Rural Libraries Promoting Walking and Walkability in Their Rural Communities

Study Overview
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Brief Summary
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The investigators will randomize 20 rural libraries to implement either a group-based walking (standard approach) or a group-based walking combined with a civic engagement program (combined approach). Each rural library will enroll between 15-20 participants. The investigators will compare the change in physical activity between participants in each group.

Detailed Description
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The goals of this study are: Increase the capacity of rural libraries to deliver evidence-based health promotion programs Compare the effects of a group-based walking program with a combined group-based plus civic engagement program on physical activity, cardiovascular fitness and collective efficacy among rural residents. Evaluate program implementation

Official Title
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Rural Libraries Promoting Walking and Walkability in Their Rural Communities

Conditions
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Physical Activity

Intervention / Treatment
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* Other: Walking only (Step It Up!)
* Other: Combined (Step It Up! plus Civic Engagement)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age 18 or older Inactive (defined as engaging in physical activity <3 days per week) Ability to walk for at least 20 minutes Living within the rural community served by the local library Ability to travel to the local library/location of walking group. Exclusion criteria: Participation/intention to participate in other lifestyle modification pro-gram(s) Cognitive impairment Inability to communicate due to severe uncorrected hearing loss or speech disorder or severe visual impairment (if precludes completion of assessments and/or intervention)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Walking only (Step It Up!)<br>A group-based, weekly walking program (Step It Up) where participants walk for up to 45 minutes. | Other: Walking only (Step It Up!)<br>* Participants will meet weekly for 60 minutes and walk together as a group. Participants will progressively build up to walking for 45 minutes at a brisk pace. Walks will start with a check-in and end with stretching as a group.<br>|
| Experimental: Combined (Step It Up! plus Change Club)<br>A group-based, weekly walking program (Step It Up) where participants walk for up to 45 minutes. Participants also spend 30 minutes each week in a civic engagement program (the Change Club) improving walkability in the community | Other: Walking only (Step It Up!)<br>* Participants will meet weekly for 60 minutes and walk together as a group. Participants will progressively build up to walking for 45 minutes at a brisk pace. Walks will start with a check-in and end with stretching as a group.<br>Other: Combined (Step It Up! plus Civic Engagement)<br>* Participants in the combined groups will meet weekly for 90 minutes with group members. They will participate in a group walk for 60 minutes followed by 30 minutes of civic engagement aimed at improving walkability in the community<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Physical activity | Participants will be asked to wear an accelerometer for >10 hours/day for seven days at the wrist to measure physical activity. An accelerometer is a small device worn at the wrist that records acceleration, the change in velocity of a participant over time. | Change from baseline physical activity at 6 months, 12 months, and 24 months. | 
| Cardio respiratory fitness | Participants will be asked to complete a six-minute walk test to measure cardiorespiratory fitness. The distance walked in 6 minutes will be recorded. | Change from baseline cardio respiratory fitness at 6 months, 12 months, and 24 months. | 
| Collective Efficacy | Participants will be asked to complete a survey regarding collective-efficacy, the Collective Efficacy Scale (Sampson and colleagues, 1997), which measures how well communities work together to make things happen. | Change from baseline collective efficacy at 6 months, 12 months, and 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Height | Researchers will measure the height of participants in inches. | Baseline | 
| Hip circumference | Researchers will measure the hip circumference of participants in inches. | Change from baseline hip circumference at 6 months, 12 months, and 24 months. | 
| Resting heart rate | Researchers will measure resting heart rate of participants by using heart rate monitor. | Change from baseline resting heart rate at 6 months, 12 months, and 24 months. | 
| Weight | Researchers will measure the weight of participants in pounds. | Change from baseline weight at 6 months, 12 months, and 24 months. | 
| Blood pressure | Researchers will measure the both diastolic and systolic blood pressure of participants using a sphygmomanometer. | Change from baseline blood pressure at 6 months, 12 months, and 24 months. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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rural populations, physical activity promotion