Association Between Physical Activity, Psychosocial Factors, and the Built Environment in Rural Adults.

BACKGROUND: Psychosocial and built environment (BE) factors can influence physical activity (PA). Objectives were to assess whether psychosocial or BE variables were associated with PA and whether associations differed by sociodemographic characteristics in rural communities. METHODS: The sample included 2215 adults enrolled in a healthy lifestyle intervention cluster-randomized trial. Sociodemographic variables included age, sex, race/ethnicity, education, and income. Health variables included general health status and body mass index. PA was assessed using the International Physical Activity Questionnaire-long form. Metabolic Equivalent-minutes per week were calculated for total PA, moderate and vigorous PA, and walking. Psychosocial (exercise attitudes, exercise confidence, social support for PA from family/friends) and BE variables (walking environment, sidewalks, street shoulders, community safety, community aesthetic quality) were assessed via questionnaire. Linear regressions modeled bivariate associations between PA and PA context variables. Multivariate regression models evaluated whether sociodemographic or health variables modified relationships between PA and PA context variables. RESULTS: All psychosocial measures were positively associated with all measures of PA. Walking environment and community safety were the only BE measures associated with all measures of PA. Being an older adult (65+) had significantly greater effects on exercise attitudes, exercise confidence, and social support from friends on walking. Education and income did not consistently moderate associations between psychosocial factors and any measure of PA. CONCLUSIONS: Future studies should confirm whether psychosocial characteristics are associated with PA in other populations and explore how these effects are moderated by sociodemographic characteristics. Further research is needed on the role of the environment in influencing PA in rural communities.