title: Perspectives on physical activity and exercise among Appalachian youth.
abstract: BACKGROUND
  Most children in the United States receive far less physical activity (PA) than is optimal. In rural, under resourced areas of Appalachian Kentucky, physical inactivity rates are significantly higher than national levels. We sought to understand children's perceptions of PA, with the goal of developing culturally appropriate programming to increase PA.
  
  
  METHODS
  During 11 focus groups, we explored perspectives on PA among 63 Appalachian children, ages 8-17. Sessions were tape recorded, transcribed, content analyzed, and subjected to verification procedures.
  
  
  RESULTS
  Several perspectives on PA emerged among these rural Appalachian youth, including the clear distinction between PA (viewed as positive) and exercise (viewed as negative) and an emphasis on time and resource factors as barriers to adequate PA. Additional PA determinants expressed in the focus groups are similar to those of other populations. We include children's recommendations for appealing PA programs.
  
  
  CONCLUSIONS
  Appalachian and other rural residents contend with the loss of rural health advantages (due to declines in farming/other occupational and avocational transitions). At the same time, Appalachian residents have not benefitted from urban PA facilitators (sidewalks, recreational facilities, clubs and organized leisure activities). Addressing low PA levels requires extensive community input and creative programming.
authors.affiliation: Department of Health Behavior, University of Kentucky, Lexington, KY, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Swanson
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Schoenberg
authors.forename: Heather
authors.initials: H
authors.lastname: Erwin
authors.forename: Rian E
authors.initials: RE
authors.lastname: Davis
mesh_terms: D000293:Adolescent; D001061:Appalachian Region; D002648:Child; D055812:Community-Based Participatory Research; D004777:Environment; D015444:Exercise / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007629:Kentucky; D008297:Male; D009043:Motor Activity; D010465:Perception; D012424:Rural Population