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Promoting Weight Loss in Rural Areas: Environmental Constraints and Healthy Behaviors

Explore the challenges and solutions related to promoting weight loss in rural South Carolina. Discover how limited access to healthy foods, transportation, and safety concerns impact obesity rates. Learn about the significance of individual, social, and environmental factors in shaping health behaviors.

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Promoting Weight Loss in Rural Areas: Environmental Constraints and Healthy Behaviors

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  1. Ecological Correlates of Obesity and Related Health Behaviors among Adults Living in Rural Areas of South Carolina Demetrius Abshire PhD, RN Abbas Tavakoli DrPH

  2. What is the biggest barrier to promoting weight loss for people who live in rural areas?

  3. “When environmental conditions exercise powerful constraints on behavior, they emerge as the overriding determinants.” Albert Bandura Sallis. 2018. Health Education & Behavior, 45(5), 661-7.

  4. The Social Ecological Model https://www.cdc.gov/nccdphp/dnpao/state-local-programs/health-equity/pdf/toolkit.pdf

  5. Promoting Healthy Behaviors in Rural Areas • Environmental Constraints1-3 • Limited/poor public transportation • Limited options for healthier foods • Physical activity infrastructure lacking • Safety concerns • “Positive Deviants”4 • Engaging in healthy behaviors despite constraints • The home environment and motivation are key • Morgan et al. 2016. BMC Public Health, 16, 305. • Bolin et al. 2015. J Rural Health, 31(3), 326-33. • Frost et al. 2010. Am J Health Promot, 24, 267-83. • Kegler et al. 2013. J Primary Prevent, 34, 5-15.

  6. The Social Ecological Model in Rural Areas • Healthy Rural Communities 2 (Home & Neighborhood) • Only perceived neighborhood access to healthy food had a direct effect on BMI • Factors positively associated with F/V and fat intake • Household inventory of FVs, family support for FV intake, household inventory of fatty foods • Factors associated with PA • More PA equipment, higher family support, higher self-efficacy • No direct effect between fat and FV intake with BMI Kegler et al. 2014. Prev Sci, 15, 1-11

  7. Obesity in Rural America • Jackson et al. 2005. J Rural Health, 21(2); 140-8. • Trivedi et al. 2015. RRH, 15; 3267. • Befort et al. 2012. J Rural Health, 28(4), 392-7. • Hales et al. 2018. JAMA, 319(23), 2419-29. • *Large MSA

  8. Methods • Cross-sectional survey of rural (n=201) and urban (n=228) dwelling South Carolina adults • Survey Sampling International • Self-reported height and weight • Environmental perceptions for PA, self-efficacy, social support, beliefs regarding diet and exercise • http://sallis.ucsd.edu/ University of Wisconsin Population Health Institute. County Health Rankings & Roadmaps 2018. www.countyhealthrankings.org.

  9. Sample Characteristics

  10. Results Hierarchical linear regression for predictors of BMI (coefficients shown for Step 4)

  11. Results Hierarchical logistic regression for predictors of obesity (ORs shown for Step 4)

  12. Discussion/Conclusion • Individual, social, and environmental factors correlated with BMI were not predictive of BMI/obesity in multivariable models. • Sociodemographic factors have a significant influence on BMI/obesity. • Next steps: Ecological correlates of behavior • Limitation: Small sample size (interpret findings with caution)

  13. Questions, Comments, and Discussion Demetrius Abshire, PhD, RN abshired@mailbox.sc.edu 803-576-6262 Thank you!

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