Perceptions of participants and staff of implementing a physical activity program in rural primary care.

Addressing the lack of physical activity (PA) in rural adults is vital because of the role it plays in the risk for many chronic diseases. The purpose of the study was to explore the feasibility of conducting a 12-week intervention utilizing a Fitbit to increase PA behavior in inactive rural adults recruited from a primary care clinic. Semi-structured interviews were conducted with study participants (n=10) and a focus group was held with nurses (n=7) from the primary care clinic. Data were analyzed using the process of immersion/crystallization. Participants and nurses both felt the program had a positive impact on PA and that the program was needed in the community. Study participants most often reported their favorite part of the study was being able to track their activity as well as the goal setting. However, study participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Further, nursing staff reported barriers in regard to a lack of resources (staffing and money) These barriers need to be examined further and addressed in order to implement a sustainable PA program that can be maintained through a primary care clinic.

Effectiveness of the 5A's Model for Changing Physical Activity Behaviors in Rural Adults Recruited From Primary Care Clinics.

BACKGROUND: Most rural adults do not meet current guidelines for physical activity (PA). A 12-week feasibility study tested the effectiveness of using the 5A's model for PA counseling on rural adults' PA behaviors. METHODS: Inactive rural adults recruited from a primary care clinic were randomized to an intervention (n = 30) or control (n = 29) group. All subjects wore a Fitbit to track steps and active minutes. The intervention group completed action plans to improve self-regulatory PA strategies and received weekly motivational text messages to improve PA behaviors. Theory of planned behavior constructs and self-regulatory strategies of planning, goal setting, and tracking (steps and active minutes) were measured with both groups. The control group received the Fitbit only. RESULTS: All individuals became more physically active; however, no significant differences between groups in active minutes or steps were found. All subjects, regardless of group, increased steps (P > .05). There were no statistically significant differences between groups on any of the theoretical variables. CONCLUSIONS: It is vitally important to continue to find ways to make PA a priority to improve the overall health and well-being of rural adults. Future research warrants adjusting the intervention dose and strategies to increase PA that can be maintained long term.

Eating Self-Regulation in Overweight and Obese Adults: A Concept Analysis.

BACKGROUND: Poor eating behaviors greatly influence the development of becoming overweight or obese. Learning to better self-regulate eating is one area in which individuals can positively influence their own health. PURPOSE: The purpose of this concept analysis is to provide an in-depth analysis of the concept eating self-regulation as it pertains to overweight and obese adults using Walker and Avant's method. RESULTS: The definition for eating self-regulation formulated as a result of this concept analysis and based on the critical attributes is the ability to initiate goal-related behaviors, to consistently self-monitor dietary intake, to regularly apply willpower to resist temptations, to self-evaluate where one stands in relationship to goal attainment, and finally to maintain motivation to positively change eating behaviors. Cognitive restraint, moderation, mindfulness, disinhibition, delayed gratification, emotions and moods, self-efficacy, social support, the environment, and physical activity are the antecedents that may influence eating self-regulation. CONCLUSION: Examining an individual's weight, body mass index, lipid levels, or blood pressure are some ways to determine if self-regulation of eating behavior is achieved. With a consistent definition of self-regulation and a better understanding of the critical factors that influence eating behaviors, research can better explore how to help individuals change their eating behaviors more effectively.

Motivational Factors Predict Weight Loss in Rural Adults.

OBJECTIVE: The objective was to: (a) describe the changes over time in motivational factors of weight loss and (b) to examine predictors of weight loss in rural adults enrolled in a weight loss program. DESIGN AND SAMPLE: A longitudinal study was conducted in a convenience sample of 50 adults recruited from a rural Young Men's Christian Association. MEASURES: Questionnaires were completed at baseline (preprogram), 1, 2 and 3 months (end of program). RESULTS: Mean age was 42.4 (SD ± 11.8); 84% were female and mean BMI was 32.9 (SD ± 4.3). Individuals lost an average of 12.1 pounds. Barriers to healthy eating decreased significantly over time (p < .001). Significant predictors of weight loss included gender (ß = .501, p < .001), and the amount of change between baseline and 3 months in controlled regulation (ß = .270, p < .05), barriers to healthy eating (ß = -0.225, p < .05), and physical activity (ß = .238, p < .05) explaining 45% of the variance (F[(8, 41] = 5.92, p < .001) in weight loss. CONCLUSIONS: Rural adults were more likely to lose weight if they had higher levels of controlled regulation, if barriers were reduced, and if physical activity levels increased during the 3-month weight loss program.