Challenging the Urban-Rural Divide: Latino Parental Perceptions of the Built Environment

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Valencia, Michael G. Curtis This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6784739/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Quantitative data alone cannot fully capture neighborhood conditions, particularly in understanding how the built environment influences child health. This study explores how Latino parents from low socioeconomic position (SEP) backgrounds in both urban and rural settings perceive their neighborhood environments concerning their children’s physical activity (PA). Using four qualitative focus groups (N = 36) we examined perceived barriers and facilitators to child health and well-being. Across both urban and rural groups, parents identified limited access to physical activity resources, such as safe parks, sidewalks, and recreational facilities as a primary barrier, highlighting striking parallels across geographies. These findings challenge the notion that urban and rural disparities are fundamentally distinct and instead suggest that low SEP is the more salient driver of constrained PA opportunities. To our knowledge, this is the first study to compare qualitative neighborhood perceptions of low SEP Latino families across urban and rural settings, providing critical insight into how structural inequities shape child health behaviors independent of geographic category. Behavioral Geography Health Policy Obesogenic environments Pediatric obesity physical activity Socioeconomic positionality Urban Latinos Socioecological model Background Globally, pediatric obesity is a significant public health issue. In the United States (US), Latino children experience a disproportionate burden of obesity with the highest obesity prevalence of all children. Twenty-six percent (26.2%) of Latino children are categorized as obese versus their non-Latino White (NLW) counterparts at 16.6%.1 Latinos remain the most uninsured population in the U.S.2 This places underserved and under- resourced Latino children with higher body mass index (BMI) at increased vulnerability for health disparities,4 including earlier age of chronic diseases onset.5–6 As Latinos are more likely to experience disease complications and comorbidities across the lifespan7, prevention strategies for excess weight in childhood are a high priority. Physical activity (PA) is a well-established obesity risk reduction strategy for pediatric populations8 and promotes a wide array of metabolic, cardiovascular, and immune benefits across the lifespan.9–10 Children from lower socioeconomic families have been found to have lower PA levels11. Studies focusing on pediatric obesity and childhood PA engagement center on the obesogenic built environment, environmental multi-level dynamics that influence individual weight,12–13 primarily measured as objective attributes of neighborhoods. Potential access to PA in the built environment, such as parks, playgrounds, and sports facilities surrounding a school, improves the fitness score of middle school-aged children.14 This area of the literature has focused predominantly on NLW populations. Moreover, these studies contribute to the global association between children’s environment and PA but do not provide insights into the multi-level socioecological drivers of PA engagement. Parents play an essential role in shaping childhood PA in terms of attitudes and engagement and have been considered the focal point for PA interventions in pediatric populations.15. Parent support is positively associated with PA levels in children. It may stem from material support as transportation and immaterial support15-16; however, less is known about the challenges families face that may influence PA engagement. The lack of evidence on parents’ neighborhood perceptions has resulted in little being known about how access to resources and perceptions of the built environment shape parental decisions around PA for their children. Our understanding of childhood PA, and by extension pediatric obesity, as being shaped by context demonstrates its meaningful role in health outcomes. Without understanding the role of neighborhood perceptions shaped by lived experiences and social positionality, we cannot fully understand the scope of impact at the individual level. Details of how communities are built and maintained via neighborhood perceptions that define neighborhoods' social infrastructure are imperative to understanding how individuals engage with their context for health and well-being. The qualitative data from our focus groups of low-income Latino parents residing in rural and urban contexts demonstrates that neighborhoods cannot be wholly understood with objective quantitative measurements, specifically how space and place are made within neighborhoods for historically marginalized populations. Our findings demonstrate that access to resources experienced by Latino families from low socioeconomic position (SEP) backgrounds, defined here as the concept of socioeconomic status as income, education, and occupation accompanied by features of social positionality that refers to a groups’ ability to possess resources17-18, have parallels despite the distinguishing features of rural and urban geographies. Qualitative considerations of perceptions of access to resources, neighborhoods, and context interpretations are meaningful for building health equity in the US, specifically for policy and zoning interventions to create structural change. This is the first study to compare Latino rural and urban parent perceptions of their contexts and access to resources that influence health outcomes by considering potential access to PA. Methods Qualitative focus groups were conducted with parents of Latino children in food-insecure households participating in a healthy lifestyle curriculum. The curriculum was delivered in rural and urban community sites serving low SEP neighborhoods in two different regions in the US Southwest. The neighborhoods were chosen based on US Census data for their comparable sociodemographic characteristics. Inclusion criteria for the families included the utilization of free meal programs. Focus groups were conducted: one rural focus group pre-curriculum program, one urban focus group pre-curriculum program, one rural focus group post-curriculum program, and one urban focus group post-curriculum. A total of four focus groups were conducted with the parents. All focus group participants provided informed consent. Pseudonyms were assigned and have been used for quotes in this paper. The quotes appear in the language spoken by the participants, with translations into English as needed. The project received approval from the University of Arizona Institutional Review Board. Rural Sample and Setting Neighborhood Attributes Based on U.S. Census Data The rural site was located within a small farming community designated a U.S. Census place with a population of 798 in 2010 and 565 in 2020.19 Approximately 82% of the community reported being Hispanic/Latino19. The average age of residents is 33 years old. About thirty percent (29.6%) of the population are under 1819. The median household income is $ 22,833.00, and 25% of these households are female heads of household19. Seventy-eight percent (78%) report speaking Spanish at home, and 40.6% report being born in a country other than the U.S.19 This community is a food desert per the United States Department of Agriculture (USDA) definition. The closest full supermarket is 24 miles away, driving approximately 30 minutes20 by car. As of March 2025, geospatial map data shows one green space in the area: a public school playground. The community’s average daily temperature in summer is 102 degrees Fahrenheit21. Rural Study Setting and Sample Demographics When these focus groups were conducted, the local branch of the public library was the primary indoor space available to the children in this community. The public library serves as the location of the community’s free summer meal program and the site of curriculum delivery. At baseline, ninety-five percent (95%) of the children participants reported receiving free lunch at school. All children were utilizing the free summer meal program. The children who participated in the intervention were predominantly males (65%; n = 13) with a median age of 10. At baseline, BMI measurements showed that 25% of the child participants were overweight or obese. The qualitative focus group participants were all women (N = 9) residing in the rural community who reported being the parent figure of one of the curriculum child participants. Many women indicated that they were born and raised in the area. The focus group participants requested that the conversation be conducted in Spanish. The participants answered questions in a mix of English and Spanish. The focus group was led by a heritage Spanish speaker fluent in English who could accommodate the participants’ language requests. Urban Sample and Setting Neighborhood Attributes Based on U.S. Census Data The urban setting is located within a small city with 5,652 residents in 2010 and 4,613 in 202019. Approximately 76% of the city reported being Hispanic/Latino19. The average age of residents is 31, with 29% of the population under 1819. The median household income is $ 28,704, and 38.2% of the houses are female of households19. Thirty-four percent (34%) of residents reported having a high school degree19. 48% of the residents reported speaking Spanish at home. The city is a Latino immigrant corridor where 46.2% of residents are living below the poverty line19. As of March 2025, geospatial data shows no green spaces or parks within their city limits. Per the USDA definition,20 the city is a food desert with the primary options for purchasing food items in gas stations and convenience stores. The closest grocery store is a mile outside of the city limits. The average daily temperature in the summer months is 100 degrees Fahrenheit21. Urban Study Setting and Sample Demographics The urban community site was a neighborhood community center that has been serving the area since 1950, with a programmatic focus on serving the area’s youth and elderly individuals. At baseline, 20 participants enrolled and completed baseline data collection. The children who completed the program were equally female (n = 6) and male (n = 6), with a median age of 10. The children participants reported that 26.67% of them spoke Spanish at home. At baseline, 40% of the urban intervention participants were obese or overweight. Focus group participants (N = 9) were primarily Latino women (n = 7), with two Latino men (n = 2). The focus groups were conducted in English per the participants’ preference. The participants answered questions in a mix of English and Spanish. The focus group was led by a heritage Spanish speaker fluent in English who could accommodate both spoken languages during the focus groups. Results To highlight Latino parents’ perceptions of barriers and facilitators to their children’s health and well- being, we conducted focus groups with parent figures to discuss health-promoting behaviors such as access to fresh produce and engagement in PA. We then coded the qualitative data and identified recurring themes regarding PA discussed by the focus group participants. For this paper, we focus specifically on the perspectives of PA. We compared themes and topics in the rural versus urban focus groups. Finally, we categorized each theme by socio-ecological levels of household/individual, community, and geographic environment (Table 1; Table 2) to better understand the multi-level factors perceived as barriers to their children's PA engagement. Urban Parent Focus Groups Urban focus group participants voiced three primary barriers to their children’s engagement in PA, a higher number of identified barriers to PA than discussed by the rural parents (Table 1). Economic Costs Presented a Challenge for Connecting Urban Children with Physical Activity Opportunities Participants pointed to cost as a prohibitive barrier to PA. They noted the cost of transportation, distance to travel, and time as deterrents. For these parents, PA options were not located near their residences. Adriana: “…our kids are really active, and they want to play sports, but some of the sports places are really far for us to go for practices, or it’s just really expensive for us to put the kids in sports…” Beatriz: “ I don’t think we have enough great options because there are no clubs or they’re expensive.” Urban Neighborhood Violence was a Primary Concern for Outdoor Physical Activities Parents expressed concern about community violence and criminal activity faced by children playing, even in their yards. It is unclear if the fear of violence and crime is based on a collective narrative of their communities or the personal experiences of the participants. Carolina: “Even in our yard, like, a car can just drive by with the windows open and anything can happen, so it’s hard to get them out and active. Because they want to be, but sometimes, just because we’re really busy, we don’t have time.” Participants perceived safety concerns at parks: Daniela: “We could go with them, but we have to keep an eye on them. I think like any park, there’s always homeless or there could be someone that looks fine, but they might want to take kids. Just, now-a-days, in the community you can’t trust anyone no matter how they look. If they come up and talk to you no matter how they look, at least that’s how I feel, you can’t trust anyone around your kids.” Gabriela: “I think there are parks and they’re not a dangerous place, but it’s not a place I will allow him to just go by himself. You always have lots of people there and you never know.” Participants' perceived safety concerns of parks were coupled with constraints of time: Enrique: “ It’s hard because, I don’t know about anybody else, but me and her are a little overprotective, we don’t want nothing to happen to our kids. So, we don’t let them go outside by themselves. So, the only time they go outside is when we have the time to go out with them.” Although the parents in the focus group thought parks were available and accessible, they were often perceived as dangerous places for children to exercise. There are no green spaces in the zip code based on geospatial information, so it is unclear what parks the parents are referencing. These quotes also reference constraints on their time that don’t allow parents to supervise their children’s outdoor PA. The parents feared for their children’s safety if they were to go outside or to the parks without adult supervision. Outdoor Heat Restricts Outdoor Physical Activity Environmental barriers, such as weather and heat, combined with a lack of indoor spaces for PA, were the final identified barriers for the urban sample. Isabel: “The only thing is that the kids want more exercise… Because there aren’t any places, just the park, and to go to the park when it’s so hot…” Alternative indoor spaces, such as school gymnasiums or places like a YMCA, were not mentioned as accessible to urban parents as PA opportunities during high heat months. Rural Parent Focus Groups Rural focus group participants voiced two primary barriers impacting their children’s PA (Table 2). Child’s Motivation was the Major Perceived Barrier to Physical Activity for Rural Parents The focus group participants expressed their children’s lack of motivation for exercise and PA, citing alternative leisure activities, such as screen time and video games, as the primary problem. Alejandra: “There's a lot of time spent on the phone, playing games on the phone, or watching things on the phone, and the Internet in the library. They don't go out and ride a bike, play baseball, you know, run around and do stuff outside. We used to climb trees; we used to do things like that.” Barbara: “The other girls will tell me, ‘ podemos caminar [can we walk] from school to the library?’. Caminando [walking] is better for me because then I don’t have to go and get them. And they’re like ‘Yeah, we’ll just walk’…. Yeah, floja [lazy] , she’s getting to be real floja [lazy]. ” The second quote refers to a mother whose daughter did not express interest in walking like the other girls in the community that the mother knows. Other parents agreed that their children were not interested in PA. Another barrier to the child’s motivation was their voicing that exercise is difficult: Carmen: “ Dice ‘Ay, yoga esta dificil. Me tengo que estilar cosas que no estilan...” [ Translation: “She says, “Yoga is difficult. I have to stretch things that don’t stretch.”] The mother’s comment noted that yoga was an indoor option for PA but that her child was not interested in engaging in that activity. The rural focus group participants indicated ample opportunity for PA in their community. The issue was the children’s dispositions toward PA. Outdoor Heat as a Challenge is Also Voiced by Rural Parents Heat was cited as a major barrier to youth PA for rural parents like urban parent. Delfina: “I think there’s be one swing and besides they don't have shade which is harder they’re aluminum or something that's really hot, so not a ton but they're working on it, but it's really rare that kids go to play.” Esperanza: “ Andar afuera? No no no no…. Caliente!” [Translation: “ Being outside? No no no no…hot!”] In contrast to the urban focus group, the rural focus group participants did not discuss venues for indoor PA, like a gymnasium. However, the rural parents did acknowledge that they and their children were aware of options for indoor activities. Discussion Neighborhood perception is an essential consideration for disentangling the complex factors that contribute to health outcomes in Latino populations, including the persistence of disproportionate childhood obesity rates. Latino health-protective benefits stemming from residing in ethnic enclaves, geographic areas with a high density of a particular ethnic group who are socially and economically distinct from the majority group22 but often exhibit characteristics of high epidemiological risk such as lower SEP across numerous disease outcomes23-24, are not fully understood. To understand how neighborhoods shape Latino health patterns, our qualitative data demonstrates that objective neighborhood attributes are insufficient for understanding access to resources that encourage positive health outcomes. Moreover, assessing objective neighborhood attributes does not provide insights into how perceptions shape the social context in making space from geographic place to establish a community. Further research is needed to understand better the role of neighborhood perceptions of low-SEP ethnic enclaves and the protective health benefits of Latinos. Rural and urban contexts are often discussed as contrasting socio-ecological situations with differential access to transportation, affordable daycare, and other social services, such as job training25. Economic resources, like access to time, transportation, and money, were barriers for these families to link their children to PA opportunities. As demonstrated by these families, SEP-constrained access to resources for low-income rural and urban residents, regardless of potential access to resources available in these distinct settings. The discussed experiences of urban versus rural contexts were found to be a function of SEP, which problematizes the perspective that resource access differs from the broader geographic contexts. The centering of SEP to better understand access within both urban and rural geographies is salient for Latinos, mainly migrants from Mexico and Central America, as they have less access to social safety net programs and are more likely to be poorer than other populations in the US25. While there is a lack of access to resources stemming from low SEP, there are also factors such as social cohesion and social network ties that have been discussed as contributing to the health benefits experienced by Latinos.26–27 The neighborhoods where these families reside have experienced historical disinvestment that has resulted in fewer green spaces, limited facilities for PA, and limited availability of public transportation to facilitate access to PA opportunities in other neighborhoods. The urban parents discussed the lack of access to other neighborhoods with PA opportunities for children. The urban neighborhoods where these families reside are experiencing gentrification, the influx of upper- and middle-income households that work to transform low- income neighborhoods, which is most often accompanied by area improvements.28–29 The changing area infrastructure has the potential to increase access to PA opportunities for these families. However, gentrification also results in the displacement of residents and the disruption of social networks, leading to shifts in neighborhood social cohesion and an altered sense of place and community.28 As the shifting social landscape of these neighborhoods may be influenced by gentrification, it is unknown how this impacts these Latino families' conceptualizations of space and place. More research is needed to understand better how gentrification influences neighborhood perceptions of these Latino families and if they experience increased access to health resources. Area disinvestment is substantial towards neighborhood heat vulnerability29. Despite geographic differences, urban and rural parents cited high heat as a significant environmental barrier to PA. The parents noted a lack of indoor alternatives, which may be a function of the neighborhood-level disinvestment. Residents of neighborhoods shaped by redlining and disinvestment have been found to have been found to experience higher numbers of heat-related illness30, which may be attributable to an overall lack of neighborhood built environment resources, including less green space and higher temperatures in these areas31. While urban parents did not mention accessible indoor PA spaces, rural parents noted that options like the library provided limited alternatives for structured activities. The lack of climate-controlled PA options in both contexts underscores the need for targeted interventions to ensure children can access safe year-round PA opportunities. A limitation of the study is that the qualitative data was derived solely from focus groups. The degree to which the more vocal participants of the group influenced the topics of conversation is unknown. Future research should further investigate the role of social infrastructure in shaping PA behaviors among Latino children, particularly within low-SEP communities. Understanding how neighborhood perceptions intersect with economic constraints and environmental conditions can inform policies and programs that support equitable access to PA opportunities. Additionally, longitudinal studies that track changes in PA engagement over time may provide insights into how interventions can sustain long-term behavior change and contribute to reducing pediatric obesity disparities in Latino populations. Conclusion This study underscores the need for multidimensional approaches to understand and address disparities in PA engagement among Latino children. Increased engagement in childhood PA among Latinos may serve as a strategy for improving health outcomes across the lifespan. While urban and rural parents identified distinct barriers to their children’s PA, the underlying influence of SEP was evident across both geographies. Future directions of this research include mixed methods consideration of neighborhood perception and quantitative infrastructure. Incorporating community perspectives into intervention strategies. Researchers, and policymakers can develop more effective and context-relevant solutions to promote PA and target pediatric obesity in Latino communities. References Centers for Disease Control and Prevention. Childhood Obesity Facts (2024) Apr 2 [cited 2025 Mar 10]. Available from: https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html Alberto CK, Pintor JK, De Trinidad Young M et al (2020) Association of maternal citizenship and State-Level immigrant policies with health insurance coverage among US-Born Latino youths. JAMA Netw Open 3(10):e2021876. 10.1001/jamanetworkopen.2020.21876 Perreira KM, Allen CD, Oberlander J (2021) Access to health insurance and health care for Hispanic children in the United States. ANNALS Am Acad Political Social Sci 696(1):223–244. 10.1177/00027162211050007 Horesh A, Tsur AM, Bardugo A, Twig G (2021) Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood—A Systematic review. Curr Obes Rep 10(3):301–310. 10.1007/s13679-021-00439-9 Weihrauch-Blüher S, Schwarz P, Klusmann J (2019) Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism 92:147–152. 10.1016/j.metabol.2018.12.001 Schwarzfischer P, Gruszfeld D, Stolarczyk A et al (2019) Physical activity and sedentary behavior from 6 to 11 years. Pediatrics 143(1). 10.1542/peds.2018-0994 Belanger MJ, Rao P, Robbins J (2022) Exercise, physical activity, and cardiometabolic health. Cardiol Rev 30(3):134–144. 10.1097/crd.0000000000000417 Kim LB, Duh-Leong C, Nagpal N et al (2023) Supporting early childhood routines to promote cardiovascular health across the life course. Curr Probl Pediatr Adolesc Health Care 53(5):101434. 10.1016/j.cppeds.2023.101434 Rhodes RE, Perdew M, Malli S (2020) Correlates of Parental Support of Child and Youth Physical Activity: a Systematic Review. Int J Behav Med 27(6):636–646. 10.1007/s12529-020-09909-1 Howie EK, McVeigh J, Smith A et al (2020) Physical activity trajectories from childhood to late adolescence and their implications for health in young adulthood. Prev Med 139:106224. 10.1016/j.ypmed.2020.106224 Gautam N, Dessie G, Rahman MM, Khanam R (2023) Socioeconomic status and health behavior in children and adolescents: a systematic literature review. Front Public Health 11:1228632 Jia P (2020) Obesogenic environment and childhood obesity. Obes Rev 22(S1). 10.1111/obr.13158 Kirk SFL, Penney TL, McHugh TL (2010) Characterizing the obesogenic environment: the state of the evidence with directions for future research. Obes Rev 11(2):109–117. 10.1111/j.1467- 789x.2009.00611.x Schipperijn J, Madsen CD, Toftager M, Johansen DN, Lousen I, Amholt TT, Pawlowski CS (2024) The role of playgrounds in promoting children’s health–a scoping review. Int J Behav Nutr Phys activity 21(1):72 Su DL, Tang TC, Chung JS, Lee AS, Capio CM, Chan DK (2022) Parental influence on child and adolescent physical activity level: a meta-analysis. Int J Environ Res Public Health 19(24):16861 Robinson T, Nathan A, Murray K, Christian H (2022) Parents' Perceptions of the Neighbourhood Built Environment Are Associated with the Social and Emotional Development of Young Children. Int J Environ Res Public Health. ;19(11):6476. Published 2022 May 26. 10.3390/ijerph19116476 Bhaktaram A, Kress AM, Li Z, Knapp EA (2024) Unpacking Neighborhood Socioeconomic Status in Children’s Health Research from an Environmental Justice Perspective: A Scoping Review. Curr Environ health Rep 11(2):288–299 Krieger N, Williams DR, Moss NE (1997) Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 18(1):341–378 United States Census Bureau Data Profiles. [Internet]. Available from: https://data.census.gov/profile?q=United+States&g=0100000US United States Department of Agriculture Food Access Research Atlas. [Internet]. Available from: https://www.ers.usda.gov/data-products/food-access-research- atlas/documentation/#:~:text = Definition%3A%20A%20tract%20in%20which,supermarket%2C%20rega rdless%20of%20vehicle%20availability National Weather Service [Internet]. Available from: https://www.weather.gov/ Lim S, Yi SS, De La Cruz NL, Trinh-Shevrin C (2015) Defining Ethnic Enclave and Its Associations with Self-Reported Health Outcomes Among Asian American Adults in New York City. J Immigr Minor Health 19(1):138–146. 10.1007/s10903-015-0334-6 Fang CY, Tseng M (2018) Ethnic density and cancer: A review of the evidence. Cancer 124(9):1877–1903. 10.1002/cncr.31177 Durazo EM, Mbassa RS, Albert MA (2016) Ethnic Enclaves and Type II Diabetes: a Focus on Latino/Hispanic Americans. Curr Cardiovasc Risk Rep 10(11). 10.1007/s12170-016-0518-1 Nolan L, Waldfogel J, Wimer C (2017) Long-Term Trends in rural and Urban poverty: New insights using a Historical Supplemental Poverty Measure. ANNALS Am Acad Political Social Sci 672(1):123–142. 10.1177/0002716217713174 Rodgers J, Valuev AV, Hswen Y, Subramanian SV (2019) Social capital and physical health: An updated review of the literature for 2007–2018. Soc Sci Med 236:112360. 10.1016/j.socscimed.2019.112360 Almeida J, Kawachi I, Molnar BE, Subramanian SV (2009) A Multilevel Analysis of Social Ties and Social Cohesion among Latinos and Their Neighborhoods: Results from Chicago. J Urb Health 86(5):745–759. 10.1007/s11524-009-9375-2 Thomas KA, Hardy D, Lazrus H et al (2018) Explaining differential vulnerability to climate change: A social science review. WIREs Clim Change 10(2). 10.1002/wcc.565 Wilson B (2020) Urban heat management and the legacy of redlining. J Am Plann Association 86(4):443–457. 10.1080/01944363.2020.1759127 Li D, Newman GD, Wilson B, Zhang Y, Brown RD (2022) Modeling the relationships between historical redlining, urban heat, and heat-related emergency department visits: an examination of 11 Texas cities. Environ Plann B: Urban Analytics City Sci 49(3):933–952 Lee EK, Donley G, Ciesielski TH, Yamoah O, Roche A, Martinez R, Freedman DA (2022) Health outcomes in redlined versus non-redlined neighborhoods: a systematic review and meta-analysis. Soc Sci Med 294:114696 Tables Table 1 Urban Parents Identified Barriers for Physical Activity of Children Number of Barriers Discussed Barrier Multi-Level Category 1 Economic Cost Individual/Household 2 Community Violence Community 3 Outdoor Heat Geographic Location Table 2 Rural Parents Identified Barriers for Physical Activity of Children Number of Barriers Discussed Barrier Multi-Level Category 1 Motivation of Child Individual/Household 2 Outdoor Heat Geographic Location Additional Declarations The authors declare no competing interests. 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In the United States (US), Latino children experience a disproportionate burden of obesity with the highest obesity prevalence of all children. Twenty-six percent (26.2%) of Latino children are categorized as obese versus their non-Latino White (NLW) counterparts at 16.6%.1 Latinos remain the most uninsured population in the U.S.2 This places underserved and under- resourced Latino children with higher body mass index (BMI) at increased vulnerability for health disparities,4 including earlier age of chronic diseases onset.5\u0026ndash;6 As Latinos are more likely to experience disease complications and comorbidities across the lifespan7, prevention strategies for excess weight in childhood are a high priority.\u003c/p\u003e \u003cp\u003ePhysical activity (PA) is a well-established obesity risk reduction strategy for pediatric populations8 and promotes a wide array of metabolic, cardiovascular, and immune benefits across the lifespan.9\u0026ndash;10 Children from lower socioeconomic families have been found to have lower PA levels11. Studies focusing on pediatric obesity and childhood PA engagement center on the obesogenic built environment, environmental multi-level dynamics that influence individual weight,12\u0026ndash;13 primarily measured as objective attributes of neighborhoods. Potential access to PA in the built environment, such as parks, playgrounds, and sports facilities surrounding a school, improves the fitness score of middle school-aged children.14 This area of the literature has focused predominantly on NLW populations. Moreover, these studies contribute to the global association between children\u0026rsquo;s environment and PA but do not provide insights into the multi-level socioecological drivers of PA engagement.\u003c/p\u003e \u003cp\u003e Parents play an essential role in shaping childhood PA in terms of attitudes and engagement and have been considered the focal point for PA interventions in pediatric populations.15. Parent support is positively associated with PA levels in children. It may stem from material support as transportation and immaterial support15-16; however, less is known about the challenges families face that may influence PA engagement. The lack of evidence on parents\u0026rsquo; neighborhood perceptions has resulted in little being known about how access to resources and perceptions of the built environment shape parental decisions around PA for their children. Our understanding of childhood PA, and by extension pediatric obesity, as being shaped by context demonstrates its\u003c/p\u003e \u003cp\u003emeaningful role in health outcomes. Without understanding the role of neighborhood perceptions shaped by lived experiences and social positionality, we cannot fully understand the scope of impact at the individual level. Details of how communities are built and maintained via neighborhood perceptions that define neighborhoods' social infrastructure are imperative to understanding how individuals engage with their context for health and well-being.\u003c/p\u003e \u003cp\u003eThe qualitative data from our focus groups of low-income Latino parents residing in rural and urban contexts demonstrates that neighborhoods cannot be wholly understood with objective quantitative measurements, specifically how space and place are made within neighborhoods for historically marginalized populations. Our findings demonstrate that access to resources experienced by Latino families from low socioeconomic position (SEP) backgrounds, defined here as the concept of socioeconomic status as income, education, and occupation accompanied by features of social positionality that refers to a groups\u0026rsquo; ability to possess resources17-18, have parallels despite the distinguishing features of rural and urban geographies.\u003c/p\u003e \u003cp\u003eQualitative considerations of perceptions of access to resources, neighborhoods, and context interpretations are meaningful for building health equity in the US, specifically for policy and zoning interventions to create structural change. This is the first study to compare Latino rural and urban parent perceptions of their contexts and access to resources that influence health outcomes by considering potential access to PA.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eQualitative focus groups were conducted with parents of Latino children in food-insecure households participating in a healthy lifestyle curriculum. The curriculum was delivered in rural and urban community sites serving low SEP neighborhoods in two different regions in the US Southwest. The neighborhoods were chosen based on US Census data for their comparable sociodemographic characteristics. Inclusion criteria for the families included the utilization of free meal programs. Focus groups were conducted: one rural focus group pre-curriculum program, one urban focus group pre-curriculum program, one rural focus group post-curriculum program, and one urban focus group post-curriculum. A total of four focus groups were conducted with the parents. All focus group participants provided informed consent. Pseudonyms were assigned and have been\u003c/p\u003e \u003cp\u003eused for quotes in this paper. The quotes appear in the language spoken by the participants, with translations into English as needed. The project received approval from the University of Arizona Institutional Review Board.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eRural Sample and Setting\u003c/h2\u003e \u003cdiv id=\"Sec4\" class=\"Section3\"\u003e \u003ch2\u003eNeighborhood Attributes Based on U.S. Census Data\u003c/h2\u003e \u003cp\u003eThe rural site was located within a small farming community designated a U.S. Census place with a population of 798 in 2010 and 565 in 2020.19 Approximately 82% of the community reported being Hispanic/Latino19. The average age of residents is 33 years old. About thirty percent (29.6%) of the population are under 1819. The median household income is \u003cspan\u003e$\u003c/span\u003e22,833.00, and 25% of these households are female heads of household19. Seventy-eight percent (78%) report speaking Spanish at home, and 40.6% report being born in a country other than the U.S.19 This community is a food desert per the United States Department of Agriculture (USDA) definition. The closest full supermarket is 24 miles away, driving approximately 30 minutes20 by car. As of March 2025, geospatial map data shows one green space in the area: a public school playground. The community\u0026rsquo;s average daily temperature in summer is 102 degrees Fahrenheit21.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e\n\u003ch3\u003eRural Study Setting and Sample Demographics\u003c/h3\u003e\n\u003cp\u003eWhen these focus groups were conducted, the local branch of the public library was the primary indoor space available to the children in this community. The public library serves as the location of the community\u0026rsquo;s free summer meal program and the site of curriculum delivery. At baseline, ninety-five percent (95%) of the children participants reported receiving free lunch at school. All children were utilizing the free summer meal program. The children who participated in the intervention were predominantly males (65%; n\u0026thinsp;=\u0026thinsp;13) with a median age of 10. At baseline, BMI measurements showed that 25% of the child participants were overweight or obese.\u003c/p\u003e \u003cp\u003eThe qualitative focus group participants were all women (N\u0026thinsp;=\u0026thinsp;9) residing in the rural community who reported being the parent figure of one of the curriculum child participants. Many women indicated that they were born and raised in the area. The focus group participants requested that the conversation be conducted in\u003c/p\u003e \u003cp\u003eSpanish. The participants answered questions in a mix of English and Spanish. The focus group was led by a heritage Spanish speaker fluent in English who could accommodate the participants\u0026rsquo; language requests.\u003c/p\u003e\n\u003ch3\u003eUrban Sample and Setting\u003c/h3\u003e\n\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eNeighborhood Attributes Based on U.S. Census Data\u003c/h2\u003e \u003cp\u003eThe urban setting is located within a small city with 5,652 residents in 2010 and 4,613 in 202019.\u003c/p\u003e \u003cp\u003eApproximately 76% of the city reported being Hispanic/Latino19. The average age of residents is 31, with 29% of the population under 1819. The median household income is \u003cspan\u003e$\u003c/span\u003e28,704, and 38.2% of the houses are female of households19. Thirty-four percent (34%) of residents reported having a high school degree19. 48% of the residents reported speaking Spanish at home. The city is a Latino immigrant corridor where 46.2% of residents are living below the poverty line19. As of March 2025, geospatial data shows no green spaces or parks within their city limits. Per the USDA definition,20 the city is a food desert with the primary options for purchasing food items in gas stations and convenience stores. The closest grocery store is a mile outside of the city limits. The average daily temperature in the summer months is 100 degrees Fahrenheit21.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eUrban Study Setting and Sample Demographics\u003c/h2\u003e \u003cp\u003eThe urban community site was a neighborhood community center that has been serving the area since 1950, with a programmatic focus on serving the area\u0026rsquo;s youth and elderly individuals. At baseline, 20 participants enrolled and completed baseline data collection. The children who completed the program were equally female (n\u0026thinsp;=\u0026thinsp;6) and male (n\u0026thinsp;=\u0026thinsp;6), with a median age of 10. The children participants reported that 26.67% of them spoke Spanish at home. At baseline, 40% of the urban intervention participants were obese or overweight.\u003c/p\u003e \u003cp\u003e Focus group participants (N\u0026thinsp;=\u0026thinsp;9) were primarily Latino women (n\u0026thinsp;=\u0026thinsp;7), with two Latino men (n\u0026thinsp;=\u0026thinsp;2). The focus groups were conducted in English per the participants\u0026rsquo; preference. The participants answered questions in a mix of English and Spanish. The focus group was led by a heritage Spanish speaker fluent in English who could accommodate both spoken languages during the focus groups.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eTo highlight Latino parents\u0026rsquo; perceptions of barriers and facilitators to their children\u0026rsquo;s health and well- being, we conducted focus groups with parent figures to discuss health-promoting behaviors such as access to fresh produce and engagement in PA. We then coded the qualitative data and identified recurring themes regarding PA discussed by the focus group participants. For this paper, we focus specifically on the perspectives of PA. We compared themes and topics in the rural versus urban focus groups. Finally, we categorized each theme by socio-ecological levels of household/individual, community, and geographic environment (Table 1; Table 2) to better understand the multi-level factors perceived as barriers to their children\u0026apos;s PA engagement.\u003c/p\u003e\n\u003cp\u003eUrban\u0026nbsp;Parent\u0026nbsp;Focus Groups\u003c/p\u003e\n\u003cp\u003eUrban\u0026nbsp;focus\u0026nbsp;group\u0026nbsp;participants\u0026nbsp;voiced\u0026nbsp;three\u0026nbsp;primary\u0026nbsp;barriers to\u0026nbsp;their\u0026nbsp;children\u0026rsquo;s\u0026nbsp;engagement\u0026nbsp;in\u0026nbsp;PA,\u0026nbsp;a\u0026nbsp;higher number of identified barriers to PA than discussed by the rural parents (Table 1).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEconomic\u0026nbsp;Costs\u0026nbsp;Presented\u0026nbsp;a\u0026nbsp;Challenge\u0026nbsp;for\u0026nbsp;Connecting\u0026nbsp;Urban\u0026nbsp;Children\u0026nbsp;with\u0026nbsp;Physical\u0026nbsp;Activity\u0026nbsp;Opportunities\u0026nbsp;\u003c/em\u003eParticipants pointed to cost as a prohibitive barrier to PA. They noted the cost of transportation, distance to travel, and time as deterrents. For these parents, PA options were not located near their residences.\u003c/p\u003e\n\u003cp\u003eAdriana: \u003cem\u003e\u0026ldquo;\u0026hellip;our kids are really active, and they want to play sports, but some of the sports\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eplaces\u0026nbsp;are\u0026nbsp;really\u0026nbsp;far\u0026nbsp;for\u0026nbsp;us\u0026nbsp;to\u0026nbsp;go\u0026nbsp;for\u0026nbsp;practices,\u0026nbsp;or\u0026nbsp;it\u0026rsquo;s\u0026nbsp;just\u0026nbsp;really\u0026nbsp;expensive\u0026nbsp;for\u0026nbsp;us\u0026nbsp;to\u0026nbsp;put\u0026nbsp;the\u0026nbsp;kids in sports\u0026hellip;\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBeatriz:\u0026nbsp;\u0026ldquo;\u003cem\u003eI\u0026nbsp;don\u0026rsquo;t\u0026nbsp;think\u0026nbsp;we\u0026nbsp;have\u0026nbsp;enough\u0026nbsp;great\u0026nbsp;options\u0026nbsp;because\u0026nbsp;there\u0026nbsp;are\u0026nbsp;no\u0026nbsp;clubs\u0026nbsp;or\u0026nbsp;they\u0026rsquo;re expensive.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eUrban\u0026nbsp;Neighborhood Violence\u0026nbsp;was a Primary\u0026nbsp;Concern for Outdoor Physical Activities\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParents\u0026nbsp;expressed\u0026nbsp;concern\u0026nbsp;about\u0026nbsp;community\u0026nbsp;violence\u0026nbsp;and\u0026nbsp;criminal\u0026nbsp;activity\u0026nbsp;faced\u0026nbsp;by\u0026nbsp;children\u0026nbsp;playing, even in their yards. It is unclear if the fear of violence and crime is based on a collective narrative of their communities or the personal experiences of the participants.\u003c/p\u003e\n\u003cp\u003eCarolina: \u003cem\u003e\u0026ldquo;Even in our yard, like, a car can just drive by with the windows open and anything can happen, so it\u0026rsquo;s hard to get them out and active. Because they want to be, but sometimes, just because we\u0026rsquo;re really busy, we don\u0026rsquo;t have time.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants\u0026nbsp;perceived\u0026nbsp;safety\u0026nbsp;concerns\u0026nbsp;at\u0026nbsp;parks:\u003c/p\u003e\n\u003cp\u003eDaniela: \u003cem\u003e\u0026ldquo;We could go with them, but we have to keep an eye on them. I think like any park,\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ethere\u0026rsquo;s always homeless or there could be someone that looks fine, but they might want to take kids.\u0026nbsp;Just,\u0026nbsp;now-a-days,\u0026nbsp;in\u0026nbsp;the\u0026nbsp;community\u0026nbsp;you\u0026nbsp;can\u0026rsquo;t\u0026nbsp;trust\u0026nbsp;anyone\u0026nbsp;no\u0026nbsp;matter\u0026nbsp;how\u0026nbsp;they\u0026nbsp;look.\u0026nbsp;If\u0026nbsp;they come up and talk to you no matter how they look, at least that\u0026rsquo;s how I feel, you can\u0026rsquo;t trust\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eanyone\u0026nbsp;around\u0026nbsp;your\u0026nbsp;kids.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eGabriela: \u003cem\u003e\u0026ldquo;I think there are parks and they\u0026rsquo;re not a dangerous place, but it\u0026rsquo;s not a place I will allow him to just go by himself. You always have lots of people there and you never know.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eParticipants\u0026apos;\u0026nbsp;perceived safety\u0026nbsp;concerns of\u0026nbsp;parks\u0026nbsp;were\u0026nbsp;coupled with constraints of time:\u003c/p\u003e\n\u003cp\u003eEnrique:\u0026nbsp;\u0026ldquo;\u003cem\u003eIt\u0026rsquo;s\u0026nbsp;hard because,\u0026nbsp;I don\u0026rsquo;t know\u0026nbsp;about anybody\u0026nbsp;else,\u0026nbsp;but me\u0026nbsp;and\u0026nbsp;her\u0026nbsp;are a little\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eoverprotective,\u0026nbsp;we\u0026nbsp;don\u0026rsquo;t\u0026nbsp;want\u0026nbsp;nothing\u0026nbsp;to\u0026nbsp;happen\u0026nbsp;to\u0026nbsp;our\u0026nbsp;kids.\u0026nbsp;So,\u0026nbsp;we\u0026nbsp;don\u0026rsquo;t\u0026nbsp;let\u0026nbsp;them\u0026nbsp;go\u0026nbsp;outside\u0026nbsp;by themselves. So, the only time they go outside is when we have the time to go out with them.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAlthough\u0026nbsp;the\u0026nbsp;parents\u0026nbsp;in\u0026nbsp;the\u0026nbsp;focus\u0026nbsp;group\u0026nbsp;thought\u0026nbsp;parks\u0026nbsp;were\u0026nbsp;available\u0026nbsp;and\u0026nbsp;accessible,\u0026nbsp;they\u0026nbsp;were\u0026nbsp;often\u0026nbsp;perceived as dangerous places for children to exercise. There are no green spaces in the zip code based on geospatial information, so it is unclear what parks the parents are referencing. These quotes also reference constraints on their time that don\u0026rsquo;t allow parents to supervise their children\u0026rsquo;s outdoor PA. The parents feared for their children\u0026rsquo;s safety if they were to go outside or to the parks without adult supervision.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOutdoor\u0026nbsp;Heat\u0026nbsp;Restricts\u0026nbsp;Outdoor\u0026nbsp;Physical Activity\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEnvironmental\u0026nbsp;barriers,\u0026nbsp;such\u0026nbsp;as\u0026nbsp;weather\u0026nbsp;and\u0026nbsp;heat,\u0026nbsp;combined\u0026nbsp;with\u0026nbsp;a\u0026nbsp;lack\u0026nbsp;of\u0026nbsp;indoor\u0026nbsp;spaces\u0026nbsp;for PA,\u0026nbsp;were\u0026nbsp;the\u0026nbsp;final identified barriers for the urban sample.\u003c/p\u003e\n\u003cp\u003eIsabel: \u003cem\u003e\u0026ldquo;The only thing is that the kids want more exercise\u0026hellip; Because there aren\u0026rsquo;t any places, just the park, and to go to the park when it\u0026rsquo;s so hot\u0026hellip;\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAlternative\u0026nbsp;indoor\u0026nbsp;spaces,\u0026nbsp;such\u0026nbsp;as\u0026nbsp;school\u0026nbsp;gymnasiums\u0026nbsp;or\u0026nbsp;places\u0026nbsp;like\u0026nbsp;a\u0026nbsp;YMCA,\u0026nbsp;were\u0026nbsp;not\u0026nbsp;mentioned\u0026nbsp;as accessible to urban parents as PA opportunities during high heat months.\u003c/p\u003e\n\u003cp\u003eRural\u0026nbsp;Parent\u0026nbsp;Focus Groups\u003c/p\u003e\n\u003cp\u003eRural\u0026nbsp;focus\u0026nbsp;group\u0026nbsp;participants\u0026nbsp;voiced\u0026nbsp;two\u0026nbsp;primary\u0026nbsp;barriers\u0026nbsp;impacting\u0026nbsp;their children\u0026rsquo;s\u0026nbsp;PA\u0026nbsp;(Table\u0026nbsp;2).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eChild\u0026rsquo;s\u0026nbsp;Motivation\u0026nbsp;was\u0026nbsp;the\u0026nbsp;Major\u0026nbsp;Perceived\u0026nbsp;Barrier\u0026nbsp;to\u0026nbsp;Physical\u0026nbsp;Activity\u0026nbsp;for\u0026nbsp;Rural\u0026nbsp;Parents\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;focus\u0026nbsp;group\u0026nbsp;participants\u0026nbsp;expressed\u0026nbsp;their\u0026nbsp;children\u0026rsquo;s\u0026nbsp;lack\u0026nbsp;of\u0026nbsp;motivation\u0026nbsp;for\u0026nbsp;exercise\u0026nbsp;and PA,\u0026nbsp;citing\u0026nbsp;alternative leisure activities, such as screen time and video games, as the primary problem.\u003c/p\u003e\n\u003cp\u003eAlejandra: \u003cem\u003e\u0026ldquo;There\u0026apos;s a lot of time spent on the phone, playing games on the phone, or watching things on the phone, and the Internet in the library. They don\u0026apos;t go out and ride a bike, play baseball, you know, run around and do stuff outside. We used to climb trees; we used to do\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ethings\u0026nbsp;like that.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eBarbara: \u003cem\u003e\u0026ldquo;The other girls will tell me, \u0026lsquo;\u003c/em\u003epodemos\u0026nbsp;caminar\u0026nbsp;[can\u0026nbsp;we\u0026nbsp;walk] \u003cem\u003efrom school to the\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003elibrary?\u0026rsquo;.\u0026nbsp;\u003c/em\u003eCaminando [walking] \u003cem\u003eis\u0026nbsp;better\u0026nbsp;for\u0026nbsp;me\u0026nbsp;because\u0026nbsp;then\u0026nbsp;I\u0026nbsp;don\u0026rsquo;t\u0026nbsp;have\u0026nbsp;to\u0026nbsp;go\u0026nbsp;and\u0026nbsp;get\u0026nbsp;them. And they\u0026rsquo;re like \u0026lsquo;Yeah, we\u0026rsquo;ll just walk\u0026rsquo;\u0026hellip;.\u0026nbsp;Yeah,\u0026nbsp;\u003c/em\u003efloja [lazy]\u003cem\u003e, she\u0026rsquo;s getting to be real\u0026nbsp;\u003c/em\u003efloja [lazy].\u003cem\u003e\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;second\u0026nbsp;quote\u0026nbsp;refers\u0026nbsp;to\u0026nbsp;a\u0026nbsp;mother\u0026nbsp;whose\u0026nbsp;daughter\u0026nbsp;did\u0026nbsp;not\u0026nbsp;express\u0026nbsp;interest\u0026nbsp;in\u0026nbsp;walking\u0026nbsp;like\u0026nbsp;the\u0026nbsp;other girls in the community that the mother knows. Other parents agreed that their children were not interested in PA.\u003c/p\u003e\n\u003cp\u003eAnother\u0026nbsp;barrier\u0026nbsp;to\u0026nbsp;the child\u0026rsquo;s\u0026nbsp;motivation\u0026nbsp;was\u0026nbsp;their\u0026nbsp;voicing\u0026nbsp;that\u0026nbsp;exercise\u0026nbsp;is\u0026nbsp;difficult:\u003c/p\u003e\n\u003cp\u003eCarmen:\u0026nbsp;\u0026ldquo;\u003cem\u003eDice\u0026nbsp;\u0026lsquo;Ay,\u0026nbsp;yoga\u0026nbsp;esta\u0026nbsp;dificil.\u0026nbsp;Me\u0026nbsp;tengo\u0026nbsp;que\u0026nbsp;estilar\u0026nbsp;cosas\u0026nbsp;que\u0026nbsp;no\u0026nbsp;estilan...\u0026rdquo;\u0026nbsp;[\u003c/em\u003eTranslation: \u003cem\u003e\u0026ldquo;She says, \u0026ldquo;Yoga is difficult. I have to stretch things that don\u0026rsquo;t stretch.\u0026rdquo;]\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe\u0026nbsp;mother\u0026rsquo;s\u0026nbsp;comment\u0026nbsp;noted\u0026nbsp;that\u0026nbsp;yoga\u0026nbsp;was\u0026nbsp;an\u0026nbsp;indoor\u0026nbsp;option\u0026nbsp;for\u0026nbsp;PA\u0026nbsp;but\u0026nbsp;that\u0026nbsp;her\u0026nbsp;child\u0026nbsp;was\u0026nbsp;not\u0026nbsp;interested in engaging in that activity. The rural focus group participants indicated ample opportunity for PA in their community. The issue was the children\u0026rsquo;s dispositions toward PA.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eOutdoor\u0026nbsp;Heat as\u0026nbsp;a Challenge\u0026nbsp;is\u0026nbsp;Also Voiced\u0026nbsp;by\u0026nbsp;Rural Parents\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eHeat\u0026nbsp;was cited\u0026nbsp;as\u0026nbsp;a\u0026nbsp;major\u0026nbsp;barrier\u0026nbsp;to\u0026nbsp;youth\u0026nbsp;PA\u0026nbsp;for rural\u0026nbsp;parents\u0026nbsp;like\u0026nbsp;urban\u0026nbsp;parent.\u003c/p\u003e\n\u003cp\u003eDelfina: \u003cem\u003e\u0026ldquo;I think there\u0026rsquo;s be one swing and besides they don\u0026apos;t have shade which is harder they\u0026rsquo;re aluminum or something that\u0026apos;s really hot, so not a ton but they\u0026apos;re working on it, but it\u0026apos;s really\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003e\u003cem\u003erare\u0026nbsp;that\u0026nbsp;kids\u0026nbsp;go\u0026nbsp;to play.\u0026rdquo;\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eEsperanza:\u0026nbsp;\u0026ldquo;\u003cem\u003eAndar\u0026nbsp;afuera?\u0026nbsp;No\u0026nbsp;no\u0026nbsp;no\u0026nbsp;no\u0026hellip;.\u0026nbsp;Caliente!\u0026rdquo;\u0026nbsp;\u003c/em\u003e[Translation:\u0026nbsp;\u0026ldquo;\u003cem\u003eBeing\u0026nbsp;outside?\u0026nbsp;No\u0026nbsp;no\u0026nbsp;no no\u0026hellip;hot!\u0026rdquo;]\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eIn contrast to the urban focus group, the rural focus group participants did not discuss venues for indoor PA, like a gymnasium. However, the rural parents did acknowledge that they and their children were aware of options for indoor activities.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eNeighborhood perception is an essential consideration for disentangling the complex factors that contribute to health outcomes in Latino populations, including the persistence of disproportionate childhood obesity rates. Latino health-protective benefits stemming from residing in ethnic enclaves, geographic areas with a high density of a particular ethnic group who are socially and economically distinct from the majority group22 but often exhibit characteristics of high epidemiological risk such as lower SEP across numerous disease outcomes23-24, are not fully understood. To understand how neighborhoods shape Latino health patterns, our qualitative data demonstrates that objective neighborhood attributes are insufficient for understanding access to resources that encourage positive health outcomes. Moreover, assessing objective neighborhood attributes does not provide insights into how perceptions shape the social context in making space from geographic place to establish a community. Further research is needed to understand better the role of neighborhood perceptions of low-SEP ethnic enclaves and the protective health benefits of Latinos.\u003c/p\u003e \u003cp\u003eRural and urban contexts are often discussed as contrasting socio-ecological situations with differential access to transportation, affordable daycare, and other social services, such as job training25. Economic resources, like access to time, transportation, and money, were barriers for these families to link their children to PA opportunities. As demonstrated by these families, SEP-constrained access to resources for low-income rural and urban residents, regardless of potential access to resources available in these distinct settings. The\u003c/p\u003e \u003cp\u003ediscussed experiences of urban versus rural contexts were found to be a function of SEP, which problematizes the perspective that resource access differs from the broader geographic contexts. The centering of SEP to better understand access within both urban and rural geographies is salient for Latinos, mainly migrants from Mexico and Central America, as they have less access to social safety net programs and are more likely to be poorer than other populations in the US25. While there is a lack of access to resources stemming from low SEP, there are also factors such as social cohesion and social network ties that have been discussed as contributing to the health benefits experienced by Latinos.26\u0026ndash;27\u003c/p\u003e \u003cp\u003eThe neighborhoods where these families reside have experienced historical disinvestment that has resulted in fewer green spaces, limited facilities for PA, and limited availability of public transportation to facilitate access to PA opportunities in other neighborhoods. The urban parents discussed the lack of access to other neighborhoods with PA opportunities for children. The urban neighborhoods where these families reside are experiencing gentrification, the influx of upper- and middle-income households that work to transform low- income neighborhoods, which is most often accompanied by area improvements.28\u0026ndash;29 The changing area infrastructure has the potential to increase access to PA opportunities for these families. However, gentrification also results in the displacement of residents and the disruption of social networks, leading to shifts in neighborhood social cohesion and an altered sense of place and community.28 As the shifting social landscape of these neighborhoods may be influenced by gentrification, it is unknown how this impacts these Latino families' conceptualizations of space and place. More research is needed to understand better how gentrification influences neighborhood perceptions of these Latino families and if they experience increased access to health resources.\u003c/p\u003e \u003cp\u003eArea disinvestment is substantial towards neighborhood heat vulnerability29. Despite geographic differences, urban and rural parents cited high heat as a significant environmental barrier to PA. The parents noted a lack of indoor alternatives, which may be a function of the neighborhood-level disinvestment. Residents of neighborhoods shaped by redlining and disinvestment have been found to have been found to experience higher numbers of heat-related illness30, which may be attributable to an overall lack of neighborhood built\u003c/p\u003e \u003cp\u003eenvironment resources, including less green space and higher temperatures in these areas31. While urban parents did not mention accessible indoor PA spaces, rural parents noted that options like the library provided limited alternatives for structured activities. The lack of climate-controlled PA options in both contexts underscores the need for targeted interventions to ensure children can access safe year-round PA opportunities.\u003c/p\u003e \u003cp\u003eA limitation of the study is that the qualitative data was derived solely from focus groups. The degree to which the more vocal participants of the group influenced the topics of conversation is unknown. Future research should further investigate the role of social infrastructure in shaping PA behaviors among Latino children, particularly within low-SEP communities. Understanding how neighborhood perceptions intersect with economic constraints and environmental conditions can inform policies and programs that support equitable access to PA opportunities. Additionally, longitudinal studies that track changes in PA engagement over time may provide insights into how interventions can sustain long-term behavior change and contribute to reducing pediatric obesity disparities in Latino populations.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study underscores the need for multidimensional approaches to understand and address disparities in PA engagement among Latino children. Increased engagement in childhood PA among Latinos may serve as a strategy for improving health outcomes across the lifespan. While urban and rural parents identified distinct barriers to their children\u0026rsquo;s PA, the underlying influence of SEP was evident across both geographies. Future directions of this research include mixed methods consideration of neighborhood perception and quantitative infrastructure. Incorporating community perspectives into intervention strategies. Researchers, and policymakers can develop more effective and context-relevant solutions to promote PA and target pediatric obesity in Latino communities.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eCenters for Disease Control and Prevention. Childhood Obesity Facts (2024) Apr 2 [cited 2025 Mar 10]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html\u003c/span\u003e\u003cspan address=\"https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlberto CK, Pintor JK, De Trinidad Young M et al (2020) Association of maternal citizenship and State-Level immigrant policies with health insurance coverage among US-Born Latino youths. JAMA Netw Open 3(10):e2021876. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1001/jamanetworkopen.2020.21876\u003c/span\u003e\u003cspan address=\"10.1001/jamanetworkopen.2020.21876\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePerreira KM, Allen CD, Oberlander J (2021) Access to health insurance and health care for Hispanic children in the United States. ANNALS Am Acad Political Social Sci 696(1):223\u0026ndash;244. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/00027162211050007\u003c/span\u003e\u003cspan address=\"10.1177/00027162211050007\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoresh A, Tsur AM, Bardugo A, Twig G (2021) Adolescent and Childhood Obesity and Excess Morbidity and Mortality in Young Adulthood\u0026mdash;A Systematic review. Curr Obes Rep 10(3):301\u0026ndash;310. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s13679-021-00439-9\u003c/span\u003e\u003cspan address=\"10.1007/s13679-021-00439-9\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWeihrauch-Bl\u0026uuml;her S, Schwarz P, Klusmann J (2019) Childhood obesity: increased risk for cardiometabolic disease and cancer in adulthood. Metabolism 92:147\u0026ndash;152. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.metabol.2018.12.001\u003c/span\u003e\u003cspan address=\"10.1016/j.metabol.2018.12.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchwarzfischer P, Gruszfeld D, Stolarczyk A et al (2019) Physical activity and sedentary behavior from 6 to 11 years. Pediatrics 143(1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1542/peds.2018-0994\u003c/span\u003e\u003cspan address=\"10.1542/peds.2018-0994\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBelanger MJ, Rao P, Robbins J (2022) Exercise, physical activity, and cardiometabolic health. Cardiol Rev 30(3):134\u0026ndash;144. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/crd.0000000000000417\u003c/span\u003e\u003cspan address=\"10.1097/crd.0000000000000417\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim LB, Duh-Leong C, Nagpal N et al (2023) Supporting early childhood routines to promote cardiovascular health across the life course. Curr Probl Pediatr Adolesc Health Care 53(5):101434. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.cppeds.2023.101434\u003c/span\u003e\u003cspan address=\"10.1016/j.cppeds.2023.101434\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRhodes RE, Perdew M, Malli S (2020) Correlates of Parental Support of Child and Youth Physical Activity: a Systematic Review. Int J Behav Med 27(6):636\u0026ndash;646. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12529-020-09909-1\u003c/span\u003e\u003cspan address=\"10.1007/s12529-020-09909-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHowie EK, McVeigh J, Smith A et al (2020) Physical activity trajectories from childhood to late adolescence and their implications for health in young adulthood. Prev Med 139:106224. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.ypmed.2020.106224\u003c/span\u003e\u003cspan address=\"10.1016/j.ypmed.2020.106224\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGautam N, Dessie G, Rahman MM, Khanam R (2023) Socioeconomic status and health behavior in children and adolescents: a systematic literature review. Front Public Health 11:1228632\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJia P (2020) Obesogenic environment and childhood obesity. Obes Rev 22(S1). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/obr.13158\u003c/span\u003e\u003cspan address=\"10.1111/obr.13158\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKirk SFL, Penney TL, McHugh TL (2010) Characterizing the obesogenic environment: the state of the evidence with directions for future research. Obes Rev 11(2):109\u0026ndash;117. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.1467- 789x.2009.00611.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1467- 789x.2009.00611.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchipperijn J, Madsen CD, Toftager M, Johansen DN, Lousen I, Amholt TT, Pawlowski CS (2024) The role of playgrounds in promoting children\u0026rsquo;s health\u0026ndash;a scoping review. Int J Behav Nutr Phys activity 21(1):72\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSu DL, Tang TC, Chung JS, Lee AS, Capio CM, Chan DK (2022) Parental influence on child and adolescent physical activity level: a meta-analysis. Int J Environ Res Public Health 19(24):16861\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRobinson T, Nathan A, Murray K, Christian H (2022) Parents' Perceptions of the Neighbourhood Built Environment Are Associated with the Social and Emotional Development of Young Children. Int J Environ Res Public Health. ;19(11):6476. Published 2022 May 26. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/ijerph19116476\u003c/span\u003e\u003cspan address=\"10.3390/ijerph19116476\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBhaktaram A, Kress AM, Li Z, Knapp EA (2024) Unpacking Neighborhood Socioeconomic Status in Children\u0026rsquo;s Health Research from an Environmental Justice Perspective: A Scoping Review. Curr Environ health Rep 11(2):288\u0026ndash;299\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKrieger N, Williams DR, Moss NE (1997) Measuring social class in US public health research: concepts, methodologies, and guidelines. Annu Rev Public Health 18(1):341\u0026ndash;378\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnited States Census Bureau Data Profiles. [Internet]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://data.census.gov/profile?q=United+States\u0026amp;g=0100000US\u003c/span\u003e\u003cspan address=\"https://data.census.gov/profile?q=United+States\u0026amp;g=0100000US\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eUnited States Department of Agriculture Food Access Research Atlas. [Internet]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ers.usda.gov/data-products/food-access-research- atlas/documentation/#:~:text\u0026thinsp;=\u0026thinsp;Definition%3A%20A%20tract%20in%20which,supermarket%2C%20rega\u003c/span\u003e\u003cspan address=\"https://www.ers.usda.gov/data-products/food-access-research- atlas/documentation/#:~:text\u0026thinsp;=\u0026thinsp;Definition%3A%20A%20tract%20in%20which,supermarket%2C%20rega\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e rdless%20of%20vehicle%20availability\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNational Weather Service [Internet]. Available from: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.weather.gov/\u003c/span\u003e\u003cspan address=\"https://www.weather.gov/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLim S, Yi SS, De La Cruz NL, Trinh-Shevrin C (2015) Defining Ethnic Enclave and Its Associations with Self-Reported Health Outcomes Among Asian American Adults in New York City. J Immigr Minor Health 19(1):138\u0026ndash;146. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s10903-015-0334-6\u003c/span\u003e\u003cspan address=\"10.1007/s10903-015-0334-6\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFang CY, Tseng M (2018) Ethnic density and cancer: A review of the evidence. Cancer 124(9):1877\u0026ndash;1903. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/cncr.31177\u003c/span\u003e\u003cspan address=\"10.1002/cncr.31177\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDurazo EM, Mbassa RS, Albert MA (2016) Ethnic Enclaves and Type II Diabetes: a Focus on Latino/Hispanic Americans. Curr Cardiovasc Risk Rep 10(11). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s12170-016-0518-1\u003c/span\u003e\u003cspan address=\"10.1007/s12170-016-0518-1\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNolan L, Waldfogel J, Wimer C (2017) Long-Term Trends in rural and Urban poverty: New insights using a Historical Supplemental Poverty Measure. ANNALS Am Acad Political Social Sci 672(1):123\u0026ndash;142. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1177/0002716217713174\u003c/span\u003e\u003cspan address=\"10.1177/0002716217713174\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRodgers J, Valuev AV, Hswen Y, Subramanian SV (2019) Social capital and physical health: An updated review of the literature for 2007\u0026ndash;2018. Soc Sci Med 236:112360. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.socscimed.2019.112360\u003c/span\u003e\u003cspan address=\"10.1016/j.socscimed.2019.112360\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlmeida J, Kawachi I, Molnar BE, Subramanian SV (2009) A Multilevel Analysis of Social Ties and Social Cohesion among Latinos and Their Neighborhoods: Results from Chicago. J Urb Health 86(5):745\u0026ndash;759. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s11524-009-9375-2\u003c/span\u003e\u003cspan address=\"10.1007/s11524-009-9375-2\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThomas KA, Hardy D, Lazrus H et al (2018) Explaining differential vulnerability to climate change: A social science review. WIREs Clim Change 10(2). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/wcc.565\u003c/span\u003e\u003cspan address=\"10.1002/wcc.565\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWilson B (2020) Urban heat management and the legacy of redlining. J Am Plann Association 86(4):443\u0026ndash;457. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1080/01944363.2020.1759127\u003c/span\u003e\u003cspan address=\"10.1080/01944363.2020.1759127\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi D, Newman GD, Wilson B, Zhang Y, Brown RD (2022) Modeling the relationships between historical redlining, urban heat, and heat-related emergency department visits: an examination of 11 Texas cities. Environ Plann B: Urban Analytics City Sci 49(3):933\u0026ndash;952\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLee EK, Donley G, Ciesielski TH, Yamoah O, Roche A, Martinez R, Freedman DA (2022) Health outcomes in redlined versus non-redlined neighborhoods: a systematic review and meta-analysis. Soc Sci Med 294:114696\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cdiv class=\"gridtable\"\u003e\u003ctable id=\"Tab1\" border=\"1\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eUrban Parents Identified Barriers for Physical Activity of Children\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber of Barriers\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDiscussed Barrier\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMulti-Level Category\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eEconomic Cost\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIndividual/Household\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCommunity Violence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eCommunity\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOutdoor Heat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeographic Location\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\u0026nbsp;\u003ctable id=\"Tab2\" border=\"1\" class=\"fr-table-selection-hover\"\u003e\n \u003ccaption language=\"En\"\u003e\n \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n \u003cdiv class=\"CaptionContent\"\u003e\n \u003cp\u003eRural Parents Identified Barriers for Physical Activity of Children\u003c/p\u003e\n \u003c/div\u003e\n \u003c/caption\u003e\n \u003cthead\u003e\n \u003ctr\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eNumber of Barriers\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eDiscussed Barrier\u003c/p\u003e\n \u003c/th\u003e\n \u003cth align=\"left\"\u003e\n \u003cp\u003eMulti-Level Category\u003c/p\u003e\n \u003c/th\u003e\n \u003c/tr\u003e\n \u003c/thead\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eMotivation of Child\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eIndividual/Household\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eOutdoor Heat\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd align=\"left\"\u003e\n \u003cp\u003eGeographic Location\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n \u003c/table\u003e\n\u003c/div\u003e\n\u003cdiv id=\"Sec18\" class=\"Section2\"\u003e\u003cbr\u003e\u003c/div\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"University of Arizona","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Obesogenic environments, Pediatric obesity, physical activity, Socioeconomic positionality, Urban Latinos, Socioecological model","lastPublishedDoi":"10.21203/rs.3.rs-6784739/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6784739/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eQuantitative data alone cannot fully capture neighborhood conditions, particularly in understanding how the built environment influences child health. This study explores how Latino parents from low socioeconomic position (SEP) backgrounds in both urban and rural settings perceive their neighborhood environments concerning their children’s physical activity (PA). Using four qualitative focus groups (N = 36) we examined perceived barriers and facilitators to child health and well-being. Across both urban and rural groups, parents identified limited access to physical activity resources, such as safe parks, sidewalks, and recreational facilities as a primary barrier, highlighting striking parallels across geographies. These findings challenge the notion that urban and rural disparities are fundamentally distinct and instead suggest that low SEP is the more salient driver of constrained PA opportunities. To our knowledge, this is the first study to compare qualitative neighborhood perceptions of low SEP Latino families across urban and rural settings, providing critical insight into how structural inequities shape child health behaviors independent of geographic category.\u003c/p\u003e","manuscriptTitle":"Challenging the Urban-Rural Divide: Latino Parental Perceptions of the Built Environment","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-06-02 01:48:20","doi":"10.21203/rs.3.rs-6784739/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"472cc1d5-c070-414c-869e-7093c489f018","owner":[],"postedDate":"June 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":49289853,"name":"Behavioral Geography"},{"id":49289854,"name":"Health Policy"}],"tags":[],"updatedAt":"2025-06-02T01:48:20+00:00","versionOfRecord":[],"versionCreatedAt":"2025-06-02 01:48:20","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6784739","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6784739","identity":"rs-6784739","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}