Using Omaha System Documentation to Understand Physical Activity among Rural Women.

OBJECTIVE(S) Examine factors related to physical activity among rural women using Omaha System data. DESIGN AND SAMPLE Mixed methods: quantitative analysis of de-identified clinical data and thematic analysis of public health nurse (PHN) focus group data. Rural women who received PHN services (N = 852) and purposively selected PHNs (N = 12). MEASURES Omaha System problems; signs/symptoms; knowledge, behavior, and status ratings; demographics. RESULTS Physical activity behavior among rural women was inconsistently appropriate (M = 3.27). Age, body mass index, physiological, psychosocial, and environmental domain problems, and physical activity knowledge explained 33.2% of physical activity behavior variance. Almost all women for whom specific problems were documented had insufficient physical activity. This included physiological problems of cognition and pregnancy; psychosocial problems of abuse, caretaking/parenting, mental health, and interpersonal relationship; and environmental problems of neighborhood/workplace safety and income. Having problems in two or more domains was significantly associated with insufficient physical activity behavior (p < .001). PHNs validated findings and expressed concerns that client complexity, priorities, and time constraints may affect client assessment and documentation. CONCLUSIONS PHNs should assess rural women who are not physically active for potentially serious physiological, psychosocial, and environmental problems. Departmental policies requiring assessment of Omaha System data across programs enabled population health measurement and research.