Rural Libraries Promoting Walking and Walkability in Their Rural Communities

项目摘要 农村居民普遍缺乏有益于健康和减少收入差距所需的体育活动水平。 与缺乏身体活动有关的慢性疾病，如心血管疾病和某些癌症。的 社会生态模型将身体活动描述为涉及以下因素之间的动态和互惠互动： 个人，社会和社区因素;因此，旨在促进身体活动的干预措施 如果它们针对个人、社会和社区因素，就可能最有效。然而，缺乏 这种多层次的干预措施，特别是对农村社区。社区团体步行计划 广泛使用，因为通过个人和 社会因素旨在改善体育活动建筑环境的公民参与干预措施 对社区（建筑环境）和社会因素产生了有益的影响。然而，尽管双方 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， 针对这三个因素。此外，相对于城市社区，农村社区一般缺乏 提供必要的资源来执行公共卫生规划。农村创新公共卫生合作伙伴 社区是公共图书馆;然而，农村图书馆往往缺乏实施循证教育的能力。 编程.因此，迫切需要确定有效的多层次身体活动干预措施 促进定期体育活动，适用于农村社区，在农村社区是可行的。整体 该项目的目标是提高农村图书馆实施项目的能力， 基于组的步行（标准方法）与组合组的比较有效性研究- 基于步行加公民参与计划，旨在提高步行能力，以增加身体活动 农村成年人。我们还将确定程序效果和结果变化之间的关键中介。 我们将使用积极的偏差分析来评估计划的实施，以了解高风险的经验。 在个人层面上，关键结果的变化较小。我们将随机匹配16个城镇， 两个办法，共招收农村居民336人.将在基线和第六， 十二和二十四个月。我们的预期成果是建立农村图书馆的能力， 以证据为基础的计划，并确定了一个组合的群体为基础的步行加公民的放大效应， 参与计划。我们还希望能够确定自我效能感，社会支持，群体凝聚力， 和感知环境是重要的中介变量。最后，我们预计已经成功地证明了 综合方案的执行情况和包括成本分析在内的完整评估。的积极 这些结果影响是多级身体活动有效性的最强的确定性证据 针对农村居民的干预措施将证明其继续发展和未来广泛传播的合理性， 农村社区。

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.