Rural Libraries Promoting Walking and Walkability in Their Rural Communities

项目总结 农村居民普遍缺乏有益于健康和缩小贫富差距所需的体育活动水平 与缺乏运动有关的慢性病，如心血管疾病和某些癌症。这个 社会生态学模型将身体活动描述为一种动态的、相互的相互作用 个人、社会和社区因素；因此，旨在促进体力活动的干预措施有 如果他们针对个人、社会和社区因素，可能是最有效的。然而，目前还缺乏 这种多层次的干预措施，特别是对农村社区的干预。基于社区团体的步行计划 被广泛使用是因为有强有力的证据表明，通过个人和 社会因素。旨在改善体力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，虽然这两个 基于群体的步行和公民参与干预在农村社区都取得了成功， 针对所有这三个因素。此外，相对于城市社区，农村社区普遍缺乏 实施公共卫生规划所需的资源。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的能力 编程。因此，迫切需要确定有效的多层次体力活动干预措施。 促进有规律的体育活动，适用于农村社区并在农村社区可行。整体而言 该项目的目标是提高农村图书馆实施计划的能力，并开展 基于小组步行(标准方法)与联合小组步行的有效性比较研究-- 以步行为基础的公民参与计划，旨在增强步行能力以增加体力活动 在农村成年人中。我们还将确定项目效果和结果变化之间的关键调节因素。 我们将使用正偏差分析来评估计划的实施情况，以了解High 以及在个人层面上对关键结果的低变化者。我们将把16个城镇与 两种方式共招收336名农村居民。测量将在基线和六点进行， 十二又二十四个月。我们的预期成果是建立农村图书馆的能力，以实施 循证项目，并确定了基于团体的步行和公民步行相结合的放大效果 参与计划。我们还期望确定自我效能感、社会支持、团体凝聚力、 和感知环境是显著的中介变量。最后，我们预计已经证明了成功 综合方案的实施情况和完成的评估，包括成本分析。积极的一面 这些结果的影响是，多层次体力活动有效性的强有力的确凿证据 针对农村居民的干预将证明其继续发展和未来广泛传播是合理的 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.