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UKnowledge > College of Public Health > Journal of Appalachian Health > Vol. 7 (2025) > Iss. 3

 

Corresponding Author

Lydia Hoskins, M.S.: hoskinsl@etsu.edu

Jodi L. Southerland, DrPH: southerlanjl@mail.etsu.edu

Author Affiliations

  1. Lydia Hoskins, MS: DrPH Student, College of Public Health, Department of Community and Behavioral Health, East Tennessee State University (Johnson City TN); E-mail: hoskinsl@etsu.edu; ORCiD: https://orcid.org/0009-0009-0905-579X
  2. Jodi L. Southerland, DrPH: Assistant Professor, College of Public Health, Department of Community and Behavioral Health, East Tennessee State University; ORCiD: https://orcid.org/0000-0002-8092-7126

Author Area of Expertise

LH: Older adults, Chronic Conditions prevention and management, Physical activity, and community-engaged research

JS: Age-friendly communities, Aging-in-Place, Caregiving, Gerontology, Intergenerational activities, Long-term and community-based services and supports, Older adults, Mixed methods and community-engaged research

Abstract

Introduction: Older adults in East Tennessee (TN), the fastest growing demographic, face significant health challenges, with 44% reporting four or more chronic conditions. The state ranks 45th in physical inactivity among older adults, exacerbating chronic disease risks, fall-related injuries, and mental health issues. Urban-rural disparities in East TN further complicate efforts to promote active living, particularly for rural residents.

Purpose: This qualitative study explored socioecological barriers and solutions to increase physical activity (PA).

Methods: In April 2024, two focus group were conducted in East TN, with a total of 11 participants composed of six community partners and five older adults. A semi-structured interview guide explored PA attitudes, beliefs, and behaviors and gathered recommendations for increasing physical activities among older adults. Data were analyzed thematically using a socioecological framework at individual, organizational, and community levels.

Results: Barriers at the individual level included poor physical, psychological, and social health, and low digital literacy skills. Organizational-level barriers included limited capacity to support PA programming (e.g., staffing, facilities, and funding limitations) and overlapping community program efforts. Community level barriers included limited social support networks and inadequately built environmental features for active living. Solutions highlighted the role of relationships (e.g., peer-to-peer, trusted facilitators) at the individual level, tailored programming and marketing efforts at the organizational level, and leveraging local resources and multi-system collaborations at the community level.

Implications: The findings highlight socioecological factors contributing to physical inactivity in East TN older adults and identifies strategies to address them. These findings can inform sustainable, multi-systems interventions to promote PA in the region.

DOI

https://doi.org/10.13023/jah.0703.08

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

Recommended Citation

Hoskins L, Southerland J. Identifying barriers and place-based solutions to physical activity for older adults in East Tennessee. J Appalach Health 2025;7(2/3):105-119. DOI: https://doi.org/10.13023/jah.0703.08

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