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A Systematic Review of Rural, Theory-based Physical Activity Interventions

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Objectives: This systematic review synthesized the scientific literature on theory-based physical activity (PA) interventions in rural populations. Methods: PubMed, PsycINFO, and Web of Science databases were searched to identify studies with a rural study sample, PA as a primary outcome, use of a behavioral theory or model, randomized or quasi-experimental research design, and application at the primary and/or secondary level of prevention. Results: Thirty-one studies met our inclusion criteria. The Social Cognitive Theory (N = 14) and Transtheoretical Model (N = 10) were the most frequently identified theories; however, most intervention studies were informed by theory but lacked higher-level theoretical application and testing. Interventions largely took place in schools (N = 10) and with female-only samples (N = 8). Findings demonstrated that theory-based PA interventions are mostly successful at increasing PA in rural populations but require improvement. Conclusions: Future studies should incorporate higher levels of theoretical application, and should explore adapting or developing rural-specific theories. Study designs should employ more rigorous research methods to decrease bias and increase validity of findings. Follow-up assessments to determine behavioral maintenance and/or intervention sustainability are warranted. Finally, funding agencies and journals are encouraged to adopt rural-urban commuting area codes as the standard for defining rural.


Document Type: Research Article

Affiliations: 1: School of Education, Peru State College, Peru, NE;, Email: [email protected] 2: Department of Health, Human Performance, & Recreation, Robbins College of Health and Human Sciences, Baylor University, Waco, TX 3: Department of Preventative Medicine, John D. Bower School of Population Health, Department of Pediatrics, School of Medicine, School of Graduate Studies in Health Sciences, and Myrlie Evers-Williams Institute for the Elimination of Health Disparities, University of Mississippi Medical Center, Jackson, MS 4: Director of Wellness, Baylor University, Waco, TX 5: Wake Forest School of Medicine, Department of Family & Community Medicine and Department of Epidemiology & Prevention, Winston-Salem, NC

Publication date: May 1, 2017

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  • The American Journal of Health Behavior seeks to improve the quality of life through multidisciplinary health efforts in fostering a better understanding of the multidimensional nature of both individuals and social systems as they relate to health behaviors.

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