title: Active living for rural children: community perspectives using PhotoVOICE.
abstract: 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.
  
  
  OBJECTIVE
  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.
authors.affiliation: National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA. erin.hennessy@nih.gov
authors.forename: Erin
authors.initials: E
authors.lastname: Hennessy
authors.forename: Vivica I
authors.initials: VI
authors.lastname: Kraak
authors.forename: Raymond R
authors.initials: RR
authors.lastname: Hyatt
authors.forename: Julia
authors.initials: J
authors.lastname: Bloom
authors.forename: Mark
authors.initials: M
authors.lastname: Fenton
authors.forename: Colby
authors.initials: C
authors.lastname: Wagoner
authors.forename: Christina D
authors.initials: CD
authors.lastname: Economos
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D016134:Organizational Policy; D010781:Photography; D011203:Poverty / Q000706:statistics & numerical data; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012424:Rural Population; D012574:Schools / Q000706:statistics & numerical data; D057185:Sedentary Behavior; D014481:United States