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Built Environments and Active Living in Rural and Remote Areas: a Review of the Literature

Current Obesity Reports volume 4, pages 484–493 (2015)Cite this article

Abstract

Rural children and adults are more likely to have obesity than their urban counterparts even after adjustment for individual-level behaviors, suggesting that rural environments may promote obesity. The rural built environment may be an important area of research that can help us understand rural–urban disparities in obesity. The purpose of this review is to summarize the rural built environment and active living literature, and to address key issues, gaps, and observations in the field. A literature review was conducted in spring 2015 to identify research published from 2000 to 2015. Our review suggests that limited active living built environments in rural communities and unique rural barriers to physical activity may contribute to a higher prevalence of obesity compared to urban populations. More empirical research is needed to build the evidence-base for the association between rural built environments, active living, and obesity. School- and community-based policies that expand active living opportunities in rural areas should also be closely examined.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Lutfiyya MN, Lipsky MS, Wisdom-Behounek J, Inpanbutr-Martinkus M. Is rural residency a risk factor for overweight and obesity for U.S. children? Obesity (Silver Spring). 2007;15(9):2348–56.

    Article  Google Scholar 

  2. Patterson PD, Moore CG, Probst JC, Shinogle JA. Obesity and physical inactivity in rural America. J Rural Health. 2004;20(2):151–9.

    Article  PubMed  Google Scholar 

  3. Jackson JE, Doescher MP, Jerant AF, Hart LG. A national study of obesity prevalence and trends by type of rural county. J Rural Health. 2005;21(2):140–8.

    Article  PubMed  Google Scholar 

  4. Befort CA, Nazir N, Perri MG. Prevalence of obesity among adults from rural and urban areas of the United States: findings from NHANES (2005–2008). J Rural Health. 2012;28(4):392–7.

    PubMed Central  Article  PubMed  Google Scholar 

  5. Davis AM, Bennett KJ, Befort C, Nollen N. Obesity and related health behaviors among urban and rural children in the United States: data from the National Health and Nutrition Examination Survey 2003–2004 and 2005–2006. J Pediatr Psychol. 2011;36(6):669–76.

    PubMed Central  Article  PubMed  Google Scholar 

  6. Kenney MK, Wang J, Iannotti R. Residency and racial/ethnic differences in weight status and lifestyle behaviors among US youth. J Rural Health. 2014;30(1):89–100.

    Article  PubMed  Google Scholar 

  7. Wilcox S, Castro C, King AC, Housemann R, Brownson RC. Determinants of leisure time physical activity in rural compared with urban older and ethnically diverse women in the United States. J Epidemiol Community Health. 2000;54(9):667–72.

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  8. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. National Center for Health Statistics, 2014.

  9. Moore JB, Brinkley J, Crawford TW, Evenson KR, Brownson RC. Association of the built environment with physical activity and adiposity in rural and urban youth. Prev Med. 2013;56(2):145–8. Authors analyzed data for 284 middle school youth from a rural county and an adjacent urbanized area to examine differences in body-mass index (BMI) and moderate-to-vigorous physical activity, and perceived and objective measures of environmental supports for physical activity.

    Article  PubMed  Google Scholar 

  10. Fan JX, Wen M, Kowaleski-Jones L. Rural–urban differences in objective and subjective measures of physical activity: findings from the National Health and Nutrition Examination Survey (NHANES) 2003–2006. Prev Chron Dis. 2014;11:E141. Authors examined rural–urban differences in four objective physical activity measures and four subjective measures (total, leisure, household, and transportation) in a nationally representative sample of adults in the National Health and Nutrition Examination Survey (NHANES) 2003–2006.

    Google Scholar 

  11. United States Department of Agriculture ERS. Rural economy and population—population and migration 2014. November 4, 2014. Available from: http://www.ers.usda.gov/topics/rural-economy-population/population-migration.aspx.

  12. Yousefian A, Ziller E, Swartz J, Hartley D. Active living for rural youth: addressing physical inactivity in rural communities. J Public Health Manag Pract. 2009;15(3):223–31.

    Article  PubMed  Google Scholar 

  13. Boehmer TK, Lovegreen SL, Haire-Joshu D, Brownson RC. What constitutes an obesogenic environment in rural communities? Am J Health Promot. 2006;20(6):411–21.

    Article  PubMed  Google Scholar 

  14. Liu JH, Jones SJ, Sun H, Probst JC, Merchant AT, Cavicchia P. Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: an urban and rural comparison. Child Obes. 2012;8(5):440–8.

    PubMed  Google Scholar 

  15. Doescher MP, Lee C, Berke EM, Adachi-Mejia AM, Lee CK, Stewart O, et al. The built environment and utilitarian walking in small U.S. towns. Prev Med. 2014;69:80–6.

    Article  PubMed  Google Scholar 

  16. Sallis JF, Glanz K. The role of built environments in physical activity, eating, and obesity in childhood. Future Child. 2006;16(1):89–108.

    Article  PubMed  Google Scholar 

  17. Sallis JF, Cervero RB, Ascher W, Henderson KA, Kraft MK, Kerr J. An ecological approach to creating active living communities. Annu Rev Public Health. 2006;27:297–322.

    Article  PubMed  Google Scholar 

  18. Bors P, Dessauer M, Bell R, Wilkerson R, Lee J, Strunk SL. The active living by design national program: community initiatives and lessons learned. Am J Prev Med. 2009;37(6 Suppl 2):S313–21.

    Article  PubMed  Google Scholar 

  19. Committee on Physical Activity Health, Transportation and Land Use, Transportation Research Board, Institute of Medicine of the National Academies. Does the built environment influence physical activity?: examining the evidence. Washington, DC: National Academy of Sciences, 2005.

  20. Wakefield J. Fighting obesity through the built environment. Environ Health Perspect. 2004;112(11):A616–8.

    PubMed Central  Article  PubMed  Google Scholar 

  21. Weich S, Burton E, Blanchard M, Prince M, Sproston K, Erens B. Measuring the built environment: validity of a site survey instrument for use in urban settings. Health Place. 2001;7(4):283–92.

    CAS  Article  PubMed  Google Scholar 

  22. Keegan TH, Hurley S, Goldberg D, Nelson DO, Reynolds P, Bernstein L, et al. The association between neighborhood characteristics and body size and physical activity in the California teachers study cohort. Am J Public Health. 2012;102(4):689–97.

    PubMed Central  Article  PubMed  Google Scholar 

  23. Yousefian A, Hennessy E, Umstattd MR, Economos CD, Hallam JS, Hyatt RR, et al. Development of the rural active living assessment tools: measuring rural environments. Prev Med. 2010;50 Suppl 1:S86–92.

    Article  PubMed  Google Scholar 

  24. Giles-Corti B, Macintyre S, Clarkson JP, Pikora T, Donovan RJ. Environmental and lifestyle factors associated with overweight and obesity in Perth, Australia. Am J Health Promot. 2003;18(1):93–102.

    Article  PubMed  Google Scholar 

  25. Ewing R, Schmid T, Killingsworth R, Zlot A, Raudenbush S. Relationship between urban sprawl and physical activity, obesity, and morbidity. Am J Health Promot. 2003;18(1):47–57.

    Article  PubMed  Google Scholar 

  26. Catlin TK, Simoes EJ, Brownson RC. Environmental and policy factors associated with overweight among adults in Missouri. Am J Health Promot. 2003;17(4):249–58.

    Article  PubMed  Google Scholar 

  27. Handy SL, Cao X, Mokhtarian PL. The causal influence of neighborhood design on physical activity within the neighborhood: evidence from northern California. Am J Health Promot. 2008;22(5):350–8.

    Article  PubMed  Google Scholar 

  28. Saelens BE, Sallis JF, Black JB, Chen D. Neighborhood-based differences in physical activity: an environment scale evaluation. Am J Public Health. 2003;93(9):1552–8.

    PubMed Central  Article  PubMed  Google Scholar 

  29. Ewing R, Brownson RC, Berrigan D. Relationship between urban sprawl and weight of United States youth. Am J Prev Med. 2006;31(6):464–74.

    PubMed Central  Article  PubMed  Google Scholar 

  30. Ferdinand AO, Sen B, Rahurkar S, Engler S, Menachemi N. The relationship between built environments and physical activity: a systematic review. Am J Public Health. 2012;102(10):e7–13.

    Article  PubMed  Google Scholar 

  31. Sallis JF, Glanz K. Physical activity and food environments: solutions to the obesity epidemic. Milbank Q. 2009;87(1):123–54.

    PubMed Central  Article  PubMed  Google Scholar 

  32. Hennessy E, Kraak VI, Hyatt RR, Bloom J, Fenton M, Wagoner C, et al. Active living for rural children: community perspectives using PhotoVOICE. Am J Prev Med. 2010;39(6):537–45.

    Article  PubMed  Google Scholar 

  33. Umstattd MR, Baller SL, Hennessy E, Hartley D, Economos CD, Hyatt RR, et al. Development of the Rural Active Living Perceived Environmental Support Scale (RALPESS). J Phys Act Health. 2012;9(5):724–30.

    PubMed  Google Scholar 

  34. Greenhalgh T, Peacock R. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. BMJ. 2005;331(7524):1064–5.

    PubMed Central  Article  PubMed  Google Scholar 

  35. Hart LG, Larson EH, Lishner DM. Rural definitions for health policy and research. Am J Public Health. 2005;95(7):1149–55.

    PubMed Central  Article  PubMed  Google Scholar 

  36. Coburn A, MacKinney AC, McBride T, Mueller KJ, Slifkin RT, Wakefield M. Choosing rural definitions: implications for health policy. Rural Policy Research Institute Health Panel, 2007.

  37. Economic Research Service. Rural–urban commuting area codes: United States Department of Agriculture; 2014 [cited 1 June 2015]. Available from: http://www.ers.usda.gov/data-products/rural–urban-commuting-area-codes.aspx.

  38. Health Resources and Services Administration. Defining the rural population: U.S. Department of Health and Human Services; [cited 1 June 2015]. Available from: http://www.hrsa.gov/ruralhealth/policy/definition_of_rural.html.

  39. United States Census Bureau. Urban and rural classification: United States Census Bureau; [cited 1 June 2015]. Available from: https://www.census.gov/geo/reference/urban–rural.html.

  40. Babey SH, Hastert TA, Yu H, Brown ER. Physical activity among adolescents. When do parks matter? Am J Prev Med. 2008;34(4):345–8.

    Article  PubMed  Google Scholar 

  41. Loucaides CA, Plotnikoff RC, Bercovitz K. Differences in the correlates of physical activity between urban and rural Canadian youth. J Sch Health. 2007;77(4):164–70.

    Article  PubMed  Google Scholar 

  42. Parks SE, Housemann RA, Brownson RC. Differential correlates of physical activity in urban and rural adults of various socioeconomic backgrounds in the United States. J Epidemiol Community Health. 2003;57(1):29–35.

    PubMed Central  CAS  Article  PubMed  Google Scholar 

  43. Zhang X, Holt JB, Lu H, Onufrak S, Yang J, French SP, et al. Neighborhood commuting environment and obesity in the United States: an urban–rural stratified multilevel analysis. Prev Med. 2014;59:31–6.

    CAS  Article  PubMed  Google Scholar 

  44. Hartley D. Rural health disparities, population health, and rural culture. Am J Public Health. 2004;94(10):1675–8.

    PubMed Central  Article  PubMed  Google Scholar 

  45. Zieff SG, Hipp JA, Eyler AA, Kim MS. Ciclovia initiatives: engaging communities, partners, and policy makers along the route to success. J Public Health Manag Pract. 2013;19(3 Suppl 1):S74–82.

    PubMed Central  Article  PubMed  Google Scholar 

  46. Green CG, Klein EG. Promoting active transportation as a partnership between urban planning and public health: the Columbus healthy places program. Public Health Rep. 2011;126 Suppl 1:41–9.

    PubMed Central  PubMed  Google Scholar 

  47. Burke NM, Chomitz VR, Rioles NA, Winslow SP, Brukilacchio LB, Baker JC. The path to active living: physical activity through community design in Somerville, Massachusetts. Am J Prev Med. 2009;37(6 Suppl 2):S386–94.

    Article  PubMed  Google Scholar 

  48. Guarino J, Weidman P. Public perceptions on transportation characteristics of livable communities: the 2009 Omnibus Household Survey. Washington D.C.: Bureau of Transportation Statistics, Research and Innovative Technology Administration, US Department of Transportation, 2011 Contract No.: SR-029.

  49. Rails to Trails Conservancy. Active transportation beyond urban centers: walking and biking in small towns and rural America. Washington DC: 2011.

  50. Umstattd Meyer MR, Sharkey JR, Patterson MS, Dean WR. Understanding contextual barriers, supports, and opportunities for physical activity among Mexican-origin children in Texas border colonias: a descriptive study. BMC Public Health. 2013;13:14. Indigenous community health workers were trained to conduct interviews with mother-child dyads of Mexican-origin to examine barriers, household and neighborhood environmental supports to physical activity opportunities and transportation options.

    PubMed Central  Article  PubMed  Google Scholar 

  51. Clarke P, Nieuwenhuijsen ER. Environments for healthy ageing: a critical review. Maturitas. 2009;64(1):14–9.

    Article  PubMed  Google Scholar 

  52. Yousefian A, Leighton A, Fox K, Hartley D. Understanding the rural food environment—perspectives of low-income parents. Rural Remote Health. 2011;11(2):1631.

    PubMed  Google Scholar 

  53. Chan L, Hart LG, Goodman DC. Geographic access to health care for rural Medicare beneficiaries. J Rural Health. 2006;22(2):140–6.

    Article  PubMed  Google Scholar 

  54. Knight KE. Federally qualified health centers minimize the impact of loss of frequency and independence of movement in older adult patients through access to transportation services. J Aging Res 2011; 2011.

  55. Walia S, Leipert B. Perceived facilitators and barriers to physical activity for rural youth: an exploratory study using photovoice. Rural Remote Health. 2012;12:1842.

    CAS  PubMed  Google Scholar 

  56. Umstattd Meyer MR, Janke MC, Beaujean AA. Predictors of older adults’ personal and community mobility: using a comprehensive theoretical mobility framework. Gerontologist. 2014;54(3):398–408.

    Article  PubMed  Google Scholar 

  57. Smart Growth America. Complete streets work in rural communities Washington DC: National Complete Streets Coalition; 2015 [cited 2015 April 16]. Available from: http://www.smartgrowthamerica.org/complete-streets/implementation/factsheets/rural-areas-and-small-towns/.

  58. ChangeLab-Solutions. Smart school siting: how school locations can make students healthier and communities stronger. National Policy and Legal Analysis Network to Prevent Childhood Obesity, 2012.

  59. Howly C, Johnson J, Petrie J. Consolidation of schools and districts: what the research says and what it means. Boulder: National Education Policy Center; 2011.

  60. Dalton MA, Longacre MR, Drake KM, Gibson L, Adachi-Mejia AM, Swain K, et al. Built environment predictors of active travel to school among rural adolescents. Am J Prev Med. 2011;40(3):312–9.

    PubMed Central  Article  PubMed  Google Scholar 

  61. Corbett AGD, Ellis W, Revere C, Chang DI. Childhood obesity prevention strategies for rural communities. Wilmington: The Nemours Foundation; 2014.

    Google Scholar 

  62. Kelly T, Treloar R, Cassarino J, Chaterjee E, Boes M, Headley S. 150 Tested strategies to prevent crime from small cities, counties and rural communities: a resource for municipal agencies and community groups. National Crime Prevention Council. 2000.

  63. Marrow MW. Finding space to play: legal and policy issues impacting community recreational use of school property. St. Paul: Public Health Law Center; 2012.

    Google Scholar 

  64. Ramage RHA. Parents’ perceptions of the rural school bus ride. Rural Educ. 2005;27(1):15–20.

    Google Scholar 

  65. Smart Growth America. Complete streets work in rural communities. March 1, 2015. Available from: http://www.smartgrowthamerica.org/complete-streets/implementation/factsheets/rural-areas-and-small-towns/.

  66. Moreland-Russell S, Eyler A, Barbero C, Hipp JA, Walsh H. Diffusion of complete streets policies across US communities. J Public Health Manag Pract. 2013;19:S89–96.

    Article  PubMed  Google Scholar 

  67. LiveWell Colorado. Guide to integrating healthy eating and active living into Colorado’s rural and small town communities. Denver: LiveWell Colorado; 2012.

    Google Scholar 

  68. Smith ML, Bazzarre TL, Frisco J, Jackman BA, Cox NJ, Ory MG. Transformation of a rural community for active living. Fam Community Health. 2011;34(2):163–72.

    Article  PubMed  Google Scholar 

  69. Maley M, Warren BS, Devine CM. Perceptions of the environment for eating and exercise in a rural community. J Nutr Educ Behav. 2010;42(3):185–91.

    Article  PubMed  Google Scholar 

  70. Brownson RC, Housemann RA, Brown DR, Jackson-Thompson J, King AC, Malone BR, et al. Promoting physical activity in rural communities: walking trail access, use, and effects. Am J Prev Med. 2000;18(3):235–41.

    CAS  Article  PubMed  Google Scholar 

  71. Seguin R, Connor L. Understanding barriers and facilitators to healthy eating and active living in rural communities. 2014;2014:146502. Focus groups were conducted with rural women in seven US states to identify factors within residents’ physical activity and food environments that helped or hindered them from being physically active and eating healthily.

  72. Scott AJ, Wilson RF. Social determinants of health among African Americans in a rural community in the Deep South: an ecological exploration. Rural Remote Health. 2011;11(1):1634.

    CAS  PubMed  Google Scholar 

  73. Findholt NE, Michael YL, Jerofke LJ, Brogoitti VW. Environmental influences on children’s physical activity and eating habits in a rural Oregon County. Am J Health Promot. 2011;26(2):e74–85.

    Article  PubMed  Google Scholar 

  74. Frost SS, Goins RT, Hunter RH, Hooker SP, Bryant LL, Kruger J, et al. Effects of the built environment on physical activity of adults living in rural settings. Am J Health Promot. 2010;24(4):267–83.

    Article  PubMed  Google Scholar 

  75. Peterson J, Schmer C, Ward-Smith P. Perceptions of Midwest rural women related to their physical activity and eating behaviors. J Community Health Nurs. 2013;30(2):72–82.

    Article  PubMed  Google Scholar 

  76. Kegler MC, Escoffery C, Alcantara I, Ballard D, Glanz K. A qualitative examination of home and neighborhood environments for obesity prevention in rural adults. Int J Behav Nutr Phys Act. 2008;5:65.

    PubMed Central  Article  PubMed  Google Scholar 

  77. Kerr J, Rosenberg D, Frank L. The role of the built environment in healthy aging: community design, physical activity, and health among older adults. J Plan Lit. 2012;27(1):43–60.

    Article  Google Scholar 

  78. King KE, Clarke PJ. A disadvantaged advantage in walkability: findings from socioeconomic and geographical analysis of national built environment data in the United States. Am J Epidemiol. 2015;181(1):17–25.

    Article  PubMed  Google Scholar 

  79. Thompson JL, Allen P, Cunningham-Sabo L, Yazzie DA, Curtis M, Davis SM. Environmental, policy, and cultural factors related to physical activity in sedentary American Indian women. Women Health. 2002;36(2):57–72.

    Article  Google Scholar 

  80. Sanderson B, Littleton M, Pulley LV. Environmental, policy, and cultural factors related to physical activity among rural, African American women. Women Health. 2002;36(2):73–88.

    Article  Google Scholar 

  81. Kegler MC, Swan DW, Alcantara I, Wrensford L, Glanz K. Environmental influences on physical activity in rural adults: the relative contributions of home, church and work settings. J Phys Act Health. 2012;9(7):996–1003.

    PubMed  Google Scholar 

  82. Eyler AA. Personal, social, and environmental correlates of physical activity in rural Midwestern white women. Am J Prev Med. 2003;25(3 Suppl 1):86–92.

    Article  PubMed  Google Scholar 

  83. Wilcox S, Oberrecht L, Bopp M, Kammermann SK, McElmurray CT. A qualitative study of exercise in older African American and white women in rural South Carolina: perceptions, barriers, and motivations. J Women Aging. 2005;17(1–2):37–53.

    Article  PubMed  Google Scholar 

  84. Bopp M, Fallon EA. Health and wellness programming in faith-based organizations: a description of a nationwide sample. Health Promot Pract. 2013;14(1):122–31.

    Article  PubMed  Google Scholar 

  85. Parker VG, Coles C, Logan BN, Davis L. The LIFE project: a community-based weight loss intervention program for rural African American women. Fam Community Health. 2010;33(2):133–43.

    PubMed Central  Article  PubMed  Google Scholar 

  86. Farag NH, Moore WE, Thompson DM, Kobza CE, Abbott K, Eichner JE. Evaluation of a community-based participatory physical activity promotion project: effect on cardiovascular disease risk profiles of school employees. BMC Public Health. 2010;10:313.

    PubMed Central  Article  PubMed  Google Scholar 

  87. Laing SS, Hannon PA, Talburt A, Kimpe S, Williams B, Harris JR. Increasing evidence-based workplace health promotion best practices in small and low-wage companies, Mason County, Washington, 2009. Prev Chron Dis. 2012;9:E83.

    Google Scholar 

  88. Swanson M, Schoenberg NE, Erwin H, Davis RE. Perspectives on physical activity and exercise among Appalachian youth. J Phys Act Health. 2013;10(1):42–7.

    PubMed Central  PubMed  Google Scholar 

  89. Dunton GF, Kaplan J, Wolch J, Jerrett M, Reynolds KD. Physical environmental correlates of childhood obesity: a systematic review. Obes Rev. 2009;10(4):393–402.

    CAS  Article  PubMed  Google Scholar 

  90. Safe Routes to School National Partnership. Rural communities: making safe routes work [cited 1 June 2015]. Available from: http://saferoutespartnership.org/sites/default/files/pdf/Lib_of_Res/SR2S_Rural_making%20SR%20work_20150331.pdf.

  91. Young DR, Spengler JO, Frost N, Evenson KR, Vincent JM, Whitsel L. Promoting physical activity through the shared use of school recreational spaces: a policy statement from the American Heart Association. Am J Public Health. 2014;104(9):1583–8.

    Article  PubMed  Google Scholar 

  92. Robinson JC, Carson TL, Johnson ER, Hardy CM, Shikany JM, Green E, et al. Assessing environmental support for better health: active living opportunity audits in rural communities in the southern United States. Prev Med. 2014;66:28–33. Eight rural communities in Alabama and Mississippi were assessed using the Rural Active Living Assessment (RALA) tools. Community Health Advisors Trained as Research Partners (CHARPS) and local staff conducted the assessments. Data were analyzed using descriptive and nonparametric statistics.

    PubMed Central  Article  PubMed  Google Scholar 

  93. Barnidge EK, Radvanyi C, Duggan K, Motton F, Wiggs I, Baker EA, et al. Understanding and addressing barriers to implementation of environmental and policy interventions to support physical activity and healthy eating in rural communities. J Rural Health. 2013;29(1):97–105.

    Article  PubMed  Google Scholar 

  94. Aytur SA, Satinsky SB, Evenson KR, Rodriguez DA. Pedestrian and bicycle planning in rural communities: tools for active living. Fam Community Health. 2011;34(2):173–81.

    Article  PubMed  Google Scholar 

  95. Edwards MB, Theriault DS, Shores KA, Melton KM. Promoting youth physical activity in rural southern communities: practitioner perceptions of environmental opportunities and barriers. J Rural Health. 2014.

  96. Scanlin K, Haardoerfer R, Kegler MC, Glanz K. Development of a pedestrian audit tool to assess rural neighborhood walkability. J Phys Act Health. 2014;11(6):1085–96.

    Article  Google Scholar 

  97. Fisher BD, Richardson S, Hosler AS. Reliability test of an established pedestrian environment audit in rural settings. Am J Health Promot. 2010;25(2):134–7.

    Article  PubMed  Google Scholar 

  98. Evenson KR, Sotres-Alvarez D, Herring AH, Messer L, Laraia BA, Rodriguez DA. Assessing urban and rural neighborhood characteristics using audit and GIS data: derivation and reliability of constructs. Int J Behav Nutr Phys Act. 2009;6:44.

    PubMed Central  Article  PubMed  Google Scholar 

  99. Rockeymoore M Moscetti C, Fountain A. Rural childhood obesity prevention toolkit. Leadership for Healthy Communities, 2014.

  100. National Recreation and Park Association. Play Deserts: NRPA; [cited 27 April 2015]. Available from: http://www.nrpa.org/Grants-and-Partners/Recreation-and-Health/Play-Deserts/.

  101. Bartram S. Making places for play. Parks Recreat Mag. 2014.

  102. Center for Global Policy and the Robert Wood Johnson Foundation. Rural childhood obesity prevention toolkit. Princeton: Robert Wood Johnson Foundation; 2014.

    Google Scholar 

  103. ChangeLab-Solutions. Checklist for developing a joint-use agreement (JUA). National Policy and Legal Analysis Network to Prevent Childhood Obesity, 2009.

  104. Spengler JO, Connaughton DP, Maddock JE. Liability concerns and shared use of school recreational facilities in underserved communities. Am J Prev Med. 2011;41(4):415–20.

    Article  PubMed  Google Scholar 

  105. ChangeLab-Solutions. On the move: safe routes to school policies in rural school districts. CA4Health, 2014.

  106. Carlson JA, Sallis JF, Conway TL, Saelens BE, Frank LD, Kerr J, et al. Interactions between psychosocial and built environment factors in explaining older adults’ physical activity. Prev Med. 2012;54(1):68–73.

    PubMed Central  Article  PubMed  Google Scholar 

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Acknowledgments

The authors would like to thank the staff at Active Living Research and the Robert Wood Johnson Foundation for supporting our formative research on active living and the rural built environment.

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Conflict of Interest

Anush Yousefian Hansen, M. Renée Umstattd Meyer, Jennifer D. Lenardson, and David Hartley declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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Authors and Affiliations

  1. Maine Rural Health Research Center, University of Southern Maine, 404G Wishcamper Center, 34 Bedford Street, Portland, ME, 04104, USA

    Anush Yousefian Hansen

  2. Department of Health, Human Performance, and Recreation, Robbins College of Health and Human Sciences, Baylor University, One Bear Place, #97313, Waco, TX, 76798, USA

    M. Renée Umstattd Meyer

  3. Maine Rural Health Research Center, University of Southern Maine, 432B Wishcamper Center, 34 Bedford Street, Portland, ME, 04104, USA

    Jennifer D. Lenardson

  4. Maine Rural Health Research Center, University of Southern Maine, 418 Wishcamper Center, 34 Bedford Street, Portland, ME, 04104, USA

    David Hartley

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  1. Anush Yousefian Hansen
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Correspondence to Anush Yousefian Hansen.

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Hansen, A.Y., Umstattd Meyer, M.R., Lenardson, J.D. et al. Built Environments and Active Living in Rural and Remote Areas: a Review of the Literature. Curr Obes Rep 4, 484–493 (2015). https://doi.org/10.1007/s13679-015-0180-9

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Keywords

  • Obesity
  • Overweight
  • Physical activity
  • Exercise
  • Transportation
  • Synthesis