Continued development of the Rural Active Living Perceived Environmental Support Scale (RALPESS): preliminary evidence for validity among American Indians.

Much of the US adult population does not engage in regular physical activity or meet the recommended guidelines for exercise. Moreover, many rural Americans disproportionately experience lower health status and life expectancy attributed to obesity, poor diet, and lack of physical activity. Evidence supports the role of perceived physical and social-environmental factors as potential influencers of exercise. However, measurement of these influencers, particularly within diverse, rural populations, has been sparse. A substantial number of American Indians live in federally defined rural areas, and many rural American Indians are at elevated risk for being overweight and obese due to physical inactivity. Therefore, this study established the validity and reliability of the Rural Active Living Perceived Environmental Support Scale (RALPESS) within a predominantly rural American Indian sample. In this cross-sectional pilot study, the 33-item RALPESS was administered to 130 adults, across 19 rural localities within Oklahoma, who were recruited from community events hosted by local partners of the tribal Head Start program. Confirmatory factor analysis was used to examine the hypothesized factor structure of the RALPESS. Confirmatory factor analysis showed an adequate fit between the hypothesized model and the data. Analyses produced an acceptable χ2 goodness of fit index with two degrees of freedom. The comparative fit index and parsimony goodness of fit index were acceptable. The root mean square error of approximation and its 90% confidence interval were also acceptable. Overall, the RALPESS showed suitable internal consistency for the full measure and its subscales, resulting in Cronbach's alpha between 0.82 and 0.96. This pilot study produced confirmatory evidence that the RALPESS is likely a valid and reliable tool for use with rural American Indian populations. Continued validation of this scale, particularly in international rural communities, will support further investigation into this important public health issue, and may further efforts towards the development and promotion of effective programming to increase exercise engagement.