An exploratory study of mothers engaging in physical activity in rural communities

Figures & data

Table 1. Participant characteristics.

Characteristic	Full Sample N = 17
Number of children in the home, mean ± SD	2.4 ± 1.1
Age in years, mean ± SD	41.3 ± 7.4
Education (n, %)
HS graduate	2, 11.8
College Graduate	14, 82.3
Missing	1, 5.9
Income (n, %)
Less than 40,000	2, 11.8
40,000 or greater	12, 70.6
Missing, declined to respond	3, 17.6
Employment (n, %)
Full-time	10, 58.8
Part-time	4, 23.5
Does not work	1, 5.9
Missing, declined to respond	1, 5.9
Marital status (n, %)
Married	13, 76.5
Divorced	3, 17.6
Missing	1, 5.9

Table 2. Themes with example quotes.

Major Themes	Subthemes	Example quote
Theme 1: Feeling pressure to prioritize family’s needs over one’s own health	Prioritizing family’s needs	… it’s an internal struggle sometimes. It’s not necessarily a physical struggle. It’s an internal thing, like feeling like you’re not spending enough time with family or whatnot, instead of doing something healthy for yourself. (P007)
		Well, for myself, I have a hard time worrying about myself, I’m more dealing with making my children happy, more so myself. Yeah, so I take more time and looking at what they need compared to what I need. (P025)
		All the time, I want my kids active. I want them to be I want them to know and have an experience that they feel they want… I’m just always trying to make sure that they’re healthy, they’re active, and are getting those essential experiences in life. (P003)
	Making choices to be a healthy role model for their family	I have a desire to make healthy foods for them. And for my son, I want to teach him, you know, I need to be a good role model for him and teach him otherwise. No, nobody else will. And then my husband too, for an accountability partner (P023)
		I wanted them to see play is the highest form of learning and we’re going to do it together and it’s going to be an adventure, our way of life or whatever. I just wanted them to catch, catch it versus, you know, this is a punishment. I didn’t want it to be exercising to be a punishment because I think that’s what most people do. You view exercise or physical movement as being punishment versus, hey, my body can do this. Isn’t that amazing? (P020)
		I try to be healthier myself because I know that I’m an influence to my children. That my behaviors directly influence my children and my husband’s behaviors as well, and vice versa. (P014)
	Engaging in physical activity to be a better caregiver	I want to show my son the benefits of being healthy. So he is an athlete, and I want to show him if you put good food in your body, you’re body will be more efficient. And I want to have longevity, I want to stave off diseases. You know, cancer and diabetes have been linked to healthy eating and activity and healthy hearts. (P023)
		I want to stay around for my kids longer. You know, if I don’t take care of myself, I can’t, I can’t, be around for them or grandchildren or whatnot. (p007)
		Well, my family, my kids, I have four kids. I guess I just do want to be there for them. You know, i have a family history of diseases also, so that kind of plays a part in some of this. And I guess, I feel that God has given me these tools. So sometimes I should use them to the best of my abilities … I just feel better. Eat better. Yeah, you just, overall, your mind just clear. Your ideas, you get more productive. (P022)
	Impact of expectations regarding family roles	Um, I don’t know, I mean, they’re always supportive about it. It’s that internal thing that tells you like, oh I should stay home and not go workout … I think, I mean, I have a really supportive husband. So he would do anything for me to do what I need to do, but it’s just that internal thing that you deal with all the time. Like, I should be there for them and not necessarily me all the time. (P007)
		But just, you know, you’re, you’re on the clock. Twenty-four hours a day … .you know, any anybody and especially any parent knows that they the schedules can be quite ridiculous. And just to find the time to fit in your own health care can be difficult. (P013)
	Being the decision maker for family health	But I think in terms of being healthy, you know, we are kind of, or I think most families’ moms are the hub. And if the hub doesn’t feel good, then the whole family doesn’t feel good. (P019)
	Not prioritizing their own selfcare because time with children was limited and timebound	… when they are smaller, you want to spend time with them. And so, in order to go out and do something really healthy by yourself, it’s not always, you know, um, I guess the guilt part of it usually overrides that so I’m not going to go out for a run or go for a bike ride by myself (P007)
		So, I think for me, the too many activities would be things that take up all of our time. Time is spent and you don’t get it back. (P020)
	Intrinsic enjoyment engaging with family as motivation for physical activity	If it’s hard to get out and find time you can just do it in your house. Yeah, I am in the kitchen cooking dinner and me and my daughter were doing squats and then every time we had to get up and we had to change of pot or pan or something we’d have to change the activities, we did push up. Oh, and we did some yoga. Yeah. So I get my I get my kids involved so they want to be in the kitchen and they like to help cooking. So whenever I do in between they have to do it with me. OK, and then I think that is really a bonding time. Yeah. Because you get a laugh with each other and joke and then you know, make it into a dance doesn’t have to be that hard exercise. (p026)
		I use them as my weight. And they love it. They love that. That’s interaction with me that’s enjoyable but then also it’s, it’s giving me and them exercise and tiring them out. (p005)
Theme 2: Family exerting positive and negative influences on health choices	Difficultly finding activities for entire family	Do the five kids inhibit me? Oh man. That that’s an ever changing, ever changing deal. I don’t know if it was and I don’t know if it inhibits or a challenge. I think it depends on your perspective. So some days it does feel like an inhibition, having five kids and then other ways I see it as a challenge, um, passing on the desire to be helpful. When they were little, you know, strap them on a backpack and head out. Now you do it at their, they want to do it by themselves. I guess I have an 11 and 9, a 7 and twin 4 year olds, but they do it at their pace. And so it is slower. And then I just need to be more mindful of passing on good habits and I guess so that comes into the mental and emotional and psychological health too. So I don’t know, I guess is perspective and it goes day by day whether I see them as an inhibition or as a challenge, you know, as a positive challenge. (P020)
	Lack of support from partners	Yeah, my husband, I think that I don’t want to say that’s a lost cause, but I can try and try and try it and unless he’s in the mood. He’s not going to. (P017)
	Desire for dedicated time to participate in exercise alone or with friends	When I’m accountable to someone other than myself, because I don’t have any trouble letting myself down. But if there are things that are scheduled, and I sign up for in advance, I always do them or if I pick someone out or if I have a commitment to someone else, and I, and I do as well. (P006)
	Family encourages trying new or different activities	We got into all of that, dancing more and singing more, and moving more. My son could now participate because he was like two at the time. So I definitely think when I get them involved, things have been easier. The walking has definitely helped a lot. I mean, three miles is still a good workout. (P026)
		I think it’s both. I think daily they keep me on my toes. I honestly can say without my kids I don’t know I’d be bike riding. It’s like one of those things, it’s like, I’m not going to say, I’m going to go bike riding. It’s my kids, they make me go do it. (P019)
		And just that extra encouragement to go for a walk or let’s go walk around the farm. Yes. Or my daughter will want to ride her bike and then we’ll walk with her. Just different, different things. (P017)
	Sharing responsibilities with family members	From like a social standpoint, when, um, your spouse steps in to help you do things that allow you, you know, or to take over something that you feel like you need to have done before you can take the time to do that. That helps. Or if they are active with you. (P006)
		I tend to work out in the morning and my husband gets the kids up for school and then I take them. Yeah, but he gets it in at night so we just try to divide up our time. (P026)
	Support and encouragement from family	So I will say my husband was not always on board with the physical activity. He was a farmer. And so a lot of his job is sedentary, you know, I mean, you’re getting on and off of trackers and things like that, but not cardio workout. And so over time, I think he’s seen how fun it is to bike and how much better he feels. So I will say that it’s gotten easier if we’re both on the same page. (P023)
		I do think relationships are huge with that. I didn’t realize until I made the choices to change, kind of, my lifestyle, and then so it’s not, like, causing, um, I think that anytime that you’re kind of, on that same path when somebody decides like, hey, I need to wait or now have diabetes and I have to make changes, but the other parties are not on board, then all the sudden now, you not only are dealing with the difficulties of living that life, but now having that somebody not necessarily against you, but yet they’re not with you. And so that you don’t have that support. (P005)
		But yeah, no I mean and even if you don’t have kids, I mean I think just having, having someone there to help push you, especially at times I just don’t feel like doing anything. And if I go up to the farm, you know, she’ll say, or my mother-in-law will say, oh lets go for a walk on the farm, or, it’s just so nice out. (P017)
Theme 3: Living in rural communities often resulted in a lack of health opportunities and feelings of isolation from social networks and health resources	Distance from family and social network:	Now, when I you know, everything is pretty much focused on the boys, I’ve lost some of that opportunity just because I’m busy with the kids. So that’s where I try to make up for that in, you know, getting them out. I don’t I don’t have a lot of opportunities for social circles. I don’t really have I don’t really have any friends that I could even exercise with. Like I have a good friend who she gets up at five o’clock every morning and goes walking with someone else, but which is fantastic. But she also lives in town. And so it’s a little more easy. So and you might touch on that, too, you know, geography. But out in the country, your options are a little less. We do live next to a bike path. (P013)
	Lack of community resources	I know some towns have things where you can walk like you could walk malls if you’re living in the cities or you could walk. I don’t know you places where you could walk inside [in my town]. (P005)
		Um, I think if there was more, well, I live in a rural area. I think if there was more availability to something more local for like a gym, or even daycare. If there was an outlet for me to go do, like a moms like, something that was specifically for me that was local would be tremendously helpful. (P018)
		We live in a very small community. There’s nothing here. I would love to take my kids to, like, a pool, but now you have to go to a pool that is like 50 minutes away. It’ll be nicer if offered within our community. (P019)
		Don’t have the time to drive somewhere really far to workout, like going to a YMCA or going to a workout class, because I just don’t have the time. And if I was part of a club, I feel like I would be throwing money away. And I would be stressed out knowing I’m throwing money away and I’m still not getting there to work out. Or it would take more time away from our family. Because you also have to take into consideration the driving time. (P021)

Table A1. Saturation of themes and subthemes.

	Subthemes	p003	p005	p006	p007	p010	p012	p013	p014	p017	p018	p019	p020	p021	p022	p023	p025	p026
Theme 1	Prioritizing family’s needs	x	x	x	x	x	x	x		x	x	x	x	x	x	x	x	x
	Making choices to be a healthy role model for their family	x	x	x	x		x		x	x	x	x	x	x	x	x	x	x
	Engaging in physical activity to be a better caregiver	x	x	x	x	x	x		x	x	x	x	x	x	x	x	x
	Impact of expectations regarding family roles	x		x	x	x	x	x		x		x	x	x	x	x	x	x
	Moms are the primary decision maker in regarding family health decisions	x		x	x	x	x	x		x		x	x	x	x	x		x
	Not prioritizing their own selfcare because time with children was limited and timebound	x	x	x	x		x		x	x		x	x	x	x		x	x
	Intrinsic enjoyment engaging with family as motivation for physical activity	x	x	x	x	x	x	x	x	x		x	x	x	x	x	x	x
Theme 2	Difficultly finding activities for entire family	x	x	x			x	x	x	x		x	x	x			x	x
	Lack of support from partners	x	x					x	x	x	x			x			x	x
	Desire for dedicated time to participate in exercise alone or with friends	x	x	x	x	x	x	x	x		x							x
	Family encourages trying new or different activities	x	x	x	x	x	x	x	x	x		x	x	x	x		x	x
	Sharing responsibilities with family members	x	x	x	x	x	x	x	x			x	x	x	x	x		x
	Support and encouragement from family	x	x	x	x		x	x	x	x		x	x	x	x	x	x	x
Theme 3	Distance from family and social network:	x	x	x		x		x	x	x		x	x	x		x	x	x
	Lack of community resources	x	x			x	x	x		x	x	x	x	x		x	x	x