Rural Libraries Promoting Walking and Walkability in Their Rural Communities

农村图书馆促进农村社区的步行和步行能力

基本信息

批准号：
10610482
负责人：
Cynthia Kay Perry
金额：
$ 67.74万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-04-15 至 2026-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10610482
关键词：
Address Adult Alcohol consumption Cardiovascular Diseases Chronic Chronic Disease Communities Cost Analysis Data Development Diet Disease Disparity Effectiveness Enrollment Environment Evaluation Evidence based program Funding Future Geography Goals Grant Health Health Benefit Health Promotion Individual Intervention Libraries Malignant Neoplasms Measurement Mediator Modeling Outcome Participant Physical activity Program Effectiveness Public Health Randomized Recommendation Reduce health disparities Research Resources Risk Factors Rural Rural Community Self Efficacy Social support Tobacco use Urban Community Walking World Health Organization built environment cardiovascular fitness cohesion community-level factor comparative comparative effectiveness study disparity reduction evidence base exercise intervention experience fitness health disparity implementation evaluation improved innovation intervention effect intervention program modifiable risk novel strategies physical inactivity process evaluation programs rural Americans rural dwellers social cohesion social factors therapy design walkability walking program webinar

项目摘要

PROJECT SUMMARY Rural residents generally lack the needed level of physical activity to benefit health and reduce disparities in chronic illness associated with physical inactivity, such as cardiovascular disease and certain cancers. The Socioecological Model describes physical activity as involving a dynamic and reciprocal interaction between individual, social, and community factors; therefore, interventions designed to promote physical activity are likely to be most effective if they target individual, social and community factors. However, there is a dearth of such multilevel interventions, particularly with rural communities. Community group-based walking programs are widely used because of the strong evidence base for increasing physical activity through individual and social factors. Civic engagement interventions aimed at improving the built environment for physical activity have had beneficial impacts on community (built environment) and social factors. However, while both the group-based walking and civic engagement interventions have been successful in rural communities, neither targets all three factors. Additionally, relative to urban communities, rural communities generally lack the necessary resources to implement public health programming. An innovative public health partner in rural communities is public libraries; however, rural libraries often lack the capacity to implement evidence-based programming. There is, therefore, a critical need to identify effective multilevel physical activity interventions that promote regular physical activity and are applicable to and feasible in rural communities. The overall objectives for this project are to increase rural libraries' capacity for program implementation and conduct a comparative effectiveness study of a group-based walking (standard approach) versus a combined group- based walking plus civic engagement program aimed at enhancing walkability to increase physical activity among rural adults. We will also identify key mediators between the program effects and change in outcomes. We will evaluate program implementation using a positive deviance analysis to understand experiences of high and low changers at the individual level on key outcomes. We will match and randomize 16 towns to one of the two approaches and enroll a total of 336 rural residents. Measurements will be taken at baseline and six, twelve and twenty-four months. Our expected outcomes are to have built rural libraries capacity to implement evidence-based programs and determined the amplified effects of a combined group-based walking plus civic engagement program. We also expect to have determined that self-efficacy, social support, group cohesion, and perceived environment are significant mediators. Finally, we anticipate having demonstrated successful implementation of the combined program and a completed evaluation including a cost analysis. The positive impact of these results is that strong definitive evidence of the effectiveness of a multilevel physical activity intervention targeting rural residents will justify its continued development and future broad dissemination to rural communities.

项目摘要农村居民通常缺乏所需的体育活动水平，以使健康受益并减少差异与身体不活跃有关的慢性疾病，例如心血管疾病和某些癌症。这社会生态模型将体育活动描述为涉及动态和相互互动个人，社会和社区因素；因此，旨在促进体育锻炼的干预措施是如果他们针对个人，社会和社区因素，可能是最有效的。但是，缺乏这样的多层次干预措施，特别是与农村社区的干预措施。基于社区小组的步行计划由于有强大的证据基础，可以通过个人增加体育锻炼和社会因素。公民参与干预措施旨在改善体育锻炼的建筑环境对社区（建筑环境）和社会因素产生了有益的影响。但是，尽管基于团体的步行和公民参与干预措施在农村社区取得了成功，也不是针对所有三个因素。此外，相对于城市社区，农村社区通常缺乏实施公共卫生计划的必要资源。农村的创新公共卫生合作伙伴社区是公共图书馆；但是，农村图书馆通常缺乏实施循证的能力编程。因此，肯定需要确定有效的多级体育活动干预措施这促进了定期的体育锻炼，适用于农村社区和可行。总体该项目的目标是提高农村图书馆实施计划的能力，并进行基于群体步行（标准方法）与组合组的比较有效性研究基于步行和公民参与计划旨在提高步行性以增加体育锻炼在农村成年人中。我们还将确定计划效应和结果变化之间的关键调解人。我们将使用积极的偏差分析评估计划实施，以了解高的经验在个人层面上，较低的改变者在关键结果上。我们将匹配并随机将16个城镇与其中一个两种方法，总共招募了336名农村居民。测量将在基线和六个十二和二十四个月。我们预期的结果是建立了农村图书馆的能力来实施基于循证的计划，并确定了基于小组的步行和CIVIC的结合效果参与计划。我们还希望确定自我效能感，社会支持，群体凝聚力，感知的环境是重要的调解人。最后，我们预计已经证明了成功联合计划的实施和完整的评估，包括成本分析。积极这些结果的影响是多级体育活动有效性的有力确定证据针对农村居民的干预措施将证明其持续的发展和未来的广泛传播是合理的农村社区。