BACKGROUND: Nationally, youth are generally not achieving 60 minutes of daily moderate-to-vigorous physical activity (MVPA). Studies suggest that rural adults are less active than their urban counterparts, although studies of children are equivocal. PURPOSE: To compare objectively measured physical activity across the rural-urban continuum in a sample of fourth- to eighth-grade youth. METHODS: In fall 2010, youth from 20 North Carolina counties wore an accelerometer a minimum of 4 monitored days (n=804, 54% female, 25% African American, 54% urban). In spring 2013, two random-effects regression models were estimated separately for boys and girls. Comparisons among minutes of MVPA/day continuous and binary (≥60 minutes vs <60 minutes MVPA/day) among rural, suburban, and urban children were made, controlling for race, monitor wear time, and grade. RESULTS: For boys, there were no differences in MVPA/day among urbanicity categories. However, a 4.2 minutes/day decrease in MVPA occurred with each increase in grade. For girls, rural girls accumulated 9.3 minutes MVPA/day and 8.0 minutes MVPA/day more than suburban and urban girls, respectively. A 3 minutes/day decrease in MVPA occurred with each increase in grade. Rural girls were 4.6 times and 2.8 times more likely to accumulate ≥60 minutes MVPA/day compared to suburban and urban girls, respectively. No interactions across all models were significant for boys or girls. CONCLUSIONS: The relationship between urbanicity and MVPA in youth appears to be more complex than previously envisioned. Rural residence appears to be supportive of MVPA in girls but not boys. Future research should consider urbanicity when investigating correlates/determinants of MVPA in youth.
