Social, environmental and policy determinants of physical activity in rural adults in Iowa

Background: Rural adults are less likely to meet physical activity (PA) recommendations than urban or suburban adults, and there is a need to understand what enables and inhibits this behavior among different domains (rather than just total PA or leisure time PA), especially in rural communities. Methods: A cross-sectional survey was administered in-person to 407 adults in two rural Iowa towns to examine PA in four domains (homecare, work, active living, and sport). Additionally, we measured potential environmental determinants such as barriers to exercise, social determinants such as receiving encouragement for exercise, and policy determinants such as attitudes towards using government funds for exercise facilities. Multiple regression analyses were conducted to examine the associations among these determinants and PA in each of those four domains. Results: A positive attitude towards zoning regulations that include walking paths was significantly associated with PA in the active living domain (p=0.024). While having friends who encourage exercise was positively associated with PA in active living (p=0.004) and sport (p<0.001), barriers to PA exhibited negative associations with these two domains. None of the environmental, social, or policy determinants were associated with PA in homecare or work domains. Conclusions: Environmental and social factors are associated with PA in active living and sport. Factors that influence PA appear to be domain-specific, and future studies should consider this when designing interventions. An intervention that improves the support of friends and policy attitudes is likely to increase active living and sport PA in rural adults.