Do obesity-reduction programs targeted to rural populations use CDC's 12 Common Community Measures for Obesity Prevention (COCOMO) for physical activity - and if so, do these strategies work?
To find out, a workgroup from 11 of the 21 academic centers participating in the CDC-funded Physical Activity Policy and Research Network conducted a review of the relevant literature from 2002 to 2013. Of the 26 studies that reported on strategies to support physical activity in rural areas, 22 reported on COCOMO strategies. The two most common strategies, implemented in 10 of the studies, were enhancing infrastructure to support walking and increasing opportunities for extracurricular physical activity. Only 14 studies measured or reported physical activity outcomes, and of the 10 that reported positive changes in physical activity, only four reported significant positive changes.
Seven of the 12 strategies were successfully implemented in two or more studies, suggesting that these strategies are relevant in rural communities. However, the researchers could not assess overall effectiveness of the strategies across studies because of variation in settings, methods, and results.
The researchers suggest that while the literature review suggests that COCOMO physical activity strategies are applicable in rural settings, future studies should be more robust in study design and measurement of outcomes.
"Few studies used objective measurement," they noted. "Rural evaluations need to consistently measure physical activity using accelerometers for a better understanding of intervention effectiveness."
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