Physical Activity Promotion in Extremely Rural Districts: An Analysis of Facilitators and Barriers in 13 Rural...

Physical activity (PA) is a fundamental determinant of health, but governments face challenges promoting it. This holds particularly true for rural areas, which are home to a third of the population in the European Union. This study explores (1) to whom local government officials in extremely rural districts attribute the responsibility for PA promotion and (2) which barriers and facilitators they encounter when attempting to implement PA promotion projects.

We conducted semistructured interviews with 24 officials responsible for PA promotion across 13 districts in the German state of Bavaria. Qualitative content analysis was applied to identify the allocation of responsibilities, as well as facilitators and barriers for rural PA promotion.

Respondents characterized PA promotion in extremely rural areas as a multisectoral endeavor, considering sport clubs as central to program implementation and local governments as key providers of PA-friendly infrastructures. They named policymakers' awareness for the issue, strong political support for project implementation, and well-established networks with external collaboration partners as important facilitators of PA promotion. Limited human and financial resources, requirements of funding schemes, inadequate infrastructures, and political challenges were identified as main barriers.

Results indicate that rural municipalities in Germany may require specially tailored funding schemes and PA promotion programs to strengthen existing structures, overcome barriers, and support local development. While confirming general findings from previous international research, this study may still provide important specific guidance for policymakers to improve PA program implementation outside of urban population centers in central Europe.