Dissertation
Developing and evaluating a physical activity intervention for rural men
University of Iowa
Doctor of Philosophy (PhD), University of Iowa
Spring 2023
DOI: 10.25820/etd.007185
Abstract
Introduction:
Rural men have higher mortality rates than urban men, in part because of higher rates of diabetes, cardiovascular disease, cancer, and obesity. While physical activity is known to reduce risk and improve outcomes related to these diseases, rural men are less active than their urban counterparts. However, little is known about the barriers for physical activity among rural men and few physical activity interventions have been targeted to this population. Therefore, the overall goal of this project is to advance the understanding of rural men’s barriers and preferences of physical activity. That information will then be used to develop a physical activity intervention, and then assess the acceptability and feasibility of a physical activity intervention tailored to rural American men.
Methods:
There were three separate studies in this dissertation. In Study 1, 447 rural men completed a needs assessment survey that asked about their interest in physical activity interventions and their preferences and barriers to physical activity. In Study 2, a subsample of 131 rural men completed a follow-up needs assessment survey that asked about their preferred delivery methods and intervention features. The findings of studies 1 and 2 were used to inform the development of a physical activity intervention tailored to rural men. In Study 3, a sample of 27 rural men completed a 10-week, remotely delivered physical activity intervention. Feasibility, efficacy, and acceptability of the intervention were measured.
Results:
In Study 1, 83.9% of men indicated they were interested in a physical activity program. Rural men reported they wanted demonstrations of physical activity that can be done at home. In Study 2, 55.7% of men reported preferring a male presenter for demonstration videos. Men also reported preferring an exercise professional (4.2 on a scale of 1-Dislike a great deal to 5-like a great deal) to deliver educational content. YouTube was rated highest (4.1 on a scale of 1-dislike very much to 5-like very much) for delivering educational materials. In Study 3, participants completed 8 out of 12 physical activity education/demonstration modules on average, and 56% of participants completed all modules. Step counts did not significantly change over the course of the 10-week intervention. The number of participants engaging in muscle strengthening exercises did improve (18% at baseline to 70% at follow-up), and muscular endurance also improved (10 more push-ups, 6 more sit-ups, and 8 more squats on average). The Fitbits were rated as a very helpful feature (81 on a scale of 1-Not helpful to 100-Very helpful), but participants suggested more interaction and accountability could improve the program.
Discussion:
Our findings suggest that rural men are interested in a physical activity intervention, but they preferred a program that was remotely delivered through YouTube videos. Demonstrations of activities that can be done from home were important features to rural men. When evaluating an intervention that accommodates these preferences, we found that muscle strengthening behaviors and muscular endurance improved, but step counts did not. Future investigation is needed to further improve the program, such as adding more interactive features and accountability in the intervention.
Details
- Title: Subtitle
- Developing and evaluating a physical activity intervention for rural men
- Creators
- Jacob Gallagher
- Contributors
- Lucas J. Carr (Advisor)Kara M. Whitaker (Committee Member)Amy Pearlman (Committee Member)Emine O. Bayman (Committee Member)Nathaniel D.M. Jenkins (Committee Member)Lisa Cadmus-Bertram (Committee Member)
- Resource Type
- Dissertation
- Degree Awarded
- Doctor of Philosophy (PhD), University of Iowa
- Degree in
- Health and Human Physiology
- Date degree season
- Spring 2023
- DOI
- 10.25820/etd.007185
- Publisher
- University of Iowa
- Number of pages
- xiii, 177 pages
- Copyright
- Copyright 2023 Jacob Gallagher
- Language
- English
- Date submitted
- 02/24/2023
- Date approved
- 06/30/2023
- Description illustrations
- Illustrations, tables, graphs, charts
- Description bibliographic
- Includes bibliographical references (pages 81-100).
- Public Abstract (ETD)
Rural men are at high risk for numerous chronic diseases, such as diabetes and heart disease. While the systemic reasons that put them at risk might be difficult to change, health behaviors, such as physical activity, are more feasible way to prevent or reverse these negative health outcomes. Rural men are underrepresented in physical activity interventions. Designing interventions that are tailored to the unique needs of rural men is necessary to drive participation, but what do rural men want in a physical activity intervention? Unfortunately, there is limited information to understand the physical activity-related needs of rural men. In fact, it is not known whether rural men are interested in receiving physical activity programs. This dissertation project first focused on understanding the physical activity needs and wants of rural men. Lessons learned were used to inform the planning, implementation and evaluation of a physical activity intervention tailored to rural men. The findings of this project suggest rural men are interested in receiving physical activity interventions. Rural men reported a desire for home-based programs delivered via the internet. The intervention developed consisted of educational/demonstration videos created by the principal investigator and access to a Fitbit activity monitor. The videos included several demonstrated behavior change techniques and were based on the Multi-Process Action Control Theory. Adhering to the evidence-based behavioral treatment development model known as the ORBIT Model, the new physical activity intervention was then tested in a proof-of-concept study. Our findings suggest completers of the program did not increase daily steps but were successful in improving muscular strength. Future studies are needed to better understand how to increase total activity and to improve ways to recruit rural men for these intervention studies. Furthermore, pilot studies with a control group are warranted to confirm that our intervention improved strength training behaviors and muscular endurance.
- Academic Unit
- Health, Sport, and Human Physiology
- Record Identifier
- 9984428942902771
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