Environmental Supports For Physical Activity During Pregnancy Across Levels Of Rurality

PURPOSE: To test the hypothesis that environmental supports for physical activity will be lower with greater rurality in pregnant individuals. METHODS: This secondary analysis from the Pregnancy 24/7 cohort study used data collected during each trimester of pregnancy from two study sites (Iowa City, IA and Morgantown, WV). LTPA was self-reported via the Pregnancy Physical Activity Questionnaire (PPAQ) and scored as MET-hr per week. Environmental supports were measured via the self-reported Environmental Supports for Physical Activity Questionnaire, which provides a score where higher values indicate better environmental support for physical activity (range of 0-195). Based on Rural-Urban Commuting Area (RUCA) codes, participants were classified as metropolitan urban (RUCA 1-3), micropolitan rural (RUCA 4-6), or small-town rural (RUCA 7-10). ANOVA compared leisure time activity durations and environmental physical activity support scores across rurality groups; post hoc tests determined pairwise differences. RESULTS: Among the 375 participants (mean age 30.2 ± 4.5 years), significant differences in LTPA across rurality groups were only significant in the second trimester (p < 0.001). Additionally, significant differences in environmental support scores were observed, with metropolitan urban groups reporting greater environmental support for physical activity compared to both micropolitan and small-town rural groups. See table for details. CONCLUSIONS: Pregnant individuals in micropolitan rural and small-town rural areas report both lower LTPA levels in their second trimester and lower environmental supports and resources for physical activity. Increasing access and support for physical activity resources warrants further investigation as a strategy to promote activity among pregnant women in rural areas. - Table. LTPA and Environmental Supports for Physical Activity in Pregnant Individuals. Metro(N = 264) Micro(N = 42) Small Town(N = 69) Overall(N = 375) p-value LTPA (MET hrs/week) Trimester 1 13.4 (11.9) 10.7 (12.6) 9.94 (11.2) 12.5 (11.9) 0.061 Trimester 2 14.7 (13.2) 8.71 (9.81) 9.74 (12.5) 13.2 (13.0) 0.002 Trimester 3 11.8 (10.6) 11.0 (12.7) 9.60 (12.1) 11.3 (11.1) 0.395 Environmental Supports Score 53.7 (9.67) 47.4 (11.6) 47.7 (12.8) 51.9 (10.9) <0.001 Supported by: The Pregnancy 24/7 Cohort Study is supported by grant R01HL153095 from the National Heart, Lung, and Blood Institute (NHLBI).