Search

The purpose of this study was to inform a community-engaged partnership concerned with mental health in their community by exploring factors associated with depression among a sample of residents in a micropolitan city in a rural state. Social and contextual factors are important influences on depression risk, but most research in this area has focused on urban settings. Micropolitan areas (midsize rural communities centered around a population core of 10,000-50,000 people) are home to the majority of rural residents and this specific social and economic context may have unique influences on depression risk. Using a random-digit-dial sampling method, adult residents completed a phone interview that assessed a range of health behaviors and measures of quality of life, social support, neighborhood context, and discrimination (n = 1101). Results indicated that being male, having a partner, and being a high school graduate protected against moderate to severe depression, whereas inadequate social support, perceived unfair treatment, and lower neighborhood cohesion were associated with moderate to severe depression. Increases in poverty were significantly associated with greater odds of reporting moderate to severe depression. This study demonstrated that factors associated with depression are similar factors in rural and urban areas, however, the prevalence of these factors may differ along the rural-urban continuum, and should be considered when developing and implementing mental health prevention and control interventions.

Background: Evidence-based interventions have been developed and tested to promote physical activity, but fewer studies have focused on identifying effective intervention strategies for mid-size rural communities, especially new immigrant destinations. We report here on the design and implementation of Active Ottumwa, a community-wide intervention using a lay health advisor approach to increase physical activity in a micropolitan new destination community in the rural state of Iowa. Methods: The Active Ottumwa study is part of a community-academic partnership in Ottumwa, IA. Evidence-based strategies recommended by the Community Guide for Preventive Services guided study implementation and included behavioral and social, campaign and informational, and environmental and policy approaches. Evaluation methods for this study are multi-faceted and include a cross-sectional community survey, longitudinal cohort assessment, observational data, key informant interviews, and project records. Results: We are currently in our second year of intervention implementation, with 45 lay health advisors (termed physical activity leaders here) trained to carry out behavioral and social intervention approaches, including walking groups, tai chi, and yoga. We have completed a communication and informational campaign utilizing five channels. Our longitudinal cohort has been recruited, with baseline and 12-month data collection completed. Conclusions: This study will assess the effectiveness and impact of a community-wide intervention to support physical activity.