A Community-Based Approach to Promoting Walking in Rural Areas

Benefits studied:
Uses studied:
Region: ,
Place: Multi-State


This study found that in southeastern Missouri, public health interventions to increase residents’ trail use, such as newsletters and fun walks, had no statistically-observable effect on residents’ walking habits or physical activity. A third of those who use the trail report increased overall physical activity levels since they began using the trail, suggesting while that trails can increase community physical activity, a primary challenge is getting residents to begin using them.


This study would be useful for those interested in finding the most effective ways to increase residents’ trail use and overall physical activity. Because this community has experienced long-term increases in trail use, it is likely that years of promotional activities in aggregate, rather than a single event, gradually affect participation. This suggests that those interested in increasing trail use should adopt a long-term communications strategy rather than a single, large promotional campaign.


The study looked at six rural communities in southeastern Missouri, and six rural communities in Arkansas and Tennessee. The Missouri communities are considered high-risk, with higher poverty, less medical access, and lower educational levels. These communities also were targeted for an earlier study on the role trails play in physical activity (see 76).

Trail Type

Each community had walking trails, often located in residential parks, ranging from 0.13 to 2.38 miles.


The purpose of the study is to demonstrate the effectiveness of interventions designed to increase walking, including the development of walking trails. The study was supported by the Centers for Disease Control and Prevention.


  • Of those who used trails, one-third reported that overall physical activity levels had increased since they started using trails.
  • Specific outreach interventions did not appear to have an effect on walking rates.
  • One-quarter of residents were aware of the trails.
  • Seventeen percent of residents reported using the trails, compared to only 8 percent reported from an earlier 1998 study.

The findings are similar to another study in Sydney, Australia (49), which was unable to attribute increased trail use to a campaign promoting a new trail.


The authors interviewed 500 randomly sampled residents in the Missouri communities and 429 in the non-Missouri communities via phone, asking questions about demographics, trail use, and physical activity levels. The response rate was not reported. The respondents were surveyed in December, 2000 through May, 2001 to establish a baseline, and again between June and August, 2002, to observe changes in walking rates after the outreach interventions.

Residents in the Missouri communities were targeted for interventions to encourage walking, including promotional newsletters and fun walks on the trails. The communities in Arkansas and Tennessee (control communities) did not have any interventions.

The authors estimated trail use using electronic trail counters as well as electronic card readers that participants swiped when they entered the trail. The card readers were used to verify self-reported data regarding frequency and duration of trail use.

The authors estimated a statistical model to determine whether interventions had a statistically significant effect on walking.


Brownson, R., E. Baker, R. Boyd, N. Caito, K. Duggan, R. Housemann, M. Kreuter, T. Mitchell, F. Motton, C. Pulley, T. Schmid, and D. Walton. 2004. “A community-based approach to promoting walking in rural areas.” American Journal of Preventive Medicine 27(1): 28-34.