Barriers to physical activity for adults in rural and urban Canada: A cross-sectional comparison

Chelsea A Pelletier; Nicole White; Annie Duchesne; Larine Sluggett

doi:10.1016/j.ssmph.2021.100964

Barriers to physical activity for adults in rural and urban Canada: A cross-sectional comparison

SSM Popul Health. 2021 Nov 12:16:100964. doi: 10.1016/j.ssmph.2021.100964. eCollection 2021 Dec.

Authors

Chelsea A Pelletier¹, Nicole White^{1

2}, Annie Duchesne², Larine Sluggett³

Affiliations

¹ School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada.
² Department of Psychology, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada.
³ University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, V2N 4Z9, Canada.

Abstract

Background: Individual differences in physical activity behavior are associated with a collection of individual and environmental factors manifesting as barriers to participation. Understanding how barriers to physical activity differ based on sociodemographic characteristics can support identification and elimination of health inequities.

Objectives: To compare the odds of reporting individual and environmental barriers to physical activity in rural and urban adults, and explore interactions between rural-urban location and sociodemographic factors to characterize patterns in barriers to physical activity.

Design: Cross-sectional.

Methods: We analyzed the 2017 Canadian Community Health Survey Barriers to Physical Activity Rapid Response, with a final weighted sample of 24,499,462 (unweighted n=21,967). The likelihood of reporting each barrier domain based on rural-urban location was examined using binary logistic regression following a model-fitting approach with sociodemographic characteristics as covariates or interaction terms.

Results: Adjusting for sociodemographic factors, rural residents showed 85% higher odds of reporting at least one social or built environmental barrier (OR=1.85 [1.66, 2.07]). Compared to urban residents, rural residents showed significantly higher odds of reporting barriers to facility access (OR=4.15 [3.58, 4.83]) and a lack of social support to be active (OR=1.17 [1.04, 1.32]). Urban residents reported lower preference for physical activity, lower enjoyment of physical activity and lower confidence in their ability to regularly engage in physical activity. Interactions between socioeconomic status and location were identified related to enjoyment and confidence to be active. There was no effect of location on predicting the odds of reporting an individual resource-related variable (e.g., time, energy).

Conclusions: Despite being more likely than urban residents to prefer and enjoy physical activity, rural residents have fewer opportunities and receive less social support to be active. It is important to consider geographic location when characterizing barriers to physical activity and in the development of context-specific health promotion strategies.

Keywords: Barriers; Exercise; Health promotion; Physical activity; Rural health; Rural-urban disparities; Social-ecological model.