Promoting Physical Activity in Rural Settings: Effectiveness and Potential Strategies

Implementing efficacious physical activity interventions in real-world rural settings is needed because rural cancer survivors are more physically inactive and experience poorer health. To address this gap, this study evaluated the effectiveness of an evidenced-based physical activity program (Better Exercise Adherence after Treatment for Cancer [BEAT Cancer]) for rural women cancer survivors when implemented by community-based nonresearch staff. Sixteen rural women cancer survivors received BEAT Cancer implemented by a rural community organization and nonresearch staff; physical activity, patient-reported outcomes, and social cognitive constructs were measured at baseline and postprogram. Cancer survivors and interventionists completed program evaluations postprogram. Cancer survivor mean age was 58 ± 12 yr; 62% were White. Mean months since diagnosis was 54 ± 72; 69% had breast cancer. Significant improvements from pre- to postprogram occurred for self-report weekly minutes of moderate to vigorous physical activity (mean change [M] = 146 ± 186, P = 0.009), anxiety (M = −1.3 ± 1.8, P = 0.016), depression (M = −2.1 ± 2.0, P = 0.001), self-efficacy (M = 20.9 ± 30.5, P = 0.019), barriers interference (M = −15.0 ± 14.1, P = 0.001), and social support (M = 5.0 ± 7.4, P = 0.02). Cancer survivors ranked the program highly, identified strategies that were helpful (e.g., group activities, personalized exercise plan, etc.), and suggested additional implementation strategies (e.g., guide for home-based phase, etc.). Interventionists identified strategies (e.g., logistics, staff training and certification, cost, etc.) for enhancing organizational readiness for program delivery. Evidence-based physical activity programs can be effective when implemented by nonresearch staff in rural settings. Further research testing strategies that improve implementation are needed. Effectiveness and identified strategies supporting delivery when implemented by a rural organization can improve physical activity promotion for rural at-risk populations.