Method: Researchers employed a community-based participatory research framework to guide collaboration during a multi-component needs assessment. Three data sources were collected: (1) Two town hall meetings to solicit feedback from community members (N=80) regarding recommendations for school-based physical activity; (2) Three focus groups with school personnel (N=22, Females=15) to identify existent strengths, weaknesses, opportunities, and threats relative to intervention; (3) School site visits (N=11) including semi-structured interviews with school personnel concerning contextual issues.
Analysis/Results: The town hall forums resulted in quantitative measures that were analyzed descriptively that indicated despite a reasonable degree of proximity to school facilities and a belief that physical activity opportunities should be accessible in the evenings/weekends, residents infrequently accessed facilities outside-of-regular school hours for these purposes. The focus group data were transcribed and deductive analysis was used to identify emergent themes: Strengths (school environment can provide the structure for students to make healthy choices), Weaknesses (schools lack appropriate, safe, and accessible facilities that meet the needs of many families), Opportunities (need to invest resources into additional programs and equipment/facilities, including transportation), and Threats (considerable number of macro-level issues such as poverty, multi-generational/aging families, condition of facilities/rampant vandalism, drug use/abuse, and road/travel conditions offer major impediments to sustainable change). The site visit data were summarized into school-specific narratives that described the context, space/facilities, and the school assets/needs. The narratives were shared with school personnel to check accuracy and analyzed for commonalities: Initiating CSPAPs, Supporting Current Programs, Use of State-mandated Fitness Tests, Outdoor Play Space Revitalization, and Joint-use Agreements).
Conclusions: Before schools invest resources into the development of CSPAPs, it is recommended that they first determine the feasibility of the approach. The results of this study support the development of CSPAPs in rural communities and provide insight into the factors influencing sustainability including policy change and environmental modification, investment in local people as a resource, school-community partnerships, and use of existent organizational infrastructure. This study provides a framework for other rural Appalachian communities interested in understanding their own facilitators and barriers to effective school-based intervention.