Insights Into Rural Youth Physical Activity: The Role of Micro- and Macro-Level Environments.

Background and Objectives: Physical activity (PA) environments at micro- (e.g., home) and macro-levels (e.g., built) may be associated with rural children's PA, an underrepresented population in research. A secondary data analyses of NU-HOME, a family-based childhood obesity prevention RCT, examined which environmental supports explain variation in moderate-to-vigorous PA (MVPA), vigorous PA (VPA), and total PA. Methods: Gold standard measurement tools (geospatial analysis; accelerometry) and surveys were used to assess children's (N=105, age 7-10) PA environments and behaviors. Environmental supports were evaluated in a block-wise manner. Each variable was placed into one block (i.e., sociodemographic characteristics, physical supports, or social supports). Blocks were added in a sequential manner to multiple linear regression models, controlling for sociodemographic variables, and analyzed for their group-wise ability to explain variation in MVPA, VPA, and total PA. Results: At micro- and macro-levels, differences in MVPA were explained by physical supports (ΔR2=0.06, p=0.03; ΔR2=0.13; p=0.04). Explained variance in VPA was improved by neither physical nor social supports at either level. Physical supports explained differences in total PA at the micro- (ΔR2=0.09, p=0.01) and macro-levels (ΔR2=0.17, p=0.01). Conclusions: Further research is warranted to explore if expanding access to PA equipment and infrastructure supports mitigates inactivity in rural youth.