Subjectively-measured Environmental Support for Physical Activity, Healthy Eating, and Breastfeeding Supports in the Rural United States: A Scoping Review to Inform Opportunities for Public Health Surveillance
Bibliographic record
Abstract
The purpose of this scoping review was to identify subjectively-measured environmental characteristics that influence PA, HE, and/or breastfeeding practices within rural U.S. communities. Guided by a scientific research librarian, searches occurred February through July 2020. Grey literature searches spanned Google, Google Scholar, government pages, and public health, federal nutrition assistance program, Cooperative Extension Services, and related webpages. Four academic databases (Medline, PubMed, Web of Science, Agricola) were selected to identify peer-reviewed research and ProQuest Dissertations and Theses Global were used to identify dissertation research. Inclusion criteria included: (1) breastfeeding, HE, and/or PA focus; (2) environmental factors assessed using subjective measures; (3) specific to U.S. rural populations/contexts; and (4) English language. PA environment results focused on initiatives in recreation (parks, playgrounds, facilities; n=54), streets/sidewalks (n=44), or school (n=33) settings. PA environmental initiatives/recommendations included increasing transport/accessibility or addressing geographic disparities for recreation settings, improving/installing walkability features for streets/sidewalks, integrating PA into lessons, or improving PA equipment/spaces for school settings. HE environment results focused on initiatives in retail (n=65) and schools/childcare (n=33) settings. HE environment change initiatives/recommendations in retail settings included increasing the availability of fruits/vegetables in existing establishments or the prevalence of healthy food outlets. In schools, HE environmental initiatives/recommendations increased fruits/vegetables served and/or reduced unhealthy foods. Breastfeeding environment results focused on workplace settings (n=3). Breastfeeding environment initiatives/recommendations in workplaces included increasing compatibility for breastfeeding by addressing environment and culture barriers. Results from this scoping review were used to create recommendations to improve PA, HE, or breastfeeding environments in rural U.S. settings.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.086 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.017 | 0.017 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".