[ This article by Joey Pitchford was originally published at NC State News. ]

FOR IMMEDIATE RELEASE

Annie Hardison-Moody | amhardis@ncsu.edu
Matt Shipman | matt_shipman@ncsu.edu

People in rural communities have long experienced disproportionate levels of chronic disease, driven in part by systemic barriers to physical activity. A new study from NC State University highlights ways some rural communities use strategic investment and community collaboration to address some of these challenges.

Researchers interviewed 25 health promotion, parks and recreation and community planning professionals, referred to as Key Informants , (KIs) from 10 rural counties in North Carolina to better understand how they make decisions around promoting physical activity.

“What we found is that many rural communities must account for long-standing obstacles when trying to build physical activity access,” said Annie Hardison-Moody, a professor in NC State’s College of Agriculture and Life Sciences and an associate director and Family and Consumer Sciences program leader with NC State Extension.

“These practitioners are embedded in structural realities that shape their everyday decisions, and some of those are difficult historical and systematic issues that they’re facing,” she said. “Whether it’s continued impacts from flooding and hurricanes that have kept their communities struggling to get by, or economic disinvestment in communities, there are significant obstacles that rural communities face.”

These obstacles make it difficult to maintain and promote spaces for physical activity. Even in places where facilities like parks or playgrounds already exist, a degrading tax base makes paying staff for those facilities difficult. Higher levels of poverty and chronic illness may also make transportation to these facilities difficult even if the facilities are functioning properly.

The researchers found that these obstacles shaped how KIs working to promote physical activity in their communities must allocate resources, which are in short supply to begin with. Informal partnerships and relationships with the members of their communities were vital for sustaining physical activity promotion.

“Because there is so little funding in these communities, you have people doing multiple jobs who realize they cannot do it all on their own,” Hardison-Moody said. “What we see is KIs looking to build out those networks in their communities. People in these counties possess incredible partnership skills, and the networks they build are extremely important for health practitioners to tap into if they want to do work in these communities.”

In trying to address these issues, KIs reported that many traditional grants or funding sources simply do not work for their specific contexts. For example, grants may assume a community has access to matching funds, pre-existing partnerships or full-time administrative staff which rural counties do not have. This puts local leaders at a disadvantage from the start, as they do not have access to the financial building blocks which could be used to address their needs.

Despite these challenges, KIs pointed out several bright spots, such as forming multi-agency partnerships and using collaborative funding models that help address their most challenging issues. The KIs identified resources and assets that existed in their communities, including recreation resources and natural environments that could be harnessed to promote health.

This research is part of a collaborative project funded by the Centers for Disease Control and Prevention (CDC), which selected the 10 counties researchers visited.

“This study exemplifies the best of the work we can do at a land-grant university, because we are working so closely with so many partners on the ground in these communities,” said Hardison-Moody. “From park and recreation directors, our partners in NC State’s Department of Parks, Recreation and Tourism Management (PRTM), and then on the Extension side, working with our Family and Consumer Sciences and 4-H agents,” she said. "This information isn’t just going to sit in a journal somewhere — we’re actively building on what we’ve learned and working with PRTM, working with Extension to try to implement projects in the communities.”

This publication was supported by the CDC of the U.S. Department of Health and Human Services (HHS). The contents of the journal article are those of the authors and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS or the U.S. government.

The paper, “Context Matters: How History, Relationships, and Resourcefulness Shape Rural Physical Activity Systems,” is published in the Journal of Rural and Community Development. Co-authors include Pauline Grist, Michael Edwards, Brenna Kirk, Jason Bocarro, Nicole Odell, Maeghan Luttrell, Lauren Morris, Virginia C. Stage, Basheerah Enahora and J. Aaron Hipp of NC State University.

Note to Editors: The study abstract follows.

“Context Matters: How History, Relationships, and Resourcefulness Shape Rural Physical Activity Systems”

Authors: Pauline Grist, Annie Hardison-Moody, Jason Bocarro, Michael Edwards, Brenna Kirk, Nicole Odell, Maeghan Luttrell, Lauren Morris, Virginia Stage, Basheerah Enahora, Aaron Hipp, NC Sate University.

Published: May 25, 2026, Journal of Rural and Community Development

DOI: 10.63315/jrcd.v21i2.3035

Abstract: Rural communities experience disproportionately high rates of chronic disease, a disparity influenced by lower levels of physical activity (PA) and persistent systemic and structural barriers. Using a constructivist grounded theory approach, we conducted 25 semi-structured key informant (KI) interviews to explore how county–municipal planners and parks and recreation professionals in 10 rural North Carolina counties navigate barriers (e.g., disinvestment, vulnerability to natural disasters, limited administrative capacity) and leverage facilitators (e.g., partnerships, shared infrastructure) to promote PA in their county. Findings revealed two structuring realities: Acknowledging Historical Challenges and Seeking Community Engagement, which consistently shaped stakeholders’ approaches. KIs described the long-term impacts of industry loss, disinvestment, and natural disasters as defining features of their community landscape, highlighting how local trust, informal networks, and community voice are essential to every stage of their work. These orientations informed three interrelated processes: Managing Financial and Organizational Resources, Maintaining Community Infrastructure, and Exploring Opportunities for Community Development and Collaboration. KIs emphasized the importance of relying on partnerships, relational networks, and adaptive strategies to sustain PA opportunities despite resource constraints. Our findings underscore the need for long-term and context-specific investment in relational and organizational capacity that aligns with communities’ historical and structuring realities to improve rural PA opportunities.