A community-based approach to promoting walking in rural areas

Background: Ecologic models are often recommended to promote physical activity, yet sparse data exist on their effectiveness. Design: A quasi-experimental design examined changes in walking behavior in six rural intervention communities in the Missouri "bootheel" region and in six comparison communities in Arkansas and Tennessee. Setting/Participants: The communities ranged in population from 2399 to 17,642; interventions focused on adults aged greater than or equal to18 years. Intervention: Interventions were developed with community input and included individually tailored newsletters, interpersonal activities that stressed social support, and community-wide events such as walk-a-thons. Main Outcome Measures: Primary outcomes were rates of walking-trail use, total number of minutes walked in the past week, and total minutes walked for exercise. Results: Among persons who used trails at baseline (16.9% of the total population), 32.1% reported increases in physical activity since they began using the trail. From community-wide samples, two subgroups indicated a positive net change in rates of 7-day total walking: people with high school degrees or less and people living in households with annual incomes of less than or equal to$20,000. However, no studied group showed a statistically significant net intervention effect. Conclusions: Although there was an increase in the rate of walking-trail rise, a community-wide change in walking rates in rural communities was not documented. Results of this study should provide guidance for future projects. (C) 2004 American journal of Preventive Medicine.