PROJECT SUMMARY/ABSTRACT
Pediatric obesity is a public health crisis as rates of obesity are increasing and contributing to negative physical
and psychosocial outcomes. Youth from rural populations are 26% more likely to have obesity compared to
their urban counterparts. Discrepancies in health behaviors between urban and rural youth may be at least in
part to blame for this disparity, and recent research illuminates the impact of the rural neighborhood and
community environments on health behaviors. Specifically, rural youth often engage in less physical activity
(PA) and utilize their environment for PA less extensively than suburban and urban youth. As rural
communities often have limited access to PA opportunities, it is important to understand the extent to which
rural youths’ utilization of their environment for PA is impacted by both the perceived and actual availability of
PA resources in their neighborhoods and communities (e.g., accessible playground equipment, quality
sidewalks). The primary objective of the current proposal is to explore how the neighborhood and community
environment influences PA among rural children (6-10 years). This essential information will be utilized to tailor
future treatment recommendations by identifying treatment targets (e.g., increased caregiver awareness),
clarifying if the psychosocial support and PA ideas provided by lifestyle interventions compensate for the
perceived less supportive environment, and identifying specific locations to promote PA within. The two
proposed aims will include virtual retrospective community audits collected specifically for this study and utilize
data from two existing studies: a randomized pediatric obesity trial delivered to rural families and an ancillary
study involving Global Positioning Systems (GPS) trackers. The first aim will compare caregiver perceptions
with objective measures of the neighborhood and community PA environment and examine their associations
with the location where rural youth engage in PA. This aim will employ cross-sectional analyses of caregiver
perceptions of the PA environment, retrospective community virtual audits examining objective PA
environment, and PA in specific locations using accelerometry combined with GPS technology. The second
aim will explore how both the perceived environment and the objectively measured environment relate to
children’s PA at baseline and changes in PA over time in the context of an 8-month pediatric obesity treatment
program. Findings from this research will illuminate important targets (e.g., increased caregiver awareness,
specific locations to promote) for future pediatric obesity treatment and prevention work with rural populations.
This research project will facilitate the development of new research skills, provide a meaningful scientific
contribution, and advance my career as an independent scientist aiming to improve health behaviors in
medically underserved populations.