ALTERING BARRIERS TO PHYSICAL ACTIVITY AND EXERCISE IN RURAL KANSAS THROUGH EDUCATION AND EXERCISE INTERVENTIONS

Abstract

Rural Americans (RA) report significantly higher percentages of obesity, chronic disease, and cognitive decline than urban-dwelling Americans. However, rural individuals face different barriers to physical activity and exercise than their urban counterparts. PURPOSE: The purpose of this study was to increase physical activity among middle-aged and older adults living in rural Kansas, increase Alzheimer’s disease knowledge through risk reduction education, and determine the unique barriers to physical activity and exercise in this rural Kansas cohort. METHODS: Sixty-nine rural dwelling adults (17 male, 52 female; mean age 63.9±7.95 years) participated in a 10-week community-based education and exercise intervention program in rural Kansas. Baseline physical fitness (Queen’s College Step Test, blood pressure), balance and muscular endurance (30-second chair sit and stand), quality of life (OPQOL), healthy lifestyle survey (HLPLII), and Alzheimer’s disease knowledge (ADKS) assessments were collected prior to participation. Subjects were randomly assigned to one of three groups and participated in either 10 weeks of education (ED), education and exercise (EDEX), or were assigned to the control group (CON). Sixty-nine (69) participants completed the 10-week study and completed follow-up assessments. A cohort of subjects (N=23) participated in interviews throughout the course of the study. Repeated measures ANCOVAs were conducted to determine differences, if any, in the dependent variables before and after interventions (p<.05). Small group interviews were conducted throughout the study period to assess views and attitudes toward exercise and physical activity and determine perceived and actual barriers faced by rural Kansas adults. Interview response frequencies and differences, if any, were determined for barriers to, benefits of and opportunities to participate in exercise and physical activity. RESULTS: The EDEX group acquired significantly more steps on average throughout the study period than the CON group, but not significantly more than the ED group (p<.05). Chair test scores improved significantly for the EDEX group compared to both the ED and CON group (p<.05). Weight and waist to hip ratio improvements did not differ significantly between groups. Scores on the HLPLII, both overall and the physical activity component alone, improved significantly for the EDEX group compared to both ED and CON groups, p<.05). Quality of life scores (OPQOL) were significantly higher for the CON group than the ED and EDEX group (p<.05). Time, lack of motivation and injury or illness were the most commonly reported barriers to exercise, while brain health and overall health were the most commonly reported benefits of exercise. Rural Kansas adults were able to successfully distinguish between physical activity and exercise and identify numerous opportunities for exercise and physical within the surrounding rural communities. Response frequencies did not differ significantly between groups (p<.05).