Physical activity barriers and assets in rural appalachian kentucky: A mixed-methods study

Natalie Jones, Deirdre Dlugonski, Rachel Gillespie, Emily Dewitt, Joann Lianekhammy, Stacey Slone, Kathryn M. Cardarelli

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Obesity is an increasing public health concern in the U.S. and a contributor to chronic illness, with trends revealing a rise in adult obesity and chronic disease rates among the most vulnerable and disadvantaged populations, including those in rural communities. A mixed-methods approach was used to examine perspectives on perceived physical activity barriers, resources, and level of community support. Researchers utilized the socioecological model to examine the multiple domains that support physical activity in rural Appalachia. The present study focuses on baseline data, including a cohort survey to assess physical activity, health status, and barriers to physical activity, and five focus groups with elected community leaders, community residents, members, and key stakeholders to assess perspectives on physical activity barriers and resources within the county. The cohort survey sample (N = 152) reported a median of 6 barriers (range 0–13) to participating in at least 30 min of physical activity daily. The qualitative analysis yielded three overarching themes related to physical activity participation: lack of motivation, physical environment, and cultural barriers. This mixed-methods study revealed the challenges and perceptions among rural residents across the socioecological model when assessing physical inactivity. Findings can be used to tailor future interventions focused on expanding social support, designing infrastructure, and creating policies that promote physical activity.

Original languageEnglish
Article number7646
JournalInternational Journal of Environmental Research and Public Health
Issue number14
StatePublished - Jul 2 2021

Bibliographical note

Funding Information:
Acknowledgments: We gratefully acknowledge the contributions to this study by Jennifer Hunter, Alison Gustafson, the Martin County Cooperative Extension Office, and the members of the Martin County Health Coalition for their continued support of this project. We would like to thank Caroline Blincoe, Haley Copeland, and Cora Teets (UK graduate students) and Grace Anderson (UK undergraduate student) for their assistance with data collection and data entry. This research utilized the Center for Clinical and Translational Science REDCap tool, supported by the NIH National Center for Advancing Translational Sciences through grant number UL1TR001998. The content is solely for the responsibility of the authors and does not necessarily represent the official views of the NIH.

Funding Information:
Funding: This study was funded by Cooperative Agreement 1NU58DP0065690100 by the Centers for Disease Control and Prevention (CDC) Division of Nutrition, Physical Activity, and Obesity (DNPAO).

Publisher Copyright:
© 2021 by the authors. Licensee MDPI, Basel, Switzerland.


  • Community-based participatory research
  • Physical activity
  • Rural
  • Socioecological model

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


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