Formative research conducted in rural Appalachia to inform a community physical activity intervention.
OBJECTIVE
Despite the well-established benefits of physical activity (PA), most Americans, especially those in rural, traditionally underserved areas, engage in considerably less PA than recommended. This study examines perceived barriers to and facilitators of PA and promising organized PA programs among rural Appalachians.


METHODS
Eight focus groups and seven group key informant interviews were conducted.


METHODS
This study was conducted in eastern Kentucky, in central Appalachia.


METHODS
One hundred and fourteen rural Appalachian residents (74% female, 91% white) participated.


METHODS
Open-ended, semistructured, and structured questions regarding perceptions of, barriers to/facilitators of, and examples of successful/failed PA programs were asked.


METHODS
Qualitative data analysis was conducted, including codebook development and steps taken to ensure rigor and transferability. Interrater reliability was over 94%.


RESULTS
In addition to barriers that are consistent with those found in other populations, rural Appalachian residents indicated that travel time, family commitments, and inadequate community resources undermine PA. Suggested avenues to increase PA include partnership with churches and the U.S. Department of Agriculture's Cooperative Extension Service; programs that include families, are well advertised, and focus on health rather than appearance; and, underlying all suggestions, culturally relevant yet nonstereotyping activities.


CONCLUSIONS
When developing PA interventions in rural Appalachia, it is important to employ community-based participatory approaches that leverage unique assets of the population and show potential in overcoming challenges to PA.
Department of Applied Health Sciences, Indiana State University, Terre Haute, IN 47807, USA. tina.kruger@indstate.edu
Tina M
TM
Kruger
Mark
M
Swanson
Rian E
RE
Davis
Sherry
S
Wright
Katie
K
Dollarhide
Nancy E
NE
Schoenberg
D000293:Adolescent; D000328:Adult; D001061:Appalachian Region; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D007629:Kentucky; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D036301:Qualitative Research; D012111:Residence Characteristics; D018570:Risk Assessment; D012424:Rural Population; D040241:Social Marketing; D011795:Surveys and Questionnaires; D013995:Time; D014481:United States; D055815:Young Adult