Abstract
Data from rural children were informative in identifying strategies for wearable activity monitor use. Lessons learned and approaches for objective measurement may be helpful for developing evaluations when implementing rural Pennsylvania programs for youth.
Primary Author and Speaker: Katy Bray
Contributing Authors: Mengyuan Hao, Veronica Lelo, Heather Katz, Susan Andreae, Kristen A. Pickett
In rural communities, health promotion programs must be culturally relevant and socially acceptable to support participation in meaningful physical activity. But rural environmental barriers and limited culturally tailored measurement tools hinder program evaluation. Our team explored the feasibility and acceptability of wrist-worn activity monitors in rural children participating in a behavioral program for families at risk for type 2 diabetes. Individuals defined as rural by Census Classification were recruited using community flyers and the Survey of the Health of Wisconsin. Participants were included if they were willing to complete group Zoom calls and participate in physical activity. Rural caregiver and child (7–11 years old) dyads were enrolled, and baseline data were collected. Children were given a wearable device and caregivers instructed to keep a log of wear time and removal reasons for 7 days. Semi-structured interviews were completed after intervention to understand children’s experiences. Interviews were audio-recorded, transcribed, and summary reports generated based on recurring themes. 10 dyads enrolled in the study. 9 Children (7 male, average age 8.7 +/- 1.4 years), and 9 caregivers (9 female, average age 43.6 +/- 8.5 years) with an annual income of ≥$40,000 completed the study. Children reported devices as broadly acceptable without negative impact on existing daily occupations. All children checked step count and some reported increased motivation towards physical activity, potentially impacting participation. Facilitators of adherence were device engagement, social acceptance, and low caregiver burden. Considering the context and lived experiences of rural populations is key to developing effective health promotion approaches and acceptable measurement strategies. Flexible scheduling and minimal travel for participants may increase adherence, while strategies respectful of context may increase adoption by rural participants.
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