Development of the Rural Activing Living Assessment Tools: Measuring Rural Environments
Objective: Develop rural-specific assessment tools to be used by researchers and practitioners to measure the activity-friendliness of rural communities.
Method: The tools were created through a mixed-methods investigation into the determinants of physical activity among rural populations. This informed the development of a conceptual framework defining activity-friendly rural environments. Questions were generated to reflect applicable existing urban-based variables and rural conceptual model elements. Pilot testing was conducted in seven rural US communities during the fall of 2008. Inter-rater reliability was assessed.
Results: The Rural Active Living Assessment (RALA) Tools include three components: Town-Wide (18 town characteristic questions, and inventory of 15 recreational amenities), Program and Policy (20 questions), and Street Segment (28 questions). We found that the Town-wide and Program and Policy tools were feasible for community members to implement. The observed agreement and k statistic across all items for the Street Segment Assessment were substantial (91.9% and 0.78, respectively).
Conclusions: The RALA Tools were shown to be feasible and reliability was supported. They assess features believed to be supportive of active living in rural environments, offer users a resource to assess rural environments for activity-friendliness, and may also inform the design of interventions to help rural communities become more active and healthy. [Journal Abstract]
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Policy Brief on Federal Health Care Reform
In this policy brief, Dr. Andrew Coburn of the Muskie School discusses three of the main components of the Patient Protection and Affordable Care Act (ACA): health insurance coverage, delivery system improvement, and cost containment, highlighting some of the provisions of the law that have already been implemented and those where important implementation decisions will have to be made.