Environmental influences on children's physical activity and food choices in a rural Oregon county

Background – Despite higher rates of childhood obesity in rural areas, little is known about the effect of the rural environment on children's physical activity and food choices. Using community-based participatory research, community-university collaborators conducted an assessment of rural schools and communities to identify factors that influenced children's physical activity and diets. This research was the first phase of a project to prevent childhood obesity in a rural Oregon county.

Methods – Semi-structured interviews with school and community leaders; focus groups with elementary school teachers, students, and parents; a school self-assessment using the Centers for Disease Control's School Health Index; photovoice involving high school students; and community observation provided data that were triangulated to produce a composite of environmental barriers and assets.

Results – Key barriers to physical activity included limited recreational facilities and equipment, street-related hazards, few lifetime or non-competitive activity programs, fear of strangers, and insufficient physical education. Barriers to healthy eating included limited access to healthy foods in small communities, perceived high cost of healthy foods, busy lifestyles (which made eating convenience foods a common practice), many fast food entrees served at schools, candy and other “sweets” used as incentives for students during school, and convenience stores located near most schools. Community assets included strong support for youth sports, the natural environment (forests, rivers, reservoirs), the popularity of gardening, and the presence of agriculture, especially orchards.

Conclusions – This study provides data on a neglected area of research, namely environmental determinants of rural childhood obesity, and suggests targets for focused intervention.