An Exploration of Physical Activity among Rural Youth Identifies Key Activities Underestimated by Standard Assessments

BACKGROUND: Existing literature indicates that rural children participate in less total physical activity (PA) than their urban and suburban counterparts. Yet, little is known with regard to how accurately current PA assessment tools capture rural children’s PA. PURPOSE: To comprehensively characterize PA trends and quantify activity-specific energy expenditure (EE) estimates among a sample of rural children using accelerometry, structured PA logs, and youth metabolic equivalent of task (METy) values from the Youth Compendium of Physical Activities. Additionally, identify activities that may be underestimated using standard PA assessments. METHODS: In summers 2017 and 2018, 97 children (age = 8.9 ± 1.1; female = 58.8%) who participated in the rural NU-HOME obesity prevention trial provided accelerometry data (mean MVPA = 44.5 ± 18.9 min/day) and completed a 7-day PA log (30-min open-response activity blocks; weekdays = 3:30-7 pm; weekends = 7 am-11 pm). Using the Youth Compendium of Physical Activities, three research team members independently coded the open-response activity blocks to determine the specific activities completed on weekdays and weekends. Inter-rater reliability was established using coder triangulation methods. Lastly, the 6-9 year category was used to calculate METy EE output and METy-min, an estimate of EE over time, for each activity. RESULTS: Across activities, swimming contributed the highest activity-specific METy output. On weekdays, the most frequently reported activities were free play (75.3%), biking (37.1%), and walking (37.1%); mean METy-min = 480 ± 693, 92 ± 210, and 72 ± 233, respectively. On weekends, the most frequently reported activities were free play (61.9%), walking (50.5%), and swimming (29.9%); mean METy-min = 714 ± 1009, 151 ± 280, and 520 ± 1030, respectively. Farm chores were frequently reported on weekdays (9.2%) and weekends (17.5%); mean METy-min = 38 ± 119 and 63 ± 217. CONCLUSIONS: Rural youth commonly report unstructured activities (free play, farm chores) and activities that are not captured well with accelerometry (swimming, biking). Thus, standard PA assessments may need to be augmented to avoid substantially underestimating PA behaviors among rural youth. Supported by NIH awards 1R01HL123699, T32HL150452 (NHLBI) and UL1TR002494 (NCATS).