Increasing Physical Activity to Improve Health Through Primary Care Clinics in Rural Nebraska

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 to increase PA behavior in inactive rural adults recruited from a primary care clinic. Subjects were randomized to the intervention (n=30) or control (n=29) group and wore a Fitbit to track PA. The intervention group completed action plans and received weekly motivational text messages to improve PA behaviors. Semi-structured interviews were conducted with study participants (n=10) and a focus group with nurses (n=7) from the primary care clinic. T-tests, Signed rank tests and Wilcoxon were used to look at changes within and across groups. Qualitative data were analyzed using the process of immersion/crystallization. All individuals improved their total PA, however, no significant differences between groups in active minutes or steps was found. There were no statistically significant differences between groups on any of the theoretical variables. Participants and nurses both felt the program had a positive impact on PA and a community program was needed. Study participants most often reported their favorite part of the study was being able to track their PA. However, participants reported barriers to continued participation in PA related to a lack of time and ability to be active in cold weather. Nursing staff reported barriers related to lack of resources (staffing and money). These barriers need to be examined further and addressed to implement a sustainable PA program that can be maintained through a primary care clinic