Rural community systems: Youth physical activity promotion through community collaboration.

A common way to address rural population health issues is through community stakeholders working together. Youth physical activity (PA) happens in adult-led in-school and out-of-school group opportunities that vary across communities and generally occur in isolated settings. This study explores similarities and differences in rural community system structure and collaborative process variables that help to conceptualize the collaborative impact influencing population youth PA outcomes. Stakeholders (Community 1,  = 23; Community 2,  = 26) and youth (Community 1,  = 205; Community 2,  = 213) were recruited in 2018-2019 as part of Wellscapes, a hybrid implementation-effectiveness community randomized trial. A stakeholder survey ( = 49) measured community system structures and collaboration processes. Youth completed the Youth Activity Profile to measure PA levels. More Community 1 respondents than Community 2 resided within city limits (73.9% vs. 34.6%). Collective efficacy was significantly greater in Community 1 ( = 4.0,  = 0.5) than in 2 ( = 3.2,  = 0.4),  < 0.05. Perceptions of trust scored significantly greater in Community 1 ( = 4.1,  = 0.3) than in 2 ( = 3.3,  = 0.5),  < 0.05. Though both communities met rural definitions and had stakeholder investment, Community 1 had a greater proportion of PA-implementing stakeholders and more residing within city limits which may have influenced that community's higher scores in collective efficacy and trust. Community 2 had more stakeholders in administrator roles and yielded greater youth PA levels. Unique and common variables of rural communities should be considered in understanding system factors that impact youth PA.