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REPORT ON THE INVESTIGATION ON HOW

PHYSICAL ACTIVITIES CAN BE PROMOTED IN


THE RURAL AREAS OF LIMPOPO
THOHOYANDOU AREA IN 2022.

BY:

KHUMBELO AUSTIN DENGA


S225474115

DATE:

7 June 2022

MODULE:

LELV111 – Professional Communication: Language

LECTURER:

Mr M. Raban
Student Name and No.: Asanda Abrahams, 205044334
LELV111 - Report Title: An investigation ...

Table of Contents
EXECUTIVE SUMMARY...........................................................................................................................1
LIST OF TABLES.......................................................................................................................................2
LIST OF FIGURES.....................................................................................................................................2
GLOSSARY..............................................................................................................................................2
INTRODUCTION......................................................................................................................................3
TERMS OF REFERENCE...............................................................................................................................3
BACKGROUND/CONTEXT............................................................................................................................3
RESEARCH OBJECTIVES...............................................................................................................................3
LITERATURE REVIEW..............................................................................................................................3
SUB-HEADING 1.......................................................................................................................................3
SUB-HEADING 2.......................................................................................................................................3
SUB-HEADING 3...............................................................................................................................................3
METHODOLOGY/PROCEDURE................................................................................................................3
RESULTS/FINDINGS................................................................................................................................3
ANALYSIS AND DISCUSSION.........................................................................................................................3
ASSUMPTIONS AND LIMITATIONS.................................................................................................................3
REMARKS AND OBSERVATIONS....................................................................................................................4
CONCLUSIONS........................................................................................................................................4
RECOMMENDATIONS.............................................................................................................................4
REFERENCES...........................................................................................................................................5
APPENDICES...........................................................................................................................................6
APPENDIX 1............................................................................................................................................6

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Executive Summary

Introduction:
In Thohoyandou, a key danger to population health equality is the lack of policy, practice, and
research action on physical activity and aspects of the physical (built and natural) environments
in rural, remote, and northern areas. This paper includes a review of existing information on the
promotion of physical activity in non-urban settings, as well as the results of a regional priority-
setting meeting and a draft call to action to help population-level initiatives targeting physical
activity in non-urban settings succeed.

Methods:
To investigate current research on physical activity promotion in rural, remote, northern, and
natural environments, we conducted a "synopses of syntheses" scoping review. The case-study
technique is a process-based, systematic, and in-depth research into the "reallife" of a
phenomenon that is closely related to its surroundings. Our methodologies were
designed to provide a comprehensive picture of physical activity participation in a small town.
I obtain information utilizing an approach known as online research, in which we look for
material on the internet and search for it. I also use the simulation method to acquire data. The
information was also obtained in a Google Scholar journal paper.

Results:
A small number of reviews focusing on physical activity and the built environment in rural,
remote, and southern regions were found. Participants from rural, remote, and northern areas
defined top priorities for policy, practice, and research action at the priority-setting conference
to begin to address the gaps and difficulties found in the literature. Self-identifying community
priorities, accumulating experiences, ensuring consistency in research definitions and
techniques, and developing mentorship opportunities are among these priorities.

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Conclusion:
The achievement of the recommendations offered in this call to action will require coordinated
action across policy, practice, and research domains.

Keywords: rural health, distant health, health policy, environment design, physical activity, and
health equity are some of the terms used.

Highlights:

The conditions and setting of rural and isolated areas must be included in physical activity
promotion.
The research literature on physical activity promotion in rural and distant communities does
not currently provide communities or public health organizations with suitable guidance.

Experts gathered in November 2015 to assess existing research and create goals for
improving physical activity promotion in rural, remote, and southern South Africa.

Priorities were outlined in a South African call to action, which includes the need for more
culturally relevant, Indigenous-led research to promote equitable action on rural and distant
physical activity promotion in Thohoyandou.

List of Tables

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No table of figures entries found.

List of Figures
No table of figures entries found.

Glossary
Term Definition
Term Definition

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Introduction
Purpose
The goal of this study is to see if walking trails are linked to greater physical activity, to see what
other factors are linked to increased physical activity, and to see what elements of the trails
may discourage or encourage use.

Terms of Reference
On 9 May 2022, Mr M.Raban, of the University of Nelson Mandela ,required that a report on
the engineering facilities at this institution be submitted to him following numerous student
complaints. The report with recommendations, is due by 07 June 2022.. The report looks at
methods to encourage physical activity in Limpopo's Thohoyandou rural communities.

Background/Context
Physical activity (PA) has been linked to a lower risk of cancer and other chronic diseases; yet,
as compared to their urban and suburban counterparts, rural residents are less likely to achieve
recommended levels of PA. Rural residents account for 75% of the population of Thohoyandou,
hence new ideas are needed methods for increasing PA in this group. The purpose of this
research is to see how effective it is to boost PA rates among rural inhabitants using a
multilayered intervention.

Decision-makers, legislators, bureaucrats, members of the media, and policy advocates in


Thohoyandou, as well as the general public, appear to be enthusiastic about population-level
interventions that encourage physical activity by focusing on the built and physical
environment. For example, according to a 2016 study done by members of the Vuka South
Africa team, 95.3 percent of policy influences support increasing physical activity possibilities

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through neighborhood redevelopment programs. 7 Furthermore, 87.7% of policymakers and


92.8 percent of the general population support establishing bicycling-friendly transportation
regulations.

Although widespread support for legislation and built-environment solutions that encourage
physical activity, non-urban settings have considerable evidence, policy, and practice shortages.
The majority of evidence on the environmental encouragement of physical activity has been
concentrated on urban settings, with little attention dedicated to settings outside of cities and
metropolitan areas. This is problematic because rural communities have fewer resources or
have less access to existing resources than urban ones, contributing to a higher prevalence of
negative health consequences.

From a practice and policy standpoint, non-urban locations also face disparities in the
promotion of physical activity. Access to physical activity is more difficult in little villages of less
than 10,000 people than in larger communities of 250 000 or more people. In comparison to
the South African average, a higher percentage of parents in rural, remote, and southern areas
perceive low accessibility as a barrier to their children's physical activity. 11 Local governments
in rural, distant, and southern areas may face additional infrastructure issues, such as a lack of
revenue and financial capability, short construction seasons, and high living costs. This makes
community programming and creating surroundings that encourage physical activity
challenging. "We have been neglecting rural South Africa...," the State of Rural South Africa
2015 study concludes. We have basically forgotten how to reinvest in rural and small-town
areas.

Understanding the differences between non-urban environments can help to increase health
equity and lead to more effective policy and environmental interventions that promote physical
activity in all settings. In light of this, we undertook a review-level synthesis of the literature on
the promotion of physical activity in non-urban areas from the standpoint of the built
environment. Following that, we conducted a meeting with invited experts to identify a list of

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practice, policy, and research priorities to enhance physical activity in rural, remote, and
Southern areas. This approach culminated in the joint creation of a South African call to action,
which is detailed in this article.

Research Objectives
• To come up with/determine at least one method for promoting physical activity
in rural areas.
• To impart knowledge to individuals in rural areas on how to increase physical
activity in their communities in order to maintain their health
• To improve society by promoting knowledge in rural areas through scientific
theories, concepts, and ideals or by Examining the independent and
moderating effects of a multilevel intervention and the community environment
on rural inhabitants' physical activity.

Literature Review
Rural locations
Articles in review with a clear rural theme
I found four review articles that looked at the impacts of the built environment on physical
activity, determinants of physical activity, challenges and role models to physical activity, and
differences in physical activity in rural, urban, and suburban built environments. Children and
adolescents, women, adults, and senior persons were among the demographic groupings
mentioned. The majority of the research took place in the United States of America (USA), as
well as South Africa and Australia. Studies from Cyprus, Iceland, Italy, Norway, and Sweden
were included in one review.

Rural definition
None of the four review articles specified how "rural" was defined explicitly. Frost et al.
Footnote8 reviewed studies that classified the population as "rural," whereas Olsen et

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al.Footnote18 used a more ambiguous definition, noting that one study limited the sample to
communities of fewer than 1000 people with no towns within a certain radius, while another
included towns with up to 49 999 people.

Physical activity differences between rural, urban, and suburban built settings
Sandercock et al.Footnote19, one of the four rural-focused review studies we included in our
synthesis, had the specific goal of comparing variations in the physical activity levels of children
living in urban and non-urban environments. Only six of the 18 studies examined by Sandercock
et al. went beyond the rural/urban divide to cover suburban and/or small-town settings and/or
demographics. They discovered that children in urban and, in certain circumstances, rural
environments had lower physical activity levels than children in suburban/small-town settings,
possibly as a result of suburbia and small towns sharing a mix of rural and urban traits, as the
authors argue. Suburban areas also had fewer low-income households and ethnic minority
people, two factors that were found to be inversely linked with adult physical activity.
Footnote19 Future research should address socioeconomic status, racial variables, and seasonal
effects on physical activity in varied constructed environments, according to Sandercock et al.

Physical exercise and the built environment are linked.


Frost et al.Footnote8 identified 11 elements of rural built environments associated with adult
physical activity levels in their review of 20 studies: sidewalks, street lighting, private and public
recreational facilities, parks, malls, aesthetics, crime/safety, traffic, walking destinations, trails,
and environmental access. Aesthetics (4/4 studies); perceptions of safety/crime levels (6/9);
and the existence of recreational facilities (5/10), trails (4/6), and parks (3/6) were all studied to
varied degrees in these studies. All of these factors were discovered to be linked to levels of
physical exercise. Footnote8After comparing findings from 18 urban studies with findings from
rural settings, Frost et al. discovered that physical activity was positively associated with
aesthetics in both settings, but that safety/crime levels, traffic, and trails were better predictors
of physical activity in rural settings. This study implies that aspects of the built environment
linked to adult physical activity may differ in rural and urban contexts.

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Obstacles and drivers


Three of the four rural-focused review articles examined environmental motivators and/or
constraints in rural areas. Footnote8, Footnote18 insufficient lighting/lack of lamps,
Footnote17, Footnote18 safety concerns (i.e. crime, presence of hunters), Footnote8,
Footnote17, Footnote18 the weather were some of the impediments highlighted. Dogs or wild
animals, Footnote17, Footnote18 Footnotes 17 and 18, as well as a lack of physical access to
amenities and transportation Parks, Footnote8, Footnote17, and Footnote18 Footnote8 For
example, Boehm et al.Footnote17 discovered that in rural and distant regions, social and
environmental barriers to exercise for elderly people—such as a poorly constructed
environment, the presence of dogs, and bad weather—were more common. While more
research is needed, the review articles suggest that (1) policy should be developed to address
barriers to physical activity in the built environment (e.g., transportation and safety), especially
for specific populations (e.g., rural women); (2) environmental design should consider
environmental motivators and barriers; and (3) practitioners should explore strategies to
overcome these barriers. Footnote8,Footnote17.

Scenes in the wild


There were four review studies found that looked at physical activity in natural environments
(such as parks and wilderness regions). Footnote47 landscape as a resource for well-being;
Footnote6 physiological advantages of exercise in a green environment; Footnote46 and
impacts of participation in physical activity in natural surroundings versus indoor settings were
among the themes covered in these review articles. These review papers imply that there is a
dearth of understanding of the impact that natural surroundings play in promoting physical
activity and improving health, especially when these settings are found in rural, isolated, or
southern communities. However, there is mounting evidence that engaging with nature is
beneficial to people's health. Natural environments, for example, were discovered to have a
more restorative effect on mental weariness and to be better equipped to increase
concentration than metropolitan areas. At the same time, there is worry about the

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sustainability of natural settings and the environmental impact of growing human presence,
Footnote46 implying that communities in natural environments require intervention design.

Overall, sustained and increased efforts to synthesis and communicate available knowledge to
inform the work of South African practitioners and policymakers are essential in all non-urban
settings. In addition, more primary research using scientifically sound methodologies is needed
to overcome current research gaps and constraints on this area.

Methodology/Procedure
Part 1: Evidence Evaluation
I conducted a scoping analysis and synthesis of the literature at the review level to understand
what is currently known about the promotion of physical activity in non-urban settings from the
perspectives of physical, constructed, and natural environments. The National Collaborating
Centre on Methods and Tools (NCCMT) recommends this "synopses of syntheses" strategy for
assessing the state of evidence on public health interventions, with searches of the highest
quality sources done. My goal was to scope and synthesize the evidence in a certain issue area,
starting with the conclusions of systematic reviews—reviews of reviews.

Data gathering
Review articles were retrieved from four main databases, including Four grey literature Sources,
for the synthesis. We also looked at references cited in major articles that we found on Google
Scholar, as well as other reviews that the research team found. A wide range of terminology
linked to physical activity and the physical, built, and natural surroundings in non-urban settings
were employed in various combinations to encourage inclusion.

Results/Findings
[Text]

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Analysis and Discussion


Experts at the meeting on setting priorities saw the need to go beyond the limited
recommendations currently available from existing research on physical activity in rural and
distant settings in order to make significant, equitable, and timely progress on physical activity
promotion in such areas. The experts drew on their extensive and deep experience working in
various settings as practitioners, decision-makers, and researchers in addition to thorough
evaluation and discussion of the data. As a result, the call to action mentioned above reflects on
expert recommendations that recognize the nuance, variation, process, and contextual factors
that go beyond the data currently accessible in the literature, while expanding on the evidence
synthesis.

While the experts used their experience of the topics to explain and expound on the
implications for physical activity research and practice in rural, remote, and northern settings,
the evidence synthesis and priority-setting approach revealed similar issues and priorities in
these settings. The fundamental lack of clarity, openness, and consistency in how the term
"rural" is defined and understood must be addressed in future study. Footnote 8, Footnote 18,
and Footnote 19 are all examples of footnotes. The lack of definition and conceptualization may
limit the evidence's usefulness and, as a result, limit the findings' applicability to other rural
contexts. Footnotes 8 and 17 The utility of the conclusions from the review articles was harmed
by the lack of transparency and consistency, prompting conference participants to discuss why
it is difficult to define "rural." Rural areas, for example, are defined as "small towns, villages,
and other populated localities with fewer than 1000 population according to the current
census," and might include "agricultural fields" and "remote and wilderness areas," according
to Statistics South Africa. Footnote49 Currently, provincial/territorial health authorities and
other governmental or organizational bodies involved with rural or distant settings have not all
adopted Statistics South Africa's definition, as different definitions may better correspond with
specific service mandates or jurisdictional authority. While "rural" is a heterogeneous construct,
the parallels in the experience of rurality, despite broad disparities in population-based or
geographic qualities commonly given to definitions of rural, complicate the notion of a single

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definition. A clear, uniform, and open definition of "rural" would make information transfer
more effective across settings. As a starting point for unraveling this intricacy, the experts
suggested using rigorous qualitative and mixed-method approaches.

The review articles found a dearth of peer-reviewed studies concentrating on treatments aimed
at larger environmental levels in distant and southern locations, Footnote41, Footnote43.
Experts highlighted this concern when determining priorities, calling for additional resources to
be committed to systematically promoting physical activity in these settings. Participants
recognized the wealth of existing practice and policy (which is not adequately represented in
current academic literature) and emphasized the need to increase long-term sustainable
funding and develop innovative funding models to reinvest in promoting physical activity in
rural, remote, and southern communities (as emphasized in the Participaction Report Card on
Physical Activity for Children and YouthFootnote50, Footnote51).
Experts explained how this investment is especially critical in Indigenous rural or
remote/southern communities to address resource imbalances that promote physical
activityFootnote52 and to rigorously evaluate and uncover how resource inequities are linked
to poor health and social outcomes. Furthermore, attempts to document a wide range of
sources of information related to physical activity in rural and remote locations should be
guided by rigorous, transparent, and culturally relevant criteria, including Indigenous research
methodologies conducted by local people.

Experts from both rural and remote/southern settings identified similar best practices for
bridging research, practice, and policy gaps, implying that local community members,
practitioners, and decision-makers should be actively involved in identifying issues and
developing and implementing solutions. While this was not listed as a theme in the evidence
synthesis, it is mentioned in both the State of Rural South Africa 2015 reportFootnote13 and
the 2016 Pathways to Policy reportFootnote53, corroborating the experts' rich process
recommendations. Participants also brought up the topic of community capacity to encourage
physical activity in rural and remote/southern locations, which is something that Participaction

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mentioned in its 2016 report card. Footnote50 They cited leadership development with youth
and other community leaders in remote/southern villages, for example, as a critical component
for long-term sustainability.

Expert panelists discussed the distinct contrasts between rural and remote/southern settings.
Experts from rural and southern locations, for example, stressed the holistic nature of
promoting physical activity, emphasizing that action should represent community culture and
be interwoven with core community interests and Indigenous leadership. Experts emphasized
the need of focusing on moving-to-the-land and on-the-land programs that include traditional
activities (e.g., hunting, snowshoeing) that incorporate physical activity and built environment
themes in ways that are relevant to the community. As one strategy for going forward, priority-
setting participants suggested focusing on resilience-based initiatives (e.g., a return to
integrating culture, the land, and medicine).

A Summons To Action
The following South African call to action gives a clear path to promote the implementation and
effectiveness of population-level and environmental projects promoting physical activity in
rural, remote, and southern regions (Table 3). The experts' critical reflection—one that is based
on their current policy and practice expertise—influenced the priority-setting meeting, which
was informed by both the evidence synthesis and the experts' critical reflection. This call to
action includes recommendations from the National Collaborating Centre for Aboriginal
HealthFootnote52 to enhance cultural relevancy and anti-oppressive behaviors in
communication, knowledge development, and leadership.

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Table 3: South Africa's
calls to action on physical
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activity promotion in
rural, remote, and
northern areas. An earlier version of the evidence synthesis and the
outcomes of the priority-setting conference were posted
Policy on the public website of the Alberta Policy Coalition for
 Increase long-term Chronic Disease Prevention, a partner in a funded
support and project on policy interventions to address obesity and
explore novel chronic diseases, to support timely knowledge
funding translation with practitioners and policymakers.
mechanisms to
reinvest in rural, Assumptions and Limitations
remote, and This analysis could have some drawbacks. To begin with,
southern categorizing review articles by setting was difficult since the
populations to phrases used—"rural and distant," "rural," and "reserve"—were
promote physical frequently jumbled in the literature, although having different
activity. Flexible operational meanings. Similarly, participants in the South
opportunities for African priority-setting process used the terms "remote" and
community "southern" interchangeably in their discussions, despite the fact
members and that these terms are used differently in international literature
practitioners to on rural and remote health. Second, data quality was not
respond to local considered as an inclusion criterion [i.e., to compensate for the
priorities and limited number of review articles available; additionally, while
support 13 of the articles were directly related to non-urban settings
communities (rural, remote, southern, and natural), the remaining 24 were
across South Africa not directly related to these settings but mentioned rural or
in sharing success remote communities in their recommendations]. As a result,
stories and best some of the review articles included may be of poor quality.
practices in a Third, because this synthesis focused on evidence that was
meaningful and expressly stated in the review articles, significant data
accessible way, presented at the study level may have been missed.
including the
14
ability to work
together across
language barriers,
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This initiative's strength comes from its integrated knowledge translation approach: we
purposefully combined scholarly information with actual evidence from practice and policy to
shed light on this vital health equity issue. Expert knowledge was used to contextualize and
enhance the findings of the synthesis in order to promote future research and action on
physical activity in non-urban settings. We understand the need to continue to engage
stakeholders with diverse viewpoints as part of future conversations and strategic planning on
enabling physical activity in rural, remote, and southern areas, and we are taking steps to do so.
The meeting will bring together a larger group of researchers, practitioners, and policymakers
working in the field of physical activity in rural, remote, and southern settings to critically
evaluate the call to action, highlight examples of current practices and new gaps for each type
of setting addressed in the call and form working groups to begin addressing the specific actions
noted in the call.

This seminar will also examine the necessity for anti-oppressive practices in the development
and sharing of knowledge for the benefit of non-urban population groups, particularly
Indigenous communities. To avoid repeating South Africa's colonial heritage, we will seek
leadership and direction from Indigenous community leaders (or members), local practitioners,
and experts in organizing and hosting the event.

Remarks and Observations


[Text]

Conclusions
Physical activity in supportive environments is crucial for fostering health and well-being. A
serious challenge to population health equality in South Africa is the lack of policy, practice, and
research action on physical activity and aspects of the physical, constructed, and natural
environments in rural, remote, and northern areas. To start addressing this problem, we
gathered experts from the research, policy, and practice domains to create a South African call
to action based on a synthesis of evidence evaluations on physical activity promotion in rural,

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remote, and northern regions. The call to action lays out a clear path to help rural, remote, and
southern communities undertake and succeed with population-level and environmental
activities that promote physical activity.

Recommendations
1. Create routes that are conducive to physical activity.
Activity-friendly paths can make promoting walking and biking in your neighborhood a lot
easier. People will be more likely to choose to be active if sidewalks, trails, and bicycle lanes are
all easily connected to public transit stops, grocery stores, schools, and jobs. Routes that
encourage walking and biking to major sites make travel safer and more accessible. Safe paths
allow people of all abilities to get to their destinations while also enjoying some exercise and
fresh air. While creating secure routes to all key destinations may seem impossible, there are
particular routes that should be prioritized. Residential communities are an excellent beginning
point for routes to surrounding schools and health care services. Create trails to parks and
other locations such as grocery stores after that. Create trails to parks and other locations such
as food stores, communities, and workplaces after that.

2. Create school-based health, nutrition, and exercise initiatives


School-based health initiatives encourage children to begin exercising at a young age. Physical
exercise can be encouraged before, during, and after school through comprehensive school
physical activity programs.
Health initiatives: School-based health clinics can aid children with their complicated health
requirements. However, putting these initiatives in place can be difficult. To enhance
collaboration between the school and health sectors, local organizations and community
members must work together. Students can also participate in health campaigns by attending
classes or workshops. Teach children about the link between nutrition, activity, and good
health.
Nutrition education is an important aspect of improving community health by educating
children about nutrition. If children do not receive nutrition education at home, school is the

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next best option. At lunchtime, children should be taught the value of a well-balanced diet and
have access to healthful meals.
Physical education classes, recess, and classroom activities are all examples of exercise
programs that can be found in schools. Physical education classes provide children with the
daily activity they require while also teaching them new skills and ways to exercise. It's also
important to encourage children to play during recess. Another fantastic idea is to implement
after-school activities. Sports programs can also help children keep active on weekends by
allowing them to participate in games or extra sessions.

3. Begin a Health Challenge in Your Community


Whether it's encouraging consumers to buy wellness items or enhance their active lifestyles,
media campaigns can have a positive impact on communities. It may be as simple as employing
marketing methods to encourage your community to adopt healthy changes to promote
physical exercise. Competitions and challenges encourage people to engage by inviting friends
and family members.

4. Provide opportunities for physical activity


People who want to get more active and improve their fitness may be unable to do so due to a
lack of enjoyable workout alternatives. Public exercise programs and events, such as yoga,
dance workshops, and walk-a-thons, can be held at parks, fitness centers, and private groups.

5. Installing a Community Playground is a good idea.


Community playgrounds provide a number of benefits. They provide a safe environment for
children to grow emotionally, cognitively, socially, and physically. These gathering venues can
also help older members of the community. Community playgrounds are ideal venues for
children to engage in cooperative and independent play, which promotes social and cognitive
development. Children learn how to speak, take turns, and manage issues as they interact with
others, all while forming friendships. Unstructured play also provides possibilities for problem-

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solving and decision-making. The children must select which equipment to use and which
activities to participate in.

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References
1. Nykiforuk, C., Atkey, K., Brown, S., Caldwell, W., Galloway, T., Gilliland, J.,
Kongats, K., McGavock, J. and Raine, K., 2018. Promotion of physical
activity in rural, remote and northern settings: a Canadian call to action.
Health Promotion and Chronic Disease Prevention in Canada, 38(11), pp.419-
435.
2. Brownson, R., Housemann, R., Brown, D., Jackson-Thompson, J., King, A.,
Malone, B. and Sallis, J., 2022. Promoting physical activity in rural
communities.
3. Derbort, J., 2005. Why Is Gender So Important?Why Is Gender So Important?.
PsycCRITIQUES, 5050(11).
4. Beck, A., Eyler, A., Aaron Hipp, J., King, A., Tabak, R., Yan, Y., Reis, R.,
Duncan, D., Gilbert, A., Serrano, N. and Brownson, R., 2022. A multilevel
approach for promoting physical activity in rural communities: a cluster
randomized controlled trial.
5. Mlangeni, L., Makola, L., Naidoo, I., Chibi, B., Sokhela, Z., Silimfe, Z. and
Mabaso, M., 2018. Factors Associated with Physical Activity in South Africa:
Evidence from a National Population Based Survey. The Open Public Health
Journal, 11(1), pp.516-525.

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Appendices
Appendix 1
[Text/Image]

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