Background: Individuals living in rural areas have higher obesity and obesity related co-morbidities than their urban counterparts. Understanding rural-urban differences associated with weight ...management may inform the development of effective weight management interventions for adults living in rural areas. Methods: The International Weight Control Registry (IWCR) is an online registry designed to assess factors contributing to successes and challenges with weight loss and weight loss maintenance across the world. We examined demographics, weight history and weight management strategies in a sample of urban and rural residents in the Midwestern U.S. (IA, IL, IN, KS, MI, MN, MO, ND, NE, OH, SD, WI). Participants were classified as rural or urban by the Rural-Urban Commuting Area Code. Analyses included Chi-square tests for proportions and independent t-test and Wilcoxon rank sum test for continuous variables. Results: The sample was 45% rural (n = 78 of a total N = 174) with a mean age of 50.3 years. Rural residents were more likely to be white, non-college graduates, and have lower family income compared with urban areas (p < 0.05). Rural and urban residents reported similar weight histories and strategies for weight management. Workrelated physical activity was higher and weekday sitting time was lower in rural compared to urban residents (p < 0.01). These data could potentially be impacted by the relative number of residents working from home during COVID-19 (Urban: 59% vs. Rural: 37%, p < 0.05). Rural residents were more likely to report a lack of neighborhood walkability (p < 0.01) and healthy food availability (p < 0.05) compared with urban residents. Conclusions: These data suggest rural-urban differences in demographic characteristics, opportunity for leisure time physical activity, and the availability of heathy foods should be considered in the development of weight management interventions. The consistency of the observed findings will be evaluated at the regional, national and international levels as the size of the available sample in the IWCR increases.
Background: Pediatric obesity interventions of 26 or more contact hours may be more effective than those with fewer contact hours, but research is inconclusive. Disagreement may be due to the lack of ...uniformity in reporting dose. To remedy this issue experts recommend reporting dose intended, dose delivered, and dose received. Also, very little is known about the accumulation of dose in rural populations, and no information has been published regarding the accumulation of dose in the time of COVID 19. The purpose of the current abstract is to describe the accumulation of dose in a fourstate pediatric obesity intervention trial that was conducted in the IDeA States Pediatric Clinical Trials Network. Methods: Rural medical clinics located in four states participated. Each clinic targeted recruitment of 28 children from rural areas who were 6-11 years of age with a BMI%ile>85th and their primary caregivers who (after consent/assent) were randomly assigned to a monthly newsletter only condition or to the iAmHealthy mHealth intervention, which was composed of 12 weekly and 3 monthly one hour group sessions and 11 hours of individual family health coaching. The 6-month intervention period began on August 24, 2020 and completed on February 7, 2021 when the impact of the COVID 19 pandemic was high in participating sites. Results: 52 of the 104 randomized participants were assigned to iAmHealthy; 87% (n = 45) of these participants were retained through the final measurement. Dose intended was 26 contact hours (15 hours of group sessions and 11 hours of health coaching sessions), with a goal for families to receive 80% of these hours (20.8 hours). Dose delivered by the intervention team included 15 hours of group sessions and up to 17 hours for health coaching sessions. Dose received varied widely for both group (0.73-16.78; X = 10.65) and health coaching sessions (0.45-16.85; X = 8.21). Therefore, total accumulated contact hours varied as well (2.4531.13; X = 18.86). Two thirds of the retained participants met the a priori dose goal of 20.8 contact hours. Conclusions: Dose intended and dose received were highly concordant, but dose received varied widely by participant. Future research should continue to explore these measures of dose, especially in underserved populations, and whether these factors are related to health behavior outcomes and body mass changes.
Access to financial capital is vital for the sustainability of the local business sector. Recent research on the restructuring of the financial industry from local owned banks to interstate ...conglomerates has raised questions about the impact on local economies, especially in rural areas. We examine the impact of bank ownership concentration on business formations, continuations, and deaths in metropolitan, micropolitan, and rural non-core U.S. counties. Using limited-access Census data, we find that local bank concentration is positively related to business births and deaths, or churn, in rural counties, but the opposite effects occur in metropolitan areas. We demonstrate robustness to several specifications and spatial spillover effects.
The December 1983 Kappan featured the story of Clinch School in Hawkins County, Tennessee, a small rural school with a student body of 161 students in 12 grades. Teresa Preston explains how the story ...of the community’s fight to keep this school open and under local control is illustrative of the dilemmas surrounding rural schools that have been covered in Kappan for a century. Articles have grappled with whether schools should focus on encouraging students to stay in rural communities, how to ensure that schools are large enough to provide adequate programs but small enough to reflect the immediate community, and what role parent and community preferences should play in improvement plans for rural schools.
India’s medical service industry is an emerging force in Southeast Asia, which should be recognized. A large portion of the country’s GDP is being earned through this sector. Paradoxically, India’s ...rural sphere has always been highly deprived of medical facilities even in rudimentary level. This huge imbalance was previously an issue for India to reach to a footing through innovation. India still being a developing country has majority of people living in rural areas where quality healthcare is not only difficult to avail but sometimes even hard to access. In such circumstances, an initiative like Lifeline Express (LLE) has provided the people with access to quality healthcare which has been crucially needed. It is a very simple idea but incredibly complex in terms of execution throughout the whole region. The LLE is a hospital which moves throughout rural India in a form of a fully equipped train. Since 1991, this initiative in India has generated some commendable projects through which it has served many rural Indians. Through this case, it will be comprehensible of how the train and the medical team function and will show the limitations and challenges healthcare in India is facing and how LLE has proved its fantastic ability to fight with the constraints and make healthcare reach the doorsteps of the rural people. Despite the challenges and limitations, it is also been revealed how the journey of LLE has grown from a three-coach train to seven-coach train where patients get treatment of many diseases from the early 1990s to this day.
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