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      Active living in rural Appalachia: Using the rural active living assessment (RALA) tools to explore environmental barriers

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          Abstract

          People residing in rural communities are more likely to be physically inactive and subsequently have elevated risks for chronic disease. Recent evidence has shown this could stem from environmental barriers, inadequate programming and policies directed at the promotion of physical activity (PA) in rural settings. The objective of this research was to assess active living features in rural towns and townships ( n = 16) across seven counties in northwestern North Carolina (NC). The study utilized the Town-Wide and Street Segment components of the Rural Active Living Assessment (RALA) as well as the 2014 American Community Survey results. The assessments were conducted in the summer of 2016 in the rural Appalachia region of NC. Using the RALA town-wide assessment scoring system (0 − 100), the range of scores was 18–84, with the mean being 50.06. Three towns had no sidewalks, nine towns had sidewalks on only one side of the main streets, and four had sidewalks on both sides of the main streets. One town was rated as highly walkable, seven towns as moderately walkable, five towns as moderately unwalkable, and three towns as highly unwalkable. The rural Appalachia region of NC offers unique topographic, geographic and environmental barriers to PA. However, our findings indicate many rural towns offer common PA amenities. Future research should utilize qualitative methods and a community-based participatory research approach to more fully understand the challenges with increasing PA in the rural and often isolated Appalachia communities.

          Highlights

          • Rural communities have increased rates of physical inactivity.

          • The built environment and recreational opportunities influence physical activity.

          • The Rural Active Living Assessment (RALA) tools help to evaluate these features.

          • Rural Appalachia offers unique topography for utilizing the RALA tools.

          • Future research should blend the use of RALA with qualitative research methods.

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          Most cited references41

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          Role of built environments in physical activity, obesity, and cardiovascular disease.

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            Neighborhood environment and physical activity among youth a review.

            Research examining the association between environmental attributes and physical activity among youth is growing. An updated review of literature is needed to summarize the current evidence base, and to inform policies and environmental interventions to promote active lifestyles among young people. A literature search was conducted using the Active Living Research (ALR) literature database, an online database that codes study characteristics and results of published papers on built/social environment and physical activity/obesity/sedentary behavior. Papers in the ALR database were identified through PubMed, Web of Science, and SPORTDiscus using systematically developed and expert-validated search protocols. For the current review, additional inclusion criteria were used to select observational, quantitative studies among youth aged 3-18 years. Papers were categorized by design features, sample characteristics, and measurement mode. Relevant results were summarized, stratified by age (children or adolescents) and mode of measurement (objective or perceived) for environmental attributes and physical activity. Percentage of significant results was calculated. Mode of measurement greatly influenced the consistency of associations between environmental attributes and youth physical activity. For both children and adolescents, the most consistent associations involved objectively measured environmental attributes and reported physical activity. The most supported correlates for children were walkability, traffic speed/volume, access/proximity to recreation facilities, land-use mix, and residential density. The most supported correlates for adolescents were land-use mix and residential density. These findings support several recommendations for policy and environmental change from such groups as the IOM and National Physical Activity Plan. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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              Social capital and the built environment: the importance of walkable neighborhoods.

              I sought to examine whether pedestrian-oriented, mixed-use neighborhoods encourage enhanced levels of social and community engagement (i.e., social capital). The study investigated the relationship between neighborhood design and individual levels of social capital. Data were obtained from a household survey that measured the social capital of citizens living in neighborhoods that ranged from traditional, mixed-use, pedestrian-oriented designs to modern, car-dependent suburban subdivisions in Galway, Ireland. The analyses indicate that persons living in walkable, mixed-use neighborhoods have higher levels of social capital compared with those living in car-oriented suburbs. Respondents living in walkable neighborhoods were more likely to know their neighbors, participate politically, trust others, and be socially engaged. Walkable, mixed-use neighborhood designs can encourage the development of social capital.
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                Author and article information

                Contributors
                Journal
                Prev Med Rep
                Prev Med Rep
                Preventive Medicine Reports
                Elsevier
                2211-3355
                22 November 2017
                December 2017
                22 November 2017
                : 8
                : 261-266
                Affiliations
                Department of Health and Exercise Science, Appalachian State University, Boone, NC, United States
                Author notes
                [* ]Corresponding author at: Appalachian State University, Holmes Convocation Center, 111 Rivers Street, Boone, NC 28608, United States.Appalachian State UniversityHolmes Convocation Center111 Rivers StreetBooneNC28608United States hegeba@ 123456appstate.edu
                Article
                S2211-3355(17)30169-9
                10.1016/j.pmedr.2017.11.007
                5704102
                29201632
                fa8aed36-320c-4333-95cf-a1c4b18e840f
                © 2017 Published by Elsevier Inc.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 21 June 2017
                : 11 November 2017
                : 20 November 2017
                Categories
                Regular Article

                rural active living assessment (rala),health disparities,physical activity,rural appalachia

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