemmich, James

Submitted to: International Journal of Environmental Research and Public Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/6/2021
Publication Date: 10/9/2021
Citation: Abildso, C., Perry, C., Jacobs, L., Umstattd Meyer, M., McClendon, M., Edwards, M., Roemmich, J.N. 2021. What sets physically active rural places apart from less active ones? A comparative case study of three US counties. International Journal of Environmental Research and Public Health. 18(20). https://doi.org/10.3390/ijerph182010574.
DOI: https://doi.org/10.3390/ijerph182010574

Interpretive Summary: In collaborative work with investigators across the United States, scientists at the Grand Forks Human Nutrition Research Center used a positive deviant’s approach to determine why the physical activity of the individuals living in some rural counties is greater than individual in similar rural counties. Competitive school sports were embraced as a common "leisure" activity and Political Capital (i.e., public policy) toward PA was limited. Human, Social, Built, and Natural Capital were important to facilitating (or constraining) physical activity in these counties but varied due to Financial Capital. Organizational Capital was important in influencing the other seven Capitals highlighting the impact that various organizations’ policies and focus matter in influencing PA.

Technical Abstract: Introduction: Rural communities experience health inequities and disparities, including lower prevalence of physical activity (PA). However, Positive Deviants (PDs) - rural communities with greater PA than their peers - exist, serving as fertile ground for identifying the influential policies, places, programming, and people unique to active living in rural areas. Methods: We conducted stakeholder interviews, on-site intercept interviews, and in-person observations to form a comparative case study of two PD counties and one non-PD county in a southern US state. The counties were chosen from among the "most rural, most active" counties, using 2010 US Census and 2011 Behavioral Risk Factor Surveillance System data. Transcriptions of stakeholder interviews and field notes from observations and intercept interviews were coded by three readers and organized according to the eight Capitals in the Community Capitals Framework. Results: Over 305 minutes of interviews with 15 stakeholders, plus nine intercept interviews and on-site observations were conducted. Common in all three counties was a Cultural view that competitive school sports were embraced as a common "leisure" activity and Political Capital (i.e., public policy) toward PA was limited. Human, Social, Built, and Natural Capital were important to facilitating (or constraining) physical activity in these counties but varied due to Financial Capital. Organizational Capital was important in influencing the other seven Capitals highlighting the impact that various organizations’ policies and focus matter in influencing PA. Conclusion: Multi-organizational PA coalitions may hold promise for influencing rural PA in the long-term by changing systems, organizational policies, and environments in the short-term.