Strategic planning to improve the physical activity behaviors of rural Maine adolescents
Drewette-Card, Rebecca Jean
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Despite the well-known benefits for youth, fewer than half of adolescents, both nationally and in Maine, meet current physical activity recommendations. Impacting young people’s physical activity is important for their physical, mental, emotional, and social health, as youth health behaviors are predictive of the same behaviors in adulthood, and physical activity levels decline in the transition from adolescence to adulthood. Rural areas have unique challenges that negatively impact physical activity including fewer physical education classes, sidewalks, and exercise facilities. While evidence is emerging on the best approaches to physical activity promotion in urban settings, best practices for rural areas are less well-defined. Rural communities interested in improving adolescent physical activity need to develop strategies that are based on existing evidence and theory, but also meet local needs. Intervention Mapping (IM) is a framework that can effectively guide strategy development. It involves six steps, beginning with a community assessment and ending with an evaluation plan to assess the implementation and effectiveness of the selected intervention strategies. IM was implemented in Machias, a rural Maine community, to develop a community-specific strategic plan to increase adolescent physical activity. Lessons learned from formative evaluation of the framework’s implementation included the importance of having an individual lead the process, how to complete the work within a specific number of meetings, which phases require more time to complete, and how to complete multiple phases simultaneously. Based on the experience in Machias, recommendations for the Maine Center for Disease Control and Prevention (Maine CDC) were developed to replicate the process in other communities. The recommendations, building on the existing Health Maine Partnership (HMP) structure, include creating a workgroup of Maine CDC and local HMP staff to identify a common planning process that could be used by all communities, be it IM or another process; developing a toolkit and worksheets to guide that process; and implementing a training plan. The experience in Machias is an example for similar communities on how to engage in a systematic strategic planning process to improve adolescent physical activity behaviors and potentially the health challenges faced by of other population groups.