Advertisement

Active Living for Rural Children

Community Perspectives Using PhotoVOICE

      Background

      Active living integrates physical activity into one's daily routine. Current understanding of active living among children and their families living in rural communities is limited. A community perspective is critical to understand the contextual factors that influence children's physical activity in rural areas.

      Purpose

      The purpose of this study was to identify the perceived environmental factors that support or hinder physical activity among rural children to develop testable hypotheses to inform future interventions for reducing unhealthy weight gain and preventing chronic diseases associated with physical inactivity.

      Methods

      PhotoVOICE was used to explore active living opportunities and barriers for children living in four low-income, rural U.S. communities. In 2007, parents (n=99) and elementary school staff (n=17) received disposable cameras to document their perspective. Using their photographs and narratives, participants developed emergent themes during a facilitated group discussion. In 2008, study authors used the Analysis Grid for Environments Linked to Obesity (ANGELO) framework to categorize the themes.

      Results

      Microenvironment themes include physical (e.g., natural features, topography); sociocultural (e.g., isolation); policy (e.g., time for school recess); and economic (e.g., funding for physical activity programs). Macroenvironmental themes related to the built and natural environments and transportation infrastructure.

      Conclusions

      This study identified rural environment elements that community members perceived as influencing children's physical activity patterns. Certain aspects were unique to rural areas, whereas other urban and suburban factors may be generalizable to rural settings. PhotoVOICE was a useful participatory research method to gain insight into perceived factors affecting rural children's physical activity behaviors.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Sallis J.F.
        • Cervero R.B.
        • Ascher W.
        • Henderson K.A.
        • Kraft M.K.
        • Kerr J.
        An ecological approach to creating active living communities.
        Annu Rev Public Health. 2006; 27: 297-322
        • Saelens B.E.
        • Handy S.L.
        Built environment correlates of walking: a review.
        Med Sci Sports Exerc. 2008; 40: S550-S566
        • Millington C.
        • Ward Thompson C.
        • Rowe D.
        • et al.
        Development of the Scottish Walkability Assessment Tool (SWAT).
        Health Place. 2009; 15: 474-481
        • Nelson M.C.
        • Gordon-Larsen P.
        • Song Y.
        • Popkin B.M.
        Built and social environments associations with adolescent overweight and activity.
        Am J Prev Med. 2006; 31: 109-117
        • Sallis J.F.
        • Owen N.
        Ecological models of health behavior.
        in: Glanz K. Rimer B.K. Lewis F.M. Health behavior and health education. 3rd ed. Jossey-Bass, San Francisco2002: 462-484
        • Yousefian A.
        • Hennessy E.
        • Umstattd R.
        • et al.
        Development of the Rural Active Living Assessment tools: measuring rural environments.
        Prev Med. 2010; 50: S86-S92
        • Boehmer T.K.
        • Lovegreen S.L.
        • Haire-Joshu D.
        • Brownson R.C.
        What constitutes an obesogenic environment in rural communities?.
        Am J Health Promot. 2006; 20: 411-421
        • Lutfiyya M.N.
        • Lipsky M.S.
        • Wisdom-Behounek J.
        • Inpanbutr-Martinkus M.
        Is rural residency a risk factor for overweight and obesity for U.S. children?.
        Obesity. 2007; 15: 2348-2356
        • National Association of Counties
        Rural obesity: strategies to support rural counties in building capacity.
        2008 (Washington DC)
        • Rural Sociological Society
        The changing face of rural America.
        Rural Sociological Society. 2006; 1
        • Johnson K.
        Demographic trends in rural and small town America.
        University of New Hampshire, Durham2006 (Report No.: 1)
        • Physical Activity Guidelines for Americans Committee
        Physical Activity Guidelines Advisory Committee Report.
        USDHHS, Washington DC2008
        • Tester J.M.
        The built environment: designing communities to promote physical activity in children.
        Pediatrics. 2009; 123: 1591-1598
        • Yousefian A.
        • Ziller E.
        • Swartz J.
        • Hartley D.
        Active living for rural youth: addressing physical inactivity in rural communities.
        J Public Health Manag Pract. 2009; 15: 223-231
        • Brug J.
        • van Lenthe F.J.
        • Kremers S.P.
        Revisiting Kurt Lewin: how to gain insight into environmental correlates of obesogenic behaviors.
        Am J Prev Med. 2006; 31: 525-529
        • Moore J.B.
        • Jilcott S.B.
        • Shores K.A.
        • Evenson K.R.
        • Brownson R.C.
        • Novick L.F.
        A qualitative examination of perceived barriers and facilitators of physical activity for urban and rural youth.
        Health Educ Res. 2010; 25: 355-367
        • Nasar J.L.
        Assessing perceptions of environments for active living.
        Am J Prev Med. 2008; 34: 357-363
        • Roosa M.W.
        • Jones S.
        • Tein J.Y.
        • Cree W.
        Prevention science and neighborhood influences on low-income children's development: theoretical and methodological issues.
        Am J Community Psychol. 2003; 31: 55-72
        • Roosa M.W.
        • White R.M.B.
        • Zeiders K.H.
        • Yun-Tein J.
        An examination of the role of perceptions in neighborhood research.
        J Community Psychol. 2009; 37: 327-341
        • McAllister C.
        • Green B.
        • Terry M.
        • Herman V.
        • Mulvey L.
        Parents, practitioners, and researchers: community-based participatory research with Early Head Start.
        Am J Public Health. 2003; 93: 1672-1679
        • Viswanathan M.
        • Ammerman A.
        • Eng E.
        • et al.
        Community-based participatory research: assessing the evidence.
        Evid Rep Technol Assess (Summ). 2004; : 1-8
        • Whitelaw S.
        • Baxendale A.
        • Bryce C.
        • MacHardy L.
        • Young I.
        • Witney E.
        “Settings”-based health promotion: a review.
        Health Promot Int. 2001; 16: 339-353
        • Borra S.T.
        • Kelly L.
        • Shirreffs M.B.
        • Neville K.
        • Geiger C.J.
        Developing health messages: qualitative studies with children, parents, and teachers help identify communications opportunities for healthful lifestyles and the prevention of obesity.
        J Am Diet Assoc. 2003; 103: 721-728
        • Economos C.D.
        • Irish-Hauser S.
        Community interventions: a brief overview and their application to the obesity epidemic.
        J Law Med Ethics. 2007; 35: 131-137
        • Nasar J.L.
        Influence of familiarity on responses to visual qualities of neighborhoods.
        Percept Mot Skills. 1980; 51: 635-642
      1. National Center for Education Statistics. Urban\rural classification systems. Institute of Education Services: US Department of Education. nces.ed.gov/.

        • Wang C.
        • Burris M.A.
        Photovoice: concept, methodology, and use for participatory needs assessment.
        Health Educ Behav. 1997; 24: 369-387
        • Wang C.C.
        Photovoice: a participatory action research strategy applied to women's health.
        J Womens Health. 1999; 8: 185-192
        • Hergenrather K.C.
        • Rhodes S.D.
        • Cowan C.A.
        • Bardhoshi G.
        • Pula S.
        Photovoice as community-based participatory research: a qualitative review.
        Am J Health Behav. 2009; 33: 686-698
        • Swinburn B.
        • Egger G.
        • Raza F.
        Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity.
        Prev Med. 1999; 29: 563-570
        • van der Horst K.
        • Oenema A.
        • Ferreira I.
        • et al.
        A systematic review of environmental correlates of obesity-related dietary behaviors in youth.
        Health Educ Res. 2007; 22: 203-226
        • Wendel-Vos W.
        • Droomers M.
        • Kremers S.
        • Brug J.
        • van Lenthe F.
        Potential environmental determinants of physical activity in adults: a systematic review.
        Obes Rev. 2007; 8: 425-440
        • Ferreira I.
        • van der Horst K.
        • Wendel-Vos W.
        • Kremers S.
        • van Lenthe F.J.
        • Brug J.
        Environmental correlates of physical activity in youth—a review and update.
        Obes Rev. 2007; 8: 129-154
        • Kirk S.F.
        • Penney T.L.
        • McHugh T.L.
        Characterizing the obesogenic environment: the state of the evidence with directions for future research.
        Obes Rev. 2009; 11: 109-117
        • Oleson J.J.
        • Breheny P.J.
        • Pendergast J.F.
        • Ryan S.
        • Litchfield R.
        Impact of travel distance on WISEWOMAN Intervention attendance for a rural population.
        Prev Med. 2008; 47: 565-569
        • Davison K.K.
        • Cutting T.M.
        • Birch L.L.
        Parents' activity-related parenting practices predict girls' physical activity.
        Med Sci Sports Exerc. 2003; 35: 1589-1595
        • Humpel N.
        • Owen N.
        • Leslie E.
        Environmental factors associated with adults' participation in physical activity: a review.
        Am J Prev Med. 2002; 22: 188-199
        • Duncan M.J.
        • Spence J.C.
        • Mummery W.K.
        Perceived environment and physical activity: a meta-analysis of selected environmental characteristics.
        Int J Behav Nutr Phys Act. 2005; 2: 11
        • De Bourdeaudhuij I.
        • Sallis J.F.
        • Saelens B.E.
        Environmental correlates of physical activity in a sample of Belgian adults.
        Am J Health Promot. 2003; 18: 83-92
        • Pikora T.J.
        • Giles-Corti B.
        • Knuiman M.W.
        • Bull F.C.
        • Jamrozik K.
        • Donovan R.J.
        Neighborhood environmental factors correlated with walking near home: using SPACES.
        Med Sci Sports Exerc. 2006; 38: 708-714
        • Saelens B.E.
        • Sallis J.F.
        • Black J.B.
        • Chen D.
        Neighborhood-based differences in physical activity: an environment scale evaluation.
        Am J Public Health. 2003; 93: 1552-1558
        • Casey A.A.
        • Elliott M.
        • Glanz K.
        • et al.
        Impact of the food environment and physical activity environment on behaviors and weight status in rural U.S. communities.
        Prev Med. 2008; 47: 600-604
        • Davison K.K.
        • Werder J.L.
        • Lawson C.T.
        Children's active commuting to school: current knowledge and future directions.
        Prev Chronic Dis. 2008; 5: A100
        • Heath G.W.
        • Brownson R.C.
        • Kruger J.
        • Miles R.
        • Powell K.E.
        • Ramsey L.T.
        The effectiveness of urban design and land use and transport policies and practices to increase physical activity: a systematic review.
        J Phys Act Health. 2006; 3: S55-S76
        • Kramer L.
        • Schwartz P.
        • Cheadle A.
        • et al.
        Promoting policy and environmental change using photovoice in the Kaiser Permanente Community Health Initiative.
        Health Promot Pract. 2010; 11: 332-339
        • Sallis J.F.
        • Hovell M.F.
        • Hofstetter C.R.
        • et al.
        Distance between homes and exercise facilities related to frequency of exercise among San Diego residents.
        Public Health Rep. 1990; 105: 179-185
        • Hoehner C.M.
        • Brennan Ramirez L.K.
        • Elliott M.B.
        • Handy S.L.
        • Brownson R.C.
        Perceived and objective environmental measures and physical activity among urban adults.
        Am J Prev Med. 2005; 28: 105-116
        • Ball K.
        • Jeffery R.W.
        • Crawford D.A.
        • Roberts R.J.
        • Salmon J.
        • Timperio A.F.
        Mismatch between perceived and objective measures of physical activity environments.
        Prev Med. 2008; 47: 294-298
        • Gebel K.
        • Bauman A.
        • Owen N.
        Correlates of non-concordance between perceived and objective measures of walkability.
        Ann Behav Med. 2009; 37: 228-238
        • Economic Research Service
        Rural America at a glance: 2005.
        U.S. Department of Agriculture, Washington DC2005
        • Humpel N.
        • Owen N.
        • Iverson D.
        • Leslie E.
        • Bauman A.
        Perceived environment attributes, residential location, and walking for particular purposes.
        Am J Prev Med. 2004; 26: 119-125
        • Wiggs I.
        • Brownson R.C.
        • Baker E.A.
        If you build it, they will come: lessons from developing walking trails in rural Missouri.
        Health Promot Pract. 2008; 9: 387-394
        • Levi J.
        • Vintner S.
        • Richardson L.
        • St. Laurent R.
        • Segal L.M.
        F as in Fat 2009: how obesity policies are failing in America.
        Trust for America's Health and the Robert Wood Johnson Foundation, Washington DC2009