title: Individual, social and environmental factors and their association with weight in rural-dwelling women.
abstract: OBJECTIVE
  Obesity is a major public health concern and women living in rural settings present a high-risk group. With contributing factors poorly explored, we evaluated their association with weight in rural Australian women.
  
  
  METHODS
  Women aged 18-50 years of any body mass index (BMI) were recruited between October 2012 and April 2013 as part of a larger, randomised controlled trial within 42 rural towns. Measured weight and height as well as self-reported measures of individual health, physical activity, dietary intake, self-management, social support and environmental perception were collected. Statistical analysis included linear regression for continuous variables as well as chi-squared and logistic regression for categorical variables with all results adjusted for clustering.
  
  
  RESULTS
  649 women with a mean baseline age and BMI of 39.6±6.7 years and 28.8±6.9 kg/m2respectively, were studied. Overall, 65% were overweight or obese and 60% overall reported recent weight gain. There was a high intention to self-manage weight, with 68% attempting to lose weight recently, compared to 20% of women reporting health professional engagement for weight management. Obese women reported increased weight gain, energy intake, sitting time and prevalence of pre-existing health conditions. There was an inverse relationship between increased weight and scores for self-management, social support and health environment perception.
  
  
  CONCLUSIONS
  Many women in rural communities reported recent weight gain and were attempting to self-manage their weight with little external support. Implications for public health: Initiatives to prevent weight gain require a multifaceted approach, with self-management strategies and social support in tandem with building a positive local environmental perception.
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.
authors.forename: Cheryce L
authors.initials: CL
authors.lastname: Harrison
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.|Endocrinology and Diabetes Units, Monash Health, Victoria.
authors.forename: Helena J
authors.initials: HJ
authors.lastname: Teede
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.
authors.forename: Samantha
authors.initials: S
authors.lastname: Kozica
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.|Endocrinology and Diabetes Units, Monash Health, Victoria.
authors.forename: Sophia
authors.initials: S
authors.lastname: Zoungas
authors.affiliation: Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Victoria.|Department of Nutrition and Dietetics, Monash University, Victoria.
authors.forename: Catherine B
authors.initials: CB
authors.lastname: Lombard
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D015992:Body Mass Index; D001835:Body Weight; D004038:Diet, Reducing; D004777:Environment; D015444:Exercise / Q000502:physiology*; D005260:Female; D015438:Health Behavior; D006293:Health Promotion; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012423:Rural Health; D012424:Rural Population; D012931:Social Environment; D012944:Social Support
keywords: environment; health behaviours; rural; social support; weight; women