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The article focuses on potential unintended outcomes of policy and environmental strategies to increase physical activity in rural communities. Topics discussed include the increased risk of injury or illness due to changes in infrastructure, rural gentrification resulting from the creation of greenspaces, and the widening of health inequities and disparities in access to physical activity resources.

The Health Equity Advancement Lab (HEAL) at the University of Iowa College of Public Health began in 2012 to support students, researchers, and community members interested in tackling persistent health inequities through a community‐based participatory research (CBPR) approach. Using concepts from critical consciousness theory, we developed an approach to building students', faculty members', and community partners' capacity to engage in CBPR to promote health equity that involved immersion in developing CBPR projects. Our paper describes the evolution of HEAL as a facilitating structure that provides a support network and engages diverse stakeholders in critical reflection as they participate in research to advance health equity, and resulting political efficacy and social action. We describe one HEAL‐affiliated research project that employs a CBPR approach and has a strong focus on providing transformative learning experiences for students, faculty, and community members. We highlight challenges, successes, and lessons learned in the application of critical consciousness as a framework that engages diverse academic and community partners seeking to promote health equity. We argue that critical consciousness is a relevant theoretical framework to promote transformative learning among students, faculty, and community partners to promote health equity research in diverse communities. Highlights: This paper describes the development and evolution of the Health Equity Advancement Lab (HEAL).HEAL emphasizes transformative learning opportunities for students, faculty and community partners.HEAL is guided by community‐based participatory research principles & critical consciousness theoryHEAL creates a support network to promote health equity research in diverse communities.We describe one HEAL‐affiliated CBPR study that exemplifies transformative learning experiences. [ABSTRACT FROM AUTHOR]

Assessing community and organizational readiness is key to successfully implementing programs. The purpose of this study was to assess the baseline readiness of micropolitan communities to adopt an evidence-based physical activity (PA) intervention by exploring three dimensions: (1) attitudes and current efforts toward prevention, (2) community and organizational climate that facilitates (or impedes) change, and (3) capacity to implement change.Data were collected from community leaders in 14 communities through an online survey in June 2021 (n = 149). Data were analyzed in aggregate using descriptive statistics for multiple-choice responses and content analysis for open ended responses. One-way repeated analyses of variance were used to compare mean score differences.In reference to their attitudes prior to the pandemic, respondents said that addressing PA was “somewhat a priority” in their professional positions (M = 2.01, SD = 0.94), their organizations (M = 2.08, SD = 0.91), and their communities (M = 2.28, SD = 0.88). Current PA efforts included statewide initiatives, community sponsored events/clubs, and youth sports leagues. The community climate included both PA facilitators (mainly outdoor PA resources) and barriers (cost, lack of social services, and an unsupportive PA environment). Individual-level capacity (M = 2.94; SD = 1.21) to adopt a PA program was regarded lower than the community’s capacity (M = 3.95; SD = 0.82), and perceptions of capacity at the community level improved even more if technical assistance (M = 3.96; SD = 0.84) or financial support (M = 4.12; SD = 0.80) were provided.Readiness varied by dimension, suggesting the need for tailored implementation supports including technical assistance and financial support. [ABSTRACT FROM AUTHOR]

Background: Evidence-based falls prevention programs are available in many communities, but participation in such programs remains low. This study aimed to develop community-based referral networks of organizations to facilitate the uptake of evidence-based falls prevention programs through engaging older adults at risk for falls with the RememberingWhen™ program and connecting them to evidence-based programs in Midwestern communities. Methods: Guided by the Practical, Robust Implementation and Sustainability Model (PRISM), referral networks were developed in two Midwestern communities (urban and micropolitan) through a seven-step community engagement plan: establishing and operationalizing the State-level Advisory Board (SAB), identifying falls prevention resources, conducting community assessments, developing Local Advisory Groups (LAG), operationalizing the LAG, developing referral network and protocols, and implementing the network. Semistructured interviews guided by the RE-AIM framework were conducted with members of the SAB, LAG, administrators and staff from organizations that participated in networks, and older adult participants. Results: After participating in the development of referral networks, participants felt they learned important skills that they can use to develop additional collaborations and networks in the future, emphasized the benefits of building community capacity among organizations with common missions. Interview data yielded strategies on enhancing the referral network’s reach, impact, adoption, implementation efficiency, and maintenance. Conclusion: Future sustainability studies of such networks should explore identified challenges and strategies to sustain efforts. Results highlight the importance of ongoing funds to support the efforts of organizational networks in communities. [ABSTRACT FROM AUTHOR]

The development and distribution of educational materials is a key strategy to support the implementation of evidence-based interventions (EBIs). Rural communities have higher rates of physical inactivity and face higher burden of many diseases that increased physical activity can prevent. To support the translation of a developed physical activity intervention for adults in micropolitan communities (10,000-50,000 people), called Active Iowa, the University of Iowa Prevention Research Center for Rural Health (PRC-RH) created a toolkit and supplemental resources designed to guide implementers through the implementation of the intervention. Through a community-engaged process, the PRC-RH underwent three phases of review and evaluation of the developed products. The first phase involved the Community Advisory Board from the pilot intervention, the second involved the PRC-RH State Advisory Board and public health practitioners from across the state, and the third involved micropolitan leaders and micropolitan health department staff. The feedback received through these three phases resulted in changes to the developed products to improve usability, readability, and clarity. The feedback also resulted in the development of additional materials to further support the implementation of the intervention. The success the PRC-RH experienced in the review process can be attributed to the strong, established partnerships with practitioners across the state who represented a variety of community roles and organizations. The developed materials can be used to improve physical activity rates in rural and micropolitan communities, in turn reducing chronic diseases and improving the quality of life for rural residents., Competing Interests: Conflicts of Interest: There are no conflicts of interest to disclose., (© JHEAL, 2024.)