Effects of the Built Environment on Physical Activity of Adults Living in Rural Settings
Abstract
Objective.: To conduct a systematic review of the literature to examine the influence of the built environment (BE) on the physical activity (PA) of adults in rural settings. Data Source.: Key word searches of Academic Search Premier, PubMed, CINAHL, Web of Science, and Sport Discus were conducted. Study Inclusion and Exclusion Criteria.: Studies published prior to June 2008 were included if they assessed one or more elements of the BE, examined relationships between the BE and PA, and focused on rural locales. Studies only reporting descriptive statistics or assessing the reliability of measures were excluded. Data Extraction.: Objective(s), sample size, sampling technique, geographic location, and definition of rural were extracted from each study. Methods of assessment and outcomes were extracted from the quantitative literature, and overarching themes were identified from the qualitative literature. Data Synthesis.: Key characteristics and findings from the data are summarized in Tables 1 through 3. Results.: Twenty studies met inclusion and exclusion criteria. Positive associations were found among pleasant aesthetics, trails, safety/crime, parks, and walkable destinations. Conclusions.: Research in this area is limited. Associations among elements of the BE and PA among adults appear to differ between rural and urban areas. Considerations for future studies include identifying parameters used to define rural, longitudinal research, and more diverse geographic sampling. Development and refinement of BE assessment tools specific to rural locations are also warranted.
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Among adults, greater accessibility to recreation or exercise spaces and facilities was generally, although not always, associated with more physical activity.
“Among adults, greater accessibility was generally, although not always, associated with more physical activity.28,337–342”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
Cross-sectional studies of land-use mix and adiposity in adults are consistent with the findings for physical activity.
“Cross-sectional studies of land-use mix and adiposity in adults are consistent with the findings for physical activity.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
Nearly all original investigations of land-use mix and physical activity in adults found significant positive associations, often with substantial magnitudes.
“Nearly all found significant positive associations, often with substantial magnitudes of associations (eg, OR in the 2- to 3-fold range or higher).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
Virtually all reviews concluded that the presence or quality of sidewalks and street connectivity was positively linked to physical activity in adults.
“Although virtually all of the reviews concluded that the presence or quality of sidewalks and street connectivity was positively linked to physical activity in adults, findings from the original investigations were much more mixed (Supplementary Table 10c).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
The large majority of studies in reviews of neighborhood safety and adult physical activity found that perceived or objective measures of safety were positively associated with physical activity, including among women and men, and with use of parks and park activities.
“The large majority of studies in these reviews found that perceived or objective measures of safety were positively associated with physical activity, including among women and men, and with use of parks and park activities.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
In children, recent findings on neighborhood aesthetics and physical activity or adiposity have been relatively limited and mixed.
“In children, recent findings have been relatively limited and mixed.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
Findings on sidewalk availability and adiposity in adults were mixed, with no significant associations among adults in the rural southern United States or Hispanic adults in Texas, and inverse associations among urban US adults and Australian adults.
“Findings were mixed, with no significant associations among adults in the rural southern United States or Hispanic adults in Texas, and inverse associations among urban US adults and Australian adults.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
Many cross-sectional studies evaluated general aesthetics or enjoyable scenery in adults, and nearly all found relations with more favorable physical activity or adiposity measures.
“In contrast, many cross-sectional studies evaluated general aesthetics or enjoyable scenery, and nearly all found relations with more favorable physical activity or adiposity measures (Supplementary Table 10e).”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
Recent systematic reviews collectively evaluated about 20 cross-sectional studies of neighborhood aesthetics and physical activity or adiposity, about half in children and half in adults.
“Recent systematic reviews collectively evaluated about 20 cross-sectional studies, about half in children and half in adults.”
From Population Approaches to Improve Diet, Physical Activity, and Smoking Habits: A Scientific Statement From the American Heart Association (2012) · cites this paper as [337]
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- Authors
- Frost, S. S., Goins, R. T., Hunter, R. H., Hooker, S. P., Bryant, L. L., Kruger, J., & Pluto, D.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Venue
- American Journal of Health Promotion
- Publisher
- SAGE Publications
- Published
- 2010-03
- Volume
- 24
- Issue
- 4
- Pages
- 267-283
- ISSN
- 0890-1171 (ISSN-L)
- 2168-6602
- OpenAlex
- W2129983949
- Cited by
- 234
- References
- 128
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 28 · 2023: 14 · 2022: 15 · 2021: 15 · 2020: 21 · 2019: 12 · 2018: 11 · 2017: 19 · 2016: 14 · 2015: 21 · 2014: 21 · 2013: 14 · 2012: 7
- FWCI
- 23.28
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Health Promotion (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Centers for Disease Control and Prevention
- National Center for Chronic Disease Prevention and Health Promotion (U48-DP-000052)
- Topics
- Social Sciences › Transportation › Urban Transport and Accessibility
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Urban Green Space and Health
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- built environment, physical activity, rural adults, urban-rural differences, trail access, parks, crime and safety, walkability, aesthetic environment
- MeSH terms
- Environment Design, Health Promotion, Humans, Health Knowledge, Attitudes, Practice, Motor Activity, Rural Population, Social Perception, United States, Health Behavior, Walking, Social Marketing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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