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This study compared rural vs urban eating and physical activity (PA) behaviors and perceived barriers. Analyses revealed rural adults cooked more at home, ate out less at restaurants (5.59 vs 4.91 days,  P  = .00; .71 days vs 1.08 days,  P  = .01, respectively), and snacked less than urban adults (1.69 vs 2.01 times per day,  P  = .03). Among rural adults, unaffordability was associated with not meeting fruit recommendations ( P  = .02) and safety and traffic concerns were negatively associated with daily PA ( P  = .03,  P  = .00, respectively). Among urban adults, inadequate selection ( P  = .03) was associated with not meeting fruit recommendations. Results revealed contextual issues for policymakers and practitioners.

Differences in Eating and Physical Activity Behaviors, and Perceived Accessibility and Availability Barriers between Midwestern Rural and Urban Adults