title: Rural Food and Physical Activity Assessment Using an Electronic Tablet-Based Application, New York, 2013-2014.
abstract: BACKGROUND
  A community's built environment can influence health behaviors. Rural populations experience significant health disparities, yet built environment studies in these settings are limited. We used an electronic tablet-based community assessment tool to conduct built environment audits in rural settings. The primary objective of this qualitative study was to evaluate the usefulness of the tool in identifying barriers and facilitators to healthy eating and active living. The second objective was to understand resident perspectives on community features and opportunities for improvement.
  
  
  METHODS
  Participants were recruited from 4 rural communities in New York State. Using the tool, participants completed 2 audits, which consisted of taking pictures and recording audio narratives about community features perceived as assets or barriers to healthy eating and active living. Follow-up focus groups explored the audit experience, data captured, and opportunities for change.
  
  
  RESULTS
  Twenty-four adults (mean age, 69.4 y (standard deviation, 13.2 y), 6 per community, participated in the study. The most frequently captured features related to active living were related to roads, sidewalks, and walkable destinations. Restaurants, nontraditional food stores, and supermarkets were identified in the food environment in relation to the cost, quality, and selection of healthy foods available. In general, participants found the assessment tool to be simple and enjoyable to use.
  
  
  CONCLUSIONS
  An electronic tablet-based tool can be used to assess rural food and physical activity environments and may be useful in identifying and prioritizing resident-led change initiatives. This resident-led assessment approach may also be helpful for informing and evaluating rural community-based interventions.
authors.affiliation: Division of Nutritional Sciences, Cornell University, 412 Savage Hall, Ithaca, NY 14853. Telephone: 607-255-8250. Email: rs946@cornell.edu.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Seguin
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York.
authors.forename: Emily H
authors.initials: EH
authors.lastname: Morgan
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York.
authors.forename: Leah M
authors.initials: LM
authors.lastname: Connor
authors.affiliation: Division of Nutritional Sciences, Cornell University, Ithaca, New York.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Garner
authors.affiliation: Department of Health Research and Policy and Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, California.
authors.forename: Abby C
authors.initials: AC
authors.lastname: King
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Jylana L
authors.initials: JL
authors.lastname: Sheats
authors.affiliation: Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, California.
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Winter
authors.affiliation: School of Nutrition and Health Promotion, Arizona State University, Phoenix, Arizona.
authors.forename: Matthew P
authors.initials: MP
authors.lastname: Buman
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D001107:Architectural Accessibility; D002908:Chronic Disease / Q000517:prevention & control; D055812:Community-Based Participatory Research; D034201:Computers, Handheld / Q000706:statistics & numerical data*; D004779:Environment Design / Q000592:standards; D005260:Female; D017144:Focus Groups; D005500:Follow-Up Studies; D005522:Food Services / Q000191:economics / Q000592:standards; D040362:Geographic Information Systems; D015438:Health Behavior / Q000208:ethnology; D006293:Health Promotion / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009518:New York; D017063:Outcome Assessment, Health Care; D010781:Photography; D036301:Qualitative Research; D012111:Residence Characteristics; D012424:Rural Population; D012959:Socioeconomic Factors; D016138:Walking / Q000523:psychology