title: An Ecological Approach to Exploring Rural Food Access and Active Living for Families With Preschoolers.
abstract: OBJECTIVE
  To identify factors using the Ecological Model of Childhood Overweight related to accessing nutritious foods and physical activity opportunities from the perspectives of rural parents of preschoolers.
  
  
  METHODS
  A mixed-methods study using a quantitative survey (Active Where?) and qualitative interviews. Analyzed interview themes provided context to the survey results. The setting was Head Start centers, county human service offices, and Women, Infants, and Children Program sites in rural counties in the Midwest. Rural parents (n = 377) of preschoolers took part in the survey in 7 Midwestern states; 15 similar participants were interviewed from 1 of the states. Transcribed interviews were coded. Frequencies and chi-square tests were computed; significance was set at P < .05.
  
  
  RESULTS
  The Active Where? survey and interviews revealed that close proximity to recreation spaces and traffic safety issues influenced physical activity. For food access, close proximity to full service grocery stores did not influence access to healthy foods because respondents traveled to urban communities to purchase healthy foods.
  
  
  CONCLUSIONS
  Public transportation solutions and enhanced neighborhood safety are potential community-wide obesity prevention strategies in rural communities. However, interventions should be tailored to the community's stage of readiness. Strong social networks should be considered an asset for community change in these regions.
authors.affiliation: Center for Family Development, University of Minnesota Extension, St Paul, MN.
authors.forename: Brandy
authors.initials: B
authors.lastname: Buro
authors.affiliation: Department of Public Health, North Dakota State University, Fargo, ND. Electronic address: abby.gold@ndsu.edu.
authors.forename: Abby
authors.initials: A
authors.lastname: Gold
authors.affiliation: Health and Nutrition Institute, Michigan State University Extension, East Lansing, MI.
authors.forename: Dawn
authors.initials: D
authors.lastname: Contreras
authors.affiliation: Family Living Programs, University of Wisconsin-Extension, Madison, WI.
authors.forename: Ann L
authors.initials: AL
authors.lastname: Keim
authors.affiliation: Department of Nutritional Sciences, University of Connecticut, Storrs, CT.
authors.forename: Amy R
authors.initials: AR
authors.lastname: Mobley
authors.affiliation: Department of Counseling and Human Development, South Dakota State University, Brookings, SD.
authors.forename: Renee
authors.initials: R
authors.lastname: Oscarson
authors.affiliation: Department of Family and Consumer Sciences, K-State Research and Extension, Kansas State University, Manhattan, KS.
authors.forename: Paula
authors.initials: P
authors.lastname: Peters
authors.affiliation: Department of Human Nutrition, Kansas State University, Manhattan, KS.
authors.forename: Sandy
authors.initials: S
authors.lastname: Procter
authors.forename: Carol
authors.initials: C
authors.lastname: Smathers
mesh_terms: D000328:Adult; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005190:Family; D005260:Female; D005523:Food Supply / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008954:Models, Biological; D010290:Parents; D063766:Pediatric Obesity / Q000453:epidemiology / Q000517:prevention & control*; D012306:Risk; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D055815:Young Adult
keywords: ecological model; environment; obesity; preschool children; rural communities