Physical activity interventions among youth living in rural and remote areas: A systematic review

Objectives: Physical activity (PA) interventions have potential to improve health and social outcomes among youth. The aim of this study was to collate the evidence on the effectiveness of PA and sports -based interventions among youth living in rural and remote areas. Methods: We searched five databases and grey literature (HealthInfoNet). Search terms included PA, rural status, adolescents , and outcome measures. Studies were included if published in English, recruited 10- to 18-year olds, and were based in rural or remote communities (Modified Monash Model [MMM] area classification range of MMM 3-7). Quasi-experimental and pre -experimental and post -experimental PA interventions were included. Two authors evaluated the articles independently following the Preferred Reporting Items for Systematic Review and Meta -Analysis (PRISMA) guidelines, and relevant data were extracted. International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020199001). Results: Of the 11802 studies identified, 6 were included in the review. Most studies were excluded for not meeting MMM 3-7 criteria. Four of the included studies had sports-related interventions, and 2 had walking-based interventions. Outcomes included self-efficacy, mental health, and academic performance. One study reported a positive effect of PA on self-efficacy (beta = 0.26, p=0.018, odds ratio = 1.43 [95% confidence interval: 1.07-1.92]). Conclusion: Few community-based PA interventions have been evaluated in rural areas. There is a need for future evaluations in rural areas and include PA as an outcome measure. Implications for Public Health: The findings highlight the need for measurement of PA outcomes in PA interventions in rural and remote areas. The findings also highlight the need for research to utilise a standardised measure of rurality.